This paper is a modified version of a talk presented by the author at the SCSS’s Capitol Hill Luncheon-Seminar on “Defending the Family,” at the Rayburn House Office Building, Washington, D.C., April 23, 2004. It is an updated examination of the subject in question since the author’s lengthy and more comprehensive article on the subject in the SCSS’s 1998 anthology, Defending the Family; A Sourcebook. Like the earlier article, it shows that the problem of false allegations of child (...) class='Hi'>abuse and neglect against parents continues to be massive. It identifies vague laws, attitudes of operatives in the child protective system, the ease of making reports, and the legal immunity of protective system operatives as the main reasons for this. It discusses the threats to children and innocent families posed by the system. It finds the limited protections for parents written into recent federal law an encouraging development, but points out that parents still have relatively few rights in the face of the system. It presents the case as to why the current child protective system is fundamentally flawed and should be eliminated in favor of a different approach to protecting children from true abuse and neglect. (shrink)

Children may be abused physically, sexually, emotionally and by omission or commission in any permutation under these headings. This is discussed in terms of the separate and overlapping responsibilities of parents, guardians, the community in which they live and the network of professional services developed to care for, protect and educate children. An attempt is made to place these issues within an ethical framework, with regard to the legislature of England and Wales. It is argued that professionals working within this (...) field have an obligation either to keep up to date in respect of a large and growing body of research and practice knowledge or to consult 'experts' within the field when making complex and far-reaching decisions on behalf of abused children and their families. A representative, inevitably incomplete, bibliography is discussed and appended and there is brief reference to the role of expert witnesses concerning children involved in civil legal proceedings. (shrink)

The nature of children's early environment has profound long-term consequences. We are beginning to understand the underlying molecular programming of the stress-response system, which may mediate the destructive long-term effects of cruelty to children, explain the evolutionary stability of cruelty, and provide opportunities for its reversal of early trauma.

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data (...) were collected through in‐depth interviews with nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational ‘rule‐centred’ culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child‐centred approach. (shrink)

Mandatory reporting laws, which vary slightly from state to state, require reporting by helping professionals when there is reasonable cause to suspect child abuse. Institutional Review Boards (IRBs) require researchers to warn subjects of this duty to report, which may have a chilling effect on subject rapport and candor. Certificates of confidentiality, in conjunction with other precautions, may reduce some barriers to valid research. Attempts to resolve problems created by reporting laws must produce the most valid research, while (...) minimizing harm and distress to research participants, their families, and the researcher and meeting local and federal legal requirements. (shrink)

To investigate the relationships among child psychological abuse and neglect (CPAN), children’s learning engagement, family socioeconomic status (family SES), and children’s academic achievement, 271 children (Mage = 9.41 ± 0.81 years old) and their parents participated in this study with a longitudinal design. Results revealed that learning engagement at T1 mediated the relationship between CPAN at T1 and academic achievement at T2 when gender, age, grade, and academic achievement at T1 were under control. Family SES at T1 (...) moderated the relationship between children’s learning engagement at T1 and academic achievement at T2. The association between learning engagement and academic achievement was stronger among children from lower family SES. Our findings highlighted the negative impact of CPAN and the critical role of learning engagement in children’s academic achievement, especially for those from low SES families. (shrink)

In Child Abuse, Family Rights, and the Child Protective System: A Critical Analysis from Law, Ethics, and Catholic Social Teaching, Stephen M. Krason gathers essays by leading scholars and practitioners to comment through the prism of Catholic social thought, on the plight afflicting American families and the role of the child protective system. Here readers will find critical essays on the deleterious effect of the 1974 passage of the Child Abuse Prevention and Treatment Act; (...) assessments of current American policies on child abuse and neglect and the role of the CPS within the context of prevailing international human rights principles and Catholic social teaching; a survey of the enforcement of CPS policies from a legal and constitutional perspective; research data disputing the CPS principle that all parents are potential abusers and illustrating the greater prevalence of abuse and neglect in broken, “blended,” and “untraditional” families; and arguments for poverty and unemployment as the prime culprits in the mistreatment of children. Also included are the amicus curiae briefs that the Society of Catholic Social Scientists submitted in two U.S. Supreme Court cases on parental rights, the CPS, and state control over the family. (shrink)

