Sir, - Apparently some people, the ISPCC and Cian O Tighearnaigh (November 27th), find this a simple issue. As a practising consultant paediatrician for the past 18 years, I deal with actual and suspected cases of child abuse or neglect on an all-too-frequent basis.
Currently all cases of proven abuse are reported, as are cases where there is a reasonable suspicion that abuse has taken place.
However the number of situations where a possibility of abuse exists are numerous in clinical practice, from excessive crying in infants, to bedwetting, faecal soiling, behaviour problems and poor school performance in older children, and the obligatory reporting of all suspicions of abuse would, in my opinion, do more harm than good. Diagnosing obvious severe abuse, with cigarette burns and fractures, is usually not difficult but represents only a fraction of the spectrum of child abuse. How much parental incompetence, or lack of parenting skills, constitutes abuse as opposed to neglect - a simple question?
I would be interested to know how much experience Mr Cian O Tighearnaigh has in personally investigating, diagnosing and reporting real cases of actual or suspected abuse that allows him to understand this complex area so fully as to make it simple. Perhaps he could share his practical expertise in this area, and educate those of us who work to improve the services for Irish children and absolutely detest child abuse, but find this question anything but simple. - Yours, etc.,
University College Dublin, Department of Paediatrics, The Children's Hospital, Temple Street, Dublin 1.