You know that a two-child family has a son. What is the probability that the family has two sons? And what is this probability if you know that the family has a son born on a Tuesday? The former question has been widely discussed previously. The latter adds a new puzzling twist to the situation. In both cases the answer should depend on the specifics of the assumed underlying procedure by which the given information has been obtained. Quantitative analysis, (...) assuming one scenario, shows that the information on the son's day of birth changes the target probability. However, the relevance of being born on Tuesday to the question of the children's genders seems bizarre, since the same would be true for any other day. This apparent paradox is further probed in an attempt to alleviate the ensuing psychological difficulty. (shrink)

This study aimed to investigate mothers’ parenting stress and explore its relationship with associated demographic variables in two-child families involving preschool children. A sample of 621 two-child families and a comparison group of 319 one-child families from China participated in the study; the children were aged between 3 and 7. The results showed that mothers of two-child families had higher parenting stress than those of one-child families; within the two-child (...) families, demographic variables, such as birth order, gender combination, and the age gap were found to have significant effects on maternal stress levels; and in two-child families, families with an income of less than 3000 yuan had significantly higher maternal stress than families with an income of more than 6000 yuan. (shrink)

This article provides a conversation analytic description of a two-part structure, ‘I don’t want X, I want/just want Y’. Drawing on a corpus of recordings of family mealtimes and television documentary data, I show how speakers use the structure in two recurrent environments. First, speakers may use the structure to reject a proposal regarding their actions made by an interlocutor. Second, speakers may deliver the structure following a co-interactant’s formulation of their actions or motivations. Both uses decrease the likelihood of (...) challenge in third-turn position. When responding to multi-unit turns speakers routinely deal with the last item first. The value of ‘I want Y’ is to formulate an alternative sense of agency which undermines the preceding turn and shifts the trajectory of the ongoing sequence. The article contributes to work in discursive psychology as I show how speakers may formulate their ‘wants’ in the service of sequentially unfolding social interaction. (shrink)

The family is hotly contested ideological terrain. Some defend the traditional two-parent heterosexual family while others welcome its demise. Opinions vary about how much control parents should have over their children's upbringing. Family Values provides a major new theoretical account of the morality and politics of the family, telling us why the family is valuable, who has the right to parent, and what rights parents should—and should not—have over their children. Harry Brighouse and Adam Swift argue that parent-child relationships (...) produce the "familial relationship goods" that people need to flourish. Children's healthy development depends on intimate relationships with authoritative adults, while the distinctive joys and challenges of parenting are part of a fulfilling life for adults. Yet the relationships that make these goods possible have little to do with biology, and do not require the extensive rights that parents currently enjoy. Challenging some of our most commonly held beliefs about the family, Brighouse and Swift explain why a child's interest in autonomy severely limits parents' right to shape their children's values, and why parents have no fundamental right to confer wealth or advantage on their children. Family Values reaffirms the vital importance of the family as a social institution while challenging its role in the reproduction of social inequality and carefully balancing the interests of parents and children. (shrink)

This paper argues the case for taking a critical realist (CR) approach to social work research. The normativity in social work is often under-communicated in the social sciences, resulting in research that has an unclear value base as its starting point. Social work practice promotes social change and people's development, empowerment, and liberation. By taking a CR of view as a starting point for researching social problems, the focus shifts towards explaining phenomena by revealing and discussing the mechanisms through which (...) they are produced and maintained. Child welfare issues are argued to be “wicked problems”, on top of which the practice of social work itself is a complex field. Two studies from the field of child and family welfare are presented here to illustrate how CR has been fruitfully applied in research on such complex phenomena. These two studies comprise research on child protection assessment and parental high conflict. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Family, Friends, and Cancer:The Overwhelming Effects of Brain Cancer on a Child’s LifeLynne ScheumannOur son was diagnosed with a medulloblastoma at the old age of 13. The “lucky” part for him was his brain was almost fully developed at this age as opposed to most “medullo” patients. While this was a benefit to him it was also one of the hardest things for him.He went into surgery a (...) highly intelligent, active, and left handed boy and came out unable to move his left side, could barely speak, and very much aware of what he just lost. We, as a family, were totally unprepared for how globally this would [End Page 23] affect the rest of his life. As we spent time in the hospital I would look at the children with other types of cancer and see them walking and talking and doing their schoolwork and God forgive me I would be jealous. The fact that the cancer was in his brain, the part of his body that makes him who he is changed everything forever.He lost all of his friends because 13–year–old boys communicate best through physical activity and that was not an option for him. He still has the same personality and sense of humor, but he will not be the architect or engineer he once dreamed of being. Math, that was once so easy for him was now like a foreign language, never to be mastered again. He was able to graduate from High School and takes classes at our local Junior College in Computer Assisted Drafting, but he can only manage one or two classes a semester due to the fatigue he still suffers from.What I most worry about and wish I had been forewarned about is his long–term quality of life. Physically he has come such a long way from how he was after the resection. It was a very slow process in which the first year of rehab was slowed by the fact that one of the chemo agents causes peripheral neuropathy. He developed contractures in his ankles and needed serial casting and ankle–foot orthotics (AFO) not just on the left leg, but now the right. He was able to switch his handedness fairly easily and his left hand will always be of limited usefulness because of ataxia. I would get angry at him that he gave up on his left side so quickly until it was finally explained to me years later that the ataxia would never get better.As far as his walking ability goes he has come a long way. At first he was unable to walk and once he started rehab he went back to learning to crawl and progressed to a walker. The first time I saw him walk with the walker brought tears to my eyes. It was so much more of an event for me than when he took his first steps as a toddler. This was so much more hard fought. He never complained, just always did what was asked of him. It had to have been such hard work and also somewhat embarrassing, as he needed help to literally do everything for months. He progressed to a cane and about two years ago decided not to use that or his AFO’s. He now wears high top boots that substitute for the AFO’s but don’t make him appear disabled. Recently he decided there are times when he would be safer if he had his cane and purchased one that looks more like a hiking stick than a cane. I think he has come to terms with the fact that physically he is as good as he is going to get and works hard to maintain what he did regain. He has a trainer and goes to the gym on a regular basis with no prompting from us. I do not know if he realizes that as he ages things will be harder for him than the average person. I think in some way he is aware of that because he did decided to use the cane if safety is an issue.His... (shrink)

