Violence towards the vulnerable may be part of the human condition, and vulnerability increases the younger the victim. In recent wars more lives were lost at home from domestic violence than from injuries on the battlefield. Child abuse is common and has been throughout history. Although it has frequently gone unrecognized, increasing awareness and changing definitions have sometimes led to over-diagnosis.

Child abuse is both emotive and emotional. Doctors, lawyers and journalists are not immune. Some doctors have admitted fabricating evidence to support children's allegations [1], a position that has ill-served the profession, justice or children. The forensic examination must be impartial, independent and objective if miscarriages of justice are to be prevented. Indeed, the interests of justice require us to consider the possibility that the allegations are false. The courts place the child's needs paramount; it is the doctor's duty to remain impartial and assist the court in understanding medical information. The doctor must remain within their area of expertise. It is the lawyer's not the doctor's duty to act as advocate.

It is essential to be aware of precise definitions in law, understand the forensic principles, different types of injury and their causation as well as the natural history of healing and changes in appearance with time.

The severity of an injury does not indicate intent or mechanism. Accurately assessing the significance of an injury may be vital for the future of the child and family; relatively minor injuries can be more difficult to evaluate than gross injuries.