31 August 2012

The Family Pediatrician as State Political Officer




One of the hallmarks of Communist societies, at least those actually experienced in the real world, is the ubiquitous and intimidating presence of the Political Officer. This official could be found throughout the various societal organizations-- professional groups, military, community groups, schools, places of employment and even (those few government-tolerated) religious groups. His purpose was to ensure doctrinal orthodoxy of the state religion by spying, harassing, intimidating, and reporting on anyone whose ideas were slightly nonconformist.

The effect was a general chilling of the natural bonds of family, friendship, and neighborhood. The natural collaborative efforts of the sub groups of any healthy society were made extremely risky, and so these groups typically failed of their intended purposes. A slave of communism had no one to trust, including at times his own family.

We have been fortunate, historically, to avoid such a regime here. But things change. Even the family pediatrician is no longer immune from the encroaching state, and the vehicle for the encroachment comes through his own professional organizations.

Parents with young children may have already experienced this new, aggressive state presence in what used to be the sanctuary of the mother's best ally-- the pediatricians
's office. The advocacy group Parental Rights.org reports on the issue:

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Your Pediatrician and Your Parental Rights

By now, the experience can only be called “commonplace.” You take your child to the doctor for a rash or a sore throat, and the next thing you know your child is fielding some unrelated questions: “Is there a gun in your home? Do you usually wear a seatbelt when riding in the car? What’s your favorite music?”

If you haven’t yet heard such a dialogue between your child and the doctor, that doesn’t mean this is not occurring. “Doctors are trained in residency how to gently steer the parent out of the room so that they can do an assessment,” reports pediatrician and ParentalRights.org board member Verlainna Callentine, M.D. “The mindset is that because so many adolescents stay healthy, there are few opportunities to have a medical impact on the child once they get out of the early years of development. When a child comes in for a particular complaint, the opportunity is seized to assess other risk factors in the child's life.”

Dr. Callentine continues, “Absolutely, it can be intrusive. It is intentional. Some doctors may not want parents to know the kinds of questions being asked out of fear that the answers they will receive from the child will not be honest and truthful.”

This line of questioning is called a “psychosocial evaluation”. There are many of these evaluation tools used in pediatric offices. One such tool is the HEEADSSS assessment, and it has been around for years. HEEADSSS is an acronym for the myriad topics the probe is intended to cover: Home, Education & Employment, Eating & Exercise, Activities and Peer Relationships, Drug /Cigarette/Alcohol Use, Sexuality, Suicide & Depression, and Safety. Some will also include Spirituality, including questions like “Does your family affiliate with any faith community?” and “How often do you go to church/synagogue/mosque/etc.?”

You won't believe some of the questions doctors are being urged to ask your child. Click here to see one such questionnaire.

If government doctors were using this, there would be constitutional issues immediately. Private doctors, however, are not limited by the Constitution. So while some doctors in certain instances could possibly be held liable for invasion of privacy, the best defense is to be aware and prepared to avoid the problem entirely.

“Parents need to be educated and understand how to navigate the healthcare system with their child,” Dr. Callentine says. “They need to know they have the right to say, ‘No’ or to request to be present during the discussion so they can best partner with the healthcare provider. Parents are the advocate for their children. It is through a ‘healthy’ partnership with their pediatrician that parents and children can best be served."

“We need to educate the parents,” Dr. Rosemary Stein, an adjunct teaching professor at the Children’s Hospital of UNC-Chapel Hill, agrees.

According to Dr. Stein, the American Academy of Pediatrics (AAP) set up a committee several years ago to promote ratification of the United Nations’ Convention on the Rights of the Child (CRC) in the United States. That committee is linked very strongly to medical teaching programs across the country, using its influence to see that the international model – including HEEADSSS assessments – is presented as “the way to practice medicine” in the U.S. (Dr. Stein was a fellow of the AAP until resigning over philosophical differences.)

