3 questions to. . . Prof. Dr. med. Jörg M. Fegert, Medical Director of the Clinic for Child and Adolescent Psychiatry at Ulm University
What should the doctor pay particular attention to when patient describes experiences of abuse?
Fegert: Research shows that doctors are privileged first contacts, but unfortunately not gifted documenters. It is important to precisely document everything that could at some point become relevant in court - preferably in full. We doctors and psychotherapists prefer to paraphrase rather than let the patient speak for themselves. However, the first statement is the most relevant statement in court proceedings. The doctor should also document the conditions in which the statement was made, i.e. whether he actively asked if he or she was suspicious or whether the person affected spontaneously expressed this. After the campaign, many will likely feel encouraged to speak to the doctor.
It is also very important to accept descriptions of sexual abuse without strong negative affect, because they are mostly for the person concerned associated with fear and shame.
What conclusions should the doctor draw from the information?
Fegert: First of all, the doctor should absolutely not keep himself in secrets get involved. He is often unable to protect child from further assault, for example. Children's hospitals or child psychiatric centers, on the other hand, offer protected environment, to which one can refer for psychological symptoms. Unfortunately, colleagues rarely communicate suspicions, but hope that we can find out ourselves. In some cases, however, you don't see the urgency, and our waiting lists are long.
In principle, child protection also goes hand in hand with data protection if we can convince parents in risky situations that the involvement of the youth welfare office is important.
When can the doctor pass on the data to the youth welfare office without violating the duty of confidentiality?
Fegert: Basically, § 203 Criminal Code provides for the unauthorized disclosure of information to third parties punishable, which is why in many federal states special authorization for disclosure is constructed. This so-called authorization norm must definitely be expanded and, above all, it should be uniform across the country. Since the Kevin case two years ago, every state has passed different child protection law. In Bavaria, for example, there is an obligation to report to the youth welfare office, in Baden-Württemberg there is an obligation to weigh up interests in relation to the risk to the child's welfare. We asked pediatricians in both countries, they simply didn't know the regulations. We therefore absolutely need federal child protection law that also gives doctors legal certainty.