A significant international development agenda in the practice of nurses supporting families with young children focuses on establishing partnerships between professionals and service users. Qualitative data were generated through interviews and focus groups with 22 nurses from three child and family health service organisations, two in Australia and one in New Zealand. The aim was to explore what is needed in order to sustain partnership in practice, and to investigate how the concept of practice architectures can help understand (...) attempts to enhance partnerships between nurses and families. Implementation of the Family Partnership Model (FPM) is taken as a specific point of reference. Analysis highlights a number of tensions between the goals of FPM and practice architectures relating to opportunities for ongoing learning; the role of individual nurses in shaping the practice; relationships with peers and managers; organisational features; and extra‐organisational factors. The concept of practice architectures shows how changing practice requires more than developing individual knowledge and skills, and avoids treating individuals and context separately. The value of this framework for understanding change with reference to context rather than just individual’s knowledge and skills is demonstrated, particularly with respect to approaches to practice development focused on providing additional training to nurses. (shrink)

In Child Abuse, Family Rights, and the Child Protective System: A Critical Analysis from Law, Ethics, and Catholic Social Teaching, Stephen M. Krason gathers essays by leading scholars and practitioners to comment through the prism of Catholic social thought, on the plight afflicting American families and the role of the child protective system. Here readers will find critical essays on the deleterious effect of the 1974 passage of the Child Abuse Prevention and Treatment Act; assessments (...) of current American policies on child abuse and neglect and the role of the CPS within the context of prevailing international human rights principles and Catholic social teaching; a survey of the enforcement of CPS policies from a legal and constitutional perspective; research data disputing the CPS principle that all parents are potential abusers and illustrating the greater prevalence of abuse and neglect in broken, “blended,” and “untraditional” families; and arguments for poverty and unemployment as the prime culprits in the mistreatment of children. Also included are the amicus curiae briefs that the Society of Catholic Social Scientists submitted in two U.S. Supreme Court cases on parental rights, the CPS, and state control over the family. (shrink)

Two of the most poignant decisions in pediatrics concern disagreements between physicians and families over imperiled newborns. When can the family demand more life-sustaining treatment than physicians want to provide? When can it properly ask for less? The author looks at these questions from the point of view of decision theory, and first argues that insofar as the family acts in the child’s best interest, its choices cannot be constrained, and that the maximax and minimax strategies are equally (...) in the child’s best interest. He then proposes a guideline according to which the family can demand LST if it is physiologically possible to preserve a life the child can be expected to welcome, and refuse such treatment if it causes suffering that is “more than can be borne” even if an uncompromised life is expected to emerge. (shrink)

Background Families whose child has unexplained intellectual or developmental differences often hope that a genetic diagnosis will lower barriers to community-based therapeutic and support services. However, there is little known about efforts to mobilize genetic information outside the clinic or how socioeconomic disadvantage shapes and constrains outcomes.Methods We conducted an ethnographic study with predominantly socioeconomically disadvantaged families enrolled in a multi-year genomics research study, including clinic observations and in-depth interviews in English and Spanish at multiple time points. (...) Coding and thematic development were used to collaboratively interpret fieldnotes and transcripts.Results Thirty-two families participated. Themes included familial expectations that a genetic diagnosis could be translated into information, understanding, and assistance to improve the quality of a child’s day-to-day life. After sequencing, however, genetic information was not readily converted into improved access to services beyond the clinic, with families often struggling to use a genetic diagnosis to advocate for their child.Conclusion Families’ ability to use a genetic diagnosis as an effective advocacy tool beyond the clinic was limited by the knowledge and resources available to them, and by the eligibility criteria used by therapeutic service providers’ – which focused on clinical diagnosis and functional criteria more than etiologic information. All families undertaking genomic testing, particularly those who are disadvantaged, need additional support to understand the limits and potential benefits of genetic information beyond the clinic. (shrink)

When formal literacy instruction begins, around the age of 5 or 6, children from families low in socioeconomic status tend to be less prepared than children from families of higher SES. The goal of our study is to explore one route through which SES may influence children's early literacy skills: informal conversations about letters. The study builds on previous studies of parent–child conversations that show how U. S. parents and their young children talk about writing and provide (...) preliminary evidence about similarities and differences in parent–child conversations as a function of SES. Focusing on parents and children aged three to five, we conducted five separate analyses of these conversations, asking whether and how family SES influences the previously established patterns. Although we found talk about letters in both upper and lower SES families, there were differences in the nature of these conversations. The proportion of letter talk utterances that were questions was lower in lower SES families and, of all the letter names that lower SES families talked about, more of them were uttered in isolation rather than in sequences. Lower SES families were especially likely to associate letters with the child's name, and they placed more emphasis on sequences in alphabetic order. We found no SES differences in the factors that influenced use of particular letter names, but there were SES differences in two-letter sequences. Focusing on the alphabet and on associations between the child's name and the letters within it may help to interest the child in literacy activities, but they many not be very informative about the relationship between letters and words in general. Understanding the patterns in parent–child conversations about letters is an important first step for exploring their contribution to children's early literacy skills and school readiness. (shrink)

Despite claims of ‘evidence based policy’, the place of empirical evidence in family law reform is ambiguous. There is ongoing socio-legal analysis of the differential value and uses of quantitative data and anecdote in detailing women’s experiences and advocating for change. In this paper, we engage with these issues through a focus on how data were constructed in a key government report, Every Picture Tells a Story, which was used to officially define the problem and outline recommendations in the controversial (...) 2006-08 reform of the Australian Child Support Scheme. Our discussion focuses on two questions: what legitimacy is accorded to different kinds of evidence in family law reform processes?; and, how is this legitimacy gendered? We applied feminist critical discourse analysis to the type, source and claims of the data included in the child support chapter of the report. Our findings indicate that both quantitative data and anecdote were used to privilege fathers’ financial interests and autonomy; in contrast, women’s voices and interests were marginalised. Thus, we argue the legitimacy of data is ascribed through its relationship to the gendered definition of the ‘problems’ of child support, rather than the type of data per se. (shrink)