During the past 20 years, states have increasingly expanded the lists of individuals who are obligated to report their suspicions of child abuse and neglect. These legal requirements are juxtaposed with ethical considerations in research and professional practice. The ethical issues include the obligation to maintain both confidentiality of information provided by human participants and the safety and protection of these participants. This article reviews the types of state child abuse reporting statutes and outlines the (...) categories of mandated reporters. I develop a model of how individual researchers should approach deciding whether they are mandated reporters of child abuse and neglect. (shrink)

Introducción: El maltrato infantil se define como el abuso y la desatención de que son objeto los menores de 18 años; incluye el maltrato físico o psicológico, abuso sexual, desatención, negligencia y explotación comercial o de otro tipo que puedan causar un daño a la salud, al desarrollo o la dignidad del niño, y poner en peligro su supervivencia, en el contexto de una relación de responsabilidad, confianza o poder. Método: Se realizó un estudio prospectivo, con enfoque cuali-cuantitativo, modalidad de (...) campo, descriptivo, analítico y longitudinal en la escuela Manuela Espejo del cantón Ambato, provincia Tungurahua, Ecuador, durante el periodo 2013-2015 con el objetivo de determinar la incidencia de maltrato infantil y brindarle la atención o tratamiento adecuado. Resultados: El 7,67 % de los niños eran maltratados, predominó el sexo masculino con un 74 %, fundamentalmente en el medio familiar con un 52,17 % en la modalidad de maltrato psicológico en un 62,16 %. Conclusiones: La violencia infantil, continúa siendo un problema a nivel internacional. La asistencia continua a las víctimas del maltrato y a sus familias puede ayudar a reducirlo y a paliar sus consecuencias. Introduction: Child abuse is defined as mistreatment and neglect of children who are under 18. It includes physical or psychological abuse, sexual abuse, neglect, negligence and commercial exploitation or any other kind of exploitation that may cause damage to children´s health, physical development or dignity, and may endanger their survival in the context of a relationship of responsibility, trust or power. Method: A prospective, descriptive, analytical, longitudinal study was conducted using qualitative and quantitative approaches at Manuela Espejo School in Canton Ambato, Tungurahua province, Ecuador, during the period of 2013-2015 in order to determine the incidence of child abuse and provide adequate care or treatment. Results: 7.67% of children were abused; of those, males predominated at 74%. The abuse took place mainly in the family environment in the form of psychological maltreatment. Conclusions: Child abuse remains a problem internationally. Continuous assistance to victims of abuse and their families can help reduce and mitigate its consequences. (shrink)

The forced marriage of minors is child abuse, consequently duties exist to stop them. Yet over 14 million forced marriages of minors occur annually in developing countries. The American Bar Association concludes that the problem in the US is significant, widespread but largely ignored, and that few US laws protect minors from forced marriages. Although their best chance of rescue often involves visits to health care providers, US providers show little awareness of this growing problem. Strategies discussed to (...) stop forced marriages include recommendations from the UN, the ABA, and the UK. The author anticipates and responds to criticisms that first, no duty to intervene exists without better laws and practice guidelines; and second, that such marriages are not child abuse in traditions where parental rights or familism allegedly justify them. (shrink)

In this article, we explore the ethical issues related to the reporting of suspected abuse or neglect in research involving children. Ethical dilemmas related to reporting child maltreatment are often complex because the rights of children and their adult caregivers may conflict and determinations of abuse or neglect are socially constructed judgments that depend on particular circumstances. We argue that when reporting is legally mandated, investigators must follow the law and report their suspicions to (...) class='Hi'>Child Protective Services. When reporting is not legally mandated, investigators still have an ethical obligation to report to help prevent additional maltreatment and allow children to obtain access to services needed to recover from abuse or neglect. We also argue that investigators should include plans and procedures in the research protocol for making reports and training research staff in recognising evidence of child abuse or neglect. Although investigators should report evidence of abuse or neglect that is discovered incidentally, they have no mandate to actively search for such evidence when it is not related to the study’s objectives. Investigators should also inform parents and children about their obligations to report suspected abuse or neglect. (shrink)

