Discussion Parenting Ethical Issues

March 8, 2022
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Discussion Parenting Ethical Issues

Discussion Parenting Ethical Issues

I’m studying and need help with a Psychology question to help me learn.

What ethical issues are associated with the following parenting topics: genetic testing, designer babies, cloning, prenatal screening, and older people having babies? Select two topics to discuss and provide your viewpoints, but remember to substantiate your views with supportive evidence.

Code of Ethics and Standards of ConductProfessional organizations, government agencies, universities, researchers, and practitioners are expected to honor codes of ethics and standards of conduct when they work with children and families in all communities. The codes and standards vary somewhat with the mission of the institution, but most of them include a version of the core principles established in the Belmont Report (United States National Commission for the Protection of Human Subjects of
8 Journal of Cross-Cultural Psychology 49(1) Biomedical and Behavioral Research, 1978): respect for the person, beneficence, and fairness and justice. These principles set standards for the ethical conduct of research, but they can serve as the foundation for practice as well (e.g., Berman et al., 2016; Guttman, 2017; Miller, Goyal, & Wice, 2015). The principle of respect for the person asks that we consider people as autonomous agents capable of making their own decisions based on their values and preferences. To respect people in this way, we need to understand that a person’s decisions may relate in complex ways to his or her socioculturally situated relationships; that making decisions implies making choices; and that people must be aware of the choices available to them. The principle of beneficence asks that our actions promote the well-being of people, com-munities, or societies as a whole. If the benefits to all are not clear, we should reconsider what we do. Our actions should minimally do no harm, or minimize harm if there is a greater benefit, whether on a physiological, psychological, or sociocultural level. The principle of fairness and justice asks that we select people for study or intervention in ways that are equitable (e.g., fair in opportunities for involvement, just in determining who actually benefits), and avoid exploiting vulnerable populations.There are widely shared standards of conduct that translate these principles into practice, for example, obtaining informed consent, protecting privacy, maintaining confidentiality, avoid-ing conflict of interest, determining noncoercive forms of compensation, and following proce-dures and using assessment instruments whose validity and reliability have been established for the people involved in the study or intervention. However, the application of the ethical principles in these and other ways is often complex. It requires that researchers and practitio-ners understand the people with whom they are working by learning about their perspectives. They must understand the lived experiences of people as they reflect the intersections of cul-tural worldviews, economic resources, ethnic background, age, gender, social status, linguistic practices, religion, and other factors, and they must become aware of and avoid acting on their biases. This is likely when there is wide-ranging representation of cultural perspectives in research and practice, especially perspectives of scholars and experts from communities that are not well represented.Without such information, the ethics of research and practice are compromised. Miller et al. (2015) give an example of this. The Strange Situation, a procedure to assess the quality of a child’s attachment to his or her caregivers, was developed based on child care assumptions of people primarily in Western lifestyle communities. But, it is considered “ethical” by institutional review board standards even though research documents the extreme stress (harm) mothers and infants in non-Western lifestyle communities may experience in this procedure (e.g., Gaskins et al., 2017).Care for Child Development InterventionWe illustrate our ethical concerns about parenting interventions by considering the CCD inter-vention that is implemented by UNICEF (with WHO) directly or indirectly through alliance networks. We single out UNICEF’s CCD intervention to make our case because of UNICEF’s considerable presence in low- and middle-income countries. This intervention, in 2015, was reported in 23 sites in 19 UNICEF-active countries (Lucas, 2016). Even this figure does not tell the entire story, as the CCD intervention is carried out by many other agencies.The CCD intervention was implemented in the late 1990s to promote positive parenting defined as “effective, sensitive, and responsive child rearing and caring practices” (Britto et al., 2015, p. 1). The assumption was that this style of care best allows caregivers to raise children to become
