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View Diary: PhRMA and Physicians Engaged in Medical Child Abuse (10 comments)

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  •  As a former DCS casemanager... (6+ / 0-)

    And current foster patent, I may be able to offer an alternative hypothesis as to why so many foster kids end up on psychotropic meds, as opposed to the general population.  Children find themselves in the system through no fault of their own.  (It's important to remember that because I've seen everyone from bio-parents to family casemanagers (FCM), to foster parents to the kid's themselves misplace the "blame".  The children are always the victims.)  Generally, children become wards of the state upon substantiation of allegations of abuse or neglect.  That abuse or neglect is unique to every family involved in the system, but many of the families share certain characteristics.  For example, in many cases, at least one of the parents involved has mental health issues (bi-polar disorder, BPD, depression, etc.).  These mental health issues are often exacerbated by the fact that the parent self-medicates with illegal substances.  So, when you take into account the chaotic home life, the history of abuse and/or neglect, and the fact that these kids are abruptly uprooted and dumped with total strangers, emotional and behavioral problems amongst foster children are common.  Then, too, consider the hereditary component to some mental illnesses.  Thorough, competent, professional mental health evaluations are not out of line.  

    Still, your point about foster children being vulnerable to victimization is well-founded.  These children often fall through bureaucratic cracks and the people who should advocate for them either don't know what they're doing, or are too overwhelmed to fulfill their responsibilities.  I would NEVER allow a foster child in my care to be used as a guinnea pig.  And, while consent for all psychotropic meds for wards must be granted by the court in our state, it's still the foster patents who administer them.  So, unless a medication has a specified benefit for my charges, they aren't taking it.  Further, I would not allow any doctor access to any child in my charge so long as they were willing to recommend unnecessary medications.  And, since in our state foster patents have the right to be notified of and attend court proceedings, I would also give the court an earful regarding the issue.  These children have been removed from their parents care, severing the most sacred of bonds, for their protection.  If we allow doctors and big pharmaceutical companies to exploit these children then, at some point, we have to honestly ask ourselves if they're any better off.

    •  Excellent post, and you take a brave stance. Many (4+ / 0-)

      caseworkers and foster parents would not have the courage to stand up to a doctor who prescribes a medication of any kind, so kudos to you for standing up for these children.

      I'd only add to your post that many low-income parents are also minimally-educated.  They lack the ability to double-check the MD's recommendation, don't know they can ask for a second opinion, and rarely have friends who can offer a recommendation for a specialist (all of which my well-educated friends and I would do).  Doctors are also dealing with a population that has a hard time managing follow-up (b/c of the time, effort and $ required to do it, this isn't a slam on low-income parents), and so often choose a "load with meds" approach rather than a 'visit in two weeks and let's double-check" approach.  That makes it easier for them, and it also likely starts to skew the numbers of the meds these children are on.  

      •  Agreed! (1+ / 0-)
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        I didn't even touch upon the ways in which children get the short end of the stick when born poor...  My focus started with the kid's evaluated once they are removed from their parents.  You are so right that parents from lower income families face heartbreaking, unacceptable obstacles in getting their children help.  Even when the kid's are covered by Medicaid (or a state's version of such for kids), parents from these homes face barriers to care, such as transportation, childcare for other children, and not having any paid time off work, which are either non-existent or minor inconveniences for me.  When you add to that the fact that most of the parents I worked with had not completed high school, it is highly unlikely any of them would second-guess a doctor.  And, as a casemanager, I was also acutely aware of how many of these doctors and specialists (not just in the field of mental health) treated our parents.  They often spoke down to them.  They intimidated them.  Certainly, I do not mean all doctors, but enough of them that it stuck out and it was a discussion that we had with home-based workers who often accompanied parents to their children's appointments.  Now, I went through a serious illness when I was 30, and I learned a lot from that experience.  Over a 7 year period, I was hospitalized more times than I care to remember, and most of the time I experienced competent, concerned medical professionals.  However, on those occasions where I felt that I was being disrespected and/or mistreated, I politely, but firmly discharged the doctors in question and requested a meeting with the head of the department to appoint a new doctor (just to be sure we were all on the same page).  I cannot imagine many of "my parents" doing the same.  Standing up to doctors can be intimidating.  (Indeed, it took a doctor making a near fatal "mistake" with me and then lying to try to cover it up before I got this brave...)

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