The doctor will accuse you now

A recent essay in Time Magazine called for a massive expansion of the nanny state through mandatory medical screening of children for signs of child abuse. The proposal, which is based on the assumption that racial bias is causing doctors to miss some cases of abuse, would strip doctors of the ability to apply reasoned, clinical judgment to cases and would require them to subject children to a battery of x-rays whenever bruising or other marks are noticed. Proponents of the plan — not its opponents, mind you — have given it the appropriately dystopian moniker, “think less, screen more.”

Perhaps as shocking as the plan itself is how nonchalant the essay’s authors, Dr. Richard Klasco and Dr. Daniel Lindberg, are about the life-altering consequences of their proposal. In an apparent attempt to downplay the harm that their plan will cause, Klasco and Lindberg wrongly suggest that the worst that will happen if they get their way is “some non-abused children will be screened, and some non-abusive parents will be offended.”

The real worst-case scenario happened to my friends, Rana and Chad Tyson, and it was far from merely an “uncomfortable byproduct.” While changing their infant daughter’s diaper, Rana and Chad noticed that she was not moving one of her legs and would recoil in pain whenever it was touched. Being the good parents they are, the Tysons immediately took her to her regular pediatrician. After being evaluated by the pediatrician, they were instructed to go to a local children’s hospital where the daughter who displayed symptoms and her twin sister were subjected to the same battery of x-rays utilized by the “think less, screen more” approach.

Those x-rays revealed that both had what appeared to be multiple healing fractures around their knees and ankles. Rather than attempting to find a medical explanation, doctors at the hospital contacted Child Protective Services. All three of the Tysons’ children were removed by the state and placed in a kinship foster placement. The family would be separated for five months while Rana, Chad, and their children’s pediatrician worked to figure out the cause of the fractures.

Ultimately, the doctors discovered that the twins had several medical conditions — including a genetic disorder (Ehlers Danlos Syndrome), Vitamin D deficiency, rickets, and osteopenia of prematurity — which make them more susceptible to spontaneous fractures. Based on this evidence, a judge ordered the children to be returned home to their parents. But reunification wasn’t the end of the story. It took two years of legal appeals before the allegations of abuse were dropped and Rana and Chad were cleared of wrongdoing. The process was so expensive the family was forced to file for bankruptcy.

As traumatizing as their experience was, Rana and Chad were ultimately reunited with their children in a relatively short period of time. Other families who have contact with the child welfare system aren’t so lucky. Nationally, most children who enter the foster care system will stay there for a little over a year and less than half will ever return home to their parents. Separating children from their families has long-term negative consequences and is a decision that should not be taken lightly. 

Klasco and Lindberg do get one thing right — there is a bias in the child welfare system against poor and minority populations. According to one study, 53-percent of African American children will experience a child welfare investigation by the time they reach age 18. Their solution, however, couldn’t be more wrong. “Just screen everyone” is a terrible way to approach solving the problem of bias within the system. Moreover, it’s incredibly dangerous. During fiscal year 2017, the most recent year we have data, 7.5 million children were reported to child protective services as possible victims of abuse and 3.5 million children actually received a CPS investigation. Of these, 674,000 children — less than 10-percent of those reported — were confirmed to be victims of abuse.

The problem isn’t under-reporting; it’s over-reporting that puts additional strain on a child welfare system that’s already stretched too thin and increases the odds that children in actual danger of harm will fall through the cracks.

Rather than following Klasco’s and Lindberg’s advice that parents shouldn’t “get mad” when they find themselves under suspicion of abuse as a result of their draconian “screen everyone” plan, parents should get mad.

Come to think of it, we should all get mad at this call to waste valuable time and taxpayer resources on a fool’s errand that will result in needless investigations, violations of the constitutional rights of untold number of families, and, tragically, more children placed in harm’s way.           

Andrew Brown (@MrACBrown) is the director of the Center for Families and Children at the Texas Public Policy Foundation.