by Marie Cohen

I Saw a Child Who Seemed Neglected. Should I Have Done Something? was the title of a column from Kwame Anthony Appiah, who writes the “Ethicist” Column for the New York Times. Appiah is a respected philosopher and writer, but he lacks in-depth knowledge about the child welfare system. In this case, he was relying on misinformation about our child protection system that has become so prevalent that it is taken for truth.

The anonymous writer told The Ethicist about a child she saw in her home town in upstate New York, which she described as a poor rural area that has been hit hard by the lost of industry and the opioid epidemic. On a “bitterly cold day,” she stopped into a local dollar store and saw two young woman who entered with a child under five years old. She noticed the child was wearing only shorts and a T-shirt, with no socks or shoes. The child also appeared extremely dirty, as if the child had not been bathed in days. The writer also noticed that the child’s hair was dyed neon green and he or she had black nail polish on fingers and toes. It seemed odd to her that somebody found time for these “fun touches” while basic care was missing. As the group left the store, she noticed the child stepping barefoot into slush and climbing into a car where the driver was smoking a cigarette. She watched the group drive away and reported, “I couldn’t shake the feeling that I may have seen a child who needed help and I simply walked away. At the same time, I worry that I’m piling assumptions onto a family I know nothing about, a family that might be doing its best. … I also know that calling Child Protective Services can create serious harm for families who don’t deserve it. What should I have done?” 

Here is “The Ethicist’s” answer, paragraph by paragraph, followed by my response,:

This probably wouldn’t be a hard call if we all trusted the ability of social services to intervene — and to refrain from intervening — thoughtfully and protectively. After all, child abuse and neglect take place on a distressing scale. In an ideal world, you could note the car’s plate number, report what you’d seen and be confident that you were more likely to help than harm. A widespread concern, though, is that C.P.S. can do a great deal of damage; indeed, some child-welfare experts have concluded that, on net, these programs do more harm than good.

Many of these “child welfare experts” that Appiah is talking about cite statistics showing the abysmal outcomes of youth who age out of foster care, such as low high school graduation and college attendance rates and high rates of teen pregnancy, homelessness and criminal justice involvement. They often talk about “the foster-care-to-prison pipeline.” But we do not know the extent to which these bad outcomes reflect the child’s earlier experiences at home versus the effects of foster care. Many of the children who are removed from abusive or neglectful homes might have fared even worse if they not been removed. It is certainly a shame that we do not have a foster care system that is nurturing and generous enough to erase the disadvantages with which children enter it, but that is not to say that our inadequate foster care system is responsible for the poor outcomes that foster children and youth experience. Moreover, youths who age out of care (the ones who are usually studied) are likely more disadvantaged than the majority of foster youth who return home, go to relatives, or get adopted, and using them to gauge the impact of foster care is misleading.

Whether foster care does more harm than good is a difficult question to research because it is not possible to do a controlled experiment in which abused or neglected children are randomly assigned to stay home or go to foster care. In marginal (lower-risk) cases where the decision to remove a child depends on the investigator assigned to the case, studies have been done using the best available methods (which are not very satisfactory) and different studies have reached different conclusions.¹ These methods cannot be used to estimate the effects of foster care for children who are at higher risk, whom investigators would tend to agree should be removed. But in these cases, it is highly plausible that foster care is likely to do more good than harm. It is impossible to know the risks facing the particular child discussed in this column because we have no idea what a visit to the child’s home would reveal.

A big problem is that C.P.S. [Child Protective Services]’s most powerful instrument is family separation, which can be traumatic for both children and parents. Despite efforts to reduce reliance on it, a built-in asymmetry of blame can lead to overuse. Headlines and public outrage can ensue when a caseworker makes a judgment that leaves a child in a dangerous situation; there’s seldom much notice when a caseworker makes a judgment that unnecessarily separates a family. As one social-policy expert has put it, this imbalance of incentives means that those in the child-protection sector aren’t so much “risk averse” as “risk-to-self averse.”

Appiah is right that CPS’ “most powerful” instrument is family separation, but it is not the most common response to a report or abuse or neglect. First, the report must be screened in to receive an investigation or an alternative esponse. Based on the latest data compiled by the federal government from state submissions, about 4.365 million reports involving 7.693 million children were made to CPS in 2024. Less than half of the calls were screened in for an investigation or an “alternative response” (often called a family assessment) which is a process often used for lower-risk cases and is designed to focus on a family’s service needs rather than determining whether maltreatment occurred. About three million (2,990,234) children received either an investigation or an alternative response. If the social worker doing the investigation or assessment decides that the child cannot be safely maintained at home, that child will likely be placed in foster care. But in cases where maltreatment is found but the child is not deemed to be in imminent danger, it is more likely that the family will receive case management and services (such as parenting education, drug treatment, and mental health services) through the opening of an in-home case.

