Rizvi Munaza Batool, Conners Gregory P., King Kevin C., Lopez Richard A., Rabiner Joni
Columbia Presbyterian, Morgan Stanley Children's Hospital
Upstate Golisano Children's Hospital
Healthcare providers in Pennsylvania are mandated reporters of suspected child abuse; if a mandated reporter has reasonable cause to suspect a child was or is a victim of child abuse, the mandated reporter must immediately make a report of suspected child abuse in accordance with the Pennsylvania Child Protective Services Law (CPSL), 23 Pa.C.S. Chapter 63 (relating to child protective services). This not only requires an understanding of the categories and common indicators of child abuse but also the roles and responsibilities for reporting suspected child abuse. In the US, over 3 million children per year are abused or neglected. In Pennsylvania, over 40,000 are the subjects of reports, and approximately 1 in 1000 children are abused or neglected. The Pennsylvania child welfare system is state-supervised and county-administered. The 2 main functions of the county children-and-youth agencies are Child Protective Services (CPS) and General Protective Services (GPS). CPS are services and activities provided by the department and each county agency for child abuse cases. Cases identified as “CPS” require an investigation because the alleged act or failure to act meets the PA CPSL’s definition of child abuse. The PA CPSL’s definition of child abuse recognizes 10 separate categories of child abuse. GPS are services and activities each county agency provides for cases requiring protective services as defined by PA DHS in regulations. Cases identified as “GPS” require an assessment for services and supports. In these cases, the alleged act or failure to act does not meet the definition of child abuse but is still detrimental to a child. The primary purpose of GPS is to protect the rights and welfare of children so that they have an opportunity for healthy growth and development. Causing bodily injury to a child through any recent act or failure to act. Fabricating, feigning, or intentionally exaggerating or inducing a medical symptom or disease that results in a potentially harmful medical evaluation or treatment to the child through any recent act. Causing or substantially contributing to serious mental injury to a child through any act or failure to act or a series of such acts or failures to act. Causing sexual abuse or exploitation of a child through any act or failure to act. Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act. Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act. Causing serious physical neglect of a child. Engaging in specific recent "per se" acts. Causing the death of the child through any act or failure to act. Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000. Is without proper parental care or control, subsistence, education as required by law, or other care or control necessary for their physical, mental, or emotional health or morals. Has been placed for care or adoption in violation of law. Has been abandoned by their parents, guardian, or other custodian. Is without a parent, guardian, or legal custodian. Is habitually and without justification truant from school while subject to compulsory school attendance. Has committed a specific act of