This paper argues the case for taking a critical realist (CR) approach to social work research. The normativity in social work is often under-communicated in the social sciences, resulting in research that has an unclear value base as its starting point. Social work practice promotes social change and people's development, empowerment, and liberation. By taking a CR of view as a starting point for researching social problems, the focus shifts towards explaining phenomena by revealing and discussing the mechanisms through which (...) they are produced and maintained. Child welfare issues are argued to be “wicked problems”, on top of which the practice of social work itself is a complex field. Two studies from the field of child and family welfare are presented here to illustrate how CR has been fruitfully applied in research on such complex phenomena. These two studies comprise research on child protection assessment and parental high conflict. (shrink)

This article explores how abortion bans in states with large Black populations will exacerbate existing racial inequities in those states’ child welfare systems.

This study explores the pivotal role of the body for political recognition and rights claims in child welfare “moral” interventions. I examine how the bodily figures in child welfare assessments, linking these manifestations to the concept of the moral economy of care. A sample of assessment reports from a Swedish municipality, all addressing violations of children’s bodies or integrity, are used as empirical material. I show how the psychosomatically suffering child is being best “heard” as (...) vulnerable. I also argue that such a moral economy of care silences children’s accounts of gendered and racial injustices. Furthermore, racialized moral divides are indicated when assessments of different child bodies are considered. A concluding remark points to a need for a child welfare moral economy of social justice that responds to structural intersecting injustices in childhoods, including to those of a racialized child welfare and its individualized and symptom-oriented services. (shrink)

This article provides a conversation analytic description of a two-part structure, ‘I don’t want X, I want/just want Y’. Drawing on a corpus of recordings of family mealtimes and television documentary data, I show how speakers use the structure in two recurrent environments. First, speakers may use the structure to reject a proposal regarding their actions made by an interlocutor. Second, speakers may deliver the structure following a co-interactant’s formulation of their actions or motivations. Both uses decrease the likelihood (...) of challenge in third-turn position. When responding to multi-unit turns speakers routinely deal with the last item first. The value of ‘I want Y’ is to formulate an alternative sense of agency which undermines the preceding turn and shifts the trajectory of the ongoing sequence. The article contributes to work in discursive psychology as I show how speakers may formulate their ‘wants’ in the service of sequentially unfolding social interaction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 99-102 [Access article in PDF] Living with Contested Knowledge and Partial Jennifer Clegg and Richard Lansdall-Welfare THESE CAREFUL AND CONSTRUCTIVE comments bring grist to our mill. Before responding to them, we observe first that they offer no substantive challenge to our thesis: ambiguities associated with meaning in the disabled life make it more likely that professional service providers will make dogmatic responses (...) to bereavement, and perhaps other essentially contested topics, responses that are defended by isolationism.Some welcome ideas came from left field to refresh our thinking, such as Colman's observations on the gendered nature of care. She reminded us that although the audit from which these cases came was established to investigate bereavement in general among adults with intellectual disability, its rough and ready sampling failed to ensure the expected range of bereavement types. Somehow the bereavements constructed as relevant for audit all transpired to concern the death of mothers. Moreover, of the six relatives who agreed to be interviewed concerning these bereavements, two were stepfathers and four were sisters. Colman underlines the invisibility of care work usually done by female family members: how wise or less wise decisions create the conditions for bereavement reactions, and how changes to care arrangements following bereavement fall most heavily on them. Traustadottir (2002) discussed the way new care initiatives often put pressure on female family members and staff to do more unpaid work. For example, Circles of Support encourages them to include people with intellectual disability in their personal social networks, without considering the personal costs. Such observations have yet to emerge from the umbrella of feminist research. Separatism has served feminism well, but issues of women and care do need to find their place in mainstream reviews.Another useful reminder from Colman is that the person with intellectual disability is not the only concern to families, although only a few adult services manage to hold wider systemic factors in mind (Clegg and Burnham 2000). If the person may make naïve comments at a funeral that would devastate family members whose needs take priority, the person will be excluded.The potency of bereavement was discussed twice. Casenave suggests that because "disability is a loss experience" bereavement resonates with it, casting some doubt onto the suggestion that our thesis generalizes to other contested topics. Reinders criticizes clinicians for being purblind to the tragic. The anonymous reviewer who questioned [End Page 99] the relevance of our discussion of the quality of "presence," a quality Reinders considers highly relevant, illustrates the point better than we can. Recognizing the way clinicians have little "patience with the notion of the tragic" encourages reflection on what other human experiences fail to capture our attention.Although these are all potentially valuable directions, we focus here on comments that may enhance our ability to work without dogma. Since at least the 1980s, clinicians in intellectual disability have criticized the discipline for using linear and univariate rather than complex and multivariate theories, and for a naïve search for magic answers (reviewed in Clegg 1993). It is our contention that little has changed, and that uncertain meaning and normalization combine to create ideal conditions for dogma. Reinders' exposition of the various uses of meaning in our article and in different linguistic and historical traditions develops a vital but neglected topic in intellectual disability, which we consider in some detail. We conclude by arguing that developments require us to distance ourselves from the universality and commonality inherent to normalization, and create new ways to appreciate particularity and diversity.The gist of Reinders' complex argument appears to be that the problems we identify in managing bereavement in intellectual disability stem from a modernist understanding of meaning that is erroneous. Implicitly, those who eschew its pursuit demonstrate the greater wisdom, because neither dialogue nor activities such as reflection can generate meaning that is unattainable. If we understand his position correctly, he contrasts two principal understandings of meaning: comprehension and apprehension.Comprehension is the illusory modernist idea that humans are agents who make sense of themselves... (shrink)

