Is your patient prostituting her child?
Three GPs discuss a tricky problem
Sharmaine is in her 30s and lives with her three-year-old twin sons and 15-year-old daughter Marika. Her long-term partner was imprisoned for armed robbery two years ago. Since then, Sharmaine has attended several times for STD screens and has had two pregnancies terminated in the first trimester. She is always effusively pleasant, and the children are well-dressed and polite. You recently prescribed the oral contraceptive pill to Marika with her mother's consent.
Late one night you are working for the co-op and are called out to see a patient with acute chest pain at an address in the red light district. As you walk from your car you pass Sharmaine and Marika, both wearing revealing clothes and smoking cannabis.
You overhear Sharmaine saying
to a man: 'Of course she's clean, she's only 13.'
Belatedly, you also recognise the man to be another of your patients.