Tuesday, July 26, 2022

The middle-class white person’s guide to dealing with a child abuse allegation

The doctor will report you now.

That’s not what the recent article in the online publication Parent Map is called, of course. The actual title is “What do Do If You Are Mistakenly Accused of Child Abuse in a Hospital Emergency Room.”  But the authors should have made clear the advice only applies if the “You” in that headline is a white, middle-class person. 

Between them the co-authors, a doctor and a lawyer, have five sets of  “look-at-all-my advanced -degrees!” initials after their names.  It begins with what happened to one of the authors,  Katheryn Goldman, DMD, MPH, ABD: 

My 9-year-old daughter was jumping on her bed. She bounced off, and I wound up taking her to the emergency room. She got two small stitches under her eye. Just a week later, two of our sons were engaged in some rough horseplay. Oops! Off to the emergency room I went again. Thankfully, no stitches were needed on the 4-year-old’s head. Both times, we were treated by the same nurse in the same examining room! I could sense that she looked at me with a tad of justifiable suspicion. That’s why I made sure that in both instances the children told the nurse what had happened. I did not want to give the impression that the kids were being coached in any way. 

Oops?  Just – oops?  Would she call the suspicion “justifiable” were she, at this very moment, making sure the house was spotless in case of a surprise inspection from CPS – in between her mandatory “counseling” and “parent education” classes?  Would she feel that way were she fighting to get her child out of foster care?  Two trips to the E.R. in a week, and one required a child to get stitches?  How many impoverished Black parents could have that happen to their children without so much as a call to the family police? 

This article is not the worst of its kind.  One pediatrician / author has practically made a career out of writing this sort of essay. 

But at no point do Dr. Godman and her lawyer co-author, Daniel Pollack, MSW, JD, so much as acknowledge that the kid gloves, anyone-can-have-an-oops treatment is reserved for the white middle class. 

Then comes a claim that, for some hospitals, is demonstrably false.  They write: 

Simply because a child gets injured and is treated at an emergency room does not mean that Child Protection Services (CPS) will become involved. The hospital contacts CPS only when staff suspect maltreatment. 

But just two days after the Parent Map story was published, KFMB-TV in San Diego reported this story: 

A Marine Corps pilot and his wife are suing the County of San Diego after Child Welfare Services took their seven-month-old son from their home for more than a month after the boy head-butted his mother as he played after breastfeeding.  

According to the story, the hospital apparently didn’t believe the infant was abused but

submitted a hotline referral to the county as required when an infant is injured and admitted to the hospital.

California law does not require this - it's simply a hospital policy that makes every parent who brings in an infant with an injury automatically suspect.

Similarly, when Children’s Hospital of Philadelphia reported City Councilmember David Oh as a potential child abuser after one of his children was injured as he taught the child martial arts, Oh says the hospital social worker explained that she “typically reports injuries children suffer in all sports.”

By the way, Councilmember Oh’s child was interviewed separately and told the social worker what happened – just like Dr. Goldman’s children.  But somehow, the result was different. 

And these are just the hospitals that will say it out loud. 

Remember, no doctor, nurse, or other mandated reporter will get in trouble for making a report that turns out to be false.  They can face huge penalties for failure to report if, later, it turns out there really was abuse.  So even in the absence of a formal policy that creates a huge incentive to report any injury, especially to the youngest children.

But not only does the Parent Map article mislead on this point, at no point does it mention the slew of studies showing that, where a report isn’t automatic, medical personnel are far more likely to call the family police if the family is not white.

Indeed, though the article claims that “Making a decision to contact child protective services is a difficult call for the vast majority of health-care providers” in fact, we’ve created incentives that make it way too easy – especially if the parent is not white and middle-class.

Now let’s consider some advice the authors offer concerning lawyers:

Even though things are happening fast in the ER, depending on the allegations, you may want to have an attorney present with you during any interviews with a CPS investigator.  Under many circumstances — but not all — you may be inclined to proactively grant CPS access to your child. While you may have the authority to deny that access in some states, such a denial may cast you in a negative light. This is a judgment call to quickly consult an attorney about. [Emphasis added.]

Is it really necessary to point out the problem with this advice?  Poor people generally don’t have a lawyer on speed dial.  And with extremely rare exceptions, the government isn’t going to provide one, either.  In some states, impoverished families have no right to a lawyer at all.  In the rest, except for a few pilot programs, they’re only guaranteed a lawyer after the family police have decided to haul the family into court.

Even then, it’s not the kind of lawyering the authors of the Parent Map article have in mind.

Scholars who worked on studies of more than 20 different family policing systems found that

attorneys  who  represent parents or children have very high caseloads, in some jurisdictions, as high as 300 cases per attorney. Parents and youth consistently reported quick interactions with their  attorneys, and many reported not knowing the name of their attorneys. Parents are routinely told  to plead and accept case plans as the quickest way to get children back home and end system involvement.

So let’s not kid ourselves.  Poor, nonwhite parents, the very parents most likely to be viewed with unwarranted suspicion in the ER, are also those least likely to be able to follow that nice advice about lawyers.

Of course there’s nothing wrong with giving advice that applies only to white middle-class families – provided it comes with a warning label.  The very fact that the authors saw no need to place such a label on their story, or even acknowledge that racial and class bias exist in the family policing system, is part of the reason we have such a system in the first place.