ObjectiveA sickness history from General Practice will be unfolded with regard to its implicit lived meanings. This experiential matrix will be analyzed with regard to its medico-theoretical aspects.MethodThe analysis is grounded in a phenomenology of the body. The patient Katherine Kaplan lends a particular portrait to the dynamics that are enacted in the interface between socially silenced domestic violence and the theoretical assumptions of human health as these inform the clinical practice of health care.ResultsBy applying an understanding of sickness that (...) transcends the mind-body split, a concealed and complex logic emerges. This logic is embedded in a nexus of the impact of childhood abuse experience and the medical disinterest in subjective experiences and their impact on selfhood and health. Its core is twofold: the violation of embodiment resulting from intra-familial abuse and existential threat, and the embodiment of violation resulting from social rules and the theoretically blinded medical gaze.ConclusionA considerable medical investment, apparently conducted in a correct and consistent manner as to diagnostic and therapeutic measures, results in the complete incapacitation of a young physician. (shrink)

Critical discursive analyses offer possibilities for equity‐oriented research, and are a resource for addressing resistant social problems, such as child neglect and abuse (CN&A). A key challenge for discourse analysts in health disciplines is the tensions between materiality and social constructions, particularly at the site of the body. This paper describes how Donna Haraway's ideas of figuration and technobiopower can augment critical discourse analysis to address this tension. Technobiopower, an intensification of biopower in the context of technoscience, (...) is seen as underpinning the melding of material and semiotic practices. The subject is no longer a material body, but a hybrid body that exists in tropic figuration between the real and unreal. This paper uses an analysis of the figuration of The Monstrous Perpetrator from a study of nursing responses to CN&A to illustrate how Haraway's figuration aligns with and provides an analytical tool to extend critical discursive analyses. Specifically, this methodology offers new ways to identify the discursive qualities of bodies, and how material aspects of bodies are exaggerated, concealing their hegemonic ideologies and discriminatory effects. By identifying discourses within or inscribed upon the body, they can be disrupted, opening new possibilities for social change. (shrink)

One million cases of child maltreatment and twelve hundred child deaths due to abuse and neglect occur per year. But since many cases of abuse and neglect remain either unreported or unsubstantiated due to insufficient evidence, the number of children who are abused, neglected, and killed at the hands of family caregivers is probably higher. One approach to combat child abuse in the U.K. has been the employment of hospital-based covert video surveillance (...) (CVS) to monitor parents suspected of Munchausen Syndrome by Proxy (MSBP). The use of CVS, however, raises concerns about voluntary informed consent, research on human subjects, privacy, and the appropriateness of healthcare providers to conduct CVS. More broadly, the use of CVS raises concerns about the ethical life of healthcare institutions and their moral obligations to the families and communities they serve. The U.K. protocol for CVS is examined in light of these concerns. Three alternative CVS protocols and two procedures for selecting a protocol are then proposed for use in the U.S. The paper concludes that any CVS protocol selected for use by hospitals ought to be selected by means of open and democratic processes that permit community input and, subsequently, the possibility of a consensus on the moral status and scope of CVS. (shrink)

Although previous studies have explored relationships between psychological abuse and social support, the pathways from psychological abuse to social support are still unclear, particularly in Chinese adolescents. This cross-sectional study attempts to delineate the prevalence of psychological abuse and explore the relationships between psychological abuse, social support, and self-esteem under the Chinese cultural context. Data were obtained from 417 Chinese adolescents aged 15–18 years old. All of them completed the Child Psychological Abuse and (...) class='Hi'>Neglect Scale, Rosenberg Self-Esteem Scale, and Multidimensional Scale of Perceived Social Support. Results indicated that the prevalence of psychological abuse in Chinese adolescents was 25.66%, and psychological abuse was negatively associated with self-esteem and social support, respectively. Self-esteem partially mediated the relationships between psychological abuse and social support. Findings highlight the importance of improving self-esteem in survivors of psychological abuse for decreasing the negative effects on social support. Additionally, the significance and limitations of the results were discussed. (shrink)

