The results of toxicology screens often are used by hospital personnel as a part of a suspected child abuse report. Although they indicate use of, or exposure to, a substance at some prior time, positive toxicology test results do not substantiate child abuse. In addition, false positive and false negative test results do occur. Thus, results should always be used in conjunction with comprehensive case evaluations of suspected child maltreatment. The possible dual use of toxicology results for both medical and legal purposes also raises important questions about informed consent.
Community standards vary for obtaining consent in cases involving prenatal substance abuse.
Other facilities require a special consent specifically authorizing toxicology testing. Other hospitals require that a patient be specifically informed of potential legal consequences before testing is conducted. Other institutions, however, require specific parental consent for toxicology screening. If parents refuse permission for testing, a court order can then be obtained in some States. Hospital protocols also provide guidance for staff as well as help ensure consistency in hospital practice.