The current thesis discusses how tools for analysing power are developed predominately for adults, and thus remain underdeveloped in terms of understanding injustices related to age, ethnicity/race and gender in childhoods. The overall aim of this dissertation is to inscribe a discourse of intersecting social injustices as relevant for childhoods and child welfare, and by interlinking postcolonial, feminist, and critical childhood studies. The dissertation is set empirically within the policy and practice of Swedish child welfare, here (...) exemplified by the assessment framework Barns Behov i Centrum. It aims to explore how Swedish child welfare, as a field of knowledge, modes of knowing and knowing subjects, constitutes an arena for claims and responses to intersecting social justice issues. The material consists of BBIC primers and selected samples from, a total of 283 case reports from a Swedish social service agency. The case reports address assessments of children. This dissertation is based on four qualitative studies using discourse analysis, as well as analysis inspired by thematic and case-study methodology. Two studies focus on child welfare discourses in BBIC documents involving social problems and violence, and two studies are based on child welfare case reports. Studies I­­-II address child welfare policy and practice by analysing the conditions required for children to participate, in terms of children’s moral status and in terms of status of ‘evidencing’ needs for protection. Studies III­­-IV explore this further from the perspective of intersecting and embodied social injustices in childhoods. Together, the studies interconnect child welfare as a field of knowledge, modes of knowing and knowers with child welfare as a moral arena for claims to rights, recognition, and social justice. The synthesised findings point to child biowelfare, in which justice discourses are largely absent. Biowelfare is informed by a mode of knowing and ‘evidencing’ risks to children’s health and development, which are confined to scientific predicting-believing, seeing-believing by professionals and a moral economy of care, all of which constrain the idea that injustices are structural and intersecting. Biowelfare primarily responds to children as ‘speaking’ biological bodies, rather than as voices of justice. In this sense, injustices of an epistemological nature are interconnected with social injustices. When issues of justice are mobilised in case reports and policy, they come across as rather ‘unjust’, primarily confined to the sphere of the family home of racialised children and not connected to ‘general’ children. In addition to intersections of age, ethnicity/race and gender, class and health are fundamental to recognition and protection in biowelfare. Finally, the dissertation indicates the need for a moral economy which responds to intersecting social injustices such as racial, gender-based and ageist violence in childhoods, and violations of children’s bodily integrity. (shrink)