Mary Midgley asserts that my argument concerning the problem of child-abuse was inappropriately framed in the language of rights, and neglected certain pertinent natural facts. I defend the view that the use of rights-talk was both apposite and did not misrepresent the moral problem in question. I assess the status and character of the natural facts Midgley adduces in criticism of my case, concluding that they do not obviously establish the conclusions she believes they do. Finally I briefly (...) respond to the charge that my suggestions were illiberal. (shrink)

In February 1997, the Committee on Bioethics of the American Academy of Pediatrics updated its position on religious exemptions to medical care. In its earlier statement, the committee noted that forty-four states have religious exemptions to the child abuse and neglect statutes, and they argued for the repeal of these exemptions. The committee did not indude in its statement a position on religious exemptions to childhood immunization requirements that exist in forty-eight states, although this issue was discussed (...) in committee meetings. In its revised statement, the committee concluded that “The AAP does not support the stringent application of medical neglect laws when children do not receive recommended immunizations.” In this paper, we consider whether failure to immunize one's child is a form of medical neglect and, if so, whether states should repeal their religious exemptions to the immunization statutes. We argue that failure to vaccinate a child properly is medical neglect. (shrink)

The best-interests standard is a widely used ethical, legal, and social basis for policy and decision-making involving children and other incompetent persons. It is under attack, however, as self-defeating, individualistic, unknowable, vague, dangerous, and open to abuse. The author defends this standard by identifying its employment, first, as a threshold for intervention and judgment (as in child abuse and neglect rulings), second, as an ideal to establish policies or prima facie duties, and, third, as a standard (...) of reasonableness. Criticisms of the best-interests standard are reconsidered after clarifying these different meanings. (shrink)

This book examines the negative power that child maltreatment has on individuals and society ethically and politically, while analyzing the positive power that parental love and healthy families have. To address how best to confront the problem of child maltreatment, it examines several policy options, ultimately defending a policy of licensing parents, while carefully examining the tension between child and adult rights and duties.

Studies of childhood abuse and neglect haveimportant lessons for considerations of natureand nurture. While each child has uniquegenetic potentials, both human and animalstudies point to important needs that everychild has, and severe long-term consequencesfor brain function if those needs are not met. The effects of the childhood environment,favorable or unfavorable, interact with all theprocesses of neurodevelopment (neurogenesis,migration, differentiation, apoptosis,arborization, synaptogenesis, synapticsculpting, and myelination). The time coursesof all these neural processes are reviewed herealong with statements of core principles (...) forboth genetic and environmental influences onall of these processes. Evidence is presentedthat development of synaptic pathways tends tobe a ``use it or lose it'' proposition.Abuse studies from the author's laboratory,studies of children in orphanages who lackedemotional contact, and a large number of animaldeprivation and enrichment studies point to theneed for children and young nonhuman mammals tohave both stable emotional attachments with andtouch from primary adult caregivers, andspontaneous interactions with peers. If theseconnections are lacking, brain development bothof caring behavior and cognitive capacities isdamaged in a lasting fashion.These effects of experience on the brainimply that effects of modern technology can bepositive but need to be monitored. Whiletechnology has raised opportunities forchildren to become economically secure andliterate, more recent inadvertent impacts oftechnology have spawned declines in extendedfamilies, family meals, and spontaneous peerinteractions. The latter changes have deprivedmany children of experiences that promotepositive growth of the cognitive and caringpotentials of their developing brains. (shrink)

This is an exploratory study of perceptions of human dignity in childhood as recalled by young adults. Our goal is to discover the range of dimensions, sources and experiences, both those that supported and violated, of the concept of human dignity. This research, drawing on responses from over two hundred university students, may help to develop a language with which to explore the concept of human dignity in a broader, more systematic way. The approach taken here permits us to move (...) beyond the ‘legal’ frame that often confines us to discussions of the extremes of child abuse and neglect, to a frame that frees us to explore the meaning and real life experiences with human dignity in childhood and the impacts on later life. Violating and not supporting human dignity in childhood helps produce a world populated by adults who, having been harmed as children, go on to harm and violate others as adults. If our goal is to have a world populated by children who were nurtured to flourish into child-centered adults who are empathic, intelligent and responsive and who have no need to hurt others, then our understanding of human dignity in childhood must be increased. This paper and the materials on which it is based seek to provide preliminary insights into the language of human dignity. (shrink)