Paul Smeyers’ keynote address to the PESA 2007 Conference, ‘The Entrepreneurial Self and Informal Education: On government intervention and the discourse of experts’ provides a timely call for questioning the governing of the family. This paper draws upon Smeyers’ key concerns to explore both historical and contemporary trends in clustering government agencies, under the guidance of child development experts. The guidance of two expert groups is problematised, with particular attention to an absence of commitment to Māori perspectives of education (...) and child‐rearing. Such an absence reflects, in New Zealand, a dangerous undermining of the historic treaty between the British and Māori. The paper then challenges, with brief reference to Jacques Derrida's discussions on autobiography and Freud's Legacy, the identity of expert groups advocating early intervention in the lives of families measured as a burden on economic and social progress. The paper posits that perhaps it is the developmental expert that requires some form of early intervention. (shrink)

Information on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s thematic synthesis method was used to synthesise data (...) from identified studies. Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices. (shrink)

After more than three decades of implementation, China’s one-child policy has generated a large number of only children. Although extensive research has documented the developmental outcomes of being an only child, research on the parent–child relational quality of the only child is somewhat limited. Using China Education Panel Survey (2014), this study examined whether the only child status was associated with parent–child relationships among Chinese junior high school students. It further explored whether children’s gender (...) moderated the association between the only child status and parent–child relationships. Two-level ordered logit models suggested that only children were more likely to report a close relationship with their mothers and fathers compared to children from multiple-child families (including two-child families). Taking birth order into consideration, we found that, only children were more likely to have close parent–child relationships than firstborns, whereas no significant differences were found between only children and lastborns. Interaction analyses further suggested that the only child advantages were gender-specific: the positive effects of the only child status were stronger for daughters than for sons, that is, daughters benefited more from being only children. Our findings highlight the importance of considering children’s gender and birth order in exploring the only child effects in the Chinese context. Additional analyses about sibling-gender composition indicated female children were more likely to be disadvantaged with the presence of younger brothers, whereas male children benefited more from having older sisters. This reveals that the son preference culture is still deep-rooted in the Chinese multiple-child families. (shrink)

This paper presents a case study that explores the application of systemic family therapy in working with children who are victims of violence within their family. The case study focuses on the Johnson family, comprising a father, mother, and their two children, who sought therapy after a traumatic incident of domestic violence. The therapeutic approach utilized a systemic family therapy framework, aiming to address the complex dynamics resulting from the violence and its impact on family members. The goals include providing (...) a safe environment for children to process their experiences, enhancing communication, promoting non-violent parenting, and strengthening the family’s support network. The interventions involved individual sessions with the children, family sessions, psychoeducation, and collaborative goal setting. Throughout the therapy process, significant improvements were observed, including enhanced communication, improved emotional well-being for the children, non-violent parenting strategies, and the development of a support network. The findings of this case study highlight the effectiveness of systemic family therapy in promoting healing, fostering healthy relationships, and creating a nurturing environment for children affected by family violence. (shrink)

Early intervention is developed following different types of service organization, which in turn require different professional and family roles. The aim of this study was to compare the perceived satisfaction and family quality of life amongst families receiving early intervention developed at centers in comparison to those receiving the routines-based early intervention in families’ homes, that is a family centered intervention in ecological environments. Under a transformative paradigm, a mixed methods design was used, using the Consumer Report Effectiveness (...) Scale (CRES-4) and the Beach Center Family Quality of Life Scale (FQOLS) and two focus groups as data collection instruments. The sample comprised 166 parents in the quantitative phase and 16 parents in the qualitative phase. Results showed that families receiving routines-based early intervention had greater satisfaction with the service although both groups showed similar scores for family quality of life in most of the analyzed domains. Three dimensions were identified throughout the qualitative phase: problem solving, professional team and service organization. Both the models analyzed have an impact on family quality of life and parents are in general satisfied. Strengths and weaknesses were found related to the problem-solving process, the role of the professional team, family empowerment and the service’s organization. The areas requiring further development are the effective training of professionals focused on family practices, the exchange of information with the family and a more participatory organization that takes parent’s perspectives into consideration. The value given to a combined model is another aspect highlighted in this study, as well as the need for a more agile assessment period to avoid unnecessary delays. (shrink)

Digital media, such as cellphones and tablets, are a common part of our daily lives and their usage has changed the communication structure within families. Thus, there is a risk that the use of DM might result in fewer opportunities for interactions between children and their parents leading to fewer language learning moments for young children. The current study examined the associations between children’s language development and early DM exposure.Participants: Ninety-two parents of 25months olds recorded their home sound environment (...) during a typical day [Language ENvironment Analysis ] and participated in an online questionnaire consisting of questions pertaining to daily DM use and media mediation strategies, as well as a Swedish online version of the MacArthur Communicative Development Inventory, which includes a vocabulary scale as well as a grammar and pragmatics scale.Results: Through correlations and stepwise regressions three aspects of language were analyzed. The child’s vocabulary was positively associated with interactional turn-taking. The child’s vocabulary and grammar were negatively associated with the likelihood of parent’s device use during everyday child routines and the amount of TV watched by the child. The child’s pragmatic development was also positively associated with the parent’s device use in child routines but also with the parent’s joint media engagement, as well as the child’s gender.Conclusion: Our study confirms that specific aspects of the 2-year old’s DM environment are associated with the child’s language development. More TV content, whether it is viewed on a big screen or tablet, is negatively associated with language development. The likelihood of parents’ use of DM during everyday child routines is also negatively associated with the child’s language development. Positive linguistic parental strategies such as interactional turn-taking with the child, JME, and book reading, on the other hand, are positively associated with the child’s language development. (shrink)

The aim of this study was to investigate whether the quality of the sibling relationship moderates the association between parental psychological distress and child maladjustment. We extended previous literature by studying mothers and fathers separately and by including an observational measure of the quality of the sibling relationship. Participants were 52 two-parent families from a community sample who had at least two children living at home. Only one child was targeted for the study and studied in relation (...) to his/her siblings. Mothers and fathers completed a self-reported questionnaire on their psychological distress and individually assessed their child’s social-emotional maladjustment. The targeted child’s interactions with his/her siblings were observed by independent judges during a home-visit. Results indicate that both maternal and paternal psychological distress are significant predictors of child social-emotional maladjustment. Moderation analyses reveal that children of distressed fathers are at lower risk of social-emotional maladjustment when they engage in highly positive interactions with their siblings. Post hoc analyses suggest that only sibling empathy is a significant moderator of the association between paternal psychological distress and child maladjustment. The results of this study provide further evidence of the influence that fathers have in their child’s development and highlight the importance of using a systemic family approach to promote children’s social-emotional adaptation in the context of parental distress. (shrink)

