Should I just stick to pharmacy?

OP

I will answer your PM.

Reply 21

winter_mute

9

Original post by ScheduleII

I will answer your PM.

Do you know the precise rates of cases where doctors have "Snitched" that have led to a child to be removed from their parents under a false accusation of abuse?

By that same token do you know the number of abuse cases where doctors could have intervened but didn't (for whatever reason)?

Seems like you're passing judgement on public policy based on personal experience.

Reply 22

Egypt

9

I would drop all your preconceived ideas if you want to be a doctor. I have been doing a paediatric job for 5 months now and have not had to raise concerns about a single child. I have however been involved in several cases where children would undoubtedly have died if People had not raised concerns. One case was a diligent health worker who noted a child has not attended any vaccinations without explanation. That child would be dead without the intervention of that individual.

The job of a doctor is not to be judge and jury but to raise concern when necessary. If you see unable to do this then you should not take on the role of doctor.

Reply 23

Original post by Beska

If you have any suspicions about a vulnerable person being abused or neglected it is your moral obligation to notify the authorities. If you don't think you would be able to do this, perhaps a profession where you are not put in that kind of situation would suit you better.

On a side note, your argumentum verbosium is very immature.

Not even moral but professional, legal, ethical. As a doctor you're an accountable practitioner, not a snitch.

Reply 24

OP

Winter_mute, that information is not possible for anyone to know, including the pro-reporting camp. There are no statistics on it. Why is "snitched" in inverted commas? Is it due to the term's colloquial origins, or because you deny the reality of it happening? And the job of a doctor is to treat a medical condition, not to be suspicious of the parents' explanation and assume that they are lying, which is the approach some take. It is dangerous as some parents who have sick or accidentally injured children are staying at home with them for fear of being reported. Furthermore, people are giving birth at home in circumstances where it is unwise to do so to avoid EPOs, and parents who have drug/alcohol issues or have been abused themselves as a child are not telling psychiatrists in case it is used against them.

Reply 25

KingofSpades

13

Original post by ScheduleII

Winter_mute, that information is not possible for anyone to know, including the pro-reporting camp. There are no statistics on it. Why is "snitched" in inverted commas? Is it due to the term's colloquial origins, or because you deny the reality of it happening? And the job of a doctor is to treat a medical condition, not to be suspicious of the parents' explanation and assume that they are lying, which is the approach some take. It is dangerous as some parents who have sick or accidentally injured children are staying at home with them for fear of being reported. Furthermore, people are giving birth at home in circumstances where it is unwise to do so to avoid EPOs, and parents who have drug/alcohol issues or have been abused themselves as a child are not telling psychiatrists in case it is used against them.

snitch has negative connotations, and its colloquial nature does not make it in the least accurate.
it could just as easily be argued that a doctors job is to maintain the welfare of his patients, a component of which would be being suspicious of maltreatment

(edited 13 years ago)

Reply 26

Beska

21

Original post by Subcutaneous

Not even moral but professional, legal, ethical. As a doctor you're an accountable practitioner, not a snitch.

Indeed! The OP seems to think it is somehow justifiable for a doctor to 'opt out' of being accountable so I thought it prudent to strike right at the heart of the issue - the fact it's fundamentally immoral to turn a blind eye to suspicions of neglect. As my trust's neglect liaison person (or something! I work at QMC, same trust as you) said at my training earlier in the year: the majority of neglect cases which result ultimately in death are a consequence of a string of practitioners turning a blind eye and thinking that it wasn't "their problem".

Original post by ScheduleII

Winter_mute, that information is not possible for anyone to know, including the pro-reporting camp. There are no statistics on it. Why is "snitched" in inverted commas? Is it due to the term's colloquial origins, or because you deny the reality of it happening? And the job of a doctor is to treat a medical condition, not to be suspicious of the parents' explanation and assume that they are lying, which is the approach some take. It is dangerous as some parents who have sick or accidentally injured children are staying at home with them for fear of being reported. Furthermore, people are giving birth at home in circumstances where it is unwise to do so to avoid EPOs, and parents who have drug/alcohol issues or have been abused themselves as a child are not telling psychiatrists in case it is used against them.

I have a lot of experience with social services, specifically dealing with children, and I guarantee you that it is not as easy to take a child permanently away from parents as you seem to think it is; even when there is substantial, empirical evidence to suggest the children are at risk. If you think a job of a doctor is narrow enough to just treat a medical condition, you evidently have absolutely no idea about what a career in this field entails. I would feel very, very uneasy if a colleague would treat, for example, a toddler's bruises month after month but not report a suspicion.