Child labor is often condemned as a form of exploitation. I explore how the notion of exploitation, as used in everyday language, can be made precise in economic models of child labor. Exploitation is defined relative to a specific social welfare function. I first show that under the standard dynastic social welfare function, which is commonly applied to intergenerational models, child labor is never exploitative. In contrast, under an inclusive welfare function, which places additional (...) weight on the welfare of children, child labor is always exploitative. Neither welfare function captures the more gradual distinctions that common usage of the term exploitation allows. I resolve this conflict by introducing a welfare function with minimum altruism, in which child labor in a given family is judged relative to a specific social standard. Under this criterion, child labor is exploitative only in families where the parent (or guardian) displays insufficient altruism towards the child. I argue that this welfare function best captures the conventional concept of exploitation and has useful properties for informing political choices regarding child labor. (shrink)

As recently as 1970 about one-fifth of the children living in single-parent households resided in ones created by the death of a father. In colonial and nineteenth-century America, death was a much more important factor in disrupting parent-child relationships than it is today. Past societal reaction to the death of a parent continues to influence social policy; for example, widows and their dependent children receive more public assistance than divorced mothers or single mothers with children born out-of-wedlock. Although the (...) material conditions for widows have improved over time, the social network available to help them cope with the emotional distress caused by the death of a husband probably has diminished. (shrink)

The aim of this paper is to show some of the limitations of the Theory of Mind approach to interaction compared to a conversation analytic alternative. In the former, mental state terms are examined as words that signify internal referents. This study examines children’s uses of ‘I want’ in situ. The data are taken from a corpus of family mealtimes. ‘I want’ constructions are shown to be interactionally occasioned. The analysis suggests that (a) a referential view of language does (...) not adequately account for how mental state terms are used in talk, (b) the dominant methodology for examining children’s understanding of ‘desires’ is based on several problematic assumptions. It is concluded that participation in interaction is a social matter, a consideration that is obscured by Theory of Mind and its favoured methods. (shrink)

International and UK legislation and policy development in childcare is placing more emphasis on children's participation rights. This continues to present ethical dilemmas for childcare workers who also have the responsibility to ensure the protection and well-being of children. In Wales, the Welsh Assembly Government has made a commitment to the UN Convention on the Rights of the Child in the ?Rights to Action? child welfare policy. In England, the government introduced five aims and outcomes of children's (...) well-being in the ?Every Child Matters? child welfare policy. This paper identifies three barriers to children accessing participation rights, and critically discusses the ethical implications of the English and Welsh child welfare policies for children's participation rights. Family Group Conferences are discussed to highlight dilemmas of participation. (shrink)

A significant international development agenda in the practice of nurses supporting families with young children focuses on establishing partnerships between professionals and service users. Qualitative data were generated through interviews and focus groups with 22 nurses from three child and family health service organisations, two in Australia and one in New Zealand. The aim was to explore what is needed in order to sustain partnership in practice, and to investigate how the concept of practice architectures can help understand (...) attempts to enhance partnerships between nurses and families. Implementation of the Family Partnership Model (FPM) is taken as a specific point of reference. Analysis highlights a number of tensions between the goals of FPM and practice architectures relating to opportunities for ongoing learning; the role of individual nurses in shaping the practice; relationships with peers and managers; organisational features; and extra‐organisational factors. The concept of practice architectures shows how changing practice requires more than developing individual knowledge and skills, and avoids treating individuals and context separately. The value of this framework for understanding change with reference to context rather than just individual’s knowledge and skills is demonstrated, particularly with respect to approaches to practice development focused on providing additional training to nurses. (shrink)

Emerging child welfare policies promoting preventive and early intervention services present a challenge to professional ethics, raising questions about how to balance respect for service users with concern for social justice. This article explains how the UK policy involves shifting the balance of power away from families towards state and professional decision making. The policy is predicated on sharing information between professionals to inform risk and need assessment and so poses a problem for the ethic of confidentiality in (...) a helping relationship. This article examines the arguments for information sharing and questions whether the predicted benefits for children outweigh the cost of eroding family privacy and changing the nature of professional relationships with service users. (shrink)

