Blog Post #10: Specific Ethical Question

Ask/address an ethical question in your field of interest.
Develop/address arguments for each side of the issue then defend your position on the issue.

The following is in response of the assignment above:

Doctors deal with children every day, whether they are pediatricians or therapists they may have to face ethical decisions when they suspect that a child may be being abused.  My career plan is Physical Therapy so the field of interest for this ethical question includes Physical Therapy, but also includes medical practitioners everywhere in many different fields.  It is a doctor’s job to help their patients, but what if they think a child is being abused?  What is the responsibility of the doctor?  This is an ethical issue that has been talked about for a long time and there are opinions on if the doctor can/should tell somebody about it or not.  This is both an important and difficult ethical question.

There are people who think that the doctor should not tell anyone about the suspected child abuse.  It is against the law to break the confidentiality of the patient regardless if it is a child, teenage or adult.  They may think that the only relationship between the patient and practitioner is for the reason that the patient is there, not anything they might suspect.  According to an article written by LeRoy G. Schultz, “Confidentiality becomes of legal concern through legislative recognition and court precedent. Disclosure of confidential information could be the basis for professional discipline through an ethics complaint or legal action through civil or criminal liability.”  Breaking this confidentiality could get the doctor into a lot of trouble with the law.  If the guardians of the child speak for the child, and if they are the abusers legally they have the right to confidentiality.

On the other hand, there are people who believe that the doctor should tell someone, another worker or the authorities, about the suspected abuse.  Ethically it is right to tell someone about the abuse so it can stop and the child won’t be harmed anymore.  That responsibility is handed to the doctor once they believe the child is being abused because that abuse is wrong and against the law.  The American Academy of Pediatrics says in a journal article they wrote, “All states have laws that mandate reporting of suspected child abuse or neglect, and HIPAA rules allow disclosure of protected health information without legal guardian authorization under these circumstances.”  In other words, practitioners have the obligation to report their suspicion of abuse.  It is actually against the law to not disclose that information. 

I believe that it would be wrong not to disclose the suspicion of child abuse.  From my ethical standpoint, if someone is being hurt and you can stop it, you should.  There are laws in place that may protect you when you break the confidentiality and it is worth the risk to help that child.  It would be wrong to abuse the child in the first place, and suspecting it but not saying anything about is close to the same thing because you are letting that happen.  Of course you would have to have good reason and/or evidence that the abuse is happening, but if you confidently think it is happening, it should be dealt with.

Comittee on Child Abuse and Neglect. "Child Abuse, Confidentiality, and the Health Insurance Portability and Accountability Act." Pediatrics. American Academy of Pediatrics, 2010. Web. 27 Oct. 2011. http://pediatrics.aappublications.org/content/125/1/197.full.

Schultz, LeRoy G. "Confidentiality, Privilege, and Child Abuse Reporting." Institute for Psychological Therapies. IPT Journal, 1990. Web. 27 Oct. 2011. <http://www.ipt-forensics.com/journal/volume2/j2_4_5.htm>.