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Is it worse to diagnose child abuse when none has occurred, or to fail to diagnose it when it has taken place? There is no indubitably correct answer to this question and, given the fallibility of all human beings, mistakes are bound to occur in both directions.
The intrinsic uncertainty of the diagnosis in many cases, when suspicion exists but proof is lacking, gives rise to extreme anxiety among those who undertake child protection work. Moreover, a doctor, nurse or social worker who makes a mistake, and diagnoses child abuse when there has been none, is often vilified or even threatened with violence. It is hardly surprising that doctors in Britain increasingly refuse to undertake child protection work, for it is thankless and disagreeable.
A paper in the November edition of the Archives of Diseases of Childhood demonstrates that two-thirds of the
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| Burn-out is common among doctors, nurses and social workers charged with diagnosing child abuse |
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workers in the child protection services in Canada have thought seriously of leaving the field altogether and taking other work. They experience what is known as 'burn-out', which is defined as physical exhaustion, a sense of failure, indifference and increasing cynicism.
The paper does not address the question of whether workers in child protection suffer more burnout than other professional groups, for example journalists. One might almost say that burn-out is the permanent condition of many members of modern society.
There is no mention in the paper, either, of the kind of social conditions, for example serial step-fatherhood, that result in child abuse. Instead, it makes the usual plea for more resources to deal with the resultant mess. 
FIRST POSTED NOVEMBER 22
 Last week: suits of woe
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