This article reviews pertinent literature and presents findings from recent research to illustrate how CAFCASS (Children and Family Court Advisory and Support Service) private law practitioners understand, experience and manage the tension between empowerment and protection in welfare report enquiries. The traditional approach in the United Kingdom has been for children to be protected, especially when their divorced or separated parents are in conflict, but the balance is changing, as calls for the active participation of children in decisions (...) that affect them continue to grow louder. (shrink)

Concerns about intercultural communication practices in child and family health were raised during a South Australian ethnographic study. The family partnership model was observed as a universal pedagogic tool introduced into the host organisation in 2003. It has a role in shaping and reshaping cultural production within child health practice. In this study, we draw on insights from postcolonial feminist scholarship together with three‐body analysis to critique the theoretical canons of care that inform intercultural communication in (...) the child and family health setting.We contend that although the family partnership model may be very useful, its intended universal application is problematic in the context of multiculture. Issues of race, gender and class were seemingly unattended when using a communication approach based in historical scientific rationalism. Liberal interpretations of discourses of equity and empathy arising out of contemporary models of communication were often adopted by child and family health nurses and protected them from seeing the inherent binaries that constrain practice. Insights from postcolonial feminist thinking enabled us to recognise the problems of applying theory to practice in a linear fashion. We demonstrate the use of three‐body analysis as a deconstruction strategy to refigure how theory might be understood and worked with in the multiculture that is Australia. (shrink)

The welfare of the child is the prevailing principle and concern regarding access to assisted reproduction in Western countries today, and there is a wish to avoid harm to future children. New research fields have developed in order to provide scientific evidence on the welfare of children living with different “types” of parents. Assisted reproductive technologies (ART) seems to be heading in a responsible direction where the care and concern for future children is vital. However, the claim (...) of this article is that the principle of the welfare of the child confuses the ethical framing of ART. Several philosophers in the past have argued that potential people must be regarded as outside the moral domain, and therefore cannot be harmed or benefitted. This message has not reached the policymakers, probably because the welfare of the child principle seems to fit so elegantly with common sense. In this article a different ethical framing of ART is proposed. The author argues that “futile care” and not “the welfare of the child” should be the guiding principle for eventually rejecting access to ART. The desired goal of ART treatment should be understood to be the production of functional families. Assisted reproduction is primarily about us, actual people in an actual society, and how potential children may affect us. (shrink)

Many authors have described the ethical issues associated with international adoption for all members of the adoption triad, including adoptive parents, birth parents and the adopted child, and for both sending and receiving countries. This paper explores how political variants of care ethics, combined with a narrative approach to practice, can be used as a conceptual framework for ethically informed practice with families formed via international adoption. Political variants of care ethics foreground the particularized needs of the individual, but (...) also take into account the broader social, political, economic and cultural dynamics in which the experience of individuals occurs. This framework is particularly applicable to collaborative work with individuals or groups, such as families formed via international adoption, whose experience is both highly individualized and shaped by broader contexts and issues of social justice. This paper describes how changes in the social construction of international adoption have meaning for applied ethics and practice. Political variants of care ethics are then explored as a framework for ethical decision making. Finally, the relevance of a narrative, approach to practice is considered. This approach focuses on understanding the needs and experiences of families from their own points of view and within the social, economic, cultural and political contexts in which they have lived; linking a relationship-based, narrative approach to practice to important assumptions in many models of care ethics. (shrink)

