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Creating A Child Abuse Policy That Reflects An Ethic Of Care
Jann Fielden RCpN, BA, MCNA(NZ) Orthopaedic Research Nurse, Department of Surgery, Wellington School of Medicine
The primary purpose of child abuse policy is to guide the action of health care providers and so ensure that the fundamental rights of those the policy intended to protect are not compromised. This discussion paper explores the ethical considerations underlying child abuse policy from bioethical and from caring ethical perspectives, both of which are outlined briefly. A process that could be used to create or analyse existing child abuse policy, in relation to underlying ethical considerations, definitions of child abuse, level of health care, resourcing needs and relationship to employment policy is outlined. A hypothetical example of such a policy is used to illustrate elements of this process. Assuming that policy is designed to direct action, it is argued that if child abuse policies were rewritten to reflect an ethic of care the quality and scope of health care provided to children and their families would improve. Consequently, stated government objectives of improving child health services, as well as primary health care aims of achieving equitable, accessible and affordable health care for children in New Zealand would be better facilitated.
Key words: Child abuse, ethics of care, bioethics, health policy.
Acts of child abuse and the long-term effects of such abuse on survivors are currently viewed in New Zealand as being of major public health concern, rather than solely the domain of officials working in the justice sector. Over recent years frequent media reports of child sexual and physical abuse, and statistics on nonaccidental injury (Ministry of Health, 1992; 1993; 1994; 1995a; 1996; 1997; 1998a) indicate a dramatic increase in the reporting and prevalence of such abuse. Continued