Medical decisions for children are usually justified by the claim that they are in a child's best interests. More recently, following criticisms of the best interests standard, some advocate that the family's interests should influence medical decisions for children, although what is meant by family interests is often not made clear. I argue that at least two senses of family interests may be discerned. There is a ‘weak’ sense of family interests and a ‘strong’ sense. I contend that there (...) are problems with both approaches in making medical decisions for children but that the weak sense is more plausible. Despite this, I argue that claims for family interests are not helpful in making medical decisions for children. (shrink)

This paper describes the evolution of the family role face – specifically, the roles of father, mother and child – in a concrete period of the Spanish social history -from the end of 19th century to the 1960s. To achieve this goal, a corpus of theater plays is analyzed from a functional and pragmalinguistic perspective in a socio-historical context. The focus is on the quantitative and qualitative analysis of the projection of role face in the expression of directive speech (...) acts and their possible modulation through two pragmatic strategies: mitigation and intensification. Based on the results of the analysis, a sociopragmatic interpretation is carried out by identifying the connection between the choice of pragmalinguistic strategies and the need of the speakers’ autonomy face and affiliation face in different roles as family member in the given period. The results point to a progressive solidarity in father-child relationships during this period. On the one hand, that is based on the erosion of the authoritarian component of parental roles. On the other hand, it is anchored in the consolidation of proximity, closeness (‘confianza’) and affectivity. From a methodological point of view, the present study confirms the possibility of characterizing a sociopragmatic aspect (role face) on the basis of pragmalinguistic elements, i.e. the linguistic expression of directive speech acts, and its modulation through mitigation and intensification. (shrink)

In Hermann Hesse's work named "Between the Wheels", an outdated education system where childhood period expected to grow mature early creates a danger that the child shall begin to experience a second unrealistic childhood period is criticized. The introverted aggression of the soul, which is deprived of childhood, gradually begins to turn towards itself. In the work, it is stated that the "ideal of high achievement" is adopted by the education authorities and their families to children by alienating (...) them from their selves, and by using a rigid and disciplinary education system and the trauma caused by this ideal on the child self and its irreparable consequences are explained. In the work, negative educational relations exposed by the children at the Maulbronn Monastery school in Schwaben, Germany are addressed. The psychic confusion of the psychic soul of Hans Giebenrath, who enrolled this school in second place under the pressure of his family and town people, but who realized later saw that this school did not give him any opportunity to develop himself, takes him away from both his nature-loving habits and his ideal of success, and he starts to dispose of working. Returning to the town, he continues his life as "the apprentice who bends the iron wheels". The work he performs with his hand skill does not make him happy. He falls into the river and his mysterious death saddens the whole people of the town. When evaluated from an educational and scientific point of view, it is thought that it is of an importance to analyze Hesse's work, in which the contradictory elements existing between the official curriculum and the hidden curriculum draw attention, in terms of the analysis of child-specific values and existential images. The aim of this research is to analyze the existentialist images of the child self in Hermann Hesse's work named "Between the Wheels". The work has been analyzed with narrative analysis technique. From the findings obtained, two themes were reached: Under "Child Self", which is the first theme; Categories named "autonomy of the self," "undirected thinking," "free will" have been identified. Under "Existential Images", which is the second theme; Categories named "nature," "friendship" and "contradictions" have been obtained. The results of the research show that the official curriculum and Hidden Curriculum should provide children with the opportunity to learn by living in line with their interests and abilities and support them to be autonomous individuals in their decisions and actions. This research shows the importance of living together with the child self and the adult self in order for the adults around the children to establish a balanced and healthy communication with the children, and the importance of the life spent by the children with nature for the healthy evolution of the child self to the higher stages. (shrink)

Most children and families have not had direct contact with child psychological and psychiatric experts. Instead they encounter developmental theories, etiological explanations and depictions of childhood disorders through indirect channels such as newspapers. Drawing on actor–network theory, this article explores two child psychological and psychiatric modes of ordering children’s mental health discernible in Sweden’s largest morning newspaper, Dagens Nyheter, during the years 1980 to 2008: a psychodynamic mode and a neuro-centered mode. In the article I show how (...) these two relatively contemporaneous modes greatly differed in how they enacted children’s mental health. The psychodynamic mode stressed the parents’ role in structuring and affecting the child’s unconscious and saw them as the primary cause of any mental illness. In contrast, the neuro-centered mode highlighted that mental issues were related to the child’s brain and proposed different solutions depending on whether the child’s brain functioned in a ‘normal’ or ‘atypical’ manner. Each mode moreover suggested differing contexts to their discussions, with the psychodynamic mode solely discussing the parental milieu while the neuro-centered mode mainly focused on how society affected children with ‘atypical’ brains. The two modes thus had significantly diverging implications for the reader on how to understand and manage children and their psychological well-being. I further argue in the article for the relevance of actor–network theory in historical studies of psychology and psychiatry. (shrink)

Two pediatric accidents in Jane Austen’s Persuasion and one in Margaret Oliphant’s The Doctor’s Family are examined from the point of view of trauma management with analysis of contributing risk factors, medical management, concerns of parents and bystanders, and course of recovery. Risk factors for injury are impulsivity, poor supervision, and parents who are unable to set limits. Medical attention is swift and competent, but no heroic measures are used; the management of the injuries, concussion with loss of consciousness and (...) dislocation of the collar bone, is consistent with the way these conditions are, for the most part, still managed today, and successful recovery depends on careful nursing and rest. Louisa Musgrove, who suffers a severe head injury, requires ten weeks of convalescence and undergoes a marked personality change, which we might today attribute in part to post-concussion syndrome but which may reflect contemporary debate about the biological basis of personality and behavior. A sudden traumatic injury to a child or adolescent changes the narrative abruptly, in fiction or in life, dividing a story into before and after, introducing grief and anxiety, and requiring that plans be rethought and personal relationships reshuffled with decisions about caretaking and nursing. (shrink)

