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85 Medico-Legal J. 3 (2017)

handle is hein.journals/medlgjr85 and id is 1 raw text is: Medico-Legal Editorial Journal Medico-Legal journal 2017, Vol. 85(l) 3-4 @ The Author(s) 2017 Reprints and permissions: sagepub.co.ul/journalsPermissions.nav DOI: 10. 1177/0025817216684616 journals.sagepub.com/home/mlj SAGE Introducing our new Medical Editor As my mother used to tell me, 'When one door shuts another door opens'. And so it is with the Medico-Legal Journal now because Dr Daniel Haines (our new President) is stepping down after six years in the post. At all times he applied his keen and efficient and sharp eyes backed by his wide-ranging medical knowledge and clinical experience when assessing the very varied of submissions that come into the Journal from all over the world. We worked well as a team and I was always able to rely on him to provide prompt and sensible advice on the many medical issues raised or that needed to be discussed. However, Daniel's departure has opened the pro- verbial door to our new Medical Editor, Professor Harry Zeitlin who, coming from a different back- ground, also has extensive and wide-ranging experience in the medico-legal field. In the past, I have worked with Harry on professional cases and soon realised that his expert advice is highly respected and valued by all 'sides', as it is always well researched and unbiased by whoever instructs him. He brings this ethos and his expertise to our Journal. Diana Brahams, Editor Sexual abuse The papers are now full of allegations of past abuse within the sport of football. There has been the same about priests, teachers, entertainers, care workers etc. There will no doubt be inquiries with limited benefit and considerable cost yet again. Concern over the abuse of children has probably always been around, but investigation of physical abuse became more focused with the work of Kemp and Kemp in the 1940s followed by neglect, sexual abuse and psycho- logical abuse. There continue to be problems about all of these but sexual abuse seems to be of the greatest concern. Public interest has swung like a pendulum between overidentification and failure to protect. In the early 1970s the main attitude was if there is smoke there is a fire. The Cleveland inquiry in 1987 changed that and tried to introduce guidelines. There continue to be numerous inquiries. The current IICSA (independent inquiry into child sex abuse) has run into problem after problem, not the least being the rejection of chairmanship presumably as it is a poisoned chalice. Why on earth is this continuing and can we do anything to improve matters? There is a range of factors that can be identified as causing at least some of the muddle. One fundamental issue is that there are a wide variety of behaviours by perpetrators which are all appropriately under the title of sexual abuse. In the public eye, if it is 'sexual abuse' then it has particular damaging effects. However, there are a number of parameters that determine the nature and severity of impact. Those include duration over which the abuse is carried out, frequency, intrusiveness, penetration, painfulness and family closeness to the perpetrator. Photographing a child while changing for football does not have the same effect as penetrative rape even though both may give the same 'kick' to the perpetrator (and even though perpetrators of both should be dealt with by the court). Another aspect is the impact of the subject of abuse on the public audience. Sex is by the very nature arous- ing. We probably would not exist if it were not. But we do have a system of control by very strict boundaries, of which, for example, incest taboo is one. Are we now in a society in which those limits and boundaries are being blurred or removed? It is probable that the media are very involved in this. Forty years ago, a six-year-old having knowledge of sexual intercourse gave a high probability of inappropriate behaviour towards a child by an adult. Now, it is highly unlikely that a six-year-old would not have seen at least simulated sexual intercourse on television. The media leap at any opportunity to have a sexually related headline, often irrespective of the accuracy. It is not seen as unreasonable to sell spangled knickers for little chil- dren. It is surely much harder now for a person to say 'I will not cross that line'. Swings in the other dir- ection could be compensatory guilt. A further issue arises concerning the evidence given by children in cases brought against alleged abusers. 'The voice of the child must be heard.' Yes, almost certainly rightly so. That is how the child thinks and feels. But equating that with the statement of the child being an objectively accurate account is highly prob- lematic. Many papers have been written about chil- dren's perception of events, memories and what influences both of those. It is for example quite possible Editorial