12 September 2011

Dear Editor,

The viewpoint by Professor Kim Oates1 and your editorial2 are a timely challenge to Australia and Australian paediatricians regarding our ongoing acceptance of the use of physical punishment for child discipline. It has been long been an issue where I have hoped to see paediatricians take the lead, as happened in the UK more than a decade ago (‘Children are Unbeatable!’ alliance 19983). Sadly, in past years I have found that there is not even consensus amongst paediatricians that physical punishment should not be acceptable.

Like many I see this issue from both a personal as well as a professional point of view. I was the recipient of only occasional smacks from my father as a child and the ‘strap’ once from a teacher at school. As a young father over a decade ago, I had also occasionally resorted to smacking my own first two children. Those few times invariably resulted in making me just as miserable as the child subjected to the smack – upset at what I had resorted to. Interestingly on 1 January 2000 both my wife and I came to the same (millennial) New Year's resolution – that we would never again resort to any physical punishment of our kids. It remains one of my few successful New Year's resolutions, and one that has given me enormous pride and relief. By not smacking, we have been able to point out effectively and without any embarrassment to our children that we don't allow violence (i.e. ‘hitting your brother/sister/other’) in our house.

For most of the last decade I took a twice-yearly junior medical staff tutorial on child protection using case scenarios. One involved a teenager who had been struck by his father with a belt, leaving obvious bruising. I used this to lead into a discussion on physical punishment – including a question on who believed that physical discipline was acceptable. I indicated that they could define what that physical punishment consisted of, and usually a third to a half of the group answered in the affirmative. I then challenged that group to come to a consensus on defining acceptable physical discipline – age range of children who can be struck; the amount of force used; timing – immediate or delayed; the state of mind of the punisher – angry (i.e. immediate?) or detached (i.e. delayed?); use of an open hand, implement or other; the part of body to be struck – whether it should be clothed or unclothed; etc. It became very clear that even in a group of similarly aged, well-educated young doctors, you cannot find a common opinion on defining an acceptable physical punishment of children.

There is only one clear line that one can draw when it comes to striking children – we should not do it. As Kim Oates points out so eloquently, ‘the only humans that it is still legal to hit are the most vulnerable ones, our children’. And as a profession we should be able to stand up and say such. We cannot keep going on with the argument that it was OK for our generation as children (or that of our parents) and ‘it never did us any harm’. It is up to us as paediatricians to make the issue about children and their rights and advocate for their now and their future. Our current position is now 10 years old and does not go far enough – concluding that ‘the use of force, either physical force or psychological threats, is an ineffective and unhelpful method of punishment and discipline of children’.4 Laws against physical discipline of children should be on the agenda for the Paediatrics and Child Health Division of the RACP and we need to partner other key organisations to achieve that goal.