The World according to DocBrain

Saturday, May 23, 2009

The government giveth...

http://www.usatoday.com/news/nation/2009-05-22-chemotherapy-vanished_N.htm

While the above case is one of dispute between parents about the treatment of their child, and it clearly is within the realm of our government to help this discussion to continue by reuniting the family in a setting where this can be fairly decided (ie, in a family meeting, or failing that, in a court of law). As is apparent in this case, a failure in communication/understanding of the nature of the problem was at the root of the apparent conflict. Often, this boils down to a difference in communication techniques, a different set of priorities, or different loci of trust. A third party who can bridge the gap is often part of the solution. However, this case has sparked discussions of when is it right for the government to tell parents how to raise their children.

Q. When should the government act in loco parentis?

A. When the parents are "choosing poorly".

The problem with this answer is that the devil is in the details. How significant does that "poor choice" have to be? Does the "poor choice" have to impact others or just the child?

A parent refusing diabetic care or cancer therapy for their child that is potentially life sustaining somehow seems wrong. And yet, the impact of this choice is only upon the child and the family. Why should the government get involved?

More disturbing are public health issues. When I was an intern in St. Louis, we had a small child with active tuberculosis in the hospital. He was quite ill and quite contagious. His mother spirited him from the hospital because she did not want him treated. We alerted the state police, who found them 2 days later over 200 miles away. In this case, the public was at risk. I believe that the decision in this event was correct, protecting the public welfare.

What about abuse? When a child is physically, sexually or psychologically abused by a parent, should the government act? Since the child is a citizen, the answer is yes. We need also to make it easier for parents who feel incapable or unwilling to raise their children to have an alternative where the child can go. This can be done with or without government intervention, can be for short or long periods, without stigma, to allow the parents to get their act together and to allow a safe environment for the child. The current system is perhaps too permanent, too bureaucratic, and too public. To avoid embarassment, inadequate parents keep their children and continue to harm them. It does take a village, but people now live isolated lives. Increased community spirit is one solution. Increased parental networking.

Does time of the impact matter? What about raising children in a way that harms them as well as harming others, but perhaps a little more slowly? 25% of US prisoners are illiterate. The daughter of a friend was murdered by an illiterate teen. What about parents who do not work with teachers to foster literacy in their children? Should teachers have the duty to report parents who do not "get with the program" in helping their children to succeed in school? What about parents who send their children to school less prepared than others? For example, in dirty clothes, unfed? What about parents who are poor role models, such as drug addicts, alcoholics, prostitutes, or even bank/auto industry CEOs?

DocBrain believes that the use of power to intervene in people's lives should be reserved for specific situations where the public is at risk. Poor parental choice is too slippery a slope for the government to exert its power. As the great Jeremiah Wright said, perhaps we just need to let the chickens come home to roost. Or perhaps Darwinism is acting here. Allowing people to experience consequences of poor decisions serves as object lessons for the rest of us. The invisible hand of right and wrong will lead us in the correct direction. As hard as it is to accept, the sacrifice of one child for the right of all of us to be free may be the best approach. There are opportunities to help children at risk, parents who are not up to the task. This is an area where more research, more options, and more innovation will lead to less parental stress, less child abuse. Yet, there will always be the hard core antisocial. True criminals, those who intentionally inflict harm, need to be prosecuted. The rules for this need to be very narrow to prevent a situation where an honest difference of opinion is not criminalized.

Once, starving people who stole a loaf of bread were placed in prison for years. Now, we have improved farming so that bread is less expensive; we have created enough wealth that we can freely give food (via food stamps, soup kitchens, etc) to those in need. Our society has stepped up to the plate and solved this problem except for the person who really just wants to commit a crime. This is the answer. A problem indicates the need for a solution, and that solution hardly ever should be more government.

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