Child Sexual Abuse - Case Study Example

1 Introduction In early summer 1981 the United Kingdom and the world was rocked by allegations of child sexual abuse occurring in Cleveland. In the years leading up to 1987, the incidence of child sexual abuse for Cleveland was no greater than for other parts of the UK; but in January 1987the numbers began to escalate rapidly, reaching its peak in May, June and July total referrals to Cleveland social services for all forms of child abuse during the period of January to July 1987 were 505 referrals compared with only 288 referrals in the equivalent period in the previous year"(Pragnell) Increasing numbers of allegations of child sexual abuse were being made by two consulting pediatricians at a Middlebrough hospitaland were base don an unproven medical diagnosis termed anal dilation test. Once these allegations were made social workers were removing children from their families on Place of Safety orders. Often in midnight and dawn raids on the family home where children were taken from their beds and placed in foster homes and residential homes. The initial crisis came when there were no more foster homes and residential home placements to accommodate the number of children involved and a special ward had to set up at the hospital to accommodate the children who continuedto be diagnosis as being sexually abused. Relationships between the public, social workers and the pediatricians broke down as the dispute in medical opinions escalated. It is alarming to note that there is no requirementfor pediatric diagnosis to be scientifically based, despite the present emphasis on 'evidence' based social work andmedicine, and there is no system of 2 verifying and validating pediatric diagnosis on which child abuse allegationsmay be based, before hey can be used in clinical practice. This was acknowledged by John Forfar, the then president of the British Pediatric Association, who wrote on e of the Pediatricians involved, Dr.Mariett Higgs, in July 1987 and gave an admonishment in regards to use of the anal dilation test. He stated; "The regulation of medical practice is achievedbest when it is accomplishedwithin the medical profession. New stances based on a new awareness of clinical signs, or new significances being attached to them, require first to be established within the profession. This takes some time and requires persuasion and scientific evidence of validity, based on the accepted method or communication to professional journals or scientific meetings"(Forfar) In the early months of the crisis, the allegations involved work class families, who were confused bewildered, and angry of being accusedof sexually abusing their children, but they were powerless againstmiddle class professionals with the authority, power, and legal sanctions to support their actions. Charles Prugnell in his piece "An abuse and misuseof professional power describes the pressure placed on the working class by the middle class thusly: "From a sociological perspective, therefore, the events in Cleveland could be seen as a punitive form of middle class oppressionof working class families by middle class professionalsand an imposition of middle class values on the working class' (Prugnell) One of the key issues in the Cleveland sex abuse scandal was the power of 3 professional groups in UK society and how these powers can be misused and abused in the absence of accountability in law for professional practice. Social workers are not personably liable in law for theiractions in child protection matters, as they can be in mental health work and it could be argued that this is a necessary development. There is a belief in some quarters that the events in Cleveland in 1987 led to the Children Act 1989, but this is incorrect. The need for child care reform legislation, both public and private law relating to children, had been identified several yearsearlier by the House of Commons Social Services Select Committee of 1984 (Children in Care), which described the then situation as complex, confusing, and unsatisfactory. A review of the child care lawfollowed and led to a white paper, "The Law on Child Care and Family Services", which was published before the findings of the Butler-Sloss inquiry was known"(Pragnell) Child Abuse Perception of the accused guilty from day one Clearly, those who are charged with protecting children are in a difficult position. The central concern of society at large and to which those involved in child abuse investigation need to be sensitive, is the necessity to protect childrenwithout being overly intrusive or damaging innocent families against whom accusations are made. The UK Children Act (1989) recognizes this dilemma and made its guidelines attempt to act asa counterbalance between the rules of child protection agencies and families emphasizing the notions of "empowerment" and "involvement" during investigations of 4 child abuse. In America laws which make it a legal requirementfor a large variety of professionals to report suspected child abuse may have exacerbated the situation. It is clear that the problem of false accusations remains endemicto both countries"(Prosser) Legislation requires the local authority to have regard not only in the physical well being of the child but also of the advantagesof not disruptingthe child's family environment: See for example section 17 of the Act of 1987 (cm 412) said at p.224: "It is a delicate and difficult line to tread between taking action too son and not taking it soon enough. Social services whilst putting the child first must respect the rights of the parents; they must also work if possible with the parents for the benefit of the children. These parents themselves are often in need of help. Inevitably