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Wednesday, June 29, 2016

The policy debate that should come out of the death of Alex Radita

Canadian media is covering the current trail of Emil and Rodica Radita for the first degree murder of their 15 year old son Alex. The allegations involve medical neglect of their son's diabetes leading to his death. The family is reported to have been involved in child protection systems in British Columbia and Ontario prior to his death in Alberta.

Much has been made of the supposed failure of British Columbia social workers to notify their counter parts in Alberta when they learned the family had moved left B.C. They had found out about the move as they were looking for the family when it became apparent they were not following through with Alex's medical care.

There has also been significant criticism of a judge in B.C. for returning Alex to parental care even when the child protection workers and specialists were arguing against it. National Post columnist Christie Blatchford has been quite critical of that decision and the failure of B.C. social workers to follow up with Alberta.

Alex Radita at age 15 (Source: Calgary Herald from photos released by the Court)

Child protection systems are often criticized for their failure to effectively communicate with agencies. It is a theme that has cropped up in most of the 91 public reviews I have examined in Canada. It is also very common in reviews in other countries.

There is an issue that needs discussing in Canada though, but also in countries such as the United States. Canada's constitution places control of child protection within provincial and territorial jurisdiction (there are specific aspects that are different for Aboriginal on reserve families but that is for another post). Health care and child protection legal processes also fall under provincial jurisdiction. Thus, each province and territory operates their own system, except for Ontario which places delivery of child protection into a complex network of children's aid societies following provincial legislation.

What this means is there is no national child protection system. It is a series of unique systems. Each jurisdiction has its own legislation, policy, procedures and service delivery mechanism. There is  no national requirement for data sharing. Families can and do move between jurisdictions to avoid continuing scrutiny by child protection. They are quite able to do so once their case in one province is no longer active.

When a case opens in one area, families are asked about their history elsewhere but there is no national database to work from. Should there be? Protagonists of data sharing might well argue for one but those who argue for protection of information and privacy might well make an alternative argument. Child protection legislators and senior managers across Canada might well take the Radita case as an opening for a national discussion. I want to emphasize that many of the workers I know make efforts to learn about families past participation in other parts of the country.

The Radita case raises some important policy issues and we should not let the chance pass. Another one is about legal duty of care. Like the Jeffrey Baldwin case in Ontario, it appears there were other adult children in the Radita home. Yet the criminal code does not place a duty of care on those who are not parents or legal guardians. Thus, other adults in the home who were aware Alex and Jeffrey were at risk cannot be held accountable . That too should be reconsidered.

It is important to note that, at the time of writing, the criminal trial noted above is still ongoing. Thus, the accused have not been convicted of a criminal offence in this matter. 

Monday, June 27, 2016

Managing the undefineable - the human judgments of child protection

Child protection is the front end of a bargain between a child and society. Essentially, society says that they will leave a family to raise their children as long as they do so safely. The deal with the child is that, if that does not happen, society will protect the child and the child protection authority will act on behalf of society. It's a bargain that we often do not know how to uphold.

To begin with, we lay that bargain out through legislation. Inherent in most such laws is a belief that the family is the root of society and is an institution that requires preservation. In other words, society should intrude into the family only as much as needed to protect the child.

Next comes the decision by child protection to enter the family - but there are certain hurdles:

  • Someone must alert the child protection authority that there is a concern. Many countries have mandatory reporting laws that require a variety of professionals to call them. Many do but there are many examples of professionals who do not because past efforts to report a concern have led to no apparent action. Some won't because they are so uncertain about whether the child really is in danger. Some professionals feel that there is little point in reporting a child because the child is already so disconnected and won't comply with efforts to help. This was seen very clearly in the Paige case that led to a blunt review by the B.C. Representative for Children and Youth
  • Once the report is filed, a human judgment is made by an intake worker to investigate or simply note the report in case there are further reports. This very human  judgment is influenced by such factors as how the report was framed, the degree of danger seems to exist, the resources available as well as the presence or absence of past reports.
  • If the report is investigated another human judgment is made which is whether or not there is a risk to the child; how serious is that risk; is it serious enough to open a case; could it be handled in a less intrusive way or is the risk sufficient to become quite intrusive.

Inherent in this series of human judgments is defining safety and risk. There are a  multitude of factors that are taken into consideration and the investigator must try to weigh the various options and meaning of the data. Some have suggested that this means structured decisions should be used by entering data into various investigative formats. Yet, in those cases, someone must still find a way to operationalize a way to define and measure safety. Even in cases of structured tools, the front line worker must make meaning out of the data; must find the data; must contextualize the data; must know what to look for and be able to see it. To enter the data they must be able to discern what is in front of them. It is a human judgment process to make meaning out of information even when you enter it into a decision making tool.

Safety is an incredibly complex concept in which many factors interact in an unpredictable way - parenting, mental health, addiction, community, culture, poverty, housing, schooling, resources, temperament and personality of the child to name a few. The worker has to figure out the interactions. The worker is asked to predict probability for the safety of the child.

The worker is but one of the decision makers. The data gathered by the worker will be presented to a variety of other human judgment makers as the open case moves along - supervisors, colleagues, contracted community resources, lawyers and the courts, for example. Each will weigh the data (which is typically constantly changing) and judge what is and should happen.

The family are also making a series of human judgments - what to tell; what to cooperate or not cooperate around; what to try and self manage; how to interpret the direction of child protection and other parties. 

It is a series of human judgments made by many parties with ever changing data that is typically imperfect seeking to predict the behaviour of human beings in an environment where no prediction tool shows reasonable accuracy. No wonder child protection gets things wrong at times - indeed how could they not. So why are we not telling that story?