Ethical and legal challenges of mandated child abuse reporters

Background

Mandated reporters inconsistently report child abuse cases. Ethical dilemmas and legal challenges to reporting arise creating barriers to assist abused children and their families.

Purpose

The purpose of this study was to describe professionals' ethical dilemmas and legal challenges to reporting child abuse.

Method

A qualitative study was conducted to explore the ethical and legal challenges of mandated reporters when reporting child abuse. Individual interviews between 60 and 100 min were conducted with a purposive sample of 18 mandated reporters including physicians, nurses, social workers, and teachers. Grounded theory methodology was used to develop categorical themes that reflected mandated reporters' experiences and challenges.

Result

Three themes emerged from the data: conflicts, time, and law as refuge. Professionals described challenges in balancing autonomy, beneficence, nonmaleficence, and justice. There was no best solution to do no harm. The associated stigma and pressure of cultural and secular norms of child abuse inhibit professionals' action based on legal and ethical requirements. The theme of time included limited time and an uncertain future. The law provides security and refuge for professionals to find a solution to the challenges of reporting child abuse.

Conclusion

The ethical and legal challenges of reporting child abuse create complex dilemmas for mandated reporters. Ethical principles are in constant opposition when negotiating rights of children and rights of parents. Supportive structures and education are needed to assist professionals in meeting their reporting obligation and solving their dilemmas.     

Multidisciplinary Child Protection Decision Making About Physical Abuse: Determining Substantiation Thresholds and Biases

The current study examined the threshold at which multidisciplinary child protection team (CPT) professionals substantiate physical abuse allegations and the extent that they utilize potentially biased constructs in their decision making when presented with the same case evidence. State legal definitions of child maltreatment are broad. Therefore, the burden of interpretation is largely on CPT professionals who must determine at what threshold physical acts by parents surpass corporal discipline and constitute child physical abuse. Biased or subjective decisions may be made if certain case-specific characteristics or CPT professionals' personal characteristics are used in making physical abuse determinations. Case vignettes with visual depictions of inflicted injuries were sent to CPT professionals in Florida and their substantiation decisions, personal beliefs about corporal discipline, and coercive discipline were collected. Results of the study demonstrated relatively high agreement among professionals across vignettes about what constitutes physical abuse. Further, CPT professionals strongly considered their perceptions of the severity of inflicted injuries in substantiation decisions. Although case specific characteristics did not bias decisions in a systematic way, some CPT professional characteristics influenced the substantiation of physical abuse. Practice implications and future directions of research are discussed.     

Child sexual abuse myths: attitudes, beliefs, and individual differences

Child sexual abuse myths comprise incorrect beliefs regarding sexual abuse, victims, and perpetrators. Relations among myth acceptance, responses to disclosure, legal decisions, and victims' subsequent psychological and health outcomes underscore the importance of understanding child sexual abuse myths. Despite accurate knowledge regarding child sexual abuse among many professional and other individuals, child sexual abuse myths persist. A Google search produced 119 child sexual abuse myths, some with overlapping themes. Coders grouped myths into four categories: (a) minimizations or exaggerations of the extent of harm child sexual abuse poses, (b) denials of the extent of child sexual abuse, (c) diffusions of perpetrator blame, and (d) perpetrator stereotypes. This review provides available data regarding the prevalence for these myths, empirical research that refutes or confirms myth categories, and considerations of cultural contexts and implications.     

Legal liability: A professional concern

Recent jurisprudence should direct the attention of social workers to two areas of possible legal liability in their professional activities. The ethical responsibility for keeping a client's communications confidential may be outweighed by the broader obligation to protect a victim from a client's violence by reporting threats to legal authorities. Damage action against physicians for failure to report suspected child abuse opened the door to civil liability to others who have a mandatory reporting responsibility.     

Dilemmas between law and ethics in Czech social work

In many situations social workers face the necessity of making a decision. One of the most frequent scenarios of making a choice is the dilemma of whether to intervene or not. The choice itself is conditioned on the one hand by the obligation to comply with the relevant legal requirements and on the other by the necessity of respecting ethical values, rules and principles. One often encounters a situation when the legal requirements and ethical conduct appear in mutual contradiction. This essay will deal with the possible concept of the relationship between law and ethics giving examples of dilemmas between ‘confidentiality’ and the ′informing or reporting obligation′ in the context of Czech social work.     

RESOLVING ETHICAL CONCERNS IN CLINICAL PRACTIVE: TOWARD A PRAGMATIC MODEL*

A pragmatic model is proposed for use in resolving ethical concerns and dilemmas in clinical practice. It encompasses five decision bases that therapists may draw on for the kind of comprehensive analysis that is necessary for reaching a defensible decision. The decision bases are: (a) theories of ethics; (b) professional codes of ethics; (c) professional theoretical premises; (d) the sociologal context; and (e) the personal/professional identity. The model is applied to five actual cases offered by several therapist who experienced ethical concerns with them. The case analyses demonstrate the model's utility for decision making and for prevention of ethical problems.     

