While I'm touching upon issues relating to children in foster care, I should mention Yvette's recent post at Six Impossible Things Before Breakfast. Yvette is a doctoral student in Family Social Science, who researches adoptive parenting. In her post, Yvette analyzes the ethical issues surrounding the testing of AIDS drugs on foster children, recently in the news. The children who have been subjects for the drug tests are disproportionately African American.
There has been a lot written recently about the role of race in decision making and actions regarding the remocal of children from their homes and termination of these children's parents' parental rights. One voice in this discussion has been that of Dorothy Roberts, for example in this essay in response to a Frontline program about the child welface system:Read the whole thing.White children are the least likely of any group to be supervised by child protective services. Black children make up more than two-fifths of the foster care population, though they represent less than one-fifth of the nation's children. Latino and Native American children are also in the system in disproportionate numbers. The system's racial imbalance is most apparent in big cities where there are sizeable minority and foster care populations.However, according to Roberts this disparity is likely not just about poverty:Even though black children are more likely to be poor than white children, racial differences in child poverty rates don't fully explain why black children are placed in foster care at higher rates. Race also influences child welfare decision-making through powerful, deeply embedded stereotypes about black family dysfunction. Black families diverge the most from the parenting ideal embodied in the white, middle-class model composed of married parents and their children. Black mothers are assumed to be irresponsible and difficult to rehabilitate. A number of studies demonstrate that caseworkers, judges, and doctors are more suspicious of non-white parents.I know of a case of a small pediatric group practice headed by two African American physicians serving a largely Black and low-income client population. These two experienced doctors had become so fed up with emergency room personnel automatically calling social services on their patients that they requested that one of them be called before any hospital staff takes such action in order to provide input, context--even advocacy.
What an unenviable position to find yourself in as a physician: treating your patients by, in part, protecting them from the actions of other physicians.