The doctor as witness in child abuse cases

Doctors who have to give evidence in cases of physical or sexual child abuse usually find it a stressful experience. Factors that may help to improve the doctor's ability to cope with the situation are discussed in this article. The importance of good medical notes and a good medical examination is stressed. Hints are given on how to minimise the inevitable delays that precede a court appearance. The hearsay rule means that the history the doctor obtains is not accepted as evidence. The medical procedure, which involves using various facts to build up a complete picture, is contrasted with the legal procedure, which involves testing each separate fact in order to create reasonable doubt that the accused may be guilty. Some common questions put to the doctor are discussed here. They include questions as to whether causes other than abuse, such as masturbation, infection or the use of other instruments, could have damaged the hymen or vagina.