The Lancet Series on Child Maltreatment, in conjunction with Royal College of Paediatrics and Child Health, is opened with a Comment by Lancet Editor Dr Richard Horton and Senior Editor Dr Richard Turner. They say: "Few topics are more emotive than child maltreatment... Children, the most precious and vulnerable members of our societies, deserve closer attention to their care and education and better protection against abuse."
They discuss the difficulties of establishing that child maltreatment has occurred, such as the victim being unable or unwilling to provide an account of abuse, the desperate steps a perpetrator may take to conceal their actions, or professionals relucatant to act owing to uncertainty about the existence or severity of abuse, or concern that the treatment of abuse will itself lead to undue disruption or damage to a child's upbringing. Drs Horton and Turner say: "When severe child abuse culminates in death, however, as in the tragic recent cases of Victoria Climbié and Baby P in the UK, the law, news media, and public can be expected to cast a harsh and unforgiving spotlight on social workers and doctors who might be perceived or portrayed as having missed opportunities to help the victims."
They add: "It is to clinicians and other professionals responsible for caring for children that The Lancet's Child Maltreatment Series is aimed, with the intention of providing them with a rigorous and up-to-date summary of scientific evidence and conceptual work on this complex and demanding topic."
Drs Horton and Turner discuss the importance of scientific evidence surrounding child maltreatment influencing policy discussion — something which is difficult to achieve under the polarising light of litigation or political division.
They conclude: "We would like to extend warm thanks to Patricia Hamilton of the Royal College of Paediatrics and Child Health for supporting this Series, and to the authors and peer reviewers of the accompanying papers and Comments for their unstinting work. This Lancet Series will unfortunately not halt the blight of child abuse, because the phenomenon is too common, too surreptitious, and too deeply rooted in deprivation and other social ills—but we nonetheless hope to raise awareness of the scientific evidence that is available, and indeed essential, to guide paediatricians and other professionals in their practice with children who might have been abused; and to help bring a new logic and clarity to public debate about this contentious area."
Dr Patricia Hamilton, President, Royal College of Paediatrics and Child Health, says*: "Our society has to accept that child abuse happens and that paediatricians and social workers have a duty to act when they suspect any forms of maltreatment. This Lancet series describes the evidence and research on which we base our actions.
"People should not be deterred from working in the professions that are involved in protecting children and young people. Most importantly, we must continue to put children first on all occasions. It is sometimes extremely hard to make judgements in child abuse cases. This series of papers shows that training, strategies to improve recognition of maltreatment and a strong evidence base are vital.
"The Royal College of Paediatrics and Child Health already provides training to give doctors more skills in safeguarding children and has published guidance and evidence to support paediatricians and other professionals."
Lancet Press Office T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com
For Dr Patricia Hamilton, please contact: Claire Brunert, RCPCH Press Office, +44 (0) 20 7092 6005 / 6006 E) Claire.Brunert@rcpch.ac.uk
*Quote direct from Patricia Hamilton and cannot be found in the text of the Comment
For full Comment: http://press.thelancet.com/childmaltreatmentcomments.pdf
Journal
The Lancet