The current thesis discusses how tools for analysing power are developed predominately for adults, and thus remain underdeveloped in terms of understanding injustices related to age, ethnicity/race and gender in childhoods. The overall aim of this dissertation is to inscribe a discourse of intersecting social injustices as relevant for childhoods and child welfare, and by interlinking postcolonial, feminist, and critical childhood studies. The dissertation is set empirically within the policy and practice of Swedish child welfare, here exemplified by (...) the assessment framework Barns Behov i Centrum. It aims to explore how Swedish child welfare, as a field of knowledge, modes of knowing and knowing subjects, constitutes an arena for claims and responses to intersecting social justice issues. The material consists of BBIC primers and selected samples from, a total of 283 case reports from a Swedish social service agency. The case reports address assessments of children. This dissertation is based on four qualitative studies using discourse analysis, as well as analysis inspired by thematic and case-study methodology. Two studies focus on child welfare discourses in BBIC documents involving social problems and violence, and two studies are based on child welfare case reports. Studies I­­-II address child welfare policy and practice by analysing the conditions required for children to participate, in terms of children’s moral status and in terms of status of ‘evidencing’ needs for protection. Studies III­­-IV explore this further from the perspective of intersecting and embodied social injustices in childhoods. Together, the studies interconnect child welfare as a field of knowledge, modes of knowing and knowers with child welfare as a moral arena for claims to rights, recognition, and social justice. The synthesised findings point to child biowelfare, in which justice discourses are largely absent. Biowelfare is informed by a mode of knowing and ‘evidencing’ risks to children’s health and development, which are confined to scientific predicting-believing, seeing-believing by professionals and a moral economy of care, all of which constrain the idea that injustices are structural and intersecting. Biowelfare primarily responds to children as ‘speaking’ biological bodies, rather than as voices of justice. In this sense, injustices of an epistemological nature are interconnected with social injustices. When issues of justice are mobilised in case reports and policy, they come across as rather ‘unjust’, primarily confined to the sphere of the family home of racialised children and not connected to ‘general’ children. In addition to intersections of age, ethnicity/race and gender, class and health are fundamental to recognition and protection in biowelfare. Finally, the dissertation indicates the need for a moral economy which responds to intersecting social injustices such as racial, gender-based and ageist violence in childhoods, and violations of children’s bodily integrity. (shrink)

ABSTRACTI argue that parents ought to be allowed to authorize their child's participation as an organ donor for another family member. I introduce a model of decisionmaking for children in intimate families which I call Constrained Parental Autonomy. This model permits wide parental discretion which is constrained absolutely by a broadly defined principle of respect for persons. In general, parental authorization alone is sufficient but I argue that the respect for persons constraint prevents certain donations and requires the (...) child's assent for other donations. I also consider two controversial implications of the application of this model: the objection that the model does not respect the child's right to bodily integrity, and the objection that the model does not and is unable to address intrafamilial disgreement. (shrink)

In chapter two of The School and Society, entitled "The School and the Life of the Child," the renowned American philosopher John Dewey demonstrates how the model of the "ideal home" can impart lessons about a model of the "ideal school." It is argued that education should give direction to the student's natural impulses, just as the concerned parent guides the growth of the child. There are at least two ways in which to interpret this argument. One is (...) that home schooling is the ideal form of early education. The other is that school life should emulate family life. Though advocates of home schooling would prefer the former account, the case is difficult to make, for Dewey rarely recommended specific institutions or practices and the interpretation does not align with the book's other thesis that the classroom should be a microcosm for the best that the community has to offer. So, consistent with the overall theme of the work, it is the latter reading, viz., that school life should resemble family life, I contend, that proves more persuasive. School teachers have an ethical responsibility to care for their students' interests and, ideally, to provide a quality of mentorship approaching, if not on par with, that delivered by concerned parents. However, unlike student-centered education, in which educators curry favor with students by appealing to their native interests, what I call Dewey's model of "education as family life" imposes discipline on the student's natural desires, directing them in ways that are intended to enrich their future adult lives. (shrink)

Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively (...) meeting the needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. (shrink)

Modern times are an arena for two opposing trends: the liberalization of mores and laws, and the distancing of changes and adoption of a conservative position against those that occur. Polish family law clearly fails to keep pace with the changes taking place and does not perceive new phenomena. Is this an intentional act of the legislator leading to the preservation of traditional values, or the expression of disapproval and belief in the transitoriness of new phenomena? It comes together with (...) the introduction of new terminology or new interpretations of already existing concepts. Hence the meaning of some of the current concepts in everyday language differs significantly from their meaning arising from legal instruments. The article is an attempt to deal with this problem. (shrink)

What is the proper balance between legislative and judicial innovation and between formal and functional family recognition once legislatures have addressed gay men’s and lesbians’ families? In the civil-law jurisdiction of Quebec, legislative reforms allow two women to register as a child’s mothers. But judges have recognized a second mother ‘in fact’ by orders sharing custody where the parties had not used the new legislative channels. Such judicial creativity is reconcilable with the civil law and comparative scholars should (...) flag it as a valuable resource. But it risks undermining legislative choices about family recognition. Perhaps the option to give a child a second mother includes the choice for a lesbian birth mother not to do so. Once two women become thinkable as spouses and mothers, judges risk inappropriately pressing a rich range of queer kinship possibilities into standard models. (shrink)

Evolutionary theory guides an investigation of foster parent selection in two northern Thai villages with different biosocial environments: one village has high levels of labour migration and divorce, and growing numbers of parental death due to HIV/AIDS, while the other village has lower migration, divorce and parental mortality levels. Focus groups examine mothers motivations and ideals regarding foster caretaker selection, and quantitative family surveys examine real fostering outcomes: specifically, the laterality (matrilateral versus patrilateral) and genetic distance of the foster caretakers (...) of all ever-fostered children in these two villages. As predicted, in environments of high marital stability and paternity certainty, parents seem to prefer close genetic kin from either side as foster parents for their children. In low marital stability and paternity certainty environments, parents trust their own lateral kin, regardless of genetic distance, over close genetic kin from the other side. The striking exception to this pattern, however, occurs in the case of parental death, in which case children are fostered to the deceased parents sex or other factors. In general, the foster parents for girls are selected with more care, reflecting the daughter/female preference expected in traditionally matrilineal, matrilocal societies. An ordered decision-making pathway for foster parent selection is proposed, taking into consideration the key factors of (a) the circumstances driving the fostering decision, (b) the gender of the child, (c) the gender of the key decision-making parent, and (d) the degree of marital and population fluidity (and subsequent paternity certainty) in the village. (shrink)