The HEEADSSS assessment was first introduced by Americans G.M. Cohen and E. Goldenring in Contemporary Pediatrics in 1988. Obviously, then, it didn't come from the United Nations. However, the implementation of HEEADSSS and of the United Nations' Convention on the Rights of the Child (CRC) can have striking parallels. That is because both include the notable presumption that parents are agents to be monitored rather than the natural safeguard for their children's health and rights.

This shared premise makes it easy to employ the CRC and the HEEADSSS assessment together to impede parental rights around the world. The New South Wales (Australia) Center for the Advancement of Adolescent Health (NSW CAAH) has published a popular “Resource Kit” to help doctors learn to administer these assessments. According to their website, the NSW CAAH “believe[s] that all young people have the right to comprehensive health care,” a catch-phrase in international law signifying the “right” of teenagers to make health decisions– especially in the areas of drug use and sexuality (including abortion) – without parental oversight, input, or consent. Not coincidentally, this “right” is often called for by the Committee on the Rights of the Child, which consistently interprets Article 24 of the CRC to include this obligation.

The mindset is the same: parents are an obstruction that must be removed from the room so that the needs of adolescents can be met.

While it is true that there are rare instances where that is in fact the case, fit parents have the fundamental right to direct the care of their children – and that includes the right to grant or deny consent for a doctor to perform a “psychosocial assessment” of your child.

Sadly, the rise of electronic medical records and the drift toward government health care point to a day when the data collected through these assessments will find its way into the hands of the government. And the push to ratify the CRC could introduce a day when the assessment is seen as a legal necessity to fulfill the government’s obligation to ensure the best interests of every child.

For now, though, you do have the right to say, “No.” When the doctor asks you to leave the room for the sake of your child’s privacy, the two of you together – you and your child – have all the legal authority to protect your family against this intrusion. Many states allow the doctor to honor your teen’s wishes over your own, but not to insert the doctor’s own wishes over those of you and your child together.

The proposed Parental Rights Amendment to the United States Constitution will ensure that this right of parents “to direct the upbringing, education, and care of their child” will remain “a fundamental right.” It will prevent ratification of the CRC and halt the intrusion of the government into your home and privacy. It will also guarantee that no law is passed to take away your right to tell an intrusive doctor, “No.”





3 comments:

Mama Bear said...

This sort of thing is already happening here in St. Louis.

The last time I took my daughter to the pediatrician, he began asking questions that I've had to answer before (like "Is there lead paint in your home?"). Then he began asking questions that seemed more intrusive -- the one that really got me was when he said, "I know I don't need to ask you this, but ... do you have any guns in your house?"

I honestly answered "no", but didn't think it was any of his business to know whether I did or didn't own a gun. What did that have to do with my daughter's ear infection or her immunizations?!

Peggy R said...

Mama Bear,
We've experienced this in IL and VA. Also, as a woman going to the ER, once for severe poison ivy on a weekend and once for possibly breaking a wrist (turned out to be a sprain). In both IL and MO, I was asked if I was a victim of domestic abuse. Quite inappropriate and irrelevant to my purpose in seeking medical services. So,for the wrist care, I was particularly careful to be complete and truthful about how I injured myself. I shouldn't have to be nervous or concerned in that way.

Medical professionals are being told/asked to ask several of these impertinent, intrusive and irrelevant questions. I completely concur with your post Timman.

Anonymous said...

Timman,

We experienced this last year with our son (15) at the pediatrician office we had gone to since he was a baby. He was at the doctor with my wife for a physical and they said they needed to do a hearing assessment in another room. We found out later that they had asked a series of questions that made my son uncomfortable, including the gun question. I was a bit more than ticked and went to the office first thing the next morning to confront the doctor and get a copy of the questions. It was just like what this article portrayed. I expressed my "inappreciation" for the deceptive practice and we have since taken our health care business elsewhere. After going with a pediatrician from our parish, the first question for him was if he asks these kinds of questions. He assured us that he doesn't and wouldn't go behind our backs as parents under any circumstance. We are certainly a lot more careful now. Banish thee, big brother!

Hercdog