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Sharing information about a child without the consent of a parent

Case study: What should Mr Halliday do when he suspects a child is being physically abused by his father?

Mr HallidayKevin is a single father and has brought his five-year-old son George, his only child, into the accident and emergency department of his local hospital on a weekday lunchtime. George has bruises on his arms and legs and a broken wrist. He is examined by a doctor in accident and emergency before being referred to a paediatric orthopaedic surgeon, Mr Halliday.

Kevin tells Mr Halliday that George was injured when falling over. Kevin is in an agitated state and has clearly been drinking. Mr Halliday has also been told that Kevin spoke in a rude manner towards the hospital’s reception staff when they were taking details from him and George. Mr Halliday notes that Kevin seems angry with George ‘for being clumsy’ and that he raises his voice when speaking to his son.

Mr Halliday examines George and, because of the location and nature of his injuries, he doesn’t think they could have been caused by a fall. He has concerns that they may be signs of abuse and may have been inflicted on George by Kevin. He asks George how he hurt himself but George seems frightened and is reluctant to speak to the doctor or answer his questions. Mr Halliday is worried that George is being discouraged from speaking openly by his father’s presence.

In paragraph 15 of Protecting children and young people: the responsibilities of all doctors, we say that doctors must listen to children and young people and talk directly to them, taking into account their age and maturity.

We say in paragraph 18 that good communication with parents is essential and that parents generally want what is best for their children. But we also say in paragraph 19 that a small number of parents do abuse or neglect their children and are dishonest about events or their lifestyle.

We say in paragraph 17 that, in some cases, having a parent in the room during a consultation may discourage a child or young person from being open about what has happened to them, or about any concerns or fears they have. In these circumstances, doctors should consider speaking to the child or young person without the parent present, in a suitable environment and with appropriate support available to them – for example, by having another health professional, an experienced colleague or a support person present.