The emerging role of health care forensics in medical education: ethical, legal and educational challenges in identifying and providing patient-centered care for victims of child abuse and human trafficking

Abstract

The advents of child abuse and human trafficking in their various forms represent a serious crime and affects virtually every country in the world, where they not only represent an issue of the violation of the basic human rights and dignity of those persons affected but also impacts their families and loved ones who may be inadvertently left behind. While most instances of human trafficking have traditionally involved humans being coercively forced to enter into areas of sex and labor violations, the emerging area of illegal organ trafficking to support a growing need for organ transplantation procedures can now be included. While children and younger adults are the most commonly affected segments of the population for some categories of trafficking, globally human trafficking may impact victims of diverse backgrounds of any age, gender, race, ethnicity, culture, or persuasion, and may present in the clinic accompanied or unaccompanied for urgent care. When presenting, a patient may exhibit cardinal signs, symptoms and clinical stigmata that may be of a suspicious nature and be indicative of further investigation to include reporting the issues to competent authorities especially when the victim is an infant or considered a minor, less than 18 years of age in most countries. Since the health care professional is often in a position to become the first point of contact where symptoms and stigmata of human trafficking, child abuse, and other signs indicative of abuse are apparent, additional modules in health care forensics would be a welcome addition to medical curricula and public health perspectives for physicians and other members of the healthcare team. Thus, the purpose of the present paper was to review the characteristics of human trafficking and abuse, to summarize key areas of legal, medical, and administrative responsibility in order to ensure availability of optimal and appropriate patient-centered care of victims, and to emphasize the need for inclusion of modules in forensic medical education in medical curricula.