The abused and neglected child - the physician role [Article in Croatian]

Abstract

Child abuse and neglect are some of the most important public-health problems of today’s world. Medical workers have a complex role in the whole circle from detection and diagnosis, through help to victims, families and perpetrators , to work on prevention with the aim of breaking the tragic cycle with all its consequences for the victims, their families and society as a whole. It is necessary to recognize the signs of physical, sexual and emotional abuse as well as the signs of neglect. Although a child can be abused anywhere, mostly it happens inside the family by close relatives. The research has found the risk factors for an increased probability of child abuse by parents on the part of the child, the parents and society. The child risk factors are: preterm infants, younger age, special temperament, ADHD (attention deficit hyperactivity disorder) syndrome, and children with special needs and developmental disturbances. The parent’s risk factors are: younger age, single parents, financial problems, low educational level, mental diseases. The societal factors are: high level of addiction, unemployment, economic crisis, poor material conditions, and social isolation. The additional risk factors are: the post war period, economical transition, the changes in social norms and values, an increased number of persons with PTSD (post traumatic stress disorder). All these factors can decrease parental capability for adequate parenting and increase the probability of abuse. The role of the physician is not only to treat the consequences of abusing. They need and according to the positive laws and regulations they have to be key players in the problem solving and they are obliged to inform other services and institutions about their findings. This is an ethical, moral and legal obligation. A systematic and multidisciplinary approach is the only way to solve this devastating problem.