Harms Of Surveillance Research Articles

Foreword

The 2001 book, Shattered Bonds: The Color of Child Welfare, by Dorothy Roberts, called out the racism of the child welfare system and the harms that system perpetrates on families and communities. Twenty years later, despite numerous reform efforts, the racism and profound harms endure. It is time for transformative change. In this foreword to the symposium Strengthened Bonds: Abolishing the Child Welfare System and Re-Envisioning Child Well-Being, honoring the 20th anniversary of Shattered Bonds, we highlight Professor Roberts’ articulation of her development as a family policing abolitionist and summarize the articles and comments contributed from scholars in numerous disciplines and well as impacted parents, family defense advocates and systemchange activists. These contributions help us learn from history and political theory; focus on the unique and shared circumstances of Native American families; critique, and call for repeal of, much of current law; condemn the punitive, and racially disproportionate, surveillance of families; and demand a new approach that diverts the massive funding of the foster-care industrial complex into support, services, and healing for families, tribes, and communities. We call for abolition of the family regulation system, the term we use as a more accurate description of what is commonly called the child welfare or child protection system. We situate this call in the context of the more developed movement for prison abolition. The current system is predicated on seeing individual parents as a risk to their children. It fails to see the strengths and resilience of parents and families; the harms of surveillance and removal; and the structural forces that harm children by failing to invest in adequate housing, income, child care, health and mental health services, and educational opportunities for all families. Abolition provides the transformative mind-set that will enable loving and strengthened families to raise happy, healthy, safe, educated, and imaginative children.

Foreword: Strengthened Bonds: Abolishing the Child Welfare System and Re-envisioning Child Well-Being

The 2001 book, Shattered Bonds: The Color of Child Welfare, by Dorothy Roberts, called out the racism of the child welfare system and the harms that system perpetrates on families and communities. Twenty years later, despite numerous reform efforts, the racism and profound harms endure. It is time for transformative change. In this foreword to the symposium Strengthened Bonds: Abolishing the Child Welfare System and Re-Envisioning Child Well- Being, honoring the 20th anniversary of Shattered Bonds, we highlight Professor Roberts’ articulation of her development as a family policing abolitionist and summarize the articles and comments contributed from scholars in numerous disciplines and well as impacted parents, family defense advocates and system-change activists. These contributions help us learn from history and political theory; focus on the unique and shared circumstances of Native American families; critique, and call for repeal of, much of current law; condemn the punitive, and racially disproportionate, surveillance of families; and demand a new approach that diverts the massive funding of the foster-care industrial complex into support, services, and healing for families, tribes, and communities. We call for abolition of the family regulation system, the term we use as a more accurate description of what is commonly called the child welfare or child protection system. We situate this call in the context of the more developed movement for prison abolition. The current system is predicated on seeing individual parents as a risk to their children. It fails to see the strengths and resilience of parents and families; the harms of surveillance and removal; and the structural forces that harm children by failing to invest in adequate housing, income, child care, health and mental health services, and educational opportunities for all families. Abolition provides the transformative mind-set that will enable loving and strengthened families to raise happy, healthy, safe, educated, and imaginative children.

Primary Care Clinician Decision-Making Around Surveillance Colonoscopies in Older Adults with Prior Adenomas

While guidelines recommend against routine colorectal cancer screening in adults >75 years and/or those with limited life expectancies, there is no clear guidance on when surveillance colonoscopies following prior adenoma detection should stop. How primary care clinicians weigh the potential risks and benefits of surveillance colonoscopies in older adults with prior adenomas is unknown. We conducted semistructured in-person interviews with 30 primary care clinicians from 21 clinics in Maryland. We asked how clinicians decided whether to continue or stop surveillance colonoscopies in older adults (65+ years) with prior adenomas. Interview transcripts were independently coded by 2 investigators using qualitative content analysis. Participants described a range of decision-making approaches. Some deferred to specialists because they did not feel confident making decisions about stopping surveillance in light of the higher cancer risk involved. Some took a more active role and discussed the decision with patients and/or specialists. Other clinicians felt comfortable stopping surveillance colonoscopies and made these decisions based on patient age, comorbidities, or life expectancy. We found a range of decision-making approaches among primary care clinicians on whether to continue surveillance colonoscopies in older adults with prior adenomas. Separate bodies of evidence currently exist on how prior adenoma characteristics influence colorectal cancer risk and on how older age and declining health influence the benefit/harm balance of screening. Information is lacking on the benefits and harms of surveillance in older adults with prior adenomas. Developing the evidence to address this knowledge gap is critically needed to inform clinical decision making.

Barrett's oesophagus, part 2: Enabling informed patient choice in surveillance

Endoscopic surveillance programmes for patients with Barrett′s oesophagus aim to detect high-grade dysplasia which may be a precursor to adenocarcinoma. However, Karen Bailey explains that before patients can be enrolled in a surveillance programme, they need to be made aware of the potential harms of surveillance, as well as the realistic chances of cancer developing. Patients need to be given simple, accessible and balanced information in order to make informed choices as to participation in surveillance or screening programmes for any condition. Health professionals also need to have an understanding of patients′ perceptions of surveillance and screening programmes and respect the informed decisions made by patients.