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as the ethical and legal issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models of (...) health care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy. (shrink)

Among the most pressing philosophical questions occupying those interested in the ethics of the family is why should parents, as opposed to charity workers or state officials, raise children. In their recent Family Values, Brighouse and Swift have further articulated and strengthen their own justification of the parent-child relationship by appealing to its crucial role in enabling the child’s proper development and in allowing parents to play a valuable fiduciary role in the lives of children. In this paper, (...) I argue that the set of interests Brighouse and Swift identify as necessary for the justification of the family fails to account for the different stages and the different cultural settings that mark the parent-child relationship. In particular, I ague that their justification of the family fails to satisfy the following two desiderata: (i) that the justification for the parent-child relationship should ideally track the good-making feature(s) of the relationship that extend across its entire history, and (ii) such justification should ideally explain what is valuable about the parent-child relationship in both liberal and non-liberal family contexts. In light of my critique, I sketch an alternative account of family values, one that appeals directly to the special mode of caring we see in the parent-child relationship, a form of caring that is certainly present in non-liberal societies and that typically extends across a lifetime. (shrink)

Although the COVID-19 pandemic has raised deserved concern regarding adverse impacts on parents’ and children’s mental health, regulations like “sheltering-in-place” may have afforded parents novel opportunities to foster positive family connections, thereby bolstering well-being. Using latent profile analysis, we distinguished family thriving during shelter-in-place from other patterns of family functioning, tested potential predictors of family functioning profiles, and examined if family thriving predicted subsequent child adjustment. 449 parents in two-parent U.S. families with children aged 2–18 years completed online (...) surveys assessing parent–child relationship quality, parents’ positive psychological adjustment, children’s emotional well-being, and parenting efficacy and satisfaction as family functioning indicators, financial, marital, parental psychosocial assets, and child predictors of family functioning, and child adjustment. LPA identified four family functioning profiles: Thriving, Managing, Struggling, and Distressed. Thriving families evinced higher scores on all functioning indicators. Logistic regressions revealed that parents in Thriving families reported significantly lower financial anxiety, less dissatisfaction with partner’s help, less child emotionality, and greater use of cognitive reappraisal, as well as more positive child adjustment in Fall 2020. These findings underscore the multidimensional nature of coping and well-being during COVID-19. Utilizing these levers to promote mental health in families languishing during comparable future crises could promote resilience, thereby protecting children’s well-being. (shrink)

Volume II in the Evolution of Gestalt series, _Relational Child, Relational Brain_ continues the development of the paradigm shift that places human development in a field that is deeply complex and fundamentally one of interconnection, taking us away from the limiting view of us as separate individuals. It builds on the foundation of contemporary views of relational neurodevelopment and the profound influence of relationship on brain growth. It shows how, particularly in the first two years of life, but continuing (...) across the whole of childhood and adolescence into early adulthood, the relational field is the context of child development. The focus then broadens out to examine the intersubjective influence of community, culture, and social and physical support. Backed by neurobiological and related research, it offers many examples of relational Gestalt practice with children, adolescents, and their families, with stories of loss, trauma, isolation, and other adversities. Not just an invaluable resource for child and adolescent therapists, _Relational Child, Relational Brain_ goes beyond the Esalen Study Conference from which it emerged and is a further invitation and challenge to apply relational Gestalt practice as a coherent and effective way forward in the troubled world of today. (shrink)

Of her two granddaughters, Grandma Yvette clearly prefers Ruby Taylor's perfect--and perfectly Jewish--cousin, Sarah. They do everything together, including bake cookies and have secret sleep overs that Ruby isn't invited to. Twelve-year-old Ruby suspects Grandma Yvette doesn't think she's Jewish enough. The Jewish religion is matrilineal, which means it's passed down from mother to child, and unlike Sarah, Ruby's mother isn't Jewish. But when Sarah starts acting out--trading in her skirts and cardigans for ripped jeans and stained t-shirts, getting (...) in trouble at school--Ruby can't help but be somewhat pleased. Then Sarah suddenly takes things too far, and Ruby is convinced Sarah is possessed by a dybbuk, an evil spirit... that Ruby may or may not have accidentally released from Grandma Yvette's basement. Ruby is determined to save her cousin, but a dybbuk can only be expelled by a "pious Jew." If Ruby isn't Jewish enough for her own grandmother, how can she possibly be Jewish enough to fight a dybbuk? (shrink)

This study examines whether mortality of two adjacent siblings in families is age-specific and is modified by the MCH78, 198590 in the treatment (MCH–FP) and comparison areas. Logistic regression was used to estimate the net effects of survival status of elder siblings on mortality of younger siblings in the neonatal, postneonatal and toddler periods, controlling for birth order, previous birth interval, maternal age, education and religion, household possession of valuable items and sex of the child.

Research on nursing ideology and the ethics of child and adolescent psychiatric nursing care is limited. The aim of this study was to describe and explore the ideological approaches guiding psychiatric nursing in child and adolescent psychiatric inpatient wards in Finland, and discuss the ethical, theoretical and practical concerns related to nursing ideologies. Data were collected by means of a national questionnaire survey, which included one open-ended question seeking managers' opinions on the nursing ideology used in their area (...) of practice. Questionnaires were sent to all child and adolescent psychiatric inpatient wards (n = 69) in Finland; 61 ward mangers responded. Data were analysed by qualitative and quantitative content analysis. Six categories - family centred care, individual care, milieu centred care, integrated care, educational care and psychodynamic care - were formed to specify ideological approaches used in inpatient nursing. The majority of the wards were guided by two or more approaches. Nursing models, theories and codes of ethics were almost totally ignored in the ward managers' ideological descriptions. (shrink)

Living related organ transplantation is morally problematic for two reasons. First, it requires surgeons to perform nontherapeutic, even dangerous procedures on healthy donors—and in the case of children, without their consent. Second, the transplant donor and recipient are often intimately related to each other, as parent and child, or as siblings. These relationships challenge our conventional models of medical decisionmaking. Is there anything morally problematic about a parent allowing the interests of one child to be risked for the (...) sake of another? What exactly are the interests of the prospective child donor whose sibling will die without an organ? Is the choice of a parent to take risks for the sake of her child truly free, or is the specter of coercion necessarily raised? (shrink)

