Fatal Child Abuse and Neglect

Abstract

The Battered Child Syndrome broke the 102-year silence that followed the 1860 work on fatal child abuse by Ambrose Tardieu. Henry Kempe’s survey of child abuse polled hospitals and district attorneys. Both had more than 10% fatality. His reference articles had graphic descriptions of fractures and death. Severe injuries may have been necessary to get past the resistance that Dr. Kempe described with doctors that “tried to obliterate suspicion from their mind.” He put himself in the process describing an injured child from his hospital who was sent home, abused, and died. Dr. Kempe opened the door for more sophisticated injury studies, multiagency child fatality review teams, child death prevention, automated data systems, domestic violence fatality review, and elder abuse fatality review. New programs address child grief support and nonfatal severe injury review. We have surpassed his science but his courage, candor, and clarity are seldom matched.