By 1990, mandatory reporting of suspected child sexual abuse had been adopted in all 50 states. This paper describes the authors' experience with the introduction of the law at the Johns Hopkins Sexual Disorders Clinic in Maryland.
Prior to mandatory reporting, physicians at the clinic were able to accept disclosures from patients with complete confidentiality. This was very important, as it often enabled timely intervention to prevent further abuses. After mandatory reporting became law, none of the patients disclosed relapse into sexual abuse of children, according to the paper.
In reality, I wonder about that, though. It seems to me that many conscientious therapists would accept such disclosures and ignore the law. Of course, such disclosures would not be reported in the paper.
The paper presents empirical evidence that the changes dramatically reduced the frequency of patients' disclosure of child sexual abuse that occurred while the patients were in treatment; that the changes dramatically reduced the frequency of disclosure of abuse that occurred before treatment; that the changes dramatically reduced the number of adults who were coming forward to report previously undetected abuse; and that the changes had absolutely no positive impact on the number of child victims identified by patient disclosures. In plain English, the changes were a bust.
The disclosure laws still contain a number of loopholes. For example, in many cases, disclosing to a doctor in another state is not subject to them. For people who have disclosures to make, my advice is to find out beforehand what laws apply, and never to just assume that it is safe.
The most disturbing thing about the paper is that it demonstrates the willingness of society to curtail the civil rights of pedophiles, even at the expense of interfering with treatment, and ultimately endangering children.
The Maryland law was actually introduced in two stages. At first, there was a loophole exempting disclosures of patients in active treatment and meeting other conditions. The authors make a convincing case that this exemption makes sense. However, opponents of the bill did not see it that way. They labelled it the "Pedophile Protection Bill," and closed the loophole within a year. I take this as an indication of the public mood, which is becoming increasingly hostile to pedophiles. No matter whether you think adult/child sex is absolute good, absolute evil, or somewhere in between, society is not doing a very good job handling it.
Peace,
Somebody Somewhere