Reply 27

OP

It is the responsibility of PARENTS to safeguard their child, and in extremis police and/or social workers can step in. What moral principle requires doctors to turn informer? Au contraire, it is fundamentally immoral to help with the unjust fragmentation of a family by the state. I have plenty of knowledge about the field otherwise I would not consider studying for it; and if I was treating a toddler's bruises I would assume they were accidental unless there was evidence otherwise, and report only if there were serious grounds to. Children can bruise easily with numerous conditions, including on areas such as the face and genitals which are held to indicate a suspicious pattern.

As for whether it is easy to remove a child, much depends on the judge. Some judges will stand up a little too vehemently for the parents, leaving children in situations they ought to be removed from, but the overall pattern is of "expert" views (doctors and psychologists being the most important, and schools also playing a part) being given far more weight than the family's evidence.

Reply 28

Beska

21

Original post by ScheduleII

It is the responsibility of PARENTS to safeguard their child, and in extremis police and/or social workers can step in. What moral principle requires doctors to turn informer? Au contraire, it is fundamentally immoral to help with the unjust fragmentation of a family by the state. I have plenty of knowledge about the field otherwise I would not consider studying for it; and if I was treating a toddler's bruises I would assume they were accidental unless there was evidence otherwise, and report only if there were serious grounds to. Children can bruise easily with numerous conditions, including on areas such as the face and genitals which are held to indicate a suspicious pattern.

As for whether it is easy to remove a child, much depends on the judge. Some judges will stand up a little too vehemently for the parents, leaving children in situations they ought to be removed from, but the overall pattern is of "expert" views (doctors and psychologists being the most important, and schools also playing a part) being given far more weight than the family's evidence.

This is turning into an ethical discussion which isn't relevant right now. As it stands, doctors (indeed, anybody that works in a position which is patient-facing, including receptionists in my trust) have a responsibility to report suspected cases of neglect. Fact. You can discuss if this is correct or not, but at the end of the day if you don't think you could act in a way which best protects suspected victims of neglect then medicine isn't for you.

Specifically for doctors, reporting suspected abuse is given in the QMC's Good Medical Practice:

6. If you have reason to believe that patients are, or may be, at risk of death or serious harm for any reason, you should report your concern to the appropriate person or organisation straight away. Do not delay doing so because you yourself are not in a position to put the matter right.

A few points from the GMC's Guidance on good medical practice:

56. Doctors play a crucial role in protecting children from abuse and neglect. You may be told or notice things that teachers and social workers, for example, may not. You may have access to confidential information that causes you to have concern for the safety or well-being of children.

61. Your first concern must be the safety of children and young people. You must inform an appropriate person or authority promptly of any reasonable concern that children or young people are at risk of abuse or neglect, when that is in a child's best interests or necessary to protect other children or young people. You must be able to justify a decision not to share such a concern, having taken advice from a named or designated doctor for child protection or an experienced colleague, or a defence or professional body. You should record your concerns, discussions and reasons for not sharing information in these circumstances.

To put it bluntly: your current views are not, in my opinion, compatible with being an accountable doctor. If you disagree with the GMC's (also known as "corrupt political nazis bent on world domination", as you say) guidance then that's a different kettle of fish. Facts are facts. You can't opt out of certain responsibilities of being a doctor.

Original post by ScheduleII

but the overall pattern is of "expert" views (doctors and psychologists being the most important, and schools also playing a part) being given far more weight than the family's evidence.

Quite rightly so.

(edited 13 years ago)

Reply 29

Persephone9

13

Original post by Beska

(indeed, anybody that works in a position which is patient-facing, including receptionists in my trust)

If you were wondering, this is also the case in the emergency GPs that I work at, and possibly the local hospitals. Every one has training on how and when to report suspicions of child abuse.

OP: if you are considering medicine, you may want to know that as a medical student you are also expected to report any suspected or disclosed abuse. Whilst it's unlikely that you will encounter it, it is possible and, as far as I am aware, you are still accountable (to an extent) as a student if you don't report it.

Reply 30

Caponester

10

Original post by ScheduleII

Instead I would keep my suspicions to myself to avoid being an active part in state sponsored child abduction.

I have never read such a load of utter ****e in my entire life.

Reply 31

fudgesundae

16

Original post by Beska

I would feel very, very uneasy if a colleague would treat, for example, a toddler's bruises month after month but not report a suspicion.

if I was treating a toddler's bruises I would assume they were accidental unless there was evidence otherwise

OP after seeing you quite clearly say you would stand by and continue treating a toddler month after month for bruises without raising any questions at all makes me very worried.

To answer your question, yes, please stick to pharmacy.

Reply 32

ApplePi

2

Original post by fudgesundae

OP after seeing you quite clearly say you would stand by and continue treating a toddler month after month for bruises without raising any questions at all makes me very worried.

To answer your question, yes, please stick to pharmacy.

If they shouldn't do medicine for that reason, pharmacy isn't a good option either.

Both are healthcare professions.

