LAUSR

Abstract Background Legislation permitting the physical punishment of children and young people is incompatible with the UN Convention on the Rights of the Child. In 2017, the Scottish Government consulted on a Bill to safeguard the wellbeing of children and young people ensuring that they were as equally protected from assault as adults by ending the legal position that physical punishment could be justified. NHS Health Scotland submitted a response to this consultation that was informed by robust evidence, which we report here. Methods We adopted a systematic approach to identify evidence in response to nine consultation questions. Questions included consideration of: the advantages, disadvantages, and sustainability of giving children and young people equal protection by prohibiting all physical punishment; and costs and benefits to children and professionals and the impact on individuals protected by the 2010 Equality Act. To augment the evidence presented in a 2015 systematic review by the National Society for the Prevention of Cruelty to Children, we searched Medline, Web of Science, Cochrane Library, IBSS, ASSIA, Sociological Abstracts, Social Service Abstracts, and Proquest Public Health databases to identify studies conducted in developed countries that were published in English between Jan 1, 2015, and June 1, 2017. Keywords used were child, young person, smack, slap, hit, spank, corporal punishment, and physical discipline. Two authors independently reviewed abstracts. Findings 880 articles were identified, of which 33 were considered. 19 of them were of sufficient quality to provide impartial evidence about the impact of physical punishment on children and young people. The 2015 systematic review showed that a parent's right to physically punish their child was outdated, potentially harmful, and an ineffective parenting strategy. A 2016 meta-analysis found no evidence that parental spanking was associated with improved child behaviour but was associated with an increased risk of negative health outcomes (eg, aggression, antisocial behaviour, externalising and internalising behaviour problems, mental health problems, negative parent–child relationships, impaired cognitive ability, low self-esteem, and risk of physical abuse). There was no evidence that spanking was only associated with negative outcomes when it was combined with physical abuse nor that spanking was only associated with negative outcomes in studies appraised as being methodologically weak. Interpretation Protecting children and young people from physical punishment is an important public health issue that is supported by robust evidence. Funding None.