This article examines the issue of intergenerational cohabitation in the family home. Its primary purpose is to demonstrate that current analysis of internal conflicts in the home is lacking, both in terms of identifying the parties’ interests and characterizing the tensions involved. It focuses on a specific three-way conflict between two parents and their adult child and identifies each of their points of view: one parent who wants the adult child to move out, one parent who wants to (...) continue to share her home with the adult child, and the adult child who wants to remain in the home.The article builds on rich multidisciplinary literature on the meaning of the home. This focus sheds new light on the conflict in two significant manners. First, the disagreement between the parents is characterized as a struggle between two conflicting visions of the home. Each of these visions reflects a different perception of the home, the family, and intergenerational commitments. Second, the focus on the home allows lawyers to acknowledge the position of the adult child, whose interest is completely not sufficiently taken into account in the conventional analysis. (shrink)

We describe a corpus of speech taking place between 30 Korean mother–child pairs, divided in three groups of Prelexical (M= 0;08), Early-Lexical (M= 1;02), and Advanced-Lexical (M= 2;03). In addition to the child-directed speech (CDS), this corpus includes two different formalities of adult-directed speech (ADS), i.e., family-directed ADS (ADS_Fam) and experimenter-directed ADS (ADS_Exp). Our analysis of the MLU in CDS, family-, and experimenter-directed ADS found significant differences between CDS and ADS_Fam, and between ADS_Fam and ADS_Exp, but not between (...) CDS and ADS_Exp. Our finding suggests that researchers should pay more attention to controlling the level of formality in CDS and ADS when comparing the two registers for their speech characteristics. The corpus was transcribed in the CHAT format of the CHILDES system, so users can easily extract data related to verbal behavior in the mother–child interaction using the CLAN program of CHILDES. (shrink)

_Background:_ Several studies have shown a connection between mothers with postnatal depression (PND) and emotional-behavioral problems in their children. Mothers’ psychopathology may impair interactional patterns with children and these outcomes can be influenced by father’s psychopathological symptoms. The primary aim of the study was to assess over time parent-infant interaction in families where mothers have experienced PND and have received psychological treatment during the child’s first year of life considering the severity of parents’ psychopathological symptoms and children’s temperament. (...) _Methods:_ Three groups of families were involved: families with mothers with PND wherein both parents followed a psychological treatment (TxMF); families with mothers affected by PND wherein only the mother followed the treatment (TxM) and control families wherein the mothers did not have a psychopathological diagnosis and did not receive any treatment (Con). The families were assessed at two time points through Symptom Check-List-90-Revised (SCL-90-R), Questionari Italiani Temperamento (QUIT) and the video-recorded procedure observing mealtime Scala di Valutazione Interazioni Alimentari (SVIA). _Results:_ Parents in the TxMF group had significantly lower SVIA scores (i.e., less maladaptive) at T2. TxMF group scored lower at T2 at SCL-90-R, whereas TxM showed no significant differences between T1 and T2. Involvement of fathers in the treatment was important to improve the psychopathological symptoms of both parents and the quality of interactions with their children. (shrink)

One million cases of child maltreatment and twelve hundred child deaths due to abuse and neglect occur per year. But since many cases of abuse and neglect remain either unreported or unsubstantiated due to insufficient evidence, the number of children who are abused, neglected, and killed at the hands of family caregivers is probably higher. One approach to combat child abuse in the U.K. has been the employment of hospital-based covert video surveillance (CVS) to monitor parents suspected (...) of Munchausen Syndrome by Proxy (MSBP). The use of CVS, however, raises concerns about voluntary informed consent, research on human subjects, privacy, and the appropriateness of healthcare providers to conduct CVS. More broadly, the use of CVS raises concerns about the ethical life of healthcare institutions and their moral obligations to the families and communities they serve. The U.K. protocol for CVS is examined in light of these concerns. Three alternative CVS protocols and two procedures for selecting a protocol are then proposed for use in the U.S. The paper concludes that any CVS protocol selected for use by hospitals ought to be selected by means of open and democratic processes that permit community input and, subsequently, the possibility of a consensus on the moral status and scope of CVS. (shrink)

The coronavirus disease 2019 health crisis is strongly affecting the psychological well-being of the general population. According to a very recent literature, the imposed lockdown and social distancing measures have generated a series of negative outcomes, including fear of the future, anxiety, and somatization symptoms. Few studies have investigated the impact of the COVID-19 pandemic on the well-being of parents and children, and still fewer studies have assessed the relationship between the psychological health of parents and children. The present study (...) aimed at understanding the effect of parents’ psychological distress and verbal aggression on behavioral and emotional symptoms of children during the COVID-19 lockdown. Using an online survey administered in the first weeks of the lockdown in Italy, we explored the mediating effects of parent verbal hostility and child emotional symptoms on the relationship between parent distress and child hyperactivity/inattention in a sample of 878 Italian parents. Two hypotheses were proposed: parent distress would significantly predict child hyperactivity/inattention, and parent verbal hostility and child emotional symptoms would mediate the association between parent distress and child hyperactivity/inattention. The serial mediated model confirmed both hypotheses, suggesting that higher rates of psychological distress in parents were associated with higher levels of hyperactivity/inattention in children. Parent verbal hostility and child emotional problems were also found to positively mediate this relation. Our results may be used to improve sociopsychological interventions in the general population in the near future. They may also contribute to the clinical definition of therapeutic paths for parents and families. (shrink)

In museum settings, caregivers support children's learning as they explore and interact with exhibits. Museums have developed exhibit design and facilitation strategies for promoting families' exploration and inquiry, but these strategies have rarely been contrasted. The goal of the current study was to investigate how prompts offered through staff facilitation vs. labels printed on exhibit components affected how family groups explored a circuit blocks exhibit, particularly whether children set and worked toward their own goals, and how caregivers were involved (...) in children's play. We compared whether children, their caregivers, or both set goals as they played together, and the actions they each took to connect the circuits. We found little difference in how families set goals between the two conditions, but did find significant differences in caregivers' actions, with caregivers in the facilitation condition making fewer actions to connect circuits while using the exhibit, compared to caregivers in the exhibit labels condition. The findings suggest that facilitated and written prompts shape the quality of caregiver-child interactions in distinct ways. (shrink)

