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"Well, my God, this is the second incest case I've seen in [then] 23 years of practice" I don't believe this. Either the doc has deliberately kept his eyes sh

"Well, my God, this is the second incest case I've seen in [then] 23 years of practice" I don't believe this. Either the doc has deliberately kept his eyes shut or hasn't spent much time talking to patients. Incest, a term wide than but inclusive of most 'child abuse', is far more widespread than laypersons realize. Docs see it regularly and geneticists debate the ethics of tests any test which might reveal family secrets. http://blogs.nature.com/spoonful/2011/02/qa_the_insidious_and_incestuou.html http://blogs.nature.com/spoonful/2011/02/qa_the_insidious_an...

zzalpha 12y ago
And yet this very post describes incest as "relatively rare". Now maybe folks don't realize that still means it's more common than they might expect. But the article doesn't seem to support the claim that " docs see it regularly", unless I missed something (which is entirely possible).
- scintill76 12y ago
  I noticed this too. To give the benefit of the doubt, it's hard to know what that sentence means, because of some ambiguity over whether it's about a) only incest that results in a child, b) "routine genetic tests" detecting incest, c) "rare" as in, say, "only" 3% of babies are the result of incest, which would still probably surprise a lot of people. (I'm not even sure what percentage I would personally expect or be surprised by.)
  - sandworm 12y ago
    Rare is a difficult term to nail down. I was taken aback by the statement that he had only seen two cases over 23 years. To think of how not-rare it is, think of all the heterosexual child abuse that goes on within families. Child abuse is not considered rare. But how many of those abuses might result in pregnancies? Any doctor who deals regularly with young people, specifically young girls who might be pregnant, sees this regularly if they care to look. The pregnant teenager whose boyfriend "isn't around anymore" is a non-rare situation. Some subset of those are pregnant by their fathers/brothers. The problem is that asking, or performing tests that might identify the true father, may do more harm than good. So doctors don't push the matter. That doesn't mean they do not suspect what's going on. What do you say to a girl pregnant by her brother? Termination is not a great option, the kid may well be healthy. Reporting the abuse, breaking up the household, isn't going to help either. From the doctor's perspective there isn't much they can do.
    - DanBC 12y ago
      > What do you say to a girl pregnant by her brother? Termination is not a great option, the kid may well be healthy. Reporting the abuse, breaking up the household, isn't going to help either. From the doctor's perspective there isn't much they can do. This attitude, while understandable, is very damaging. You report the abuse. You do so because your professional registration probably tells you to; there might even be mandatory laws requiring you to; and because you know that you do not have access to reports from other agencies (police, school, sexual health clinics, etc) and so you cannot understand the whole picture. You're right that interventions for abused children are appalling and that looked after children have some pretty lousy outcomes (shorter life, lower quality of life, increased mental illness, increased risk of death by suicide, increased criminal behaviour, etc etc etc)
      - sukilot 12y ago
        You advocate handing the matter over to government, even though you know government fails to handle it better than not? That's cruel.
scintill76 12y ago
Well, he then opened his eyes and/or talked to them more: > "And so I started routinely inquiring about childhood sexual abuse, and I was really floored." > More than half of the 300 or so patients said yes, they too had been abused. Are you saying you're surprised it took 23 years for him to notice? How long should it take, then? I know nothing of his professional background, but don't you think it's possible certain types of doctors are less likely to "see it regularly" than others?
dang 12y ago
> Either the doc has deliberately kept his eyes shut or hasn't spent much time talking to patients. That's a terribly unfair dismissal, only possible because you cut the quote in half. Here's what he really said: "You know, I remember thinking, 'Well, my God, this is the second incest case I've seen in [then] 23 years of practice,' " Felitti says. "And so I started routinely inquiring about childhood sexual abuse, and I was really floored." "Floored" clearly means he found it was more common than he expected—so much so that he devoted the rest of his career to studying its effects. This was in the 1980s—those are the first three words of the article. Widespread awareness of this was just getting started then. It looks to me like this guy was one of the researchers who pioneered that awareness, and you're criticizing him for lacking it.
stefantalpalaru 12y ago
> Incest [...] is far more widespread than laypersons realize. Maybe in West Virginia. In most of the world it's a very rare occurrence.
DanBC 12y ago
I remember "Stranger danger" - people were fixed on the idea that child abuse was something that was caused by someone outside the family. Even today most people don't know that the person most likely to harm a child is their sibling.

