The Real Cause Of The Broken Rib: Developments In Pediatricians\u27 Approach To Child Abuse; 1960 - 2020

In 1962, C. Henry Kempe published his landmark work, The Battered Child Syndrome, and set into motion a new discourse on child abuse within the American pediatrics community. This paper discusses the tension pediatricians felt between longstanding assumptions of parental virtue and the implications of the emerging conversation on child abuse started by Kempe. It also discusses the resistance shown by some pediatricians to accepting the reality of abuse and the slow process by which that resistance was overcome, aided by factors such as pediatricians’ involvement in adoption procedures. As pediatricians began confronting and understanding child abuse more deeply, their views of the ‘family’ and who they served became more nuanced and complicated. Their engagement in the conversation on child abuse therefore also influenced their thinking about related issues such as family privacy, corporal punishment, and children’s rights. This paper is based on an analysis of primary literature published in the journal Pediatrics between 1962 and the late 1970s, the historical period in which child abuse was explicitly named, defined, and discussed for the first time in the medical literature. Contemporary pediatricians continue to grapple with questions about children’s rights, shared decision-making, and the importance of minors’ consent. The COVID-19 pandemic has also brought the topic of child abuse to the forefront of pediatricians’ consciousness, as rates of abuse and neglect are suspected to be high given the stressors brought on by the pandemic and the interruption to in-person school attendance. Today, child abuse is an established part of the pediatric lexicon and pediatricians face the challenge of championing children’s rights while constrained by the limited resources health care has to address child abuse and neglect