habitual disobedience to the reasonable and lawful commands of their parent, guardian, or other custodian, who is ungovernable and found to need care, treatment, or supervision. Is under 10 years of age and has committed a delinquent act. Has been formerly adjudicated dependent under section 6341 of the Juvenile Act (relating to adjudication) and is under the court's jurisdiction, subject to its conditions or placements, and who commits an act defined as ungovernable. Has been referred under section 6323 of the Juvenile Act (relating to informal adjustment), and who commits an act that is defined as ungovernable. The 3 components of child abuse include the following: 1. A child: An individual under 18 years old. 2. Act(s) or failure(s) to act; Recent act; or Recent act or failure to act- Act: Something that is done to harm or cause potential harm to a child- Failure to act: Something that is NOT done to prevent harm or potential harm to a child- Recent act: Any act committed within 2 years of the date of the report to the department or county agency- Recent act or failure to act: Any act or failure to act committed within 2 years of the date of the report to the department or county agency. 3. Intentionally, Knowingly, or Recklessly- Intentionally: Done with the direct purpose of causing the type of harm that resulted- Knowingly: Awareness that harm is practically certain to result- Recklessly: Conscious disregard of substantial and unjustifiable risk. Perpetrator: A person who has committed child abuse. The term includes only the following: Parent of the child. Spouse or former spouse of the child's parent. Person 14 years or older and responsible for the child's welfare or having direct contact with the child as an employee of a childcare service, school or school program, activity, or service. Individual 14 years or older who live in the same house as the child. Individual 18 years or older who does not live in the same home as the child but is related within the third degree of consanguinity or affinity by birth or adoption to the child. Individual 18 years or older who engages a child in severe forms of trafficking in persons or sex trafficking as defined in section 103 of the Victims Protection Act of 2000. Only the following may be considered a perpetrator for failing to act: A parent of the child. A spouse or former spouse of the child's parent. A paramour or former paramour of the child's parent. A person aged 18 years or older and responsible for the child's welfare. A person aged 18 years or older who resides in the same home as the child. The PA CPSL defines "child abuse" as intentionally, knowingly, or recklessly doing any of the following: Causing bodily injury to a child through any recent act or failure to act. Fabricating, feigning, or intentionally exaggerating or inducing a medical symptom or disease that results in a potentially harmful medical evaluation or treatment to the child through any recent act (This is also known as Munchausen By Proxy). Causing or substantially contributing to serious mental injury through any act or failure to act or a series of such acts or failures to act. Causing sexual abuse or exploitation of a child through any act or failure to act. Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act. Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act. Causing serious physical neglect of a child. Engaging in any of the following recent "per se" acts: Kicking, biting, throwing, burning, stabbing, or cutting a child in a manner that endangers the child. Unreasonably restraining or confining a child, based on consideration of the method, location, or duration of the restraint or confinement. Forcefully shaking a child under 1 year of age. Forcefully slapping or otherwise striking a child under 1 year of age. Interfering with the breathing of a child. Causing a child to be present at a location while a violation of 18 Pa.C.S. § 7508.2 (relating to the operation of a methamphetamine laboratory) is occurring, provided the violation is being investigated by law enforcement. Leaving a child unsupervised with an individual other than the child’s parent, who the actor knows or reasonably should have known: Is required to register as a Tier II or Tier III sexual offender under 42 Pa. C.S. Ch. 97 Subch. H (relating to registration of sexual offenders), where the victim of the sexual offense was under 18 years of age when the crime was committed. Has been determined to be a sexually violent predator under 42 Pa. C.S. §9799.24 (relating to assessments) or any of its predecessors. Has been determined to be a sexually violent delinquent child as defined in 42 Pa.C.S. § 9799.12 (relating to definitions). Has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.58 (relating to assessments) or has to register for life under 42 Pa.C.S. § 9799.55(b) (relating to registration) . Causing the death of the child through any act or failure to act. Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000: Impairment of physical condition or substantial pain : The law considers 2 parameters: impairment and pain. Impairment - If, due to the injury, the child’s ability to function is reduced temporarily or permanently in any way. Substantial pain - If the child experiences what a reasonable person believes to be substantial pain: A psychological condition, as diagnosed by a physician or licensed psychologist, including the refusal of appropriate treatment, that: Renders a child chronically and severely anxious, agitated, depressed, socially withdrawn, psychotic, or in reasonable fear that the child’s life or safety is threatened or; Seriously interferes with a child’s ability to accomplish age-appropriate developmental and social tasks: Any of the following when committed by a perpetrator that endangers a child’s life or health, threatens a child’s well-being, causes bodily injury, or impairs a child’s health, development, or functioning: A repeated, prolonged, or egregious failure to supervise a child in a manner that is appropriate considering the child’s developmental age and abilities. The failure to provide a child with adequate essentials of life, including food, shelter, or medical care: Any of the following: The employment, use, persuasion, inducement, enticement, or coercion of a child to engage in or assist another individual to engage in sexually explicit conduct, which includes but is not limited to: Looking at sexual or other intimate parts of a child or another individual for the purpose of arousing or gratifying sexual desire in any individual. Participating in sexually explicit conversation