Alyce Horstman^1,2, J Anne S Smith^1,2, Richard B Bassed^2,3, Lyndal Bugeja²

¹Victorian Forensic Paediatric Medical Service, Royal Children’s Hospital, Melbourne, Australia; ²Department of Forensic Medicine, Monash University, Melbourne, Australia; ³Victorian Institute of Forensic Medicine, Melbourne, Australia

 

Background: Paediatricians play a vital role as expert witnesses in child maltreatment cases, providing insights on injury mechanisms, timelines, and consequences. However, the impacts of testifying on paediatricians remain underexplored.

Objective: This review aimed to systematically identify and synthesize research on the benefits and harms to paediatricians resulting from testifying in such cases.

Methods: A systematic scoping review was conducted following PRISMA-ScR guidelines.

Results: Testifying poses significant psychological and professional challenges for paediatricians. Individually, they face stress and anxiety, driven by fears of discreditation and litigation. Negative interactions with legal professionals, including harsh cross-examinations and scheduling difficulties, further compound these challenges and can affect future reporting of child maltreatment. Professionally, testimony disrupts clinical duties, incurs financial losses, and is hindered by insufficient training.

Conclusion: Evidence on the impacts of testifying in child maltreatment cases is limited and varied. There are significant gaps in the literature. However, the available findings indicate a considerable psychological, professional, and logistical burden for paediatricians who testify in cases of child maltreatment.