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Understanding general practitioners' conflicts of interests and the paramountcy principle in safeguarding children
  1. Paul Wainwright1,
  2. Ann Gallagher2
  1. 1Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, Kingston upon Thames, UK
  2. 2The International Centre for Nursing Ethics, Faculty of Health and Medical Sciences, Division of Health and Social Care, University of Surrey, Guildford, Surrey, UK
  1. Correspondence to Professor Paul Wainwright, Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, Kingston Hill, Kingston upon Thames KT2 7LB, UK; p.wainwright{at}


As family physicians, general practitioners play a key role in safeguarding children. Should they suspect child abuse or neglect they may experience a conflict between responding to the needs and interests of the child and those of an adult patient. English law insists on the paramountcy of the interests of the child, but in family practice many other interests may be at stake. The authors argue that uncritical adoption of the paramountcy principle is too simplistic and can lead, paradoxically, to greater harm. They argue for a more subtle and nuanced view of interests and of conflicts of interest in safeguarding children.

  • Legal aspects
  • newborns and minors
  • professional–professional relationship

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  • Funding This study was funded by the Department of Education and Skills. However, the view expressed are the views of the authors and may not necessarily represent the views of the DH/DCSF.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the South East Multi-Centre Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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