zzalpha 12y ago

And yet this very post describes incest as "relatively rare". Now maybe folks don't realize that still means it's more common than they might expect. But the article doesn't seem to support the claim that " docs see it regularly", unless I missed something (which is entirely possible).

scintill76 12y ago
I noticed this too. To give the benefit of the doubt, it's hard to know what that sentence means, because of some ambiguity over whether it's about a) only incest that results in a child, b) "routine genetic tests" detecting incest, c) "rare" as in, say, "only" 3% of babies are the result of incest, which would still probably surprise a lot of people. (I'm not even sure what percentage I would personally expect or be surprised by.)
- sandworm 12y ago
  Rare is a difficult term to nail down. I was taken aback by the statement that he had only seen two cases over 23 years. To think of how not-rare it is, think of all the heterosexual child abuse that goes on within families. Child abuse is not considered rare. But how many of those abuses might result in pregnancies? Any doctor who deals regularly with young people, specifically young girls who might be pregnant, sees this regularly if they care to look. The pregnant teenager whose boyfriend "isn't around anymore" is a non-rare situation. Some subset of those are pregnant by their fathers/brothers. The problem is that asking, or performing tests that might identify the true father, may do more harm than good. So doctors don't push the matter. That doesn't mean they do not suspect what's going on. What do you say to a girl pregnant by her brother? Termination is not a great option, the kid may well be healthy. Reporting the abuse, breaking up the household, isn't going to help either. From the doctor's perspective there isn't much they can do.
  - DanBC 12y ago
    > What do you say to a girl pregnant by her brother? Termination is not a great option, the kid may well be healthy. Reporting the abuse, breaking up the household, isn't going to help either. From the doctor's perspective there isn't much they can do. This attitude, while understandable, is very damaging. You report the abuse. You do so because your professional registration probably tells you to; there might even be mandatory laws requiring you to; and because you know that you do not have access to reports from other agencies (police, school, sexual health clinics, etc) and so you cannot understand the whole picture. You're right that interventions for abused children are appalling and that looked after children have some pretty lousy outcomes (shorter life, lower quality of life, increased mental illness, increased risk of death by suicide, increased criminal behaviour, etc etc etc)
    - sukilot 12y ago
      You advocate handing the matter over to government, even though you know government fails to handle it better than not? That's cruel.

scintill76 12y ago

Well, he then opened his eyes and/or talked to them more: > "And so I started routinely inquiring about childhood sexual abuse, and I was really floored." > More than half of the 300 or so patients said yes, they too had been abused. Are you saying you're surprised it took 23 years for him to notice? How long should it take, then? I know nothing of his professional background, but don't you think it's possible certain types of doctors are less likely to "see it regularly" than others?

dang 12y ago

> Either the doc has deliberately kept his eyes shut or hasn't spent much time talking to patients. That's a terribly unfair dismissal, only possible because you cut the quote in half. Here's what he really said: "You know, I remember thinking, 'Well, my God, this is the second incest case I've seen in [then] 23 years of practice,' " Felitti says. "And so I started routinely inquiring about childhood sexual abuse, and I was really floored." "Floored" clearly means he found it was more common than he expected—so much so that he devoted the rest of his career to studying its effects. This was in the 1980s—those are the first three words of the article. Widespread awareness of this was just getting started then. It looks to me like this guy was one of the researchers who pioneered that awareness, and you're criticizing him for lacking it.

stefantalpalaru 12y ago

> Incest [...] is far more widespread than laypersons realize. Maybe in West Virginia. In most of the world it's a very rare occurrence.

DanBC 12y ago

I remember "Stranger danger" - people were fixed on the idea that child abuse was something that was caused by someone outside the family. Even today most people don't know that the person most likely to harm a child is their sibling.