feature
Referring to and relying on specialists for follow-up is second nature
for doctors. In this case, the consultants happen to be CAS.
Children’s Aid Society (CAS) of any suspicions that a child is or may be in need of
protection. Being aware of the duty to report,
and how to act on it, is a critical obligation
for doctors.
Referring to and relying on specialists for
follow-up is second nature for doctors. In this
case, the consultants happen to be CAS, says
Dr. Michelle Shouldice, the former director
of the SCAN (Suspected Child Abuse and
Neglect) Program at SickKids and head of the
Pediatric Medicine Division at SickKids. She
said CAS can assess concerns of abuse and
neglect in ways that physicians typically cannot – attending the home, for example.
Anyone can report that a child is in need
of protection. However, Ontario’s Child and
Family Services Act (CFSA) recognizes that
professionals working closely with children
have a special awareness of the signs of child
abuse and neglect, and a particular responsibility to make a report.
Under the CFSA, these individuals include
health-care professionals; teachers and school
principals; social workers and family counsellors; religious leaders; operators or employees
of child care centres; youth and recreation
workers, and child and youth service providers; peace officers; and coroners.
The duty to report was thrust into the spotlight after the tragic life and death of Jeffrey
Baldwin of Toronto in 2002. The result of
the Coroner’s Inquest into Jeffrey’s death was
reported in 2014 and the series of recommendations that came out of the inquest continue
to resonate to this day.
Jeffrey was born on January 20, 1997. He
suffered years of mistreatment by his grand-
parents, who had involvement with the child
protection system. On November 30, 2002,
Jeffrey died at age 5 years and 10 months. He
weighed 21 pounds, the same as when he was
2. Cause of death was pneumonia and septic
shock due to chronic starvation. His grandparents were convicted of manslaughter.
The Coroner’s Inquest jury made 103
recommendations, four of which focused on
the duty to report as set out under the CFSA.
Eight months after the jury reported, and 12
years after Jeffrey died, a life-size bronze statue
of him was unveiled in Toronto’s Greenwood
Park. He is dressed up as Superman, the
invincible hero who Jeffrey loved.
Living up to the duty
Recommendation #93 from the inquest called
on the CPSO to ensure doctors have ongoing
on-the-job training on the duty to report and
recognize signs of child abuse and neglect. As
a regulator, the CPSO doesn’t do such training. But it does communicate expectations via
policies, including one on Mandatory and
Permissive Reporting.
First, it’s vital to understand just who is a
child in need of protection. See the sidebar,
“When to Report”, for the list of what constitutes possible abuse or neglect. The duty to
report applies to any child who is, or appears
to be, under 16. It also applies to children
already under a child protection order who
are 16 and 17.
The term “reasonable grounds” is important. Under the CFSA, you don’t have to be
certain a child is or may be in need of protection to make a report to a CAS. As the Ministry explains, “Reasonable grounds refer to the
Continued on pg. 13
10
Dialogue Issue 3, 2015