Ethical assessment and moral reasoning in child therapy

Social workers find it hard to operationalize the profession's Code of Ethics, and few professionals even rely on the Code, as a point of reference in making judgments when faced with ethical dilemmas. Children and adolescents hold a special position in clinical practice. Issues requiring ethical judgments are more complex, because any intervention involves people other than the child. How the professional meets the interests of the parents and those of the child, is frequently a cause for conflict. This article presents philosophical models of moral reasoning, and ethical assessment, to assist clinicians in identifying and resolving frequently faced practice dilemmas, with the goal of improving the quality of patient care, in terms of both the process and the outcome. Emphasis is not only on the ethics of the actual decision but also on the ethics of the decision-making process itself.This article is based on the author's unpublished dissertation, seminars, and grand rounds presentations on applied ethics in clinical social work. Additionally, this author has had consultative and collaborative contact with the Hastings Center, Institute of Society, Ethics and Life Science.     

Judgments regarding parental alienation when parental hostility or child sexual abuse is alleged

Abstract

Allegations of Parental Alienation (PA), the systematic disparaging of one parent by the other parent aimed at alienating their child’s affections, as a basis for child custody decisions are highly controversial. Claims of parental hostility or allegations of child sexual abuse in custody cases may trigger concerns about PA. Family court professionals (N?=?280) rated young children’s accuracy of report (e.g., suggestibility, honesty) in general and also read three custody scenarios varying as to whether or not they included allegations of parental hostility or child sexual abuse, or no such allegations. For each scenario, the alleged alienating parent’s gender was experimentally varied between subjects. Participants rated the likelihood that each case involved PA. For the scenario that included allegations of child sexual abuse, professionals who viewed young children as more inaccurate reporters or who read about the mother (rather than a father) as the alleged alienator were more likely to rate the scenario as involving PA. For the scenario that described parental hostility but no child sexual abuse allegations, professionals who were older or female were more likely to judge the scenario as involving parental alienation when a mother (rather than a father) was the alleged alienator, whereas there were no significant predictors of responses to the no-allegation scenarios. Findings are discussed in relation to the difficult task of evaluating custody cases for PA when parental hostility or child sexual abuse is alleged.     

Elder Abuse: Clinical,Ethical, and Legal Considerations in Social Work Practice

As a consequence of the steadily growing older population, and increased demands on family for community based care of elderly, elder abuse is an issue to be considered in all domains of social work practice. Intervention in cases of elder abuse is often fraught with ambiguity and ethical dilemmas as the application of professional principles is less than straightforward, bringing to the fore personal, legal, and ethical concerns in the management of the client’s safety and well-being. This article addresses challenges which arise from the complexity of elder abuse cases and reviews clinical, ethical, and legal obligations to inform ethical decision-making.     

Cultural and ethical considerations in late-life polyvictimization

ABSTRACT

This article examines the cultural and ethical considerations for professionals working with older adults who experience polyvictimization. Drawing from the Department of Justice training program, Polyvictimization in Later Life (OVC/TTAC, 2017), topics include cultural competencies, ethical standards, personal and professional ethics, and ethical considerations when working in teams. Also described are specific suggestions and recommendations to ensure sensitive and ethical responses when working with cases involving polyvictimization.     

Chapter Four

Mental health professionals contribute in important ways to both the clinical and ethical issues raised by cases of elder mistreatment. Their clinical competencies contribute to improving quality of life by diminishing psychological suffering and the symptoms of mental illness. They are also used for managing the ethical issues raised by these cases. The ethics of mental health care are based on the values of beneficence, nonmaleficence, autonomy, and justice. The value of autonomy in mental health care gives priority to an individual's long-term ability to act as independently, rationally, and fully in all aspects of life as possible. The concepts of legal and clinical competence also aid in managing the ethical problems represented by cases of elder mistreatment. The ethical protocols of mental health professionals may be distinguished from some other disciplines by the premium given to long-term autonomy and by the aim of insuring treatment for all persons involved in cases of elder mistreatment, rather than limiting treatment responsibilities to the victim.     

Training Mental Health Professionals on Ethical Issues and HIV/AIDS

This report describes the importance of ethics training for mental health professionals working with persons infected or affected by HIV/AIDS. We first describe three major ethical dilemmas (confidentiality, duty to warn, and suicide) faced by mental health providers serving persons with HIV/AIDS, and the legal and clinical aspects of these dilemmas. We present data from the South Texas AIDS Training Project describing the types of mental health professionals who have attended workshops on ethical issues and HIV/AIDS. Finally, we report observations about the impact of the ethics training sessions on the participants' knowledge and attitudes.     

The spiritual healing "defense" in criminal prosecutions for crimes against children

Spiritual healing as a defense in cases of parents' rejection of medical treatment for their sick children involves questions of the rights of parents, of children, of the state, and of the U.S. Constitution. State legislation protecting rights of religion, long on the books, is coming into conflict with new legislation on child abuse. This article reviews the current picture of applicable laws in the states and in recent court cases. Limiting the use of spiritual healing as a legal defense is an emerging trend.     

