Child Abuse Research Today is a free monthly online journal that collates and summarizes the latest research about Child Abuse, including details on family violence, examinations, long-term effects, psychiatrics disorders. | ||||||||
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A clinical forensic scientist in the burns unit: necessity or not? A prospective clinical study.Yasti AC, Tumer AR, Atli M, Tutuncu T, Derinoz A, Kama NA Ankara Numune Education and Research Hospital, 4th Department of Surgery, 3. cad. 48. sk. No: 5 D:3, 06510 Bahçelievler, Ankara, Turkey. cinaryasti@hotmail.com Child abuse by burning is a common means of assault that may be difficult to prove. Even though well trained in burns management physicians on the burn team may not be sufficiently qualified to clarify the medicolegal aspects of the incident. In Turkey, physicians have a responsibility to notify the law offices of injury to children caused by any non-accidental mechanism including neglect. The consequences of false positive and/or false negative reports to the legal offices may be damaging for the care-takers and/or the children. In our study, 239 consecutively hospitalized children with burns were studied prospectively. A clinical forensic scientist and a physician of the burns team interpreted incidents separately so that neither had an idea about the other's diagnoses until the end of the study. There were found to be some differences in the interpretation of the incidents by the clinical forensic scientist and the burns team physician. These differences were described as discordant diagnoses. The physician accepted 99 (41.4%) of the incidents as an accident while only 66 (27.6%) of the victims were labelled as accidents by the forensic scientist. A multivariate analysis identified low socioeconomic status, aged between 3 and 6 years, and a family size of more than six as independent variables significantly associated with discordant diagnoses (p = 0.0388, 0.0001, 0.0203, respectively). As a conclusion, we suggest that to minimize the likelihood of a legally inaccurate diagnosis, a clinical forensic scientist seems to be necessary in the emergency department. Published 17 January 2006 in Burns, 32(1): 77-82.
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