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Horstman A, Smith JAS, Bassed RB, Bugeja L. Impacts on paediatricians testifying in cases of child maltreatment: protocol for a systematic review. BMJ Open 2024; 14:e081331. [PMID: 38702078 PMCID: PMC11086465 DOI: 10.1136/bmjopen-2023-081331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/21/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION Paediatricians perform medical assessments for children in cases of suspected child maltreatment. Due to their role with statutory child protection agencies and police, paediatricians may be asked to testify in court about child protection and criminal justice matters. To the authors' knowledge, there has been no previous systematic review of the literature synthesising the evidence on the impacts on paediatricians testifying in cases of child maltreatment. METHODS AND ANALYSIS A search strategy comprising indexed and key terms will be applied to six electronic reference databases from inception to May 2023: Medline, EMBASE, PsycINFO, CINAHL, Criminal Justice Abstracts and Cochrane Library. Two reviewers will independently screen titles and abstracts and full-text articles against predefined eligibility criteria to identify studies of interest. Conflicts will be independently adjudicated by a third reviewer. ETHICS AND DISSEMINATION Since the systematic review methodology aims at synthesising information from available publications, this study does not require ethical approval. An article reporting the results of the systematic review will be submitted for publication in a scientific journal, presented at relevant conferences and used in subsequent stakeholder consultations.
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Affiliation(s)
- Alyce Horstman
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
- Victorian Forensic Paediatric Medical Service, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
| | - J Anne S Smith
- Victorian Forensic Paediatric Medical Service, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Richard B Bassed
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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Bloemen EM, Tietz S, Lindberg DM, Hayes J, Lum H, Gottesman E, Elman A, Sullivan M, Pino C, McAuley J, Shaw A, Hancock D, Chang ES, Yasui R, LoFaso VM, Stern ME, Rosen T. Elder abuse geriatrics: describing an important new medical specialist. J Elder Abuse Negl 2024:1-17. [PMID: 38602348 DOI: 10.1080/08946566.2024.2339242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Elder mistreatment, including elder abuse and neglect, is a difficult diagnosis to make and manage for most providers. To address this, two elder abuse consultation teams were developed for patients in the hospital and emergency department settings. As these teams have developed, the providers involved have obtained specialized training and experience that we believe contributes to a new field of elder abuse geriatrics, a corollary to the well-established field of child abuse pediatrics. Providers working in this field require specialized training and have a specialized scope of practice that includes forensic evaluation, evaluation of cognition and capacity, care coordination and advocacy for victims of abuse, and collaboration with protective services and law enforcement. Here we describe the training, scope of practice, ethical role, and best practices for elder mistreatment medical consultation. We hope this will serve as a starting point for this new and important medical specialty.
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Affiliation(s)
- Elizabeth M Bloemen
- Division of Geriatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sarah Tietz
- Division of Geriatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Daniel M Lindberg
- Department of Emergency Medicine and The Kempe Center for the Prevention and Treatment of Child Abuse & Neglect, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jason Hayes
- Division of Geriatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Hillary Lum
- Division of Geriatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Elaine Gottesman
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Michelle Sullivan
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Chloe Pino
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Jennine McAuley
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Amy Shaw
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA
| | - David Hancock
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - E-Shien Chang
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Robin Yasui
- Division of Geriatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Veronica M LoFaso
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Michael E Stern
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
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Ethical Expert Witness Testimony. J Forensic Nurs 2024; 20:E8-E9. [PMID: 38373104 DOI: 10.1097/jfn.0000000000000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Forensic nurses are routinely called upon to provide expert consultation and witness testimony. Nearly half of the enumerated standards in the Forensic Nursing Scope and Standards of Practice reference competencies directly related or complementary to ethical testimony. Requests from the field, coupled with the increasing opportunities for forensic nurses to serve as expert witnesses, necessitate the development of clear parameters for ethical expert witness testimony.