This article examines baby farming as an urban neighborhood-based system of group child care in Philadelphia in the late nineteenth century and considers the dangers and abuses the practice of baby farming posed for parents, children, and baby farmers. It explores reformers' early efforts to regulate the city's baby farms. Finally, the essay also investigates the ways in which the residents of Philadelphia's poor neighborhoods monitored the child-care establishments in their communities that catered to working mothers.

El presente texto se inscribe dentro de la temática dirigida a la investigación sobre la violencia intrafamiliar. Tiene como objetivo sistematizar aspectos históricos y teóricos inherentes al estudio del maltrato infantil y sus consecuencias en el ámbito social y familiar para su detección y tratamiento en el nivel de atención primaria de los servicios de salud en Cuba. Mediante una revisión bibliográfica se logró concretar un análisis documental de materiales y textos en soporte digital e impreso que condujo a los (...) acercamientos teórico e histórico del fenómeno en el ámbito internacional y nacional, para su conceptualización, la determinación de su tipología y el establecimiento de sus consecuencias; elementos imprescindibles del saber profesional del futuro egresado de las ciencias médicas, en función de su desempeño en los diferentes niveles de atención de salud, en especial, la atención primaria. The text falls within the research on intrafamiliar violence subject matter. Its objective is to systematize historical and theoretical aspects inherent to the study of child abuse and its consequences within the social and domestic scopes for its detection and treatment in the Cuban primary health care services. By means of a bibliographic review, a documentary analysis of electronic and printed form materials and texts was summarized. It led to theoretical and historical approaches to the phenomenon within the national and international scopes for its conceptualization, the establishment of its typology and consequences. They are essential elements of the professional knowledge of future medical sciences graduates towards their performance in different health care levels, especially in primary health care. (shrink)

In 2010, a South Carolina mother was taken to court when her fourteen‐year‐old son reached 555 pounds. An article on the story reported, “His mother, Jerri Gray, lost custody of her son and is being charged with criminal neglect. Gray is facing 15 years on two felony counts, the first U.S. felony case involving childhood obesity.” If the caretakers of obese children are negligent, then they are also morally and legally blameworthy. I want to suggest, however, that important ethical (...) differences exist between negligent or abusive caretakers and the caretakers of obese children and that these differences ought to make a moral and legal difference. The distinctions are nuanced, and the ethical pictures in cases of abuse, neglect, and obesity are far from black and white. However, the various types of harm that children face from their caretakers should be placed in neither the same ethical nor the same legal category.When children are beaten or sexually molested, the justification for taking them out of the home is clear: the caretakers are violating the rights of their children. Similarly, with neglect, caretakers are failing to provide their children the necessities to which they are entitled. The central question that I want to address in this article is whether the actions (or inaction) of caretakers that allow a child to become obese are morally or practically analogous to physical abuse or neglect. Ultimately, I will argue that parenting that allows a child to become obese is so morally different from both abuse and neglect that it is best understood as falling outside these categories altogether. This conclusion has important moral, practical, and legal implications. (shrink)

Potential ethical issues can arise during the process of epidemiological classification. For example, unnatural infant deaths are classified as accidental deaths or homicides. Societal sensitivity to the physical abuse and neglect of children has increased over recent decades. This enhanced sensitivity could impact reported infant homicide rates. Infant homicide and accident mortality rates in boys and girls in the USA from 1940 to 2005 were analysed. In 1940, infant accident mortality rates were over 20 times greater than infant (...) homicide rates in both boys and girls. After about 1980, when the ratio of infant accident mortality rates to infant homicide rates decreased to less than five, and the sum of infant accident and homicide rates became relatively constant, further decreases in infant accident mortality rates were associated with increases in reported infant homicide rates. These findings suggest that the dramatic decline of accidental infant mortality and recent increased societal sensitivity to child abuse may be related to the increased infant homicide rates observed in the USA since 1980 rather than an actual increase in societal violence directed against infants. Ethical consequences of epidemiological classification, involving the principles of beneficence, non-maleficence and justice, are suggested by observed patterns in infant accidental deaths and homicides in the USA from 1940 to 2005. (shrink)

