Comment by danenania
2 years ago
My first inclination here is to blame the doctor. Per the Hippocratic Oath, doctors need to understand the implications of making reports like this and only do so in cases where there isn't reasonable doubt or plausible explanations other than abuse. Separating children from parents and making accusations like this is extremely traumatic in itself, so the evidence bar needs to be very high.
Even if the rules tell doctors that they need to make a report in a given scenario, they should not be following the rules when they know the bureaucracies that handle these reports are dysfunctional and prone to separating children without conclusive evidence. Imo they are responsible for protecting their patients from the system in these cases.
So you err on the 'some children are abused and die' side of things, and other people err on the 'some parents get separated from their children' side.
I don't think the line is at doctors reporting, and I'll tell you why.
There are many cases of MD's having patients where they know the whole family and can't believe that abuse would be going on, so they don't report things like spiral fractures and pattern bruising in a five year old. Those are markers of serious domestic violence and abuse, but since the doc knows the parent, and the parent has a sorta reasonable explanation, fine.
No. The doctor reports, then the parents get investigated. Sorry it sucks, but the point to fix is the people interacting with the family at the point of investigation, not the report by an MD, because unfortunately the MD is going to lean towards not reporting until it is too late.
That would be fine if the investigations were fair and followed basic principles of jurisprudence like "innocent until proven guilty", but it's plain to see that kids are being separated based on very flimsy evidence.
In my book, a doctor doesn't get to absolve themselves of responsibility by saying "just following orders" and that it's the investigative system that needs to be fixed. If they know the system is broken, it's both immoral and a deep betrayal of trust for them to report people without strong evidence.
Almost any injury can be framed as possible evidence of abuse. Parents shouldn't have to be afraid that taking their kids to the hospital after an injury will get them taken away. The vast majority of injuries are not from abuse, so a system with a low bar for evidence is going to end up with more false positives than cases of abuse. This is exacerbated by the fact that abusers, for obvious reasons, are often going to avoid getting medical care for the kids they abuse.
If your reasoning were applied more broadly, we'd put anyone accused of a crime, or of even planning a crime, in prison immediately, since otherwise crimes will occur (with people hurt/killed) that could have been prevented. There's a reason the legal system doesn't work this way.
I think the point is that the blame lies with DCF, not the doctors. Doctors should report, and DCF should competently investigate. In this scenario, the doctor did their job and DCF did not.
2 replies →
My first inclination is to blame DCF workers.
> These people are working in the shadows, in darkness," Lamanna said. "They can show up at your house in the middle of the night with no paperwork, no court order whatsoever, and say we’re removing under the B, we’ve decided an emergency exists."
> According to DCF’s 2022 quarterly report, about 60% of parents are reunited with their kids within a year after being removed by DCF.
Anyone who feels justified in stealing kids from parents in the middle of the night, without any due process, WITH A 60% MISS RATE, is completely and truly evil.
Seriously, more often than not DCF realizes they made a mistake and the kid goes back home. Insane.
Reuniting within a year is not intrinsically evidence that it was a bad removal - a parent can change a lot in less than a year. Most obviously, one abusive parent can be jailed or kicked out and the children go home to live with the remaining parent, who may have been abused themselves. Rehab, counseling, parenting classes, diagnosis and treatment for mental illness, moving out of an unsafe hoarding home, etc, can all be done in that time.
The ones you want to really examine are the kids who go home in less than a week. At one point I think I read that New Mexico had about 25% of children who entered care returning home within days. Those are very likely to be children who were not at risk of harm in the first place.
Who gave DCF the power to take away kids in the middle of the night without due process?
Until we vote out of office the elected representatives who passed the laws that give government agencies such draconian powers, and insist on those laws being changed, we won't fix this problem.
>we won't fix this problem.
I agree.
I'm not sure if it's federal, but in my state a doctor is required to report anything they feel is unusual. Mandated reporter, it's called.
There's a federal act (CAPTA) that requires states to adopt mandatory reporting rules, but the rules vary from state-to-state. Some states, simply by being in a particular profession you are required to report (even when not on the job); in other states it's specifically when evidence is uncovered while performing your duties; in some states, all people are required to report.
I've never encountered a state in which a medical doctor encountering evidence of abuse while seeing a patient is not required to report it, with the exception of some states exempting mental-health professionals told things in confidence (so a psychiatrist, which is also an MD, might not be required to report it depending on the state).
In my state, all doctors are required to report any evidence of child abuse, even if they don’t believe abuse has occurred.
That’s the law.
At the same time, reporting doesn’t guarantee or even suggest any outcome. Most reports end up as entries in a database and nothing more.