A MAJOR CONFLICT OFTEN ARISES BETWEEN HEALTH PROFESSIONALS AND THE LEGAL SYSTEM WHEN A CHILD ABUSE CASE ENTERS THE COURTS. A PHYSICIAN, SOCIAL WORKER, OR PSYCHOLOGIST WHO HAS WORKED WITH THE BATTERED CHILD IS OFTEN OUTRAGED WHEN THE LEGAL SYSTEM SEEMS TO VIOLATE ALL EFFORTS TO PROTECT THE CHILD. OFTEN THIS SITUATION IS AGGRAVATED BY THE FRAGMENTATION OF ABUSE LAWS AND DISCUSSIONS OVER WHETHER THE TRIAL SHOULD BE HANDLED AS A CIVIL OR CRIMINAL CASE. DESPITE FEELINGS OF HEALTH PROFESSIONALS, THE ULTIMATE DISPOSITION OF THE CHILD IS A MATTER OF LAW. GUIDELINES ARE GIVEN FOR WORKING WITHIN THE FRAMEWORK OF THE LAW IN SUCH CASES. THE CASE MAY BE HEARD IN CRIMINAL COURT, IN WHICH CASE THE RULES OF EVIDENCE ARE STRICTLY FOLLOWED. IF THE CASE IS HEARD IN JUVENILE COURT THE SITUATION MAY BE MORE FLEXIBLE AND THE CHILD MAY BE JUDGED 'IN NEED OF ASSISTANCE.' THIS ALLOWS FOSTER HOME PLACEMENT WITHOUT THE BITTERNESS OF A FULL TRIAL. PHYSICIANS SHOULD FILE A REPORT AS SOON AS ABUSE IS SUSPECTED. THE HOSPITAL COORDINATOR OF SOCIAL SERVICES SHOULD BE RESPONSIBLE FOR FOLLOWUP ON THE REPORT. EXTRAORDINARY CARE SHOULD BE TAKEN IN RECORDING INJURIES AND TREATMENT. THE CONFIDENTIALITY OF THE PATIENT-PHYSCIAL RELATIONSHIP IS DISCUSSED. IT IS POINTED OUT THAT IN ABUSE CASES THE CHILD IS THE PATIENT, NOT THE PARENT, AND THE PHYSICIAN SHOULD ACT IN THE BEST INTERESTS OF THE CHILD. CHART REVIEWS ARE RECOMMENDED FOR YOUNG CHILDREN WHO ARE SEEN FREQUENTLY FOR ACCIDENTS. OFTEN ABUSE IS A PATTERN WHICH BECOMES APPARENT OVER TIME. HOSPITALS SHOULD BE PREPARED TO SET UP A TEAM TO HANDLE CHILD ABUSE CASES. THIS TEAM SHOULD HAVE A PEDIATRICIAN, PSYCHIATRIST, PSYCHOLOGIST, SOCIAL WORKER, AND A LAWYER AND SHOULD COORDINATE ALL SUBSEQUENT ACTIONS. THE SOCIAL WORKER USUALLY GOES INTO COURT AS THE WITNESS. THE MEDICAL RECORDS ARE USUALLY SUBPOENAED. A JUNIOR HOUSE STAFF PHYSICIAN OFTEN TESTIFIES, BUT CAN BE PERCEIVED AS OUTRANKED BY A DOCTOR WITH MORE CREDENTIALS BROUGHT FORWARD BY THE DEFENSE. THE VARIOUS TYPES OF HEARINGS ARE EXPLAINED. MUCH DEPENDS UPON THE PHILOSOPHY OF THE COURT. IN THE FAMILY COURT OF NEW YORK THE PARENT HAS THE OBLIGATION OF EXPLAINING AWAY THE INJURIES. OTHER COURTS HAVE VARIOUS INTERPRETATIONS OF THEIR RESPONSIBILITY. FOLLOWUP IS OFTEN REQUIRED AFTER FOSTER HOME PLACEMENT. AGAIN, THE HOSPITAL SHOULD HAVE A COORDINATOR TO HANDLE SUCH MATTERS. A BIBLIOGRAPHY IS INCLUDED. (GLR)