Frasier L D
Division of General Pediatrics, University of Missouri Hospital and Clinics, Columbia 65212, USA.
Pediatr Ann. 1997 May;26(5):306-11. doi: 10.3928/0090-4481-19970501-09.
The history of sexual abuse that a child gives to the pediatrician may be the single most important factor in determining if a child has been abused. Most children have completely normal anogenital examinations; very rarely is definitive forensic evidence obtained or a sexually transmitted disease discovered. Physicians, in general, are given unique authority and privilege in reporting such hearsay evidence. The pediatrician often is the first professional with whom a child has contact when an allegation of abuse is made. Child protective issues then become paramount. It is important, therefore, for the physician to have the basic skills and knowledge of the developmentally appropriate approach to interviewing a child. How that interview is preserved and documented is also critically important and will be scrutinized in any legal proceedings. The physician's interview should not replace a skilled forensic interview but be considered a supplement, whose purpose is foremost the health, well-being, and protection of the child.
儿童向儿科医生讲述的性虐待史可能是判定儿童是否遭受虐待的最重要的单一因素。大多数儿童的肛门生殖器检查完全正常；极难获得确凿的法医证据或发现性传播疾病。一般而言，医生在报告此类传闻证据时被赋予了独特的权力和特权。当提出虐待指控时，儿科医生往往是儿童接触的首位专业人士。儿童保护问题于是变得至关重要。因此，医生掌握针对儿童进行与其发育阶段相适应的访谈的基本技能和知识很重要。此次访谈如何保存和记录也至关重要，并且在任何法律程序中都会受到审查。医生的访谈不应取代专业的法医访谈，而应被视为一种补充，其首要目的是儿童的健康、福祉和保护。