Observing abuse: Professional ethics and personal morality in field research

Based on the author's participant observation research in a state institution for the mentally retarded, this article deals with moral and ethical dilemmas that occur in research at settings characterized by routine human abuse. After a discussion of the choices posed by these dilemmas, the author presents preferred solutions. The importance of anticipating potential moral and ethical dilemmas prior to entering the field and delineating the relation between professional ethics and personal morality are discussed as implications of this problem.The author would like to thank Robert Bogdan and Shulamit Reinharz for their extensive comments on previous drafts of this article.Partial support for this article was provided through cooperative agreement No. G0085C03503 with the National Institute on Disability and Rehabilitation Research. The opinions expressed herein are solely those of the author.     

The philosophical foundations of Las Vegas

Las Vegas is a city that has long challenged social norms of the rest of the United States and built a highly successful economic base on gambling and other hedonistic pursuits. Now that many other states and communities are pursuing or actively considering following the route of legal casinos for economic development purposes, the ethical considerations that have confronted Las Vegas about the question of gambling and its broader social impacts take on greater import.This paper examines the ethics of gambling relative to Las Vegas at two levels: first, as a pragmatic trade-off of accepting an activity with some bad consequences because of the economic benefits that can be derived; and second, more fundamentally, by examining the validity of the major ethical arguments against gambling.     

The Role of Ethical Theories in Decision Making by Social Workers

This study analyses the arguments provided by a convenience sample of 62 Israeli social workers for their preferred ethical principles in terms of ethical theories. Content analysis of arguments given in four different contexts shows that the large majority of social workers in the study based their arguments on either deontological or utilitarian ethical concepts, less frequently using concepts from virtue theory, rights theory and care theory of ethics. However, the analysis reveals a discrepancy: when social workers were requested to justify their rank ordering of ethical principles without reference to a specific practice situation, they most frequently preferred concepts reflecting deontological theory of ethics, such as right intention, universalism, and duty. In contrast, when confronted with a specific practice situation, the social workers' most frequently chosen concepts were relating to results, consequences, and utility, concepts identified with the utilitarian theory of ethics. In view of the findings, the need for more thorough knowledge of a variety of ethical theories and their potential role in ethical decision making in social work practice and education are discussed.     

Human research ethics committees and ethical review: The changing research culture for social workers

Social workers have a long-standing concern with developing codes of ethics, which govern and protect those involved in practice and research scenarios. As more social workers engage in research, successfully negotiating the ethical review process becomes imperative. In Australia, the task of ensuring ethical compliance of research protocols resides with human research ethics committees (HREC) mandated under the National Health and Medical Research Council. However, given the scope for discretion exercised by HREC, this process can be intimidating to novice and experienced researchers. The review process needs to be understood in the context of Australian ethics policy, the roles and responsibilities, and cultures of HREC. This paper outlines practical strategies in preparing ethics protocols to increase the likelihood of successful review. To do this, social workers need to recognise the way policy, legal developments and risk management strategies influence the ethical review process.     

The child abuse and divorce myth

When the authors of this article undertook a study into the way the Australian legal process managed child abuse allegations in custody and access disputes following partnership breakdown in de facto and legal marriages, they encountered what they came to think of as ‘the child abuse and divorce myth’. The myth centred around a belief that child abuse allegations made during or after partnership breakdown were weapons fashioned to gain advantage in the marital war. Therefore, they were not real; therefore, they should not be taken seriously. Despite little previous research, these views were strongly held by both families and professionals. The article examines the myth, believed to be an international phenomenon, and shows, in detail, how the study's findings do not support it. In fact, the findings from this unique study contradict the myth in its totality and in its specific aspects. Thus, it is argued that the myth should be abandoned and a new knowledge base for professional intervention that recognizes the reality of this problem be adopted instead. As a result of the study, a new specialized intervention program for children involved in residence and contact disputes where child abuse was alleged is being trialled in the Family Court of Australia. Hopefully, the introduction of further intervention programmes based on the reality of child abuse in these circumstances rather than on the myth will follow. Copyright © 2001 John Wiley & Sons, Ltd.     

Comment on Cross, Fine, Jones, and Walsh (2012): we are now on the same page

Role conflict has been an issue in the intervention of child abuse cases since the beginning of the alliance drawn between the legal and mental health professions. In child abuse cases, clearly defined roles will prevent an attack on the process, thereby providing successful interventions to protect children. The child advocacy center concept is one of the best ways to meld the two professional functions into a cohesive approach to those interventions.     

Comment on Cross,Fine, Jones,and Walsh (2012): We Are Now on the Same Page

Role conflict has been an issue in the intervention of child abuse cases since the beginning of the alliance drawn between the legal and mental health professions. In child abuse cases, clearly defined roles will prevent an attack on the process, thereby providing successful interventions to protect children. The child advocacy center concept is one of the best ways to meld the two professional functions into a cohesive approach to those interventions.