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図書 |
図書
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東京都南多摩保健所編
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論文(リポジトリ) |
論文(リポジトリ)
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高塚, 尚和
概要:
子どもへの虐待が疑われ, 児童相談所に通告された件数は, 平成2年度, 全国において1,101件であったが, 平成22年度は55,152件と大幅に増加している. 虐待を受けている子どもの人権・生命を守り, 健全な発育・成長を支援していくため
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には, 虐待をすみやかに発見し, 児童相談所による的確な介入, 支援が重要であることは言うまでもない. しかし「虐待が疑われても, 虐待の事実に確信が持てず, 児童相談所へ通告しなかった事例」あるいは「児童相談所が事前に認知していたが, 適切な対応が取れなかった事例」が報告されている. 著者は, 前任の島根大学において, 平成19年6月より「島根県医療的機能強化事業」の一環として, 身体的虐待もしくはネグレクトが疑われ, 児童相談所に通告もしくは一時保護された子供を診察して, 損傷の性状およびその機序等を記載した診断書 (意見書) を発行する制度の立ち上げに携わり, 新潟においても, 平成22年4月から「新潟県児童虐待・DV防止処遇検討専門会議」の委員として, 身体的虐待が疑われ一時保護された子供の損傷の検査・診断を行っている. 法医学の視点から損傷を検査し記録に残すことは, (1) 虐待者に虐待の認識を持たせること (虐待事実の証明), (2) 虐待を受けた子供の一時保護並びに児童養護施設入所の根拠 (処遇会議の判断資料), (3) 刑事事件及び裁判の証拠 (虐待者に刑事罰を問うための資料) に活用することができる. 現在は, 主として肉眼的外表検査の所見に基づいて損傷を診断しているが, 今後は, エコー等を導入することにより, 科学的, 客観的な診断方法を研究・確立する必要があると考える.<br />The number of suspected child abuse cases that were reported to child consultation centers nationwide was 1,101 in 1990; however, it continued to increase rapidly and reached 55,152 in 2010. Needless to say, it is essential for child consultation centers to promptly discover cruelty to children and to provide appropriate intervention and support in order to secure the human rights and lives of the abused children and help their healthy growth and development. Meanwhile, there exist suspected cases that were not reported to the centers because of a lack of definite evidence of child abuse and cases that were reported but were not handled properly by the centers. From June, 2007, in a former post at Shimane University, and as part of the Shimane Medical Function Strengthening Project, the author was involved in both the examining of the children who were reported to or were in the temporary custody of child consultation centers because of suspected physical abuse or neglect and the issuing of medical certificates (written opinions) containing the description and mechanism of their injuries. In Niigata, too, the author has engaged in examining such children and making diagnoses of their injuries as a member of the Niigata Professional Committee for the Prevention of Cruelty and Domestic Violence to Children since April, 2010, It is significant to investigate and record the injuries of abused children from the viewpoint of forensic medicine in order to: (i) make child abusers recognize their cruelty (substantiation of cruelty to children); (ii) provide reasonable bases for the temporary custody by child consultation centers or accommodation in foster homes of abused children (assessment evidence for case conferences); and (iii) provide evidence for criminal cases and trials (material to impose criminal penalties on child abusers). Currently, an external macroscopic examination is the dominant method to diagnose the injuries of the children. However, in the future, more scientific and objective diagnosis methods must be studied and established by introducing medical methodology such as ultrasound techniques.
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