Is a pediatrician required to report a 14-year-old female patient's disclosure of sexual assault (rape) by a 14-year-old male that occurred three years prior in another state?

From the Guidelines

The pediatrician is likely required to report this disclosure, but the specific requirements depend on the state's mandatory reporting laws. Generally, healthcare providers must report known or suspected child abuse, which includes sexual abuse, even when it occurred in the past or in another state 1. While the alleged perpetrator was also a minor at the time, this doesn't typically exempt the incident from reporting requirements. The pediatrician should document the disclosure thoroughly and report to the appropriate child protective services agency in their current state. Some states have specific timeframes for reporting (usually 24-72 hours). The purpose of reporting is not punitive but to ensure the patient receives appropriate support services and to protect other potential victims.

Key Considerations

• The pediatrician should explain to the patient that they must report the disclosure while reassuring her that this step is taken to help her access resources for healing.
• The pediatrician should also assess the patient for ongoing safety concerns and mental health needs related to the trauma.
• According to the most recent guidance, pediatricians should be aware of the current reporting requirements related to sexual assault and state laws ensuring the rights of adolescents to obtain medical care at sexual assault or rape crisis centers in their states 1.
• The pediatrician should be knowledgeable about the specific resources available to respond to sexual assault and rape in their communities and when and where to refer adolescents for forensic medical examinations and sexual assault care as well as resources for teenagers with disabilities.

Reporting Requirements

• Healthcare providers must report known or suspected child abuse, which includes sexual abuse, even when it occurred in the past or in another state.
• The pediatrician should document the disclosure thoroughly and report to the appropriate child protective services agency in their current state.
• Some states have specific timeframes for reporting (usually 24-72 hours).

Patient Support

• The pediatrician should explain to the patient that they must report the disclosure while reassuring her that this step is taken to help her access resources for healing.
• The pediatrician should also assess the patient for ongoing safety concerns and mental health needs related to the trauma.
• Appropriate STI screening, PEP, treatment, and follow-up should be provided per CDC guidelines, including referrals for acute and follow-up testing and care 1.
• Emergency contraception should be offered to adolescent girl patients who disclose sexual assault if reported within 120 hours of the assault 1.

From the Research

Mandatory Reporting Requirements

• The provided studies do not directly address the specific scenario of a pediatrician being informed by a 14-year-old female patient about a rape that occurred three years prior in another state.
• However, the study 2 discusses the importance of recognizing, diagnosing, and preventing child maltreatment, which may be relevant to the pediatrician's situation.
• According to 2, child maltreatment cases are still not always diagnosed, and clinicians may lack experience or understanding of proper evaluation approaches.
• The study 2 also mentions that the evaluation and diagnosis of sexual abuse continues to evolve, with the literature providing advice about what is or is not normal on physical exam, as well as advice for providers who work with adolescent sexual assault victims.

Reporting Requirements for Pediatricians

• As a mandatory reporter, a pediatrician is required to report suspected child abuse or neglect to the appropriate authorities.
• However, the specific requirements for reporting may vary depending on the state or jurisdiction in which the pediatrician practices.
• The studies provided do not specifically address the reporting requirements for a situation like the one described, where the abuse occurred in another state three years prior.
• It is likely that the pediatrician would need to consult with local authorities or a child protection agency to determine the appropriate course of action in this situation, as suggested by 2.