Reporting abuse has been a legal and ethical dilemma for years in the healthcare system. Some doctors, nurses and other health care workers are quick to report abuse, while others are more reluctant to do so for fear of overreacting to an event. This leaves children and the elderly in an unknown state of protection against their attackers. Although these medical personnel are reluctant to report abuse, approximately 2,000 child deaths are reported each year due to abuse. Among the elderly, the number of deaths is uncertain. In the case of older adults, medical examiners have difficulty distinguishing possible abuse from normal health problems and injuries. Of note, most older adults who report abuse are generally twice as likely to die within a year of reporting abuse than non-abused older adults. A physician's suspicion of child abuse or neglect does not state that a child has been undeniably abused or neglected; this is just a red flag that further investigation into the child's care should take place. Doctors are not very willing to report certain cases. They feel too close to parents, don't trust state child protection services, or aren't sure the evidence isn't the result of an undiagnosed illness. There has been a change since 2009 that helps resolve these dilemmas. There are now board-certified specialists known as child abuse pediatricians. These specialists can provide additional knowledge when an incident involving a child is involved. The number of cases of child abuse and neglect reported each year is unacceptably high, and with the availability of specialists to help resolve these incidents, this reduces the dilemmas of first responders in the midst of tragedy. .Works CitedBlock, R.W. (June 28, 2010). Child abuse requires specialized treatment and reporting. American Medical News. Retrieved from http://www.amednews.com/article/20100628/profession/306289942/5/Dybuncio, M. (February 6, 2012). 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. (August 4, 2009). 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 (May 24, 2006). The ethical challenges of elder abuse. Medscape Internal Medicine. Retrieved from http://www.medscape.org/viewarticle/532943