How would you approach this issue?
In Miya’s case, I would first look at what is causing me to feel there is an ethical problem. I would stick with the facts that made me uneasy about her case. Miya has a broken arm that was noticed right away; she has old bruises on her neck and arms, and it is apparent that the aunt does not know her niece well. I would not look at the fact that she is crying because she could be crying due to her arm having a fracture. After discovering the findings listed, I would consult a co-worker to assess Miya to confirm what I am seeing and if they feel there is cause to make a report. A study done at a psychiatric facility showed that respondents sought and valued the advice of peers and co-workers when faced with clinical decision-making and challenging clinical issues (Tufford & Lee, 2019). I would also look at the types and patterns of injury. A friend of mine’s son’s leg was fractured when he was ten months old while going down the slide with his sister. When the ER doctor examined his leg, she said right away that she had seen those types of injuries before, and it was a typical fracture for someone’s leg that was caught while going down the slide. It is very important that clinicians understand the types and patterns of injuries indicative of physical abuse, including how presentations vary among ages and plausible accidental injury mechanisms, to determine whether injuries warrant concern for physical abuse (Letson & Crichton, 2023).
How would you go about discovering what is going on with Miya?
I would first identify any information gaps by determining if there is a need for more information. I would look at the already apparent information and see if there is a need to get her involved. Once discussing the case with a co-worker and if decide more information is needed, I would use a funnelled approach. The funnelled approach begins with open-ended questions, and questions become increasingly more specific and leading until the child discloses, or a decision is made not to proceed further to avoid the risk of contaminating the interview (Garcia et. al, 2022). I would ask Miya’s aunt if I could speak to Miya alone. Still, I would again like to assure her that further questioning is needed because I wouldn’t want to put Miya in danger if there is insufficient evidence to report the aunt and keep Miya away from her.
How do you manage to be both culturally sensitive and oriented to best health practices in dealing with this topic?
When looking at the cultural sensitives of any case, I would first determine the patient’s primary language and determine if an interpreter is needed. If it is determined that an interpreter is needed, I would next determine who would be the most appropriate interpreter. I would also look at the cultural practices or beliefs when investigating an alleged abuse. Some countries may believe and have laws that allow children to work, and others may have laws against children working. Therefore, culture will play a significant role in ethical decisions (Letson & Crichton, 2023).
If Miya seems at risk from her protector, what steps might you take to protect her?
When it comes to protecting a minor, things should be done to make sure that the child is not at risk after approaching the alleged abuser. There was a case where a child was in for an outpatient mental appointment, and she was found to have clear signs of abuse. Before the mother was approached about the abuse, security was brought into the room, and the mom was asked to step out, the police were waiting for her, and the child was safely turned over to child protective services. When thinking back on the situation, this was the safest approach for the child because I have seen where the alleged abuser will take off with the child, and the child’s safety is compromised.
What are the regulations in your state related to minors, abuse, and trafficking?
Georgia’s law states that anyone who commits the offense of trafficking an individual under the age of 18 is subject to be guilty of being a felon and, if convicted, will face no less than 25 years in prison. Georgia came up with a plan to enhance Georgia’s response to protect victims of sex trafficking and ways to identify child sex trafficking and gangs.
References:
Letson, M. M., & Crichton, K. G. (2023). How Should Clinicians Minimize Bias When Responding to Suspicions About Child Abuse? AMA Journal of Ethics, 25(2), 93–99. https://doi.org/10.1001/amajethics.2023.93
Roth, M. (2023). The Ethics of Research With Children on Violence Re-Examined. Emerald Publishing Limited EBooks, 65–81. https://doi.org/10.1108/978-1-80455-526-220231005
Tufford, L., & Lee, B. (2018). Decision-Making Factors in the Mandatory Reporting of Child Maltreatment. Journal of Child & Adolescent Trauma, 12(2), 233–244. https://doi.org/10.1007/s40653-018-0211-2
Garcia, F. J., Brubacher, S. P., & Powell, M. B. (2022). How Interviewers Navigate Child Abuse Disclosure After an Unproductive Start in Forensic Interviews. International Journal on Child Maltreatment: Research, Policy and Practice. https://doi.org/10.1007/s42448-022-00121-0
