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Racism in child welfare: Ethical considerations of harm.

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Systemic racism causes significant racial disparities in the US child welfare system. Bioethics must address how mandatory reporters consider social context and potential bias when reporting child abuse and neglect to protect all children.

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Area of Science:

  • Child Welfare
  • Bioethics
  • Public Health

Background:

  • Systemic racism in the US child welfare system leads to significant disproportionality and disparity.
  • Black children are nearly twice as likely to be victims of substantiated abuse and neglect claims compared to other racial groups, despite race not being an inherent risk factor.

Purpose of the Study:

  • To review the impact of racism on child welfare.
  • To discuss ethical considerations for mandatory healthcare reporters when determining potential child abuse and neglect referrals.
  • To broaden the consideration of what constitutes harm, particularly for children of color.

Main Methods:

  • Review of the impact of racism on child welfare.
  • Discussion of ethical considerations for mandatory reporters.
  • Presentation of a hypothetical case to illustrate bias in the referral process to Child Protective Services (CPS).

Main Results:

  • Bias can enter the referral process to CPS due to systemic racism and a narrow definition of harm.
  • Thoughtful reporting requires consideration of social and historical context and alternative explanations for concerning findings.

Conclusions:

  • Medical providers should consider social context, seek clarification from families, and ensure internal consistency when contemplating CPS referrals.
  • Expanding the definition of harm is crucial, especially for children of color, to ensure equitable child protection.
  • While clear safety concerns must be addressed, nuanced situations require careful ethical consideration to avoid perpetuating racial disparities.