This article examines how domestic violence impacts the lives and education of young children, children, and young people and how they can be supported within the education system. Schools are often the service in closest and longest contact with a child living with domestic violence; teachers can play a vital role in helping families access welfare services. In the wake of high profile cases of child abuse and neglect, concerns have been raised about the effectiveness of (...) multi-agency responses to children living with abuse. In the UK, the case of four-year-old Daniel Pelka who died in 2012 following abuse and starvation by his mother, who experienced domestic violence, and her partner, led to a serious case review. It found recording systems in Daniel’s school were not used consistently, and details held by different agencies were not collated to enable the formation of a coherent assessment. The lack of integrated working cited in the report echoes findings from previous serious case reviews. A strong correlation exists between domestic abuse and child abuse, with approximately half of all domestic violence situations involving direct child abuse. Children can also be affected indirectly by violence occurring in their home by seeing or hearing it taking place. This article examines the impact of domestic violence on the mental health of children, and the impact on their education. Violence in children’s lives often causes disruption to their schooling and harms the quality of their educational experiences and outcomes. The abuse children experience can result in emotional trauma, physical and psychological barriers to learning, and disruptive behavior in school, while the underlying causes of these problems remain hidden. Knowing when and how to seek advice from multi-agency professionals is an essential part of effective practice among school staff. Despite their vital role in identifying signs of abuse and signposting referral pathways, research indicates teachers often lack confidence and knowledge for such work. The article examines how the professional learning and professional confidence of teachers can be developed, and how recent policy and practice developments in the UK have the potential to influence work in this area. (shrink)

Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity (...) (rsFC) between the amygdala and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p <.025, FWE-corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology. (shrink)

The study of child abuse and child homicide has been based on the often implicit assumption that there is a continuum of violence ranging from mild physical punishment to severe abuse and homicide. Empirical data supporting this assumption are sparse. Existing data can be shown, however, to support an assumption that there are distinct forms of violence, not a continuum. This paper reviews these data and discusses their implications for the study of violence, abuse, and (...) homicide in terms of substantive and methodological explanations. In addition, the implications of the assumption that violence consists of distinct behaviors as opposed to a continuum are discussed in light of sociobiological and evolutionary explanations of child abuse and child homicide. (shrink)

The Law is a grim, unsmiling thing, Not Justice, though. Justice is witty and whimsical and kind and caring.Rohinton Misuy, A Fine Balance;When the South Carolina Supreme Court upheld the conviction and twelve-year sentence of Regina McKnight, it affirmed that state 's commitment to bring the full force of the law to the punishment of pregnant women who use drugs. Prosecutors linked the delivery of Ms.McKnight 's stillborn baby to her use of cocaine, and argued successfully for a finding of (...) homicide by child abuse. The McKnight judgment follows the South Carolina Supreme Court decision in the case of Cornelia Whitner. Whitner was sentenced to prison for illegal drug use during pregnancy on the grounds that the viable fetus is a child under the state s criminal child endangerment statute.On the basis of constitutional concerns such as due process and privacy, worries that criminal prosecutions may thwart public policy goals such as keeping families together and promoting the health of women and children, and findings that legislatures did not intend to include the fetus in the scope of drug laws or child abuse and neglect laws, criminal prosecution has been resisted in most jurisdictions. (shrink)

Parents are generally viewed as having broad discretion when it comes to the decisions they make for their children. With the exceptions of outright abuse and neglect, society does not interfere with many of those decisions. Nowhere is parental decision making considered more sacrosanct than in the area of the religious upbringing of children. Parents are assumed to have the right to instill their particular religious beliefs and practices—beliefs and practices that may include intolerant, sexist, misogynistic, or racist (...) ideas—provided that this inculcation does not harm the child. (shrink)

