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Significant numbers of children are severely abused and neglected by parents and caregivers. Infants and very young children are the most vulnerable and are unable to seek help. Many of these children experience both initial harm and enduring effects, at substantial cost to the individual and society. These situations present complex normative and practical questions. Should measures be taken to identify these situations? If so, what measures should be adopted? Once cases are identified, what responses should be implemented? This chapter is primarily concerned with aspects of the second question, of what measures should be adopted to detect cases of severe child maltreatment. It discusses the apparent effect of mandatory reporting laws on ‘overreporting’ by referring to Australian government data about reporting patterns and outcomes, with a particular focus on New South Wales. It demonstrates that raw descriptive data about report numbers and outcomes appear to show that reporting laws produce both desirable consequences (identification of severe cases) and problematic consequences (increased numbers of unsubstantiated reports).

The discourses and debates on errors and mistakes in child protection in Sweden hold many different sub-themes. Relatively recently, the Swedish state both recognised and apologised to persons maltreated in the Swedish child welfare system before 1980. At times, the discourse has been dominated by parents’ abuse or neglect resulting in child deaths. The role of social services in these cases has been depicted as faulty. Other areas of discourse focus on strengthening children’s rights in child protection, and impact on the day to day work of social services arising in part from the increase in unaccompanied children entering Sweden over recent years. This chapter aims to describe and discuss past and current strategies to avoid and handle errors and mistakes in child protection in Sweden. The chapter describes legal errors, organizational errors and professional errors as well as strategies to handle them. It builds on research from the two authors and others. The strategies are presented in themes, including: a) the different measures within the quality assurance systems – such as mandatory reports of mistreatment to the regulatory authority; b) the strategies to avoid errors and mistakes including increased legislation, control and governmental inspections and more attention to children’s voices; c) strategies originating from professional groups aiming to avoid errors and mistakes. Finally, the chapter discusses possible strategies designed to promote learning from errors and mistakes in social work education and for policy development.

Chapter 4 provides a history of legislative reforms related to domestic violence and stalking. The push to reform these laws did not begin with the courts whose opinions formed the law, the police who enforced it, or the attorneys who prosecuted it. Rather, it was an outgrowth of the women’s movement of the 1970s. Feminist advocates challenged the concept of family privacy and forced the perpetration of violence against women onto the nation’s collective consciousness. The chapter focuses on English common law and the way it influenced statutes in America, including concepts of chastisement and the “rule of thumb.” Chapter 4 describes reforms relating to police, prosecutors, and the courts, and it discusses cases involving “failure to protect,” mandatory arrest, mandatory prosecution, and reforms ranging from domestic violence courts to victim advocacy. The chapter also examines mandatory reporting laws and describes the history of civil protective orders.

Canada has a wide expanse of geographic terrain that encompasses urban, sub-urban, rural, and remote areas. The purpose of this chapter is to explore the unique challenges of mandatory reporters living and working in northern parts of provincial and territorial Canada. The chapter opens with a discussion of how the north has been defined historically and by Indigenous and settler perspectives. The chapter proceeds to examine the economic and social context of northern Canada before moving into a review of the challenges facing mandatory reporters. The chapter offers suggestions to mandatory reporters to balance their statutory responsibilities with the contextual reality of living in the community.

Despite the general principles of parental autonomy and privacy, domestic violence and child maltreatment invite police, lawyers, social workers, and judges into the most intimate spaces within a family. Domestic violence is described in terms of intimate partner violence, child maltreatment, and elder maltreatment. Because these topics would be sufficient for an entire separate book, this chapter focuses on the following specific issues related to these forms of domestic violence: domestic violence courts, corporal punishment, obesity as neglect, termination of parental rights, informal caregiving for elders, and mandatory reporting laws for elder maltreatment.

This chapter explores the historical foundations of Canadian child welfare and mandatory reporting of child maltreatment. The first section addresses the changing conceptions of childhood from the Middle Ages through Canadian confederation to the present time. Legislation, both Canadian and international, which has profoundly impacted children’s lives is reviewed along with prominent figures who have increased our understanding of the attachment needs of children. What follows is an overview of the historical rise of the child welfare system in Canada and the jurisdictional separation of child welfare under provincial and territorial realms. The final section addresses the involvement of Canada’s Indigenous children in the child welfare system and provides a comprehensive overview of historical injustices against Indigenous peoples.

Despite profound shifts in the scientific underpinnings of SBS, the diagnosis continues to operate in familiar ways. Most notably, the SBS that convicts defendants in criminal court remains unambiguous and fully certain, even though the medical establishment has made formal concessions both to ambiguity and uncertainty. This chapter examines the close resemblance of today’s SBS to its predecessor and suggests a number of reasons for the staying power of the old model. The chapter considers the dynamics of child abuse specialization, including the creation of a mandatory reporting regime; the growth of multidisciplinary teams; and the advent of organizations like the National Center on Shaken Baby Syndrome. The chapter also discusses the phenomenon of prosecutorial certainty regarding the triad’s diagnostic significance.

From confidentiality, contact notification, and disclosure to decisional capacity, advance directives, and end-of-life care, AIDS presents special bioethical challenges to caregivers. Stigma, fear of rejection, and discrimination play significant roles in the bioethical aspects of the care of persons with HIV and AIDS. As a consequence, caregivers are often faced with bioethical dilemmas and conflicts. While many persons with HIV and AIDS are comfortable with disclosure to partners and family members, some persons with HIV refuse to disclose their serostatus even to sexual partners. Many persons with HIV and AIDS are able, especially with support, to come to safer and healthier decisions about disclosure and about their health and medical care. In this chapter, we will explore these dilemmas and provide suggestions on how to deal with them. Strategies for dealing with ethical dilemmas, determining decisional capacity, addressing end-of-life issues, and maintaining confidentiality in the care of persons with HIV and AIDS are also presented. To begin a discussion of ethics as applied to clinical care, it is important to define the terms used in this context. The definitions of the terms used in this chapter are based not only on formal definitions as published in bioethics texts and articles but also their use in common medical practice. Table 13.1 provides definitions of some of the bioethics terms that are relevant to this discussion. Within the doctor–patient relationship, physicians are expected to understand and relate to their patients as their own primary decision-makers. Patients are presumed to be autonomous and to have decisional capacity. However, at times, decisional capacity can be called into question, such as when a medical condition impairs the patient’s capacity to understand the illness or results in impaired judgment. Since autonomy is such a protected right, multiple criteria must be fulfilled in order to substitute another person’s judgment for that of the patient in cases where the patient is unable to make an appropriate decision for him- or herself. This assessment is called an assessment for capacity and is specific for each decision—a separate assessment must be performed for each decision to be made if the patient’s decision-making ability is under question.