Canada's most prestigious medical journal is calling on parents, lawmakers and doctors to put an end to the practice of spanking children.

In an editorial published Tuesday, Canadian Medical Association Journal editor-in-chief John Fletcher adds his publication's heft to a growing call to strike down Section 43 of the Criminal Code of Canada, which outlines legally allowable "corrective" physical punishment of children by their parents.

"It is time for Canada to remove this anachronistic excuse for poor parenting from the statute book," he writes.

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Section 43 states that a parent is "justified in using force by way of correction … if the force does not exceed what is reasonable under the circumstances."

Dr. Fletcher says he's not advocating for the criminalization of the occasional poor parenting choice. "If the aim is to improve parenting," he writes, "then calling the police is the wrong approach."

Instead, he's hoping to shift the focus to how ineffective spanking actually is.

"I'm not sure the message has got out that regular physical punishment isn't a good way to get kids to behave properly and can lead to later problems," he said in an interview. He defines regular physical punishment as more than two incidents a month.

The research clearly points to spanking as a flawed discipline tool. A Canadian meta-analysis released in February by experts Joan Durrant and Ron Ensom looked at 20 years of study and found that physical punishment is "no better at eliciting compliance than other methods," Dr. Fletcher writes.

What's more, the analysis found growing evidence of actual harm, including increased levels of childhood aggression and other effects that crop up in adulthood, including emotional and behavioural problems and drug and alcohol use.

This summer, the American Academy of Pediatrics released a study linking harsh physical punishment, including pushing, grabbing, shoving, slapping or hitting, to later mental illness. Researchers found that between 2 and 7 per cent of mental disorders were attributable to physical punishment in childhood.

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Experts recommend alternatives including timeouts, diversion tactics and better communication of rules and expectations to children. They also encourage parents to control their own anger and impatience in what feel like crisis moments.

Joan Durrant, an associate professor of social work at the University of Manitoba, says parents need to develop a broader understanding of their own parenting goals and their child's stage of development. A toddler isn't trying to break your favourite dish, for instance, she's just exploring her world.

In a widely-circulated guide called Positive Discipline, Prof. Durrant leads parents through an exercise on this topic. Using the dish example, she suggests that instead of shouting at the toddler or slapping her to teach her not to touch your things, the better choice is to explain how sad you are about it, then have her help clean it up or fix it.

"Explain that when some things are broken, they can never be fixed. Put all of your treasures in a safe place out of her reach. Sit with her and show her how to touch objects gently. Let her practice on unbreakable objects," she writes.

This approach requires parents to temper their responses – to calm down or count to 10 before reacting to a situation.

Elisa Roman, an associate professor of psychology at the University of Ottawa, says that none of this is easy. "Effective parenting takes work and sustained effort, but strategies such as ignoring behaviour, rewarding and explaining are well worth the effort because they are effective and they don't involve inflicting any kind of physical harm on children."

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Not only does spanking teach children aggressive behaviour, it can compromise the parent-child relationship, she says, adding that spanking also fails to teach more appropriate behaviours to children.

Prof. Roman has been overseeing new, unpublished research that appears to show that physical punishment is on the decline. But she applauds Dr. Fletcher's CMAJ stance, saying that family doctors are well placed to talk to families about these issues – and to promote non-physical forms of punishment.

"There is growing awareness, but we need to keep spreading the word."