The aim of this research was to explore the elements that configure the quality of care among three Mexican same-sex planned families: two female-parented families (through donor insemination) and a male-parented one (through adoption). The first family consisted of two mothers and a 3-year-old daughter; the second one had two mothers and a 1.5-year-old set of boy twins and the third family consisted of two fathers and a 2-year-old girl. It was assumed that Ainsworth’s notions of quality of (...) care organization are useful in order to understand caregiver-child attachment relationships, regardless of the parents’ sexual orientation. A collective case study was selected due to the fact that these families shared their “unconventionality” (i.e. parents were not heterosexual) and the fact that they were planned, but each one constituted a particular case with a unique configuration. Four trained independent observers used the q-sort methodology (Maternal Behavior Q-Sort and Attachment Q-Sort) to describe parents’ and children’s behavior, respectively. The findings showed that parents were highly sensitive and all children used them as a secure base. To provide an in-depth examination of which elements configure the quality of care, a semi-structured interview with each parent was carried out. Through a thematic analysis, an over-arching theme named Affections and Emotions was identified, together with six subthemes: 1) Creating an affective environment; 2) Being available; 3) Acknowledging and expressing emotions; 4) Perceiving, interpreting and responding adequately to the child’s real self; 5) Taking the child’s perspective into account; and 6) Agreeing on roles and dividing the tasks. In order to showcase the particular configuration of gay parenting, the male-headed family narrative is reported in detail, because gay parents have been perceived as violating traditional gender roles as well as the hegemonic model of masculinity. The findings were consistent with the notion of quality of care as proposed by Ainsworth and her collaborators. The implications of the methodological device and research regarding same-sex planned families are discussed so as to understand the organization of the caregiving environment. (shrink)

Studies have supported the effectiveness of the From Timid to a Tiger and Supportive Parenting for Anxious Childhood Emotions program in reducing childhood anxiety. This study is the first to compare the effectiveness of the two programs in the treatment of childhood anxiety disorder and reducing family accommodations levels. Parents of children aged 6 to 9 were randomly allocated to either FTTT or SPACE groups, and each attended ten online sessions following the manuals of the interventions. Throughout the study, 9 (...) participants dropped out, resulting in a total of 49 participants, and we performed statistical analyses based on data from these 49 participants. The assessment took place pre- and post-treatment and at a ten-week follow-up on parent-rated child anxiety and family accommodation measures. Analyses of variance and gain scores were conducted to examine the data. The results indicated that both treatments approaches produced significant reductions in outcome measures, and the post-treatment gains of both treatments were maintained at a ten-week follow-up, though when considering the mean differences and effect sizes across the assessment scores and between groups, overall, the FTTT was significantly more effective in reducing child anxiety scores and family accommodation levels. Our results demonstrated that FTTT significantly outperformed the SPACE program in reducing childhood anxiety problems and family accommodation levels. (shrink)

This study investigated the importance of socioeconomic factors such as education, income, religion, family structure and residence in explaining the increased risk of mortality among vulnerable populations aged less than 20 years in Rio de Janeiro, Brazil. Data used were from the 1991 Brazilian Demographic Census and comprised 121,060 women aged 15–49 residing in Rio de Janeiro. Two alternative statistical methods were used to calculate the risk of death: the widely used Brass method (an indirect estimate which assesses population risks) (...) and a case-control study (which assesses individual risks). The study also focused on the importance of indicators of human and social capital, the lack of which may explain the higher risk of death among children and adolescents. Lack of education was found to be a major determinant of mortality at young ages. Residence in a favela (shantytown), families in which mothers were the head of the family, and a lower median level of income were found to be significant determinants of mortality among vulnerable populations in Brazil. However, religion was not found to be as important a predictor of high mortality. (shrink)

In this article, I challenge the widespread presumption that a child should have exactly two parents. I consider the pros and cons of various numbers of parents for the people most directly affected – the children themselves and their parents. The number of parents, as well as the ratio of parents to children, may have an impact on what resources are available, what relationships can develop between parents and children, what level of conflict can be expected in the family, (...) as well as the costs involved in parenting and the experience of parenting a child. Indirectly, there is also an effect on who will have the opportunity to be a parent, as well as on wider social issues that I mention but do not discuss. Having considered all these factors, I conclude that there is some reason to believe that three or more parents is usually better than one or two, especially if children are to have siblings, which is typically beneficial. However, these reasons are not strong enough to support a general presumption in favor of any particular number. We should therefore jettison the two‐parent presumption and make different numbers of parents more socially accepted as well as legally possible. (shrink)

Background Research in children is essential for them to benefit from the outcomes of research but involvement must be weighed against potential harms. In many countries and circumstances, medical research legally requires parental consent until the age of 18 years, with poorly defined recommendations for assent prior to this. However, there is little research exploring how these decisions are made by families and the ethical implications of this. Aim To explore key ethical debates in decision-making for participation of children (...) and adolescents in a human papillomavirus (HPV) vaccine trial. Methods Semi-structured interviews were undertaken with Tanzanian girls (aged 9–16 years) who had participated in an HPV vaccine trial (n = 13), their parents or guardians (n = 12), and girls together with their parents (in paired parent-child interviews) (n = 6). The interviews were analysed using thematic analysis. Interview data came from a qualitative acceptability study undertaken as part of the Dose Reduction Immunobridging and Safety Study of Two Human Papillomavirus (HPV) Vaccines in Tanzanian Girls (DoRIS) trial. Results Girls and parents desired collaborative decision-making, with parents ultimately making the decision to consent. However, girls wanted a larger part in decision-making. Decisions to consent involved many people, including extended social networks, the trial team, media outlets and healthcare professionals and this resulted in conflicts to be negotiated. Deciding where to place trust was central in participants and parents considering decisions to consent and overcoming rumours about trial involvement. Conclusions Existing models of decision-making help to understand dynamics between parents, adolescents and researchers but neglect the important wider social impacts and the fundamental nature of trust. Children’s roles in discussions can be evaluated using the principles of consent: autonomy, freedom and information. Concepts such as relational autonomy help to explain mechanisms families use to negotiate complex consent decisions. Whilst interviewees supported the maintenance of legal parental consent, researchers must design consent processes centring the child to ensure that whole family decision-making processes are supported. (shrink)