Ethics of Foster Care
Charles Loring Brace, social reformer and philanthropist, is noted as a founder of the foster care system as he removed children from the streets of New York City in the mid-19th century and sent them to farms in hopes of bettering their future (Marriott). This act, known as the Orphan Train Movement, along with others, led to the development of the current foster care system in which state and federal systems collaborate to support children and youth that may be removed from their houses for a plethora of reasons, such as neglect or physical or sexual abuse (Marriott). The purpose of foster care is to provide a safe and comforting home for children who are not able to live in their current home. The different resources and experiences foster children face can affect their lives throughout their time in the system as well as in their adult life. Many aspects of the system are questioned and even create concern by many as they create arguments towards whether what is being done is morally correct.
For instance, foster parents are meant to be a vital resource for foster children, caring and providing for them. According to the Foster Parent Code of Ethics, foster parents are meant to “meet [the] physical and mental health care needs [of children],” and “advocate for resources to meet the unique needs of the children and youth in their care,”. Although it is directly stated that foster parents have the duty to care for the foster’s mental health, studies indicate adults in foster care have a higher rate of having PTSD than U.S. combat veterans, 25.2% and 8%-15% respectively (Marriott). These high rates are due to lack of awareness and knowledge on the situation, as well as lack of care and advocacy as these children are placed in multiple homes (Marriott). So while foster parents may want to help their children they may be lacking the correct training and awareness to best look after them. In addition, these children are missing a stable network of support as they are constantly moving and being seperated.
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The relationship between a foster child and their birth parents can also have an impact on the child’s life. When a child is first placed into the foster care system, one of the first tasks is to terminate the birth parent’s rights so the child can continue in the system, with the goal of them being adopted. The pace at which this is done is being questioned as it may have negative effects on the child. In some states the adoption process can’t begin until the parent’s rights are terminated, and some claim it is beneficial to the foster child as many adoptive parents may become skeptical in adopting a child that has ties with their birth parents (Ellis, Raquel, et al). On the other hand, some judges are concerned with terminating the parent’s rights, as the child would become a legal orphan, possibly having negative effects(Ellis, Raquel, et al). These judges worry the legal orphans they are creating are not being secured a permanent family, the child might be affected emotionally by losing ties to siblings and family, and they may lose benefits such as child support and survivor benefits. (Ellis, Raquel, et al.). Overall, while terminating parental rights is a process that must be done in order to give foster children opportunities to finding homes, those that stay in the system after the rights are terminated may be affected negatively. In order to prevent these negative effects, concerned judges are less likely to terminate parental rights without knowing the child would be immediately placed in a home, and they encourage placing orders for family visitations, or in some cases where the state allows it, the use of an open adoption in which birth families are allowed to play a role in the child’s life.
In the U.S., around two-thirds of foster children have siblings in the system as well, and most of them are separated from each other either initially or over time (“Sibling Issues in Foster Care and Adoption”). For example, two studies found that in a sample of more than ten thousand fosters in California, only 23%-46% of fosters are initially placed with all their siblings (Sibling Issues in Foster Care and Adoption). Also, in the state of Nebraska, in 2018, 54.4% of foster children removed from their siblings were still placed with all of them (Care Review Office). While the numbers are not great, the Department of Children and Families is becoming more aware about this issue and are trying to lessen these numbers. Siblings staying together while being part of the system can have many benefits and would be doing harm by separating them. Some of those benefits would be they would feel safer and a more natural, mutual support would be provided (“Sibling Issues in Foster Care and Adoption”). By separating siblings, children would have “additional loss, grief, and anxiety over their siblings’ well-being,” (“Sibling Issues in Foster Care and Adoption”). With children in the foster care system suffering from losing their sibling and possibly never seeing them again, some people and organizations are trying to prevent this and provide support. For example, in Nebraska a summer camp was created to “reunite separated siblings for a weekend of fun, adventure, and connection,” (“Camp Catch-Up””). The camp’s mission is to be able to help the hundreds of kids who have lost a sibling while in the system, allowing them to find and reconnect with one another. While organizations such as Camp Catch-Up have a powerful mission meant to benefit foster children, there are only three locations in the state and few organizations with similar missions exist.
