Re: screening questions for abuse vs. harsh discipline

[Des Runyan <drunyan@xxxxxxxxxxx>]

my thoughts:  How will a parent respond to the question of leaving a mark?
The likely response to a normal spanking is a red area in which there is
capillary dilitation.  This change may be visible for several hours.  Does
this constitute a "mark?"  If you mean a bruise you need to be more
specific than just asking about a mark.  A bruise may not fully capture the
common understanding either since a switch mark may not meet a non-medial
person's idea of a bruise.  My suggestion would be to ask if the spanking
left a mark that was still visible the next day.  The other problem with
this definition is that the child's physiology is involved in defining the
problem as abuse instead of just the act alone.  A child with hemophilia, a
platelet disorder or other bleeding condition may bruise while another
child, the recipient of the same act, may not bruise.  Defining abuse by
consequences instead of by the act may be easier but conceptually it
confuses the issue.

We had a child who was spanked by his mother while standing alongside an
ironning board.  He dropped to the floor to protect his butt during the
spanking and dislodged the iron from the ironining board and it dropped
into his lap.  This was reported by the child and witnessed by another
child.   The resulting burn was not intentional but the child was injured
in a way that was both serious and the direct result of the attempt to use
discipline.  Is this nelect for disciplining him in a dangerous place,
physical abuse by burning, or an unintentional injury complicating normal
discipline practices?  My thought is that we need to focus on the parental
intention and action and not the consequences in defining the problem.  I
called this neglect (and stupidity) while a colleague focused on the result
and argued that this was physical abuse.

Des

>If a person answered yes to any of the three questions they are
>using corporal punishment.
>
>>1) Have you spanked your child more than once in the previous
>month?
>>2) Have you ever felt like you have lost control while spanking
>your child?
>>3) Have you ever left a mark from spanking your child?
>
>Although I am aware that there is disagreement about the meaning
>of  abuse among people on this list, answering yes to either
>question two or three constitutes abuse, I think even by
>strictest definitions.  In my opinion, based upon my definition
>of nurturing and abuse (i.e. misuse of parental power intended to
>nurture a child), answering yes to number one is also abuse.
>
>Distinguishing between "harsh discipline" and abuse seems as
>convoluted as trying to distinguish between malnourishment and
>starvation--neither is an appropriate way to nurture another.
>
>Jerry Jensen
>Executive Director
>CedarBrook Center www.cedarbrook.gen.mn.us (under construction)
>email: jensenje@cedarbrook.gen.mn.us


___________________________________________________________________________
Desmond K. Runyan, MD, DrPH                             	tel. (919)
962-1136
Professor and Chair of Social Medicine                	fax (919) 966-7499
Professor of Pediatrics
Campus Box 7240
	e-mail:<drunyan@med.unc.edu>
University of North Carolina School of Medicine
Chapel Hill, NC  27599-7240
___________________________________________________________________________