General practitioners (GPs) have to negotiate a range of challenges when they suspect child abuse or neglect. This article details findings from a Delphi exercise that was part of a larger study exploring the conflicts of interest that arise for UK GPs in safeguarding children. The specific objectives of the Delphi exercise were to understand how these conflicts of interest are seen from the perspectives of an expert panel, and to identify best practice for GPs. The Delphi (...) exercise involved four iterative rounds with questionnaires completed by an expert panel. Results from each round were distilled and findings sent to panel members until consensus was reached. Panel members shared insights regarding their understanding of conflicts of interest in relation to GPs and safeguarding children and responses when conflicts of interests arise. Findings suggested a broader understanding of conflicts of interest (intrapersonal, interpersonal, interprofessional and interagency), the importance of professional judgement in uncertain situations when both action and inaction have potentially negative consequences and the importance of trust. The Delphi exercise was an effective means to bring together a wide range of professional and disciplinary perspectives on a complex topic. Findings caution against the oversimplification of the conceptual and practical issues, emphasise the importance of professional judgement, and support the development of open and trusting relationships with families and among professionals in health and social care agencies. (shrink)

LaFollette proposed that the best way to protect children from abuse and neglect caused by their parents would be to implement parental licenses to prospective parents. In this paper, I re-evaluate his proposal by looking at various facts and data related to child abuse and neglect. It will be suggested that (a) parenting as a profession does not satisfy the third of LaFollette’s criteria for the introduction of licenses, which is “The benefits of the licensing (...) program outweigh any theoretical reasons against it” (LaFollette 2010, 328), (b) it would subject too many people to unnecessary tests and (c) parenting cannot be compared to other professions licenses are usually issued for. (shrink)

The treatment of pregnant women addicted to drugs provides an especially important and illustrative example of how political and popular demands can successfully challenge professional ethical norms associated with clinical medicine — norms such as confidentiality, patient autonomy, and the right to consent to and to refuse treatment. One increasingly popular policy approach is to limit patient autonomy by coercing women in an attempt to change their behavior, either by involuntary civil commitment or by imprisoning them for drug abuse (...) or child neglect. Thirty-five states have criminally prosecuted women for substance abuse or alcohol use during pregnancy. Other states aggressively use involuntary civil commitment as a means to protect the yet-to-be-born from harm during pregnancy. Medical professionals have been forced to participate in these programs by mandatory reporting requirements. (shrink)

This is a systematic case study of the assessment and treatment of Anna, a woman presenting with posttraumatic stress disorder following a drug-facilitated sexual assault that occurred over twenty years earlier. She was also diagnosed with avoidant personality disorder. Treatment with cognitive therapy for PTSD and social phobia was supplemented by imagery rescripting of memories of childhood trauma within a schema therapy approach. The study documents how her intrusive memories of the rape were potentiated by early maladaptive schemas that developed (...) in response to abusive and neglectful parenting. Within a broader narrative, three examples of IR are described which show how, as an emotion-focused intervention, this approach discloses deeper memories and emotional states that are distressing and traumatic and allows them to be transformed through a healing process that is organic and displays what Bohart and Tallman call “self-organizing wisdom.”. (shrink)

Due to the enormous disparity of power in the child welfare professional-client relationship, a high level of trust is necessary for this relationship to achieve its intended benefits, including protecting, caring for, terminating parental rights to, and finding appropriate adoptive homes for, abused and neglected children. This paper first defines conflicts of interest as necessarily including the exercise of judgment, and then argues that contractual relationships between private child welfare agencies and public departments of child welfare often (...) betray their fiduciary responsibilities through conflicts of interest inherent in these contracts, particularly as regarding incentives for and against finding permanent homes for abused and neglected children. Finally, I propose an evidence-based strategy to ameliorate conflicts of interest when making permanent placement decisions for foster children. (shrink)

Nurses are well positioned to contribute to child protection efforts but are underutilised. This paper describes a critical discursive analysis of nursing responses to child neglect and abuse (CN&A) in British Columbia, Canada. Legal and practice guidelines were analysed alongside nurse interview texts, offering a glimpse into how nurses prevent CN&A in their everyday practice with families. Results show how the primacy of mandatory reporting to child protection authorities coordinates a series of deferrals and how (...) nurses engage with and interrupt these deferrals in everyday practice. Nurses' relational approaches are essential to gain access to the private sphere of the family to assess, plan, elicit cooperation with interventions and monitor the situation. They considered reporting to be one among many possible responses. This study highlights how nursing contributions to prevention are largely overlooked and points to the potential for a more significant role for nurses in a public health approach to child protection. (shrink)

