Reporting abuse has been a legal and ethical dilemma in the healthcare system for years. Some doctors, nurses, and other healthcare workers are quick to report abuse, while others are more reluctant to report abuse for fear of overreacting to an event. This leaves children and the elderly in an unknown state of protection from their attackers. Although these medical personnel are reluctant to report abuse, approximately 2,000 child deaths due to abuse are reported each year. Among the elderly, the number of deaths is uncertain. In the case of the elderly, medical examiners have difficulty distinguishing possible abuse from normal health problems and injuries. It has been noted that most older adults who report abuse are typically twice as likely to die within a year of reporting compared to older adults who have not experienced abuse. A doctor's suspicion of child abuse or neglect does not declare that a child has been undeniably abused or neglected; this is just a red flag indicating that further investigation into the child's care should be made. Doctors are not very forthcoming in reporting some cases. They feel too close to their parents, don't trust state child protective services, or aren't sure the tests aren't the result of an undiagnosed condition. There has been a change since 2009 that helps resolve these dilemmas. There are now certified specialists known as child abuse pediatricians. These specialists can provide additional knowledge when an event involving a child is in question. The number of child abuse and neglect cases reported each year is unacceptably high, and with specialists becoming available to help in these cases, initial care dilemmas are reduced. .Works CitedBlock, R.W. (2010, June 28). Child abuse requires specialized treatment and reporting. American Medical News. Retrieved from http://www.amednews.com/article/20100628/profession/306289942/5/Dybuncio, M. (2012, February 6). Child abuse causes thousands of hospitalizations and deaths. CBS News. Retrieved from http://www.cbsnews.com/8301-504763_162-57371829-10391704/child-abuse-causes-thousands-of-hospitalizations-deaths/Gordon, S. (2009, August 4). Elder abuse and neglect make premature death much more likely. US News & World Report. Retrieved from http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2009/08/04/elder-abuse-neglect-make-early-death-far-moreWilliams, ME (2006, May 24). The ethical challenges of elder abuse. Internal Medicine Medscape. Retrieved from http://www.medscape.org/viewarticle/532943