The relevance of the Goudge inquiry to the practice of child protection/forensic paediatrics

• Forensic assessment of suspicious injury must meet legal standards.
• Forensic assessment usually cannot state abuse has occurred or is confirmed.
• Use of a default diagnosis of abuse in absence of explanation should not be used.
• Content of interim reports during an investigation differs from finalised report.
• Recommendations, adapted from Goudge are applied to child protection paediatrics.

In 2008 Ontario, Canada the Goudge Inquiry arose following increasing concerns about practices surrounding forensic pathology and the investigation of paediatric deaths. Some of the considerations and recommendations have relevance to child protection/forensic paediatricians, particularly in relation to their responsibilities in opinion formulation and as expert witnesses. By examining the Inquiry recommendations, this paper applies them in relation to child protection/forensic paediatrics by discussing forensic medicine and its legal context, how interpretation of published reports and data should be used in opinion formulation; issues of ‘diagnosis’ versus ‘opinion’; issues specific to child protection paediatrics; quality control; aspects of report writing and terminological considerations. It concludes with an adaptation of key recommendations directly from those of Goudge, applied to the context of paediatric forensic medicine undertaken in child protection assessments.