Accessibility and Order: Crossing Borders in Child Abuse Forensic Reports

Abstract

Physicians write child abuse forensic reports for nonphysicians. We examined 73 forensic reports from a Canadian children's hospital for recurrent strategies geared toward making medical information accessible to nonmedical users; we also interviewed four report writers and five readers. These reports featured unique forensic inserts in addition to headings, lists, and parentheses, which are typical of physician letters for patients. We discuss implications of these strategies that must bridge the communities of medical, social, and legal practice.

Notes

¹Reports documenting sexual abuse are almost all identical because the medical examination is usually negative, and it is important to explain that, while this lack of evidence does not support the abuse allegation, it also does not deny it.

^aRange of Instances/Report: Headings, 1–17; Bullets, 1–6; Parentheses, 1–36; Inserts, 1–7

^a‘General” headings appeared in 15 reports outside of the History, Exam, Formulation or Summary (Sum) sections (e.g., “SCAN Program Assessment, Date” [R-2]).

^bSixty one of the list headings pertained to exam results (all skin markings); two list headings were general headings (e.g., sources of data for report).

^aSkin markings: bruises (20), hyperpigmentation (3), petechiae (tiny ruptured blood vessels; 2), burn (1).

^bFractures: leg (4), arm (3), rib (2), clavicle (1), skull (1), vertebra (1)