CHILD'S SAFETY OR PARENTS' RIGHTS?

Our Turn

In the past few weeks, Child Protective Services has twice made headlines
for its decisions.

In the first case, CPS was lambasted by state Rep. Debra Brimhall for
removing Samuil Baldwin from his home. Samuil had third-degree burns on his
feet, bruises all over his body and a handprint on his bottom.

CPS decided it was best to place Samuil in the care of his adopted
grandparents - and has had to endure media attacks because of the decision.

A few days later, CPS was again in the news, but this time it was because
it did not remove Anndreah Robertson from her cocaine-addicted mother's care.

There seems to be no shortage of experts in our community ready and willing
to tell CPS how to do its job. Anyone who has lived in Arizona for more
than a few years knows that sad cases like those of Anndreah and Samuil
occur with some predictability, and the response is predictable as well:
lots of finger-pointing and hand-wringing.

There is an old saying that in any given situation, the proper course of
action is determined by subsequent events.

In retrospect, Anndreah should have been removed from her drug- infested
home. However, prenatal substance abuse is not a crime and in the past the
courts have not supported CPS' decision to remove children from their
substance-abusing parents.

As pediatricians, we think no child should be left in the custody of a
cocaine addict, because a parent who is high and continually seeking drugs
cannot appropriately care for their child. It is neglect, however, and not
medical complications of drug exposure, that poses the biggest risk for
these babies.

While deaths from direct exposure to illicit drugs are rare, fatalities
from accidental injuries that could have been prevented by better parental
supervision and medical care are unfortunately common when children are
left in the care of addicted parents.

If legislative change is necessary to make it easier for CPS to take
custody of these cocaine babies, then let's do it. However, legislation
alone will not prevent further tragic deaths like Anndreah's.

Who is going to pay to care for these children after they are removed from
their homes and provide treatment for their parents? The number of children
at risk in our community is staggering. According to the 1999 National
Household Survey on Drug Abuse, one-third of the total adult population in
the United States admitted to the use of some illicit drug and one-fourth
of these individuals identified cocaine as their drug of choice.

About 45,000 infants are born each year in this country after having been
exposed to cocaine in utero. We lack treatment programs for these mothers
and we lack foster homes for their children. Even if treatment is
available, many of these mothers are not interested in abstinence and the
only solution may be to sever parental rights. This is also a difficult
task - and even if these children could be permanently removed from their
homes, are there 45,000 families available each year willing to adopt a
cocaine baby?

Arizona has a long tradition of upholding the rights of parents to raise
their children as they see fit. In general, the Legislature has sent a
clear message to CPS over many years: Society must not interfere with the
rights of its citizens, especially parents. There is an active, angry and
vocal group of parents who feel that has happened to them, and who seem to
have the sympathetic ear of many legislators.

The CPS workers that we know are caring, thoughtful, hard-working people
(often parents themselves) who are constrained by limited resources,
inadequate manpower and the pervasive (and perverse) policy that often
places parents' rights before the child's safety.

They must make painfully difficult decisions, working within the legal and
financial constraints of an overburdened child-protection system. We are
not apologizing for CPS, but they are in a "damned if you do and damned if
you don't" situation.

Public policies regarding substance-abusing parents must be based on sound
medical evidence. While it is easy to criticize, working toward meaningful
solutions to such a complex problem as parental drug abuse is hard.

As pediatricians, we are horrified by these deaths and injuries and would
like to help ensure that all children have the opportunity to be loved and
nurtured by parents who are capable of doing so. And, we hope that
legislators, judges, journalists and community leaders will support these
goals as well.