Denial of abuse puts the child in danger.
Press release from the French Academy of Medicine (*)
May 28, 2024
The French Academy of Medicine would like to recall the following points:
– Child abuse has always been the subject of denial.
– However, the consequences of abuse put the victim’s physical and mental life at risk, and the concept of an abused child has taken on an international dimension with the adoption by the United Nations General Assembly of a convention on the Rights of the Child on November 20, 1989.
– The expanded definition of abuse includes the notion of a child in danger, whether the aggression is physical, psychological, sexual, or whether it involves deficiencies and negligence.
– Child abuse can affect all social classes and a distorted media presentation can lead to delay the consideration of the warning signs.
– Denial contributes to delaying the diagnosis of abuse. However, the absence of diagnosis or the concealment of abuse leads to a risk of repeated violences with a lethal risk for the child or the presence of serious physical or psycho-emotional after-effects.
– The slightest suggestion of abuse must lead to an immediate hospitalization of the child to ensure his/her protection and accurately assess his/her situation.
– Talking about abuse is as difficult in adolescents as in early childhood as warning signs are very varied. Some lesions are obvious, others are hidden. This diagnosis is therefore widely discussed and requires specialized pediatric skills to be definitively confirmed. An objective analysis of the child or adolescent overall context is essential.
– The trauma inflicted is more severe in abused children than in injured children. These may include traumatic lesions of the skin from blows, pressure or burns, fractures from forced manipulation, brain and eye lesions secondary to shaking sometimes associated with throwing the baby onto his bed, traumatic abdominal lesions or chest pain caused by kicking or squeezing.– The diagnosis is made across the entire medical context, meticulously analyzed, eliminating all other possible medical causes of observed lesions. It is never a single doctor who makes the diagnosis but a multidisciplinary team. – The harmful effects of psychological abuse are not always immediately visible. They appear during the child’s development and can last for many years after the acts. – When dealing with child abuse, professionals need to have a vision that includes the child victim, his/her family and the perpetrator of the abuse. The main aim is to protect the child victim. – The context of child abuse puts doctors and caregivers in an uncomfortable situation regarding the child and those around him. The caregiver intervenes without knowing who the perpetrator of the abuse is, even if this abuse is certain. The investigation belongs exclusively to investigators and magistrates. – The main concern is the child. He is always part of a family constellation, present or not, that must be considered for subsequent care. The Academy strongly encourages all search into prevention and the interests of abused children. The Academy encourages also awareness of the deleterious effects of denial that should no longer reasonably take place. (*) This press release has been validated by the Board of Directors of the Academy.
PRESS CONTACT: Virginie Gustin +33 (0)6 62 52 43 42 virginie.gustin@academie-medecine.fr
ACADÉMIE NATIONALE DE MÉDECINE, 16 rue Bonaparte – 75272 Paris cedex 06
Site : www.academie-medecine.fr / Twitter : @Acadmed
