Drummond Rachel, Gall John A M
Department of Paediatrics, The University of Melbourne and Victorian Forensic Paediatric Medical Service, Royal Children's Hospital, Melbourne, Australia.
J Forensic Leg Med. 2017 Feb;46:37-45. doi: 10.1016/j.jflm.2016.12.006. Epub 2016 Dec 23.
Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment.
A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA.
With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events.
The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect.
疑似儿童身体虐待、性虐待和忽视的情况并不少见。作为这些案件评估的一部分，可能会获取法医病史。这份法医病史不仅用于确定保障儿童福祉所需采取的措施，还用于指导法医检查。目前，对于法医病史是否应始终被视为儿科法医评估的一个组成部分，尚无明确共识。本研究探讨了在儿童接受评估时，医生获取法医病史而非依赖传闻证据所产生的价值。
对2014年至2015年间维多利亚州法医儿科医疗服务机构（VFPMS）接诊的儿科病例进行回顾性研究。审查了274份法医病例报告，并将数据录入Excel电子表格，使用STATA中的卡方检验进行分析。
随着儿童年龄的增长，获取法医病史的可能性显著增加。医生能够获得更多信息，而如果仅依赖警方的询问，这些信息原本是无法获取的。官方第三方（警方或儿童保护机构）报告中儿童所说内容与儿童对医生所说内容之间的差异以及儿童所述事件版本与第三方（如父母、照顾者、朋友）所述事件版本之间的差异均随年龄增长而减小。
研究表明，通过获取儿童的法医病史可以获得更多信息。此外，在儿童身体和性虐待及忽视案件中，检查医生获取儿童的法医病史具有一定价值。
