The patient who has sustained a high cervical level injury will require a tremendous amount of support/care from caregivers. Unfortunately, due to the demands placed on caregivers and the dependence of the injured individual abuse may occur which goes unreported.  Consider one of the following questions in relationship to the dental hygienist's responsibility when abuse is suspected: (Support your response).

1. Is the hygienist legally or ethically responsible for reporting his/her suspicions of abuse. Why or why not? 
2. To whom should the hygienist address his/her concerns and with what documentation?
3. What measures should be taken to help the office staff know how to handle this situation in the future?