either in person, by telephone, by computer, or by computer-aided device for the purpose of sexual stimulation or gratification of any individual. Actual or simulated sexual activity or nudity for the purpose of sexual stimulation or gratification of any individual. Actual or simulated sexual activity for the purpose of producing visual depiction, including photographing, videotaping, computer depicting or filming. *The above bullets do NOT include consensual activities between a child who is 14 years or older and another person 14 years or older and whose age is within 4 years of the child’s age. Any of the following offenses committed against a child: Rape as defined in 18 Pa.C.S. § 3121 (relating to rape). Statutory sexual assault as defined in 18 Pa.C.S. §3122.1 (relating to statutory sexual assault). Involuntary deviate sexual intercourse as defined in 18 Pa. C.S. §3123 (relating to involuntary deviate sexual intercourse). Sexual assault as defined in 18 Pa. C.S. §3124.1 (relating to sexual assault). Institutional sexual assault as defined in 18 Pa. C.S. §3124.2 (relating to institutional sexual assault). Aggravated indecent assault as defined in 18 Pa. C.S. § 3125 (relating to aggravated indecent assault. Indecent assault as defined in 18 Pa.C.S. § 3126 (relating to indecent assault). Indecent exposure as defined in 18 Pa.C.S. § 3127 (relating to indecent exposure). Incest as defined in 18 Pa.C.S. § 4302 (relating to incest). Prostitution as defined in 18 Pa.C.S. § 5902 (relating to prostitution and related offenses). Sexual abuse as defined in 18 Pa.C.S. § 6312 (relating to sexual abuse of children). Unlawful contact with a minor as defined in 18 Pa.C.S. § 6318 (relating to unlawful contact with a minor). Sexual exploitation as defined in 18 Pa.C.S. § 6320 (relating to sexual exploitation of children). The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services through the use of force, fraud, or coercion for subjection to involuntary servitude, peonage, debt bondage, or slavery: Peonage: Paying off debt through work. Debt bondage: Debt slavery, bonded labor, or services for a debt or other obligation. Slavery: A condition compared to that of a slave with respect to exhausting labor or restricted freedom. 2. Sex trafficking in which a commercial sex act induced by force, fraud, or coercion or in which the individual induced to perform such act has not attained 18 years of age: Sex trafficking: The recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act. Commercial sex act: Any sex act on account of which anything of value is given to or received by any person. Labor trafficking is labor obtained through threat of serious harm, physical restraint, or abuse of legal process. Examples: Being forced to work for little or no pay (frequently in factories or farms). Domestic Servitude – providing services within a household from 10-16 hours per day (frequently in child care, cooking, cleaning, yard work, gardening, etc.).