The total number of children placed in foster care in FFY 2024 was 170,955, which is less than six percent of the three million children who received an investigation or alternative response, and barely two percent of the children who were the subject of a call to CPS. Unfortunately we do not know how many children receive in-home services because the Children’s Bureau does not collect that data.² But clearly the number placed in foster care is small relative to the number of children who are the subject of calls and the number who are investigated.

Appiah seems to be living in another world when he says that “Headlines and public outrage can ensue when a caseworker makes a judgment that leaves a child in a dangerous situation;….. this imbalance of incentives means that those in the child-protection sector aren’t so much “risk averse” as “risk-to-self averse.” That may be the case, but the national conversation in child welfare for at least ten years has been all about keeping families together and kids out of foster care. Every day brings a new report of a child being left in an obviously dangerous home and ultimately dying. Right now, we may have to worry more about children being left in dangerous homes than about them being unnecessarily removed.

When people talk as if all that matters is the “best interests of the child,” they turn an important idea into a simplifying rule. It isn’t as if we believe that billionaires are entitled to take the babies of low-income parents on the grounds that they can promise better life chances. The harm done to parents, along with the harm done to children by tearing their families apart, has to figure into any proper moral accounting.

Here, Appiah has created a straw man. Nobody is saying that children should be removed when they could have a better life in a different family or that the best interests of the child is grounds for removal. Harm to parents? Yes, parents are harmed by the removal of their children. But when the parents have been severely abusing or neglecting their child, I don’t think their well-being should enter into the equation at all.

All of that brings us back to your position in this episode. As you say, you don’t really know much about this situation, and your letter indicates a certain class distance that may add to your uncertainty. What you witnessed was worrisome, but you did not see someone shivering or sick. Nor do you live in the community. Others in the store, townspeople, saw the child, too. The child presumably has neighbors who see the preschooler’s everyday life, and any of them could have reported what they knew (and, for all you know, have done so). They may know the local record of C.P.S. and have a keener sense than you of both the risk to the child and the risk of calling in the state. So you shouldn’t reproach yourself for not reporting this child. That’s not because C.P.S. couldn’t possibly have helped. It’s because you didn’t know enough to decide what was needed and there were others better placed to do so.

A child who is wearing shorts and a tee shirt and no socks, shoes or coat in cold weather is clearly neglected, and some kind of intervention is necessary. But Appiah’s point about residents of the community being in a better position to report is a good one. This child is clearly not being hidden away, so others in the community probably have a better sense of what is going on than a stranger observing this group for the first time. Can one be sure that this child goes to school or is regularly exposed to people in the community who would be inclined to report? Based on my ignorance about the answer to this question, I would probably call CPS, despite my doubts about whether the call would be accepted given that only a license plate could be provided to identify the child and family.

The Ethicist’s final conclusion that the anonymous writer should not reproach herself for not calling CPS about this child is reasonable. But that conclusion stems from the writer’s position as a stranger in the community and is not applicable to the more common scenario in which a potential reporter has longer-term knowledge about a child’s circumstances. What is more important is that the three preceding paragraphs contain misinformation that may discourage people from reporting in situations when they really should do so. It is unfortunate that The Ethicist has fallen victim to the current ideological climate, where right and left agree in opposing government interference in the lives of children, even those who are abused or neglected.

Notes

1. Joseph Doyle of MIT, in a pathbreaking study, found a way to simulate such an experiment by taking advantage of the fact that children are essentially randomly assigned to different investigators who have different propensities to place children in foster care. Treating assignment to an investigator as an “instrumental variable,” Doyle was able to estimate the effects of foster care in marginal cases, where the assignment of an investigator determines whether the child will be placed in foster care. His results, using data from Illinois, suggested that “children on the margins of placement tend to have better outcomes when they remain at home.” But Doyle’s data are over two decades old and from a state with an atypical foster care system. Use of the same method with data from Michigan, Gross and Baron found that assignment to foster care for children at the margin of placement improved children’s safety and educational outcomes and in the long-term reduced the chances of adult arrests, convictions and incarceration. A similar study in Rhode Island found that found that removal significantly increased test scores and reduced grade repetition for girls and had not discernible impacts for boys. ↩︎
2. In its Child Maltreatment reports, the Children’s Bureau provides an estimate of the number of children reported to CPS and how many of those children ultimately end up receiving “postresponse services,” which includes both foster care and in-home services. Unfortunately, the numbers are duplicated, so that the same child can be counted more than once if that child is the subject of a new report after leaving foster care or having an in-home case closed. Moreover, the concept of “postresponse services” is quite broad and includes very limited services, such as information and referral, that may not require the opening of a case. ↩︎