This document primarily concerns medical confidentiality dilemmas when a doctor becomes aware of abuse or risk of abuse to a child. The document brings together previous guidance to multiagency child protection networks and views from the General Medical Council and other bodies on medical confidentiality. The main impact on the work of general psychiatrists, who have a responsibility to their patients, and general practitioners, who have a responsibility to all family members, is likely to be whether to inform statutory agencies about knowledge of abuse or risk of such to a child, as well as how to participate in multiagency child protection case conferences. The core principle of the document is that "the needs of the child must always be regarded as of first importance." Doctors who are unsure about whether their concerns have reached a critical threshold are advised to "consult through an established mechanism" with a "designated doctor" who is experienced in the child protection field and then, if appropriate, to be prepared to share their concerns with a statutory agency. The document does contain some areas of ambiguity, particularly in using the word "usually," without adding further guidance on what circumstances would require doctors to override their ethical tradition of confidentiality. 3 references