Last week, the New York Times published an interesting op-ed by Maxine Eichner, a professor of law at the University of North Carolina, entitled "The New Child Abuse Panic."
She cited the case of Justina Pelletier, a teen that was treated at Tufts and later at Boston Childrens Hospital for mitochondrial disease. Some of the doctors thought the symptoms were psychiatric and called in Child Protective Services.
Professor Eichner then goes on to relate an experience with her own teenage daughter, who developed a condition called POTS at age 13. Some doctors they consulted labelled the condition emotional. By age 18, she too had a diagnosis of mitochondrial disease - which was treated, and she is now in college.
This reminds us of a teen currently in our practice who, at the age of two weeks, was brought to a pediatrician with swollen arm. X-ray showed a fracture. Skeletal survey showed additional suspicious epiphyseal fractures. The child and her two year-old brother were taken from the parents - who had been completely cooperative with the authorities.
Eventually, the parents had to hire a pediatric orthopedic surgeon from a major medical center who testified that the x-rays had been over-read and did not show epiphyseal fractures.
Moreover, a little known condition called "Temporary Brittle Bone Disease of Infancy" (now recognized as vitamin D deficiency) might well have been involved with the arm fracture. The girl had been born in the spring -- when vitamin D is typically at its lowest level.
Suspected child abuse or neglect is a very sensitive, difficult matter. We second Dr. Eichner's conclusion:
We must protect children from the rare disturbed parent. But medical child abuse, as it has been understood, is far too big and blunt an instrument to accomplish this purpose.
It has harmed too many genuinely sick kids, and made life hell for too many loving parents. It is time to end the medical abuse panic.
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