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Strouse PJ, Callahan MJ, Annam A, Brown SD, Chung T, Guillerman RP, Jaramillo D. Guidelines for expert testimony in pediatric radiology. Pediatr Radiol 2021; 51:1275-80. [PMID: 33904950 DOI: 10.1007/s00247-021-05046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/03/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Pediatric radiologists have the professional and ethical duty to assist, inform and educate the legal system in regard to matters involving medical imaging in children. These guidelines, drafted by the Society for Pediatric Radiology Ethics Committee and approved by the Society for Pediatric Radiology Board of Directors, provide recommendations for expert legal testimony in pediatric radiology and codify minimal ethical norms for the pediatric radiology expert witness in legal proceedings.
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Shur NE, Summerlin ML, McIntosh BJ, Shalaby-Rana E, Hinds TS. Genetic causes of fractures and subdural hematomas: fact versus fiction. Pediatr Radiol 2021; 51:1029-1043. [PMID: 33999244 DOI: 10.1007/s00247-020-04865-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/19/2020] [Accepted: 09/30/2020] [Indexed: 10/21/2022]
Abstract
Genetic disorders are in the differential diagnosis when young children present with unexplained fractures or intracranial hemorrhage. For medical and legal reasons, it is imperative to make the correct diagnosis and provide clear, evidence-based explanations of how alternative diagnoses were ruled out. A genetics consultation in cases of suspected child physical abuse should synthesize the history of present illness, medical history, family history, physical examination, and radiologic and laboratory findings in consultation with other specialists. The medical geneticist highlights how these disorders truly present. When the natural history of a genetic disorder is understood, it becomes clear that genetic disorders are not mysterious or difficult to diagnose. As highlighted in this case-based review, mainstream medical practice allows for differentiation among the intracranial and skeletal manifestations of osteogenesis imperfecta, Menkes disease, glutaric acidemia type 1 and child physical abuse. This review also highlights how a genetic disorder, Ehlers-Danlos syndrome, can be misused in a courtroom. Finally, this review summarizes when genetic testing is appropriate in cases of suspected child physical abuse.
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Affiliation(s)
- Natasha E Shur
- Rare Disease Institute, Division of Genetics and Metabolism, Children's National Hospital, 111 Michigan Ave., NW, Washington, DC, 20010, USA. .,George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | - Maxwell L Summerlin
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Bruce J McIntosh
- Child Protection Team System, Children's Medical Service, Florida Department of Health, Tallahassee, FL, USA
| | - Eglal Shalaby-Rana
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, USA
| | - Tanya S Hinds
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Child & Adolescent Protection Center, Children's National Hospital, Washington, DC, USA
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Strouse PJ, Moreno JA, Dias MS, Narang SK. Preparing for court testimony. Pediatr Radiol 2021; 51:1084-1092. [PMID: 33999250 DOI: 10.1007/s00247-020-04926-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/26/2020] [Accepted: 12/03/2020] [Indexed: 11/25/2022]
Abstract
Pediatric radiologists are frequently summoned to testify in court regarding the imaging of child abuse. This essay provides guidance on how to prepare for trial and what to expect in court. Preparation is paramount and includes meeting with the attorney and reviewing imaging studies, medical records and pertinent reports in anticipation of questioning in court. We also provide guidance to aid in testimony in court. Legal standards for testimony are discussed herein.
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Affiliation(s)
- Peter J Strouse
- Section of Pediatric Radiology, C. S. Mott Children's Hospital, Room 3-231, Department of Radiology, Michigan Medicine, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4252, USA.
| | - Joëlle A Moreno
- School of Law, Florida International University, Miami, FL, USA
| | - Mark S Dias
- Departments of Neurosurgery and Pediatrics, Penn State Health College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA
| | - Sandeep K Narang
- Child Advocacy and Protective Service, Children's Hospital of Wisconsin, Milwaukee, WI, USA
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