Reply 33

OP

It seems I will either be changing my goal to pharmacy or making a "semi-committed" application to medicine, keeping my views on the matter of child abuse/neglect very strictly to myself. What if I was asked in interview about a possible situation ? I hate telling lies though... that's another moral/ethical discussion.

I have not received a single supportive response, so it seems if you're not prepared to go along with the filling in of CPR1s without proof, supporting social workers in their legalised theft, and acting as a political pawn you don't make a good doctor. If this is so all I can do is continue my support for the anti-forced adoption campaign, or risk disregarding the regulations and trying to change things from the inside. The second is probably not something I am cut out for.

And ApplePi, I have been in contact with experienced pharmacists who have said co-operation with social services and family courts is not any part of the job. There has NEVER been a case of a pharmacist being struck off or disciplined by the RSPGB (now GPhC) over a child protection issue. I could be the first- but a pig could also fly.

Reply 34

Original post by Beska

Indeed! The OP seems to think it is somehow justifiable for a doctor to 'opt out' of being accountable so I thought it prudent to strike right at the heart of the issue - the fact it's fundamentally immoral to turn a blind eye to suspicions of neglect. As my trust's neglect liaison person (or something! I work at QMC, same trust as you) said at my training earlier in the year: the majority of neglect cases which result ultimately in death are a consequence of a string of practitioners turning a blind eye and thinking that it wasn't "their problem".
.

The QMC has a neglect liason officer? Ive never seen ir heard from them or had a talk...despite spending 3months of my degree looking at NUH negligence claims/cases and writing 7k words on it...tssh! Probably think nurses don't deserve it...which is a viable NHS policy atm lol

Reply 35

mkb230

2

Didn't really read your entire post but I just feel like boasting about Pharmacy. So up yours medics.

Reply 36

tcdc09

Original post by ScheduleII

It seems I will either be changing my goal to pharmacy or making a "semi-committed" application to medicine, keeping my views on the matter of child abuse/neglect very strictly to myself. What if I was asked in interview about a possible situation ? I hate telling lies though... that's another moral/ethical discussion.

I have not received a single supportive response, so it seems if you're not prepared to go along with the filling in of CPR1s without proof, supporting social workers in their legalised theft, and acting as a political pawn you don't make a good doctor. If this is so all I can do is continue my support for the anti-forced adoption campaign, or risk disregarding the regulations and trying to change things from the inside. The second is probably not something I am cut out for.

And ApplePi, I have been in contact with experienced pharmacists who have said co-operation with social services and family courts is not any part of the job. There has NEVER been a case of a pharmacist being struck off or disciplined by the RSPGB (now GPhC) over a child protection issue. I could be the first- but a pig could also fly.

As shown in my sig i study pharmacy and under the new pharmacuetical council the role of the pharmacist will be changing greatly. There will be more patient contact and they are planning for pharmacies to become a first line in healthcare which means looking at patients and even prescribing under pateint group directives - which is happening now.

Agreed there hasnt been a case of a pharmacist not reporting child abuse but thats due to the fact that there used to be limited patient contact, something that will be changing. There won't be a rule about it but in the degree you are taught about law and ethics and it is ethical to report suspected abuse etc get involved with the patien, contact GPs to see if frequent visitor to doctos with worrying signs.

These new rules could actually alter the way of pharmacy so yes at the moment there has been no case of it, and im sure a pharmacist would never be struck off because of it but they could be disicplined

Reply 37

Beska

21

Original post by Subcutaneous

The QMC has a neglect liason officer? Ive never seen ir heard from them or had a talk...despite spending 3months of my degree looking at NUH negligence claims/cases and writing 7k words on it...tssh! Probably think nurses don't deserve it...which is a viable NHS policy atm lol

It's something like that... although I could have made the title up! Blonde lady, gave a 2 hour training lecture on how to spot neglect etc. although I did do this training up at City so it might be a different lady at QMC? Who knows!

Reply 38

Original post by Persephone9

If you were wondering, this is also the case in the emergency GPs that I work at, and possibly the local hospitals. Every one has training on how and when to report suspicions of child abuse.

OP: if you are considering medicine, you may want to know that as a medical student you are also expected to report any suspected or disclosed abuse. Whilst it's unlikely that you will encounter it, it is possible and, as far as I am aware, you are still accountable (to an extent) as a student if you don't report it.

Its not, unfortunately, uncommon. I'm training in adult nursing, meaning all placements (except a 4week stint in a school) and have seen far more many cases than I'd have liked too. You're right though as a student there is the responsibility there, however despite not being fully qualified your main responsibility is ensuring you learn to recognise and how to act upon suspicions and the agencies involved.

OP- turning this on its head, would you report symptoms and signs of sexual abuse on say an adult (eg aged 30 hypothetically) who has learning difficulties with mum as main carer? Or an elderly man who's 'fallen' a lot down the stairs according to carers yet lives in a bungalow..? Despite it being simply concerns?

Reply 39