Of all the changes to the Human Fertilisation and Embryology Act 1990 that were introduced in 2008 by legislation of the same name, foremost to excite media attention and popular controversy was the amendment of the so-called welfare clause. This clause forms part of the licensing conditions which must be met by any clinic before offering those treatment services covered by the legislation. The 2008 Act deleted the statutory requirement that clinicians consider the need for a father of any (...) potential child before offering a woman treatment, substituting for it a requirement that clinicians must henceforth consider the child’s need for “supportive parenting”. In this paper, we first briefly recall the history of the introduction of s 13(5) in the 1990 Act, before going on to track discussion of its amendment through the lengthy reform process that preceded the introduction of the 2008 Act. We then discuss the meaning of the phrase “supportive parenting” with reference to guidance regarding its interpretation offered by the Human Fertilisation and Embryology Authority. While the changes to s 13(5) have been represented as suggesting a major change in the law, we suggest that the reworded section does not represent a significant break from the previous law as it had been interpreted in practice. This raises the question of why it was that an amendment that is likely to make very little difference to clinical practice tended to excite such attention (and with such polarising force). To this end, we locate debates regarding s 13(5) within a broader context of popular anxieties regarding the use of reproductive technologies and, specifically, what they mean for the position of men within the family. (shrink)

This article confronts the challenges and opportunities presented by medical-legal partnerships (MLPs) representing families impacted by the family regulation system. Based on the authors’ experience developing a collaboration between a medical-legal partnership, interdisciplinary law school clinic and nurse home visiting program focused on clients impacted by the family regulation system, the article challenges traditional conceptions of the MLP model and proposes an expanded vision for MLPs to address systemic injustice and improve outcomes for families.

Work—family policy strategies reflect gendered assumptions about the roles of men and women within families and therefore may lead to significantly different outcomes, particularly for families headed by single mothers. The authors argue that welfare states have adopted strategies based on different assumptions about women's and men's roles in society, which then affect women's chances of living in poverty cross-nationally. The authors examine how various strategies are associated with poverty rates across groups of women and also examine more (...) directly the effects of specific work—family policies on poverty rates. They find that while family benefits and child care for young children unequivocally lower poverty rates, particularly for families headed by a single mother, long parental leaves have more ambivalent effects. The findings suggest that it is critical to examine the gendered assumptions underlying work—family policies rather than viewing all work—family policies as the same. (shrink)

Child poverty is one of the biggest challenges of today, harming millions of children. In this book, it is investigated from a philosophical social justice perspective, primarily in the context of modern welfare states. Based on both normative theory (particularly the capability approach) and empirical evidence, the authors identify the injustices of child poverty, showing how it negatively affects the well-being of children as well as their whole life course. But child poverty is not 'given by (...) nature'. It is avoidable and there is certainly the moral duty to alleviate it. Therefore, Graf and Schweiger develop a normative theory of responsibilities, which clarifies the moral role of different agents in the poor child's environment: the family, the state and many others, that have so far been neglected in philosophical theories. They conclude their book by sketching how their theory can be extended to global child poverty and what it means to show equal respect and concern for every child - no matter where and in which context they were born. (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)

Since its inception, donor conception practices have been a reproductive choice for the infertile. Past and current practices have the potential to cause significant and lifelong harm to the offspring through loss of kinship, heritage, identity, and family health history, and possibly through introducing physical problems. Legislation and regulation in Australia that specifies that the welfare of the child born as a consequence of donor conception is paramount may therefore be in conflict with the outcomes. Altering the (...) paradigm to a child-centric model, however, impinges on reproductive choice and rights of adults involved in the process. With some lobby groups pushing for increased reproductive choice while others emphasise offspring rights there is a dichotomy of interests that society and legislators need to address. Concepts pertaining to a shift toward a child-centric paradigm are discussed. (shrink)

Social welfare workers in the protective services field—among them social workers, psychologists, and psychiatrists—are expected to follow the laws of the state in which they practice, but are also bound by their professional code of ethics. Often this does not present a problem, but at times ethical and legal expectations differ. This is particularly problematic where the professionals may be seen as agents of control, reporting possible child abuse, conducting child abuse investigations, inspecting homes, monitoring families, removing (...) children from their homes and the like, often working with or reporting to law enforcement agents where expectations are different and codes of ethics absent. This paper explores the relationship between law and professional ethics, and, in particular, situations in which actions and decisions can be legal yet unethical or ethical but yet illegal. It then analyzes some critical child protective service activities where Child Protective Services (CPS) workers exert significant control over parents and children, and where the legal and ethical requirements may differ. Finally, the paper discusses the problems that CPS professionals face when law and ethics collide, and suggests various steps to resolve some of these conflicts. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

