Keywords
violencia infantil, diagnóstico médico, medicina defensiva, responsabilidad profesional sanitaria, child violence, medical diagnosis, defensive medicine, medical liability
Aspectos jurídicos del diagnóstico clínico del maltrato infantil: error de diagnóstico y medicina defensiva
Abstract
La detección y confirmación de la violencia ejercida sobre un menor exige siempre del desarrollo de un proceso clínico de diagnóstico, lo que determina la necesaria participación de un profesional de la salud, médico y/o psicólogo. El diagnóstico es un elemento sustancial del tratamiento integral del maltrato infantil. Como tal proceso de diagnóstico conlleva necesariamente un riesgo para el profesional derivado de los posibles errores que puedan cometerse, tanto cuando no se acierta diagnosticando algo que realmente ha ocurrido, como cuando se diagnostica algo que no tuvo lugar, sino que es consecuencia de hechos ajenos a un acto de violencia como puede ser una patología que sufre el menor que deje heridas similares a las que ocasiona la violencia. Así pues, el error de diagnóstico de la violencia sobre el menor puede ser por defecto o por exceso. Incluso, este último supuesto es más frecuente de lo que pueda creerse, y ello, como consecuencia del fenómeno de la medicina defensiva que provoca que el profesional, ante el temor a ser demandado judicialmente, prefiere optar por considerar que el menor ha sido objeto de un acto de violencia, aun cuando los correspondientes signos sean poco expresivos y puedan enmarcarse en otro proceso clínico diferente.
The detection and confirmation of the violence on a minor always requires the development of a clinical diagnostic process, which determines the necessary participation of a health professional, doctor and / or psychologist. Diagnosis is a substantial element in the comprehensive treatment of violence over a child. As such a diagnostic process necessarily involves a risk to the professional arising from possible errors that may be committed, both when it is wrong to diagnose something that has actually occurred, and when something is diagnosed that did not take place, but is a consequence of other people's actions to an act of violence such as a pathology suffered by the child that leaves wounds similar to those caused by violence. Therefore, the misdiagnosis of violence on the child can be by default or by excess. Even, the misdiagnosis by exccess is very frequent as an expression of defensive medicine that causes the professional prefers to consider that the minor has been the object of an act of violence, even when the corresponding signs are not very expressive and can be framed in a different clinical process.
The detection and confirmation of the violence on a minor always requires the development of a clinical diagnostic process, which determines the necessary participation of a health professional, doctor and / or psychologist. Diagnosis is a substantial element in the comprehensive treatment of violence over a child. As such a diagnostic process necessarily involves a risk to the professional arising from possible errors that may be committed, both when it is wrong to diagnose something that has actually occurred, and when something is diagnosed that did not take place, but is a consequence of other people's actions to an act of violence such as a pathology suffered by the child that leaves wounds similar to those caused by violence. Therefore, the misdiagnosis of violence on the child can be by default or by excess. Even, the misdiagnosis by exccess is very frequent as an expression of defensive medicine that causes the professional prefers to consider that the minor has been the object of an act of violence, even when the corresponding signs are not very expressive and can be framed in a different clinical process.
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