Another issue affecting these foster children are the use of psychotropic drugs. With up to 80% of children in foster care with mental health issues, common treatments include psychotropic medication, with 13%-52% of youth in foster care being prescribed these forms of medication (“Mental Health and Foster Care”). While some forms of these medications include mood stabilizers, antipsychotics, anti-anxiety medications and stimulants, many are concerned with the use of these medications, specifically with the use of multiple psychotropic medications simultaneously and these medications being prescribed to young children (“Mental Health and Foster Care”). With so many foster children being prescribed these medications, states are becoming more worried about the issue. In a study conducted in forty-eight states and the District of Columbia, it was found that 58.7% of states saw psychotropic medications as a high concern (“Child Welfare”).
With psychotropic medication being commonly associated with foster children, states are required to monitor the use of these medications throughout time. However, monitoring these medications lacks high priority as in a study conducted in five states, 34% of children did not receive treatment planning or medication monitoring (“Treatment Planning”). Additionally, the Government Accountability Office examined six states and found that only one of the six met “ideal” guidelines for “establishing training requirements for child welfare, court personnel and/or foster parents to help them become more effective advocates for children in their custody,” and a majority of states did not meet “ideal” guidelines of including adverse effect ratings, reports on prescription patterns, and/or “links to helpful, accurate, and ethical websites about child and adolescent psychiatric diagnoses and psychotropic medications” on the state’s website (“HHS Guidance”). With states failing to properly monitor the use of these medications on foster children, it allows for the drugs to be misused and the consumers, foster children, to be misinformed about the medication.
In conclusion, the foster care system is far from perfect, with many states concerned over issues involved in the system. These issues can affect the lives of fosters as they age out of the system as they would have experiences such as being separated from their siblings to not being monitored correctly for their medication.
“Camp Catch-Up | Nebraska Children.” Camp Catch Up, Camp Catch Up, campcatchup.org/.
“Child Welfare: Oversight of Psychotropic Medication for Children in Foster Care.” Congressional Research Service, 17 Feb. 2017, www.everycrsreport.com/files/20170217_R43466_74f90fe0b0a68eead9696c2dd87a56129a95e227.pdf.
Ellis, Raquel, et al. “The Timing of Termination of Parental Rights: A Balancing Act for Children’s Best Interests.” Child Trends Research Brief, Child Trends, Sept. 2009, www.childtrends.org/wp-content/uploads/2009/09/Child_Trends-2009_09_09_RB_LegalOrphans.pdf.
“Foster Parent Code of Ethics.” National Foster Parent Association – Becoming a Foster Parent, National Foster Parent Association, nfpaonline.org/Ethics.
“HHS Guidance Could Help States Improve Oversight of Psychotropic Prescriptions.” Government Accountability Office, United States Government Accountability Office, Dec. 2011, www.gao.gov/assets/590/586906.pdf.
Marriott, Brigid R. “Ethical Considerations for the Treatment of Youth in Foster Care.” Ethics & Behavior, 21 Nov. 2017, doi.org/10.1080/10508422.2017.1407654.
“Mental Health and Foster Care.” National Conference of State Legislatures, National Conference of State Legislatures, 9 May 2016, http://www.ncsl.org/research/human-services/mental-health-and-foster-care.aspx.
“Sibling Issues in Foster Care and Adoption.” Child Welfare Information Gateway, Children’s Bureau, Jan. 2013, www.childwelfare.gov/pubPDFs/siblingissues.pdf.
“State of Nebraska Foster Care Review Office Annual Report 2017-2018.” Nebraska Foster Care Review Office, Sept. 2018, www.fcro.nebraska.gov/pdf/FCRO-Reports/2018-annual-report.pdf.
“Treatment Planning and Medication Monitoring Were Lacking for Children in Foster Care Receiving Psychotropic Medication.” Office of Inspector General, U.S. Department of Health and Human Services, Sept. 2018, oig.hhs.gov/oei/reports/oei-07-15-00380.pdf.