This article conceptualises theories of ethics relevant to the recognised problem of decision variability in child protection. Within this field, social workers are faced with multiple ethical imperatives when making decisions about children’s care. They must respond to justice principles concerned with duties and consequences, as well as ethical obligations created by the relational and contextual elements of each case. Recent scholarship on decision variability highlights the justice issues that arise when decisions in response to apparently similar cases differ. (...) An ethical imperative is that similar cases should be treated ‘like for like’ so that children’s and family’s rights are upheld consistently. This article contends that ethical concepts relating to both universalist duties such as respect for persons, extended by the concept of interactive universalism, and contextual responses based on an ethic of care, help theorise the complexities of ethical decisions in child protection. These concepts develop a nuanced understanding of the ways social workers resist risk discourses, may make decisions reflecting the participation of service users, and contextual evaluations of risk based on understanding service user’s life histories. Understanding this combination helps explain the reasons behind variability, and evaluate the moral acceptability or otherwise of apparently variable decisions. (shrink)

The author uses a case history to compare the approaches taken by social care teams in engaging with parents whose care of their children has been called into question. As organising secretary for Parent Aid, a voluntary support service for Essex families who had or were likely to become clients of Social Services, she drew up a list of five keys points that would improve working relations with parents in child protection and court situations and relates them to the (...) ethical framework; write reports that are both factual and objective ; take as much time to build a relationship with the parents as you do with the child; remember to treat gossip with extreme caution; donât back off from parents just because they seem hostile; and try to be as honest and reliable as possible. The examples used to illustrate these points are said to demonstrate the five areas where parents most often take objection to Social Servicesâ approach; the same areas that are most likely to cause parentsâ anxiety and anger to harden into belligerence. The author goes on to show that all of these points can be found embedded in the Code of Practice for Social Workers. (shrink)

This study is the first to explicitly assess the connections between welfare state spending and the gendered and classed dimensions of unpaid care work across 29 European nations. Our research uses multi-level model analysis of European Quality of Life Survey data, examining childcare and housework burdens for people living with at least one child under the age of 18. Two key findings emerge: First, by disaggregating different types of unpaid care work, we find that childcare provision is more (...) gendered than classed—reflecting trends toward “intensive mothering”. Housework and cooking, on the contrary, demonstrate both gender and class effects, likely because they are more readily outsourced by wealthier individuals to the paid care sector. Second, while overall social expenditure has no effect on hours spent on childcare and housework, results suggest that family policy may shape the relationship between gender, income, and housework. Specifically, family policy expenditure is associated with a considerably smaller gender gap vis-à-vis the time dedicated to housework: This effect is present across the income spectrum, but is particularly substantial in the case of lower income women. (shrink)

The concept of the ‘well-being of the child’ (like the ‘child’s welfare’ and ‘best interests of the child’) has remained underdetermined in legal and ethical texts on the needs and rights of children. As a hypothetical construct that draws attention to the child’s long-term welfare, the well-being of the child is a broader concept than autonomy and happiness. This paper clarifies some conceptual issues of the well-being of the child from a philosophical (...) point of view. The main question is how well-being could in practice acquire a concrete meaning and content for a particular issue or situation. A phenomenological-hermeneutic research perspective will be outlined that allows the child’s well-being to be elucidated and specified as an anthropological and ethical idea. It is based on a contextual understanding of generative relationships, a combination of the theory and practice of making sense, here described as ‘generative insight’, which could provide ethical guidance for decision making in families, legal practice, medicine or biomedical research. (shrink)

