Clinical forensic examinations and prosecution in Danish child physical abuse cases

Despite the central role of forensic medical examinations in child physical abuse cases, evidence on how their findings impact prosecution is scarce.

We studied the association between the dependent variable, filing of formal charges, and independent variables related to the child, suspect, and case characteristics, the acts of violence, and forensic findings, such as cutaneous lesions.

We included 221 children aged between four and 14 years who were reported as victims of suspected physical abuse to the Copenhagen Police between April 1, 2020 and December 31, 2022. All the children participated in a video-recorded interview and underwent a clinical forensic medical examination.

Data were extracted from police reports, court documents, and forensic reports. Logistic regression models were applied.

Formal charges were filed in 56 cases (25 %). Children's disclosures of violence exposure were associated with the filing of formal charges, irrespective of forensic findings (abuse-related findings: OR = 5.4, 95 % CI [1.7, 16.6]; accidental/unspecific findings: OR = 3.9, 95 % CI [1.4, 10.9]). In cases where violence was undisclosed but abuse-related lesions were found, a borderline association was observed (OR = 3.2, 95 % CI [0.9, 11.8]).

The child's disclosure of violence seems of importance for filing formal charges, and the forensic medical examination may be important in the absence of such disclosure, but this needs confirmation in larger studies. Knowledge of factors that influence prosecution decisions may contribute to secure systematic assessment of every child physical abuse case.