A Failure to Report Abuse

by Frank Stechey, BA, DDS

We are all familiar with the following recent headlines; “Paterno and Sandusky are indicted at Penn State”; “Player abuse should have been reported years ago”; “the coaches should have acted sooner.”

But failing to report suspected abuse could just as easily involve Canadian dentists and not sports professionals.

Some Interesting facts are as follows:
• Over 60% of abusers are close friends of the family, eg. coach, teacher, babysitter, priest/nun, etc. and not the parent;
• Abusive injuries can mimic sporting injuries;
• When accident histories do not match the injury pattern, report your suspicion;
• Over 65% of all physical abuse occurs in the head and neck areas (our domain);
• Over 89% of all physical abuse injuries are easily viewed by dentists;
• Seniors are equally abused;
• 85% of today’s child victims become abusers unless the cycle of abuse is broken;
• Reporting abuse means both the child and the abuser receive treatment, thus breaking the cycle of abuse;
• All dental professionals MUST report suspicions of abuse – by Law.

All North American professionals dealing with children are governed by an Act similar to Ontario’s Child & Family Services Act (CFSA) mandating & obligating the reporting of suspicions of abuse to proper authorities.

Decades of forensic experience in child abuse leads me to one reality: many dentists are not fully or properly educated on their mandated responsibilities of reporting suspected child abuse before graduating from dental school.

Could you be tomorrow’s headlines replacing Paterno & Penn State? Do you know your mandated responsibility to child patients?

Many of our young patients in North America have been victims of abuse; over 85% want to tell someone, fewer then 4% of practitioners even ask whether a patient is or has been a victim of abuse.

Most health professionals don’t even know that the CFSA exists, let alone how or why to activate the system! They were not educated to recognize abuse, report abuse or to have properly trained authorities respond to investigate.

Section 72 (1) of the CFSA states we must report the suspicion that a child is being or has been abused; that we cannot delegate this responsibility to someone else; that this report must be done promptly to the proper investigative authorities (police services and/or children’s aid society).

Under the CFSA, failure to report is an offence and any professional is liable, on conviction, to a fine up to $1,000. This conviction must be reported to Regulatory bodies who may take other actions as deemed appropriate.
The CFSA states we must report, but Section 72 (7) also protects against liability if civil action is brought against the reporter, as long as there was no malice in reporting.

Patient records are confidential & private, but once a suspicion of abuse occurs, our duty to report overrides the provisions of other Statutes such as PHIPA (Personal Health Information Protection Act, 2004) or PIPEDA (Personal Information Protection and Electronic Documents Act) or even the Dentistry Act, 1991. A dentist is legally bound by a subpoena or warrant and must surrender his/her original patient records to a police officer.

Information on the CFSA and our responsibilities on detecting & reporting child abuse via:
www.rcdso.org and search “child abuse’;
www.oralhealthjournal.com/child-abuse
www.cacas.org/childwelfare/report;
www.oda.on.ca and search “child abuse”;

Children must come first! Our child patients deserve no less. OH

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