Child abuse has emerged in the last fifteen years as a visible and important social problem.
The two dilemmas of social policy alluded to above are defined as:
1. family autonomy
vs.
2. coercive intervention
(compassion vs. control). and professional response.
Theoretical Confusion and cClinical Inadequacy
We propose that these consequences result, in part, from medical and legal ambiguity concerning child abuse and from two fundamental, and in some ways irreconcilable, dilemmas about social policy and the human and technical response toward families in crisis. We call these dilemmas family autonomy versus coercive intervention and compassion versus control.
How children's rights-as opposed to parents' rights-may be defined and protected is currently the subject of vigorous, and occasionally rancorous, debate.
The family autonomy vs. coercive intervention dilemma defines the conflict central to our ambiguity about whether society should intervene in situations of risk to children. The traditional autonomy of the family in rearing its offspring was cited by the majority of the U.S. Supreme Court in its ruling against the severely beaten appellants in the controversial "corporal punishment" case (Ingraham vs. Wright et al).25 The schools, serving in loco parentis, are not, in effect, constrained constitutionally from any punishment, however cruel.
Yet in California, a physician seeing buttock bruises of the kind legally inflicted by the teacher in the Miami public schools risks malpractice action if he fails to report his observations as symptoms of child abuse (Landeros vs. Flood).32 He and his hospital are potentially liable for the cost of the child's subsequent injury and handicap if they do not initiate protective measures.
This dilemma is highlighted by the recently promulgated draft statute of the American Bar Association's Juvenile Justice Standards Project, which, citing the low prevailing quality of protective child welfare services in the U.S., would sharply restrict access to such services.28 The Commission would, for example, make the reporting of child neglect discretionary rather than mandatory, and would narrowly define the bases for court jurisdiction to situations where there is clear harm to a child.
Our interpretation of this standard is that it would make matters worse, not better, for children and their families.8 So long as we are deeply conflicted about the relation of children to the state as well as to the family, and whether children have rights independent of their parents', we shall never be able to articulate with clarity how to enforce them.
What's your view?

