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Making the case for greater certainty in child protection
  1. Geoff Debelle1,
  2. Adam Oates2
  1. 1 Child Protection, Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, UK
  2. 2 Radiology, Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Geoff Debelle, Child Protection, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK; g.debelle{at}

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Paediatricians, as with all healthcare professionals, have a duty to protect children from harm. They are called on to make the case for inflicted injury, often during a busy service week. If an inflicted injury to a child is not identified and acted on appropriately, the child or a sibling may present with further, serious or fatal injury, and, conversely, a decision in favour of inflicted injury that is not adjudicated as such may have serious human and societal consequences, including needless separation of the child from the family. This commentary and the related article by Arthurs et al 1 are book-ended by two such situations: the cases of two children removed from their respective parents on the basis of suspicious injuries, only to be returned to their parents following reappraisal of the radiological evidence by court-appointed experts, and the tragic cases of two children abused and murdered by their parents.

The Viewpoint article was written in response to press coverage surrounding the cases of the two children, removed from, and then returned to their parents. The authors, eminent in the fields of child protection, paediatric radiology and the law, ask, ‘are we getting it right’ in safeguarding children? In broad statistical terms, we are getting it right, for example, the rates of fatal child maltreatment in England and Wales have fallen steadily over the past 30 years2 and the rates for children on Child Protection Plans in England have remained relatively constant since 2013.3 Yet statistics belie the …

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  • Contributors Both authors made equal contribution to manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Both authors have provided independent expert testimony in court on child protection matters.

  • Provenance and peer review Commissioned; internally peer reviewed.

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