If we had universal health care in this country, at least one of these cases would not be a case at all. First, her son's doctor would have been able to spend enough time with her to educate her on the causes and dangers of severe obesity, and, second, she would have been able to afford the care available. It is appalling that many of our neglect cases are actually "neglect by poverty" - parents love and even may know how to care for their children (or would with some help), but simply can't afford it. What should the state do in this instance, given our current system? Leave a child to live in a vermin-infested building in disrepair (all the parent can afford to pay for), on bad quality food, with no health care, with an overwhelmed parent who wants to do right by their child but simply can't - or take the child, traumatizing it by tearing it away from a loving parent, place it in a foster home that may be abusive or neglectful (and the drastically overloaded agency barely squeaking by on a slashed budget has no resources to inspect and/or correct problems), with no way to fix the situation so the child can go home?
On the other hand, there are many parents who are truly dysfunctional and aren't going to be able to provide a healthy environment for their kids regardless of their income. Just because two human beings mated and produced offspring doesn't mean the offspring should not be protected by their community from abuse or neglect; just because two people made a baby doesn't mean they should be able to do anything they want to it, even if what they want is to deprive it of an education, of proper food and medical care and a healthy emotional life - for religious reasons or other. A person doesn't develop rights only when he or she reaches adulthood; whatever rights a parent has, a child has the same or corresponding rights. We should not value the parents' "rights" over those of the children; nor should we forget that the community has a strong and vested interest in seeing children grow to be healthy, happy and productive members of that community.
Sure, there are tough questions when it comes to what the standards should be for state intervention in child care - but the horror stories of medical care people have described are actually the exception rather than the rule, and most treatment decisions are not that controversial. That a child's parents may have powerful religious ideas or delusions should not mean the child should be deprived of a chance to live a healthy life - why should a parent's first amendment right to freedom of religion outweigh a child's due process rights, or its first amendment right to choose its own religious beliefs, if any?
Universal health care. Universal good quality education. It's less expensive in the long run.
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What Makes a Parent Negligent?
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In fact, the social-service stories that often make the news are ones where agencies didn't intervene in time: where they failed to protect severely abused children. Sadly, the cases only attract public attention when the neglect results in death or serious harm.
But aside from structural problems within the social-service system, Schneider points out the extremely challenging position the state faces when the issue is medical neglect. "[The state] can tell you to take better care of your child, and if you just don't do it, then what? It's hard to sanction parents," he says. "Are you going to fine some parent who is probably poor to start off with? Are you going to put the mother in jail? That won't do the kid any good. After that, you have to start talking about taking the child away, and that is unlikely to be a good thing."
The effects of poverty can't be overlooked when evaluating cases of possible neglect. Doctor's appointments and medicine are expensive. The government provides social services to help parents who don't have the financial or emotional means to care for a child, but understanding, accessing and corralling those services—which can be spread out through different departments and branches of government—can prove challenging for even the most organized parent. And the parents who end up working with social services are often facing circumstances that make being organized nearly impossible. Many don't get paid sick leave, so taking a child to a Medicaid doctor across town can mean losing a day's pay or even a job if the absences are repeated. Often, says Schneider, "these are parents who are leading very, very difficult lives with all kinds of horrifying problems to deal with, and the child is only part of the difficulty of their lives. They have very few resources for helping themselves, much less helping the child."
In situations like these, the state has to make a choice between endangering a minor's physical health by doing nothing, or endangering his emotional health by taking away whatever stability the family provides. Even when parents love their children, the government often has to determine if that love is enough. It's never easy, it's always heartbreaking and—worst of all—the child loses out, one way or another.
© 2009
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