宾夕法尼亚州的医疗保健提供者是涉嫌虐待儿童的强制报告人;如果强制报告人有合理理由怀疑一名儿童曾经或正在遭受虐待,该强制报告人必须立即根据宾夕法尼亚州《儿童保护服务法》(CPSL)(23 Pa.C.S.第63章,涉及儿童保护服务)报告涉嫌虐待儿童的情况。这不仅需要了解虐待儿童的类别和常见指标,还需要了解报告涉嫌虐待儿童的角色和责任。在美国,每年有超过300万儿童遭受虐待或被忽视。在宾夕法尼亚州,每年有超过40000份相关报告,每1000名儿童中约有1名遭受虐待或被忽视。宾夕法尼亚州的儿童福利系统由州政府监督、县政府管理。县儿童和青年机构的两项主要职能是儿童保护服务(CPS)和一般保护服务(GPS)。CPS是该部门和每个县机构针对虐待儿童案件提供的服务和开展的活动。被认定为“CPS”的案件需要进行调查,因为所指控的行为或不作为符合宾夕法尼亚州CPSL对虐待儿童的定义。宾夕法尼亚州CPSL对虐待儿童的定义涵盖10个不同类别的虐待行为。GPS是每个县机构针对宾夕法尼亚州人类服务部(PA DHS)法规中定义的需要保护服务的案件提供的服务和开展的活动。被认定为“GPS”的案件需要进行服务和支持评估。在这些案件中,所指控的行为或不作为不符合虐待儿童的定义,但仍对儿童有害。GPS的主要目的是保护儿童的权利和福利,使他们有机会实现健康成长和发展。通过最近的任何行为或不作为对儿童造成身体伤害。通过最近的任何行为编造、假装、故意夸大或诱发医疗症状或疾病,导致对儿童进行可能有害的医学评估或治疗(这也被称为代理孟乔森综合征)。通过任何行为或不作为或一系列此类行为或不作为对儿童造成或极大促成严重精神伤害。通过任何行为或不作为对儿童进行性虐待或剥削。通过最近的任何行为或不作为造成对儿童身体伤害的合理可能性。通过最近的任何行为或不作为造成对儿童性虐待或剥削的可能性。对儿童造成严重身体忽视。实施最近的特定“本身即违法”行为。通过任何行为或不作为导致儿童死亡。使儿童参与2000年《人口贩运受害者保护法》第103条所定义的严重形式的人口贩运或性交易。
没有得到适当的父母照顾或监管、生活必需品、法律规定的教育或其身心健康或道德所需的其他照顾或监管。被违法安置以获得照顾或收养。被其父母、监护人或其他保管人遗弃。没有父母、监护人或法定保管人。在应受义务教育时习惯性且无故逃学。实施特定的习惯性不服从其父母、监护人或其他保管人合理合法命令的行为,其无法管束且被认定需要照顾、治疗或监管。未满10岁且实施了违法行为。以前根据《青少年法》第6341条(关于判决)被判定为受抚养人,且在法院管辖之下,遵守其条件或安置规定,却实施了被定义为无法管束的行为。根据《青少年法》第6323条(关于非正式调整)被转介,且实施了被定义为无法管束的行为。
实施了虐待儿童行为的人。该术语仅包括以下人员:儿童的父母。儿童父母的配偶或前配偶。14岁及以上且负责儿童福利或作为儿童保育服务机构、学校或学校项目、活动或服务的员工与儿童有直接接触的人。与儿童住在同一所房子里的14岁及以上的个人。与儿童没有住在同一所房子里但与儿童有三代以内血缘或姻亲关系的18岁及以上的个人。18岁及以上且使儿童参与2000年《受害者保护法》第103条所定义的严重形式的人口贩运或性交易的个人。
儿童的父母。儿童父母的配偶或前配偶。儿童父母的情人或前情人。18岁及以上且负责儿童福利的人。与儿童住在同一所房子里的18岁及以上的人。
宾夕法尼亚州CPSL将“虐待儿童”定义为故意、明知或鲁莽地实施以下任何行为:通过最近的任何行为或不作为对儿童造成身体伤害。通过最近的任何行为编造、假装、故意夸大或诱发医疗症状或疾病,导致对儿童进行可能有害的医学评估或治疗(这也被称为代理孟乔森综合征)。通过任何行为或不作为或一系列此类行为或不作为对儿童造成或极大促成严重精神伤害。通过任何行为或不作为对儿童进行性虐待或剥削。通过最近的任何行为或不作为造成对儿童身体伤害的合理可能性。通过最近的任何行为或不作为造成对儿童性虐待或剥削的可能性。对儿童造成严重身体忽视。实施以下任何最近的“本身即违法”行为:以危及儿童的方式踢、咬、扔、烧、刺或割儿童。基于对约束或限制的方式、地点或持续时间的考虑,不合理地约束或限制儿童。用力摇晃1岁以下的儿童。用力拍打或以其他方式击打1岁以下的儿童。干扰儿童的呼吸。在违反宾夕法尼亚州刑法典第18篇第7508.2条(关于甲基苯丙胺实验室的运营)的行为发生时,使儿童处于该地点,前提是该违法行为正在由执法部门进行调查。将儿童交给儿童父母以外的其他人监管,而行为人知道或理应知道该人:根据宾夕法尼亚州刑法典第42篇第97章H子章(关于性犯罪者登记)的规定,需要登记为二级或三级性犯罪者,其性犯罪的受害者在犯罪时未满18岁。根据宾夕法尼亚州刑法典第42篇第9799.24条(关于评估)或其任何前身的规定,被认定为性暴力捕食者。根据宾夕法尼亚州刑法典第42篇第9799.12条(关于定义)的规定,被认定为性暴力违法儿童。根据宾夕法尼亚州刑法典第42篇第9799.58条(关于评估)的规定,被认定为性暴力捕食者,或根据宾夕法尼亚州刑法典第42篇第9799.55(b)条(关于登记)的规定必须终身登记。通过任何行为或不作为导致儿童死亡。使儿童参与2000年《人口贩运受害者保护法》第103条所定义的严重形式的人口贩运或性交易:身体状况受损或剧痛:法律考虑两个参数:受损和疼痛。受损——如果由于伤害,儿童的功能能力以任何方式暂时或永久降低。剧痛——如果儿童经历一个理性的人认为是剧痛的情况:一种由医生或持牌心理学家诊断的心理状况,包括拒绝接受适当治疗,这种状况:使儿童长期严重焦虑、激动、抑郁、社交退缩、精神错乱,或合理地担心其生命或安全受到威胁;或严重干扰儿童完成适合其年龄的发展和社交任务的能力:犯罪者实施的以下任何行为危及儿童的生命或健康、威胁儿童的福祉、造成身体伤害或损害儿童的健康、发展或功能:考虑到儿童的发育年龄和能力,以不适当的方式反复、长期或严重未能监督儿童。未能为儿童提供足够的生活必需品,包括食物、住所或医疗护理:以下任何行为:雇佣、使用、劝说、诱导、引诱或胁迫儿童参与或协助另一个人参与露骨的性行为,这包括但不限于:为了唤起或满足任何人的性欲而查看儿童或另一个人的性器官或其他私密部位。亲自、通过电话、通过计算机或通过计算机辅助设备参与露骨的性对话,以刺激性欲或满足任何人的性欲。为了刺激性欲或满足任何人的性欲而进行实际或模拟的性活动或裸体展示。为了制作视觉描绘而进行实际或模拟的性活动,包括拍照、录像、计算机描绘或拍摄。*以上要点不包括14岁及以上的儿童与年龄在其4岁以内的另一个14岁及以上的人之间的自愿活动。对儿童实施的以下任何犯罪:宾夕法尼亚州刑法典第18篇第3121条(关于强奸)所定义的强奸。宾夕法尼亚州刑法典第18篇第3122.1条(关于法定性侵犯)所定义的法定性侵犯。宾夕法尼亚州刑法典第18篇第3123条(关于非自愿偏离性交)所定义的非自愿偏离性交。宾夕法尼亚州刑法典第18篇第3124.1条(关于性侵犯)所定义的性侵犯。宾夕法尼亚州刑法典第18篇第3124.2条(关于机构性侵犯)所定义的机构性侵犯。宾夕法尼亚州刑法典第18篇第3125条(关于加重猥亵攻击)所定义的加重猥亵攻击。宾夕法尼亚州刑法典第18篇第3126条(关于猥亵攻击)所定义的猥亵攻击。宾夕法尼亚州刑法典第18篇第3127条(关于暴露下体)所定义的暴露下体。宾夕法尼亚州刑法典第18篇第4302条(关于乱伦)所定义的乱伦。宾夕法尼亚州刑法典第18篇第5902条(关于卖淫及相关犯罪)所定义的卖淫。宾夕法尼亚州刑法典第18篇第6312条(关于对儿童的性虐待)所定义的性虐待。宾夕法尼亚州刑法典第18篇第6318条(关于与未成年人的非法接触)所定义的与未成年人的非法接触。宾夕法尼亚州刑法典第18篇第6320条(关于对儿童的性剥削)所定义的性剥削。
通过使用武力、欺诈或胁迫手段招募、窝藏、运输人员,提供或获取人员以进行劳动或服务,使其遭受非自愿奴役、偿债劳役、债务质役或奴役:偿债劳役:通过工作偿还债务。债务质役:债务奴隶制、债务劳役或为债务或其他义务提供的服务。奴役:一种与奴隶状况相比,劳动繁重或自由受限的状况。2. 性交易,其中商业性行为是由武力、欺诈或胁迫诱导的,或者被诱导进行此类行为的个人未满18岁:性交易:为了商业性行为的目的招募、窝藏、运输人员,并提供、获取、光顾或招揽人员。商业性行为:任何基于此给予或接受任何有价值东西的性行为。
劳动贩运是通过严重伤害威胁、身体约束或滥用法律程序获得的劳动。例如:被迫从事很少或没有报酬的工作(通常在工厂或农场)。家庭奴役——每天在家庭中提供10至16小时的服务(通常在儿童保育、烹饪、清洁、庭院工作、园艺等方面)。