a degree of conflict develops between these objectives. The relationship between the social worker and the child's parents is frequently one of conflict, the parent wishes to retain care of the child, the social worker having to consider whether to remove it. This is fertile ground in which to foster ill feeling and litigation, often hopeless, the cost of which both in money and human resources will be diverted from the performance of the social service for which they were provided"( House of Lords) In the Cleveland case one of the major findings of Butler-Sloss inquiry was that children had been removed precipitately by social workers who had failed to seek corroborative evidence to support the allegations of the pediatricians and had failed to carry out comprehensive assessments of the children and their families. Consequently a requirement was introduced that social workers should not act solely on the basis of 5 medical opinion"(Pragnell) False accusations of sexual abuse produce a cost to the child, the person accused and the society. Children are victimized in a way that can be more damaging to them than actual sexual abuse. Accused persons are assaulted by the readiness of society to assume guilt, by the social isolation and alienation, and the prolonged effects of being under investigation and prosecution, including financial ruin and lost jobs, families and marriages" (Pragnell) The accused is often thrusted into a no win situation, that has been perceived as guilty from day one, that the onus is on him to prove his innocence and that too much emphasis was placed on confirmatory evidence and too little weight given to refuting investigator's beliefs of guilt. These beliefs may be well founded and are also reported in the work of Frost and Zuskin (1988). Is it possible that fathers displaying anger or losing their temper confirmed guilt in investigator's eyes, as would being cooperative and friendly There is little research in this area, but La Fontaine (1990) reflects on the difficulty investigators face at these particular times: " it is true that guilty fathers often react with angry denial and may be supported in this way by their wives. It requires training and time to distinguish between denial of all responsibility which characterizes most sexual abusers and a general declaration of innocence"(La Fontaine) Investigators only seeking confirmatory evidence In the Butler-Sloss Inquiry of the Cleveland case, concerns were expressed regarding the use of video-recording equipment for surveillance of interviews with 6 children and the use of anatomically correct dolls in the questioning of children where sexual abuse was alleged. During such video related sessions, social workers were seen to threaten and attempt to bribe children in order to bring pressure on the children to confirm the social workers views that they had been abused and leading questions were asked of the children which would not have been permitted in courts. The interviews of the children by the social workers also confused the investigatory nature of such interviews with a therapeutic purpose. Where the interviews containing a therapeutic element with children whose abuse is alleged is conducted before trial courts, courts Could take the view that such interviews contaminated and corrupted the child's evidence. Anatomically correct dolls can now only be used by professionals who have undertaken intensive training in their use, and serious doubts have been raised by some psychologists regarding the use of such dolls, citing the differences in interpretations of children's behaviours which can be made and how readily false assumptions can be made. Poor Recording of Evidence In a August 7, 2005 article in the Sunday Times, Mark Macaskill and Jason Allardyce chronicled a report which highlighted Scotland's biggest child sex investigation, wherein they point out that Care Workers 'failed victims of child abuse'. Seven men and a woman were arrested in 2003 in a series of coordinated raids on the Isle of Lewis and in Dorset, Leicestershire and West Yorkshire. They were charged with sex offences involving girls under the age of 16. However, all charges were dropped without explanation by the crown office. 7 In a report released by the Social Work Inspection Agency, it was concluded that there was clear evidence that the children had been subject to "sever and prolonged abuse", of a physical and sexual nature "over many years". The report identifies a range of shortcomings in the way information on vulnerable children is shared between the police, health and social workers and makes 31 recommendations to plug the gap. The case has echoes of the Orkney child abuse scandal of 1991, when nine children were placed in care following allegations of ritual child abuse by their parents and a minister. However, the 133 days of investigation collapsed due to lack of evidence. "solicitors acting for some of those wrongly accused warned that the report could lead to legal action against Western Isles Council if social workers are found to have acted negligently. The report urges ministers to tighten up the guidelines on obtaining testimonies from child witnesses is cases involving a large number of alleged victims and abusers"(Times) In the Cleveland sexual cases the turning point of events came in late May on the day the parents decided to march from the hospital where the children were being held, to the offices of the local newspaper, and they began telling their versions of the events, which of course varied considerably from the narrative constructions of the pediatricians and social workers. Gradually, the media turned to support the parents, and the social workers came under intense public and political