Do No Harm. Part 1. A devastating diagnosis

Summary

Reporters in the US from the Houston Chronicle and NBC News spent nine months examining more than 40 cases and spoke with more than 100 attorneys, doctors and current and former state employees. Their reporting reveals that some doctors have diagnosed child abuse with a degree of certainty that critics say is not supported by science.

This article, the first in a series, was published in partnership with NBC News.

Content

The reporting reveals a legal and medical system that sometimes struggles to differentiate accidental injuries from abuse, particularly in cases involving children too young to describe what happened to them. Physicians intent on protecting the most vulnerable in some instances have overstated the reliability of their findings, using terms such as “100 percent” and “certain” to describe conclusions that usually cannot be proven with absolute confidence. Child welfare workers, overworked and untrained in complex medical issues, are not always sure how to proceed when the primary evidence against a caregiver comes in the form of a doctor’s note.

Under this system, children are sometimes taken from seemingly caring parents, while others are left in situations that, in rare cases, turn out to be deadly.

Parents managed to regain custody in most of the cases reviewed by reporters, in some instances after additional medical findings or reports from outside experts raised doubts about the initial abuse determination. Nevertheless, some parents lost jobs or faced financial ruin as the result of their fights with Child Protective Services, and a few children emerged from foster care suffering from depression or other health issues. In a few instances, caregivers were charged criminally or had their parental rights permanently terminated, despite questions about the doctors’ findings in their cases.