Children’s welfare agencies are typically administered by state governments and are often colloquially known and abbreviated as CPS for “child protective services.” CPS involvement in children’s and families’ lives can be initiated by a range of professionals, including in health care, who exercise their duties as mandatory reporters of suspected neglect, maltreatment, or abuse. Systemic variation is introduced by a range of subjective, structural, social, and cultural factors that influence clinicians’ perceptions of clinical examination findings, understandings of laws and regulations that govern mandatory reporting, decisions about when and how to act, and what, exactly, to describe in a report. In clinical settings, these and other sources of uncertainty are exacerbated by common knowledge about CPS operations as fraught with inequity, overwhelming case volume, legal and procedural inefficiency, and lack of oversight. Some clinicians’ worry their reports could initiate a cascade of unintended, unforeseen consequences or abet racial, gender, and resource-based discrimination in how cases are investigated and adjudicated. This theme issue illuminates ethical, clinical, and legal questions about roles mandatory reports have played in promoting or undermining a child’s health over their entire lifespan.
Manuscripts submitted for peer review consideration and inclusion in this March 2027 issue must follow Instructions for Authors and be submitted by 30 April 2026.
The AMA Journal of Ethics® invites original, English-language contributions for peer review consideration on the upcoming themes.