Introduction : kith, kin, and family / Sally Haslanger and Charlotte Witt Adoption and its progeny : rethinking family law, gender, and sexual difference / Drucilla Cornell Open adoption is not for everyone / Anita L. Allen Methods of adoption : eliminating genetic privilege / Jacqueline Stevens Several steps behind : gay and lesbian adoption / Sarah Tobias A child of one’s own : property, progeny, and adoption / Janet Farrell Smith Family resemblances : adoption, personal identity, and genetic (...) essentialism / Charlotte Witt Being adopted and being a philosopher : exploring identity and the "desire to know" differently / Kimberly Leighton Real othering : the metaphysics of maternity in children’s literature / Shelley Park Accidents and contingencies of love / Songsuk Hahn ; comments by Harry Frankfurt Abuse and neglect, foster drift, and the adoption alternative / Elizabeth Bartholet Feminism, race, and adoption policy / Dorothy Roberts Racial randomization / Hawley Fogg-Davis You Mixed?: racial identity without racial biology / Sally Haslanger. (shrink)

The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses (...) which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment. (shrink)

I criticise the ‘liberal’view of the proper relationship between the family and State, namely that, although the interests of the child should be paramount, parents are entitled to rights of both privacy and autonomy which should be abrogated only when the child suffers a specifiable harm. I argue that the right to bear children is not absolute, and that it only grounds a right to rear upon an objectionable proprietarian picture of the child as owned by its (...) producer. If natural parents have any rights to rear they derive from duties to bring their children into rational maturity where they can exercise rights for themselves. The presumption that natural parents are best suited to rear their own children should be discounted, as should the assumption that alternatives to natural parenting are unacceptably bad. I reject the suggestion that parents should be ‘licensed’but argue for a much closer monitoring of the family. Familial privacy, which such monitoring breaches, is shown to have a culturally specific and, given the facts of abuse, dubious value. In conclusion, I briefly specify the forms of monitoring I approve. (shrink)

This study examines girl child abuse in an internally displaced people's camp in north‐central Nigeria and the response of community health workers. The conflict in Benue State is caused by religious differences between the natives (Tiv people) and the invading Fulani herdsmen. During these conflicts, women and girls were displaced, and they were kept in internally displaced persons (IDPs) located in different parts of the state. Literature has been extensively written on internal displacement in Nigeria, but none has (...) been able to elucidate the health needs of girls and the various abuses girls and women are suffering in IDP camps. In this study, literature was extended (1) to explore the environment of the girl child in IDP camps, (2) to identify reasons for the abuse of the girl child in IDP camps, (3) to investigate the impacts of the abuse on the girl child in IDP camps and (4) to investigate how healthcare workers could be used to alleviate the plight of girl children in IDP camps. This is a qualitative case study, with data obtained from relevant academic literature and personal observation. The data were analysed using content analysis. Findings reveal that the girl child is suffering from psychological, economic and health challenges due to the various forms of abuse they are going through. Following the devastation in Benue State, healthcare workers from the community relocated to neighbouring states. There is a need to recall those healthcare workers and provide them with the necessary materials to assist girls in IDP camps. Recommendations are discussed. (shrink)

Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely on surrogates to make decisions for them. Who should be the decision-maker when an infant’s biological parents are also minors? In this paper, we analyse a case in which the biological mother is a child. The central questions raised by the case are whether minor parents should make medical decisions on behalf of an infant, and if so, what are (...) the limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different ethical arguments to underpin parental decision-making authority; we argue that provided that minor parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the ethical limits to minor parents’ decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a moral right to make medical decisions for their infants within the same ‘zone of parental discretion’ that applies to adult parents. We conclude that adult and minor parents should have comparable decision-making authority for their infants. (shrink)