Suspected child abuse: communicating with a child and her mother.

The purpose of this article is to explore and examine how the value judgments of the health professionals involved affected the interaction between themselves and a mother with her injured child who presented at an accident and emergency department. The interaction is depicted by means of a classroom role-play in which the "actors" are nurses. Analysis of the interaction demonstrates clearly how the perspectives of health professionals may be enshrouded by a miasma of suspicion. Indeed, by focusing on the actions of the mother rather than the needs of the child, suspicion gained momentum and finally entered the public domain. Encouraging health professionals to listen to what the child has to say goes some way to challenging the suspicion of abuse. Nonetheless, in the role-play analyzed, the mounting suspicion so antagonized the mother that an angry confrontation with the doctor ensued, the doctor being forced to make an embarrassing apology. Yet the interaction is so irredeemably prejudiced that it remains impossible either to confirm or reject the suspicion of abuse. Analysis of the interaction attempted to unravel some of the knots in which we, as health professionals, unfailingly tie ourselves when communicating with patients-knots of suspicion, labeling, conflict, embarrassment, and power that fail to anchor the humanity of "self" or others. Copyright 2002, Elsevier Science (USA). All rights reserved.