Peer-reviewed article
Discrepancy Between Clinical Suspicion and Legal Outcomes in Suspected Child Abuse: A 10-Year Single-Center Study.
Jang HR, Lee CJ, Back JH, Kim EY, Cho J et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined 83 children evaluated for suspected abuse at a Korean hospital over 10 years, using a standardized screening tool. Despite clinical suspicion, 40% of cases were not pursued legally, and nearly half of the most severe cases (requiring surgery, intensive care, or resulting in death) were deemed to have 'no suspicion.' A 2021 policy change slightly improved these outcomes, but a significant gap remains between what doctors identify and what the legal system investigates.
Key points
- 39.8% of clinically suspected child abuse cases were determined as 'no suspicion' by authorities
- 45.8% of severe cases (requiring surgery, intensive care, or resulting in death) were classified as 'no suspicion'
- Mechanical injury was the most common type of abuse identified (n=68 of 83 cases)
- A 2021 policy reform reduced the 'no suspicion' rate from 45.7% to 37.8%
- Mean age of evaluated children was 4.3 years
Limitations
This is a retrospective single-center study from one hospital in Korea, so findings may not represent all child abuse cases nationally or internationally. The document does not explain why authorities determined cases as 'no suspicion' or what factors influenced legal outcomes.
Abstract
Despite mandatory reporting, many suspected child abuse cases never proceed to formal investigation in Korea. We retrospectively reviewed 83 pediatric patients evaluated for suspected child abuse at a tertiary hospital between 2015 and 2025, screened using the Finding Instrument for Non-accidental Deeds score, and analyzed clinical characteristics, injury severity, and investigative outcomes. The mean age was 4.3 years, and mechanical injury was the most common abuse type (n = 68). Twenty-four patients (28.9%) were severe cases requiring surgery or intensive care or resulting in death. Overall, 33 patients (39.8%) were determined as 'no suspicion,' including 11 of 24 severe cases (45.8%); this proportion decreased from 45.7% to 37.8% after the 2021 policy reform. A critical gap persists between medical recognition of child abuse and the legal response, warranting closer integration of clinical assessment with child protection and investigative systems.