title: Relevance of medical reports in criminal investigations of cases of suspected child abuse.
abstract: If a case of physical child abuse is suspected in Germany, the general feeling is often that "it does not matter whether you make a report or not" because, generally, no conviction is made anyway. This study investigates the juridical analysis of complaint cases of physical child abuse [criminal complaint parag. 225 StGB (German penal code) with filial victim]. It focuses on the doctor's role and the impact of their practice in relation to a later conviction. It is based on the analysis of 302 files of the enquiry from 2004-2009 from the department of public prosecution in Cologne, Germany. Besides general epidemiological data on the reporting person, the affected child and the presumed offender, the documents were reassessed for the relevance of medical reports for successful convictions. Only 7% (n = 21) of 302 complaints led to a conviction. In 38.1% (n = 8) of those cases, a medical report was mentioned as a piece of evidence, and just in two cases a (legal) medical report was quoted and mentioned as relevant for the conviction. 50% of the complaint cases with legal medical expertise led to a trial. In contrast, only 30.2% with a common medical report and 7.3% without a report led to a trial. The results show how a medical report existed in only a few cases. In those cases, the rate of performed trials was higher than for those without a medical report, but the report played a minor part when reasoning a verdict.
authors.affiliation: Institute of Legal Medicine Medical Faculty, University of Cologne, Melatengürtel 60/62, 50823, Cologne, Germany. katharina.janssen@uk-koeln.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Janßen
authors.affiliation: Institute of Legal Medicine Medical Faculty, University of Cologne, Melatengürtel 60/62, 50823, Cologne, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Greif
authors.affiliation: Institute of Legal Medicine Medical Faculty, University of Cologne, Melatengürtel 60/62, 50823, Cologne, Germany.
authors.forename: Markus A
authors.initials: MA
authors.lastname: Rothschild
authors.affiliation: Institute of Legal Medicine Medical Faculty, University of Cologne, Melatengürtel 60/62, 50823, Cologne, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Banaschak
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000331:legislation & jurisprudence*; D002655:Child Custody / Q000706:statistics & numerical data; D000068216:Child Protective Services; D002675:Child, Preschool; D004282:Documentation / Q000706:statistics & numerical data*; D017579:Domestic Violence / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006236:Handwriting; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D010819:Physician's Role; D014947:Wounds and Injuries / Q000453:epidemiology
keywords: Burden of proof; Conviction; Legal medical expertise; Medical report; Physical child abuse