Numerous laws have passed to move away from criminalising youth who trade sex. Specialised courts have also been established to support youth. Despite proponents' contention that specialised, trauma-informed courts are less punitive than typical interventions, research is limited. This article explores one specialised dependency court's efforts to assist youth ‘at risk’. Drawing on interviews and ethnographic observations, I argue that laws and trauma-informed court interventions intensify the supervision of youth and families while inadvertently concealing the gendered-racialised effects of child (...) welfare system involvement. Ethnographic findings contribute to sociolegal and anti-carceral feminist research on carceral control beyond the criminal legal system. This work also explores the ethics of carceral-trauma entanglements that accompany decriminalisation’s afterlife. (shrink)

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as the ethical and legal issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models (...) of health care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy. (shrink)

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as the ethical and legal issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models (...) of health care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy. (shrink)

Information on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s thematic synthesis method was used to synthesise data (...) from identified studies. Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices. (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public (...) care to a private family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

The United Nations' designation of 1979 as the International Year of the Child marked the first global effort undertaken to heighten awareness of the special needs of children. Activities initiated during this special year were designed to promote purposive and collaborative actions for the benefit of children throughout the world. Michigan State University's celebration of the International Year of the Child was held from Septem ber 1979 through June 1980. A variety of activities focused attention on the multiplicity (...) of factors affecting the welfare of today's children as well as the children of the future. Many people involved with the university were concerned that benefits to children continue beyond the official time allocated to the celebration. The series Child Nurturance is one response to this concern. The first five volumes of Child Nurturance reflect directly the activities held on the Michigan State University campus and consist of original contributions from guest speakers and invited contributors. Subsequent biennial volumes will present original contributions from individuals representing such fields as anthropology, biology, education, human ecology, psychology, philosophy, sociology, and medicine. We hope the material presented in these volumes will promote greater understanding of children and encourage interdisciplinary inquiry into the individual, family, societal and cultural variables which influence their welfare and development. We would. like to express both our thanks and our admiration for who not only typed the camera-ready copy for each of Margaret Burritt the volumes, but also served as general manager of the entire project. (shrink)

What is family-centred care of a hospitalized child? A critical understanding of the concept of family-centred care is necessary if this widely preferred model is to be differentiated from other health care ideals and properly evaluated as appropriate to the care of hospitalized children. The article identifies distinguishable interpretations of family-centred care that can pull health professionals in different, sometimes conflicting directions. Some of these interpretations are not qualitatively different from robust interpretations of the ideals of (...) parental participation, care-by-parent and partnership in care that are said to be the precursors of family-centred care. A prominent interpretation that regards the child and his or her family collectively as the ‘unit of care’ arguably arises from ambiguity and is significantly problematic as a model for the care of hospitalized children. Clinical practice driven by this interpretation can include courses of action that do not aim to do what will best promote a hospitalized child’s welfare, and such cases will not be unusual. More broadly, this interpretation raises challenging questions about the responsibilities and authority of health professionals in relation to the interests of hospitalized children and their families. (shrink)

This article reviews an epochal change in international thinking about physical punishment of children from being a reasonable method of chastisement to one that is harmful to children and troubling to families. In addition, the article suggests shifts in thinking about physical punishment were originally pioneered as part and parcel of the dismantling of national laws granting fathers’ specific rights to admonish children under conventions of patria potestas. A comparative historical framework of analysis involving two case studies of Ireland and (...) Ghana illustrates non-unilinear pathways of international convergence towards the prohibition of physical punishment. The comparative historical analysis highlights the 1930s and 1940s as an era when Ireland began to reject patria potestas and religious or judicial rulings which allowed for children to be given ‘a good beating’ in family and school settings. However, from the same period, Ghana is seen to experience Christian remonstrations not to ‘spare the rod’ leading to the ‘conventional’ tradition of ‘this is how we do it here’. Two case studies serve to illustrate that banning physical punishment was less controversial in Ireland where allied traditions of patria potestas and disciplinarian Christian beliefs had lost their moral hegemony than in Ghana where such beliefs still held influence. The article concludes overall that normative campaigns against physical punishment of children emanate from a coherent paradigm of family policy where childcare, education, and well-being of children are embedded as everyday societal responsibilities rather than privatised or patriarchal familial obligations. The coherent model offers an alternative moral hegemony to neo-liberal and Janus-faced conceptualisations of good or ‘intact’ families versus ‘broken’ or ‘troubled’ families. (shrink)

