Ethical and legal obligations
When identifying whether abuse is occurring or has occurred, there is an ethical obligation to respond if you reasonably believe abuse is, or is likely to be, occurring. People with developmental disability have the same rights as others and should be empowered to exercise their rights, including the right to respect and dignity as an individual1.
Reporting abuse is integral to competent medical practice.
Consider whether the abuse or suspected abuse infringes any of the person’s rights; for example:
- to access community facilities and services including health care
- to live in the general community, and take part in activities enjoyed by the general community
- to achieve their maximum physical, social, emotional and intellectual potential, and to become as self-reliant as practicable
- to participate, to the greatest extent practicable, in decisions affecting their life
- to privacy and confidentiality.
People with developmental disability should be presumed to have capacity, except when there is a clinically identified deficit; see also Consent, capacity and decision making in people with developmental disability.
As a general practitioner, you may be considered a ‘mandatory reporter’ of abuse, depending upon the state or territory in which you practice; see the Australian Institute of Family Studies (AIFS) website. If you are a ‘mandatory reporter’, you are obliged to report suspected abuse of anyone under the age of 18 years to the relevant authority.
Consider confidentiality (eg who has access) when recording concerns in the person’s medical record, but also the need for others involved in the person’s care to be aware of safety concerns. Practitioners should seek legal advice if medical records are subpoenaed.