How a Doctor Should Address Molestation Issues

Questions
1
Yes, it is appropriate. Sometimes people need care but are embarrassed to seek it out or their situation does not enable them to get to traditional clinics. For the case of women living in shelters or in extreme poverty, it can be difficult to obtain medical care because they may lack the funds to pay for it, they may lack awareness of the fact that they need care, or they may be hampered by social or environmental issues that keep them from reaching out for help. Sometimes people need to see first that there are others outside of their own small world who are willing to enter in and offer assistance. This has been shown to be the case with educators who make home visits and the same is true for physicians (Ventura et al., 2014).
2
Genital warts are spread through skin-to-skin contact and cannot be spread any other way. They must come from contact with the genitals (Genital Warts, 2017). The doctor feeling relief about the mother’s story of the boy in the shower stall shows a significant degree of gullibility on the part of the doctor, at least in that moment. It sounds like she did not want to face the issue any more than the mother did.
3
Dr. Vicky’s struggle is certainly understandable but it is also regrettable. The situation she was in with the mother was undoubtedly uncomfortable but as a physician, she should have known immediately that the boy was being molested. She should not have allowed the mother to leave with the son because who knows what could happen next? They might have fled the shelter and the boy could still be in harm’s way.
4
Being an advocate is about publicly promoting a cause that you believe to be important. Going to the shelter to help provide quality care to the homeless is a good cause—and Dr. Vicky clearly wanted to show advocacy in this way. However, she was not mentally prepared for some of the issues she might find there—such as child endangerment. She was not betraying the family by alerting the authorities; rather, she was betraying the cause by accepting the “shower stall” excuse as an out. A doctor can remain an advocate while also reporting crimes because a crime is a crime; criminals should not be protected just because reporting them means that the family gets to stay together. If a family is under assault, external help needs to be called in; not doing so is a dereliction of duty.
5
If I were in the Department of Children Services and had this case, the intervention I would suggest would be an immediate recourse to therapeutic care, as recommended by the National Research Council (1993). However, I would also recommend that temporary housing be given to the child and assistance to the mother while the case is resolved. Clearly there are signs of molestation and that needs to be investigated to see where it is occurring and who is the culprit. If the activity is being done at the shelter, a legal intervention needs to be imposed; if the culprit is unknown, the mother and the child should receive counseling/therapy to deal with the attendant issues that are likely to be taking place alongside this discovery. Aside from the obvious medical treatment that the child needs, the psychological trauma that the child has received will need to be addressed, so some form of therapeutic counseling should be delivered along with the possibility of family counseling.

References
Genital Warts. (2017). Planned Parenthood. Retrieved from
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/genital-warts
National Research Council. (1993). Understanding Child Abuse and Neglect.
Washington, DC: The National Academies Press.
Ventura, A. et al. (2014). Home-based palliative care: A systematic literature review of
the self-reported unmet needs of patients and carers. Palliative Medicine, 28(5): 391-402.