In pediatric emergency rooms (ERs), social workers must navigate diverse responsibilities including acting as advocates and liaisons between families and multidisciplinary treatment teams, providing compassionate support to families in crisis, and assessing for and reporting any suspicions of child abuse or neglect. These potentially contrasting roles can place social workers at the center of dealing with ethical dilemmas and advocating against ethical violations, such as bias and discrimination toward families. This qualitative study seeks to gain insight into ethical issues (...) commonly encountered in pediatric ERs by exploring the perspectives of 23 social workers at Level 1 trauma centers in the United States. Thematic analysis was used to develop major themes and subthemes related to ethical violations, dilemmas, and best practices in pediatric ERs. Major themes emerged related to unfair treatment of families (with subthemes of bias, discrimination, and compassion fatigue), ethical dilemmas (with subthemes of cultural issues, safety and system issues), and promoting ethical practices (with subthemes of self-awareness, advocacy, and efforts to change the system). This study provides important insights into ethical issues in pediatric ERs as experienced by social workers and can inform efforts to improve the quality and equity of care for all families in pediatric ERs. (shrink)

The welfare reform law of 1996 completely overhauled the nation's system of assistance to low-income families. The reauthorization of that law, now several months overdue because of congressional delays, presents an opportunity for religious social ethicists to evaluate the adequacy of our nation's anti-poverty efforts. This paper surveys policy developments from 1996 to 2003 and analyzes five key issues in the reauthorization debate: the size and structure of welfare block grants; work requirements; welfare time limits, sanctions, and (...) exemptions; marriage promotion and the family cap; and ancillary programs providing work supports such as food stamps, Medicaid, and child care subsidies. A variety of ethical critiques of policy proposals is offered, some of them from the perspective of Catholic social teaching. The trail of missed opportunities in welfare reform will probably continue, as American social policy fails to act upon an accurate portrayal of the challenges facing poor families today. (shrink)

If a child’s well-being is at risk of considerable harm within their own family, state institutions usually intervene. In severe cases, the parents’ right to rear is suspended. Cases of risk assessment and potential state intervention are decided within a conflict between parents’ rights and claims of children for protection. There is, we argue, a standard model of normative assessment underlying these decisions: It rests on premises rooted in classic liberal political philosophy, which is prevalent in many Western (...) societies, such as a strong commitment to individualism, a separation of private and public, or a conceptualization of children as lacking the status of full right holders. We proceed in three steps. Based on cases in social work and child welfare offices, firstly, the article proposes an inductive approach to describe the problem. Second, we point out the most critical problems and shortcomings of the standard model. On this basis, third, we develop an alternative, pragmatistic perspective on child welfare and state intervention. It argues that child welfare must be understood more broadly as a societal concern than merely as a matter of the legitimacy of state intervention. A practice-oriented section follows to show what conclusions can be drawn from our alternative model. (shrink)

This article reports on exploratory research into social workers? perceptions and actions regarding ?forewarning? clients of their child abuse reporting obligations as a limitation of confidentiality at relationship onset. Ethical principles and previous research on forewarning are discussed prior to stating the research methods and presenting findings. Data obtained from South Australian social workers engaged in human service work with adult family members articulate a strong desire to practise in accordance with professional codes of ethics. However, the findings (...) suggest that proactive forewarning is extremely infrequent, with minimized forewarning accomplished only in response to client-initiated inquiry and where prior suspicions of child abuse may exist. Generally, discomfort with forewarning was found to result in its avoidance due to concerns about client retention, working in tense relationships and personal uncertainties about client's reactions towards participants. Through the avoidance of forewarning, participants are potentially supporting their own personal feelings and viewpoints more actively than the rights of others. This may correlate with having a private model of professionalism in opposition to a public model, in which relationship parameters are presented honestly and openly to clients when establishing the practice context?a problematic issue for ethical social work. (shrink)