scrutiny, which eventually led to the setting up of a public inquiry led by Justice Butler-Sloss. "The inquiry examined the cases involving the 121 children where sexual abuse was alleged to have been identified using the anal dilation test and the actions of the 8 pediatricians and social workers involved. Of the 121 cases where sexual abuse of children was alleged, the courts subsequently dismissed the proceedings involving 96 of the children, i.e., over 80 per cent were found to be false accusations. There were some workers and medical professionals who found difficulty in accepting the findings of the courts and are 'in denial' that they were wrong allegations. They have sought to use the findings of a medical panel which claimed that, on the basis of an examination of cases involving 29 of the children, 75 per cent of the children had been sexually abused. Medical opinion is not, of course, proven fact, whereas opinions and supportive evidence given in open courts can be challenged and tested under cross examination as to their validity and veracity"(Pragnell) Prosser and Lewis (1992) found that in 23 of 30 cases (77 per cent) parents perceived social workers as being unsympathetic in the way they record data and on the basis of the number of factual mistakes in reports submitted to the courts by social workers, there was substance in their concerns. This suggest that a systematic form of recording data (other than formal interviews) may not be a part of the professional code of practice or working culture of social workers in the UK"(Prosser) High Status Doctors (a consultant) having substantial influence over other investigators Clearly, the high status doctors, particularly consultants, hold in society assigns them substantial influence and power over others within their profession and investigating agencies. Prosser and Lewis (1992) found evidence to confirm that this belief was held by others in similar situations. They established that in 23 of 30 cases (77 per cent), the influence of an individual (either a doctor or a social worker) was seen by 9 parents as pivotal and having a major influence on their case"(Prosser and Lewis). The case of Dr. Camille San Lazaro represents a typical example of how things can get out of kilter when a doctor (consultant) is provided unfettered control and access. Dr. Lazaro was a senior lecturer and consultant pediatrician at Newcastle Royal Victoria Infirmary and Newcastle University. She was critized in 2002 for her role in the investigation into false claims of abuse at a Newcastle nursery by Dawn Reed and Christopher Lillie. Additionally, her evidence was blamed for the conviction of Kevin Brown's conviction. Brown had completed his seven year sentence for the rape of a five year old boy. Dr. Lazaro's evidence had been central to the prosecution. A judge later ruled that the conviction of Brown was unsafe in the light of the fresh evidence. It only took the authorities a little more than seven years to uncover her misguided diagnosis. Brown's first appeal was dismissed in 1997 but his case was referred back to the appeal court by the criminal cases review commission which investigates claims of miscarriage of justice. The CCRC obtained three medical reports, including one from the doctor at the forefront of the 1987 Cleveland child sex abuse inquiry that suggested injuries to the boy may not have been caused by a sexual assault. He added that a large portion of the prosecution case at trial had been reliant on evidence from Dr. Lazaro. Lord Justice Kennedy said of the boys injuries: "It now has to be recognized that what was found was capable of a number of explanations"(Kennedy) "If the jury had the advantage of hearing the additional evidence that we have hears, it seems to us that they would have been bound to have had serious doubts about the extent to which they could rely on the medical evidence, to assist them to reach a conclusion. Dozens of child abuse 10 cases have been re-opened because of the evidence of (Dr. Lazaro) and other controversial experts"(Kennedy) Also, in the case of the Lillie and Reed allegations of their alleged sexual abuse of children at the nursery where they were employed, a judge awarded them 100,000 pounds for libel, which was based on Dr. Lazaro's evidence. Dr. Lazaro had examined 50 children who had alleged abuse at the hands of the two nurses. The doctors findings stated that some of them showed signs of sexual abuse or other abuse. These findings were used by the prosecution as presented in a report by Dr. Richard Barker, head of the review team which wrote the report "Abuse in Early years, was subsequently slammed by a judge for being unprofessional. The judge said his four strong inquiry team had fallen under the spell of Dr. Lazaro. Works Cited Butler-Sloss, E. (1988) Report on the inquiry into child abuse in Cleveland 1987, presented tp Parliament by the Secretary of state for Social services by Her Majesty, July, 1988. London HMSO House of Lords Opinions of the Lords of Appeal for judgement in the course JD (FC) (Appellant)v. East Berkshire Community Health NHS Trust et al [2005] UKHL 23 La Fontaine, J. (1990) Child Sexual Abuse, Cambridge, England, Polity Press Luza, S., & Ortiz, E.,(1991) The dynamics of shame in interactions between child protedtive services and families falsely accused of child abuse. Issues in Child abuse accusations, 3 108-123 Macaskill, M., Allardyce, J., Sunday Times, 7 August 205 Prosser, J., A Case Study of a Family Wrongly Accused of Child Abuse IPT volume 7 - 1995 Prosser, J., & Lewis J., (1992) child abuse Investigations: The families perspective. Parents against injustice, 3 Riverside Business Park, Stansted, Essex CM 24 8 PL UK Child Act (1989) Read More