Child abuse is a common but underdiagnosed problem in our country. The abuse ranges from minor injury to severe head trauma. The true incidence of intentional head injury in children remains uncertain.
We published a case of child abuse with blunt head trauma with intracranial haemorrhage presenting as loss of consciousness simulating a diabetic ketoacidosis. We received a complaint from a reader about a photograph illustrating the case which showed details of the abuse (bruises and signs of abuse around the perineum but the upper half of the body was not visible). We believe the case report warranted that the photo be published.
However, the complainant argues that he believes it was wrong to publish the photograph at all and especially in its present explicit form. The complainant believes that publishing this photograph of the child is a violation of child’s human rights. The complainant also states that before publishing the photograph, he hopes the editors had obtained appropriate consent to publish.
Some members of the Forum questioned whether it was necessary to print the photograph of the child. Could the case have been described adequately without the photo? Although the photograph is already published, some suggested removing the picture from the online version of the journal. Others argued that as the editor believed overwhelmingly in the importance of this case and had published it in good faith, he should stand by his original decision. The father of the child had agreed to the photograph being published and the child had since died, so there was no issue of consent. Another suggestion was to write an editorial on the subject highlighting the issues involved.
Our editorial board decided not to delete the photo from the e-issue because it was thought that it was an important finding and it was necessary to keep it to educate our readers (doctors/paediatricians).