Legitimate medical interventions v. CPS medical kidnappings.

We've heard so many horror stories about parents deciding to exert parental authority against the white-robed drug salesmen that pass as "doctors" (and their close connection to "child protective" "services..."CPS,") and subsequent kidnappings, that we wanted to know what the situation looked like, instead, when there was genuine caretaker medical neglect of children with legitimate medical needs.

(Courtesy of healthimpactnews.com.)

Fortunately, a study does exist which looked into this exact situation.

Here is the link:

https://hosppeds.aappublications.org/content/6/4/204

A lot of the information is pretty date. The study was conducted just a couple years ago, but a lot of the data collected is more than a decade old, but I think we can still glean some useful information for the purposes of comparison. According to those conducting the study the purpose of the study were to:

"Our objective was to describe a group of children reported to child protective services (CPS) for medical neglect to define this population as well as identify prevention and intervention approaches."

The study is very limited by the sample chosen, however...one particular hospital in one neighborhood (of Chicago) over a six year period. Still, some of the findings are quite interesting.

(Note: This chart is not part of the current study being discussed. Image courtesy of lawanddisorder.com.)

Here is the first excerpt:

"Of the 154 patients reported for medical neglect, 140 (91%) had chronic illness. The most common diagnoses were type 1 diabetes, organ transplantation, and prematurity-related conditions. Most patients (83%) were black or Hispanic and 90% were publically (sic) insured. More than half of patients (54%) had at least one CPS report during the study period. Almost all patients (88%) returned to the hospital for care subsequent to the medical neglect report. Risk factors for child maltreatment, family stressors in the year preceding the report, and practical barriers to care were documented in more than two-thirds of patients."

As you can see, we are not talking about minor cuts & abrasions, or the common cold here. These kids had legitimate long-term, serious diseases...meaning caretakers had to have known there were legitimate health issues with their kids. Even with that, over six years, at a major city hospital, there were only 154 cases in 6 years. That's two per month.

(Courtesy of medicalnegligenceassist.co.uk.)

This sounds like one of the few situations where (if we must have CPS, and that is very debatable) CPS intervention is valid. However, not even one full time position for a large chunk of Chicago seems to be needed to handle this issue. In fact, one good employee could handle all such cases for the entire greater Chicago area of five million residents. How many are there actually in that area? SEVERAL HUNDRED.

The fact that 83% of legitimate cases of neglect were by minorities is interesting, but I am not sure what conclusions we can (or should) try to draw from that. Are racial minorities somehow less caring or concerned about their own children? That doesn't seem likely. We are talking about people who are ALL INSURED too (90% on the public dole,) so financial issues (other than transportation problems) shouldn't be the issue either. Strangely, the article--though long and extensive--never seems to address this question at all.

(Courtesy of malpracticeteam.com.)

The article also doesn't delve into what parental rights groups are most concerned about when it comes to the medical/CPS interactions, i.e. with parents not willing to follow medical advice. This study concerns itself solely with parents who seem to just be blatantly neglectful, and that have no philosophical, conscientious or religious problems with the treatments prescribed.

Here is another excerpt:

"A study published in 1989 described 61 children diagnosed with chronic illness and any type of neglect. To our knowledge, there are no recent studies focused on characterizing a cohort of children reported to CPS for medical neglect. A...clinical report provides general guidelines on recognizing and responding to medical neglect. However, there are no disease-specific guidelines for managing or reporting medical neglect, and the lack of evidence-based data could result in inconsistent reporting practices. For example, medical professionals were asked to review vignettes describing families failing to seek medical care after a positive newborn screen for diseases such as phenylketonuria, sickle cell disease, congenital hypothyroidism, cystic fibrosis, and carnitine palmitoyltransferase. Respondents were then asked to indicate if they would file a report to CPS for medical neglect. Although all vignettes described failure to seek necessary medical care, reporting rates ranged from 40% to 61%, and varied based on respondent gender."

(Courtesy of slideplayer.com.)

Frankly, I am not sure what to make of this either. If medical "professionals" are only willing to report about half of cases of blatant neglect to CPS, what are we to make of THAT? I'd love to suggest that some medical professionals have a conscience, and they know that children will be worse off if reported to CPS than they would be fighting such diseases without treatment. I know that's a pretty breathtaking claim, but the article makes no suggestions, and so the mind is left to just wander... (If you have a theory please feel free to comment below.) Again, this obviously dated material and the new wave of drug sal...uh..."doctors" of the past couple decades are probably a lot less reticent to report than older doctors.

Finally, this is the most useful paragraph of the whole article/study:

"Risk factors for child maltreatment studied were parental mental illness, substance abuse, domestic violence, and any history of caregiver police involvement. Barriers to care including lack of child care for siblings, transportation problems, and financial concerns were noted if documented at least once in the medical record. The following stressors in the year leading up to the report were recorded if documented in the medical chart: move, job change, major illness in another family member, birth of a new sibling, parental divorce or separation, incarceration, or death in the family."

OK...so now we have a picture that brings some sense to these rare incidents. Even though there was no financial hardship regarding the costs of exorbitant medical care, we are dealing with "care takers" with some serious problems. I am surprised "laziness" isn't listed, as I'm sure that is a factor as well. But, clearly, we are not dealing with people here who are conscientious parents that simply differ with medical advise, diagnoses, or treatments ordered by "medical professionals" who think that they have superior rights to parents. These are the parents that, invariably, are targeted for the most invasive and bullying tactics that CPS can muster.

Again, however, in these cases of genuine medical neglect, why is that we need CPS again? Prior to the 1980s, law enforcement would have handled this, if direct cajolement by medical staff didn't do enough to resolve the issue. Again, CPS has no real role here, and we would all be better off if it would simply just go away.