Morelli et al. 9successful members of the community. UNICEF has a long history of promoting children’s well-being, and it is the only intergovernmental agency devoted exclusively to children. In the early days of its inception, UNICEF provided emergency and health care to children (Watt & Roosevelt, 1949). It widened its scope to include mothering practices, perhaps, as LeVine and LeVine sug-gest, “on the assumption that the mothering practices of the poorer countries with high infant mortality rates must be putting babies at risk psychologically as well as medically” (LeVine & LeVine, 2016, p. 47).The ethical concerns we have about this intervention extend to all interventions that aim to change the child care practices of people, especially in communities whose lifestyles are poorly understood. Our critical examination of the difficult ethical dilemmas this parenting intervention faces is not a critique of all the other interventions and programs UNICEF has put into place over the years. We appreciate and cherish all efforts to help families. However, as we detail, the CCD intervention and other similar interventions worry us because their goal is to modify how people with certain lifestyles care for children by training them in positive parenting practices of people with different, Western lifestyles. We extend our critique to attachment theory because of its universal claims regarding positive parenting and its impressive influence into real-life situations worldwide (Rosabal-Coto et al., 2017).Attachment TheoryAttachment theory is psychology’s most influential theory of relationships, and it has dominated developmental accounts of children’s close relationships in the last decades. From the start of the 20th century, psychologists of different orientations studied the attachments that infants form with their main caregivers and offered different explanations for those ties. John Bowlby (an English psychiatrist and psychoanalyst) along with his colleague Mary Ainsworth (a U.S.-Canadian psychologist) made the case that infants have an innate need to attach to their mothers (if the mother is not available, a child will attach to a mother-figure: for example, Ainsworth & Bowlby, 1991), but the quality of the attachment stems from the way a mother cares for her child (Ainsworth, Blehar, Waters, & Wall, 1978). When care is sensitive and responsive, a child feels secure in the presence of his or her mother, is able to explore the environment with confidence, and thus, is able to master the physical and social world. When care is not sensitive and respon-sive, a child is less able to do this. For these reasons, the security that care engenders is seen by attachment theorists as paramount to the child’s social and emotional development, to the child’s ability to learn about the world on his or her own and from others, and to all of the child’s future relationships (e.g., Cassidy & Shaver, 2016).The sensitive and responsive care described by Bowlby, Ainsworth, and researchers who con-tinue with their intellectual tradition is accepted as the gold standard of care by which all care, worldwide, is compared and evaluated. This is so despite the fact that attachment theory has received numerous criticisms since its inception (Vicedo, 2017).Implementation of the Care for Child Development InterventionThe CCD intervention trains caregivers in positive parenting skills, based on attachment theory, that should maximize children’s ability to achieve their full potential (Britto et al., 2015; Lucas, 2016). (This intervention takes place as part of existing health, nutrition, and other family-support services.) Caregivers practice these skills primarily in the context of play and talk. The assumption is that positive parenting, especially when it takes place in these contexts, will pro-mote secure attachment relationships. With this, children are believed to be more likely to develop stronger social (e.g., cooperation), cognitive (e.g., language), and emotional (e.g., regulation) skills (UNICEF, 2012; UNICEF/WHO, 2012b).
10 Journal of Cross-Cultural Psychology 49(1) In this intervention, caregivers are taught to treat the child as a separate person, to see the world from the child’s point of view, and to respond contingently and appropriately to the child’s explicit signals (Lucas, 2016; UNICEF, 2012; UNICEF/WHO, 2012b). Accordingly, caregivers practice: Exclusive and intensive dyadic exchanges with the child that rely on distal senses, for example, caregivers are instructed to look closely at the child, into the child’s eyes when communicating with the child; to take turns with the child; and to talk with the child when-ever possible (especially while breastfeeding), starting on the first days of life. Child-centered ways of engaging with the child, for example, caregivers are instructed to focus on the child’s interests and not to change the child’s focus; to respond to their child’s words, actions, sounds, interests, and so on; to not correct the child; to give the child choices rather than saying “don’t”; to notice and praise what the child does; and to wait for the child to make a response before responding. Affectionate and affectively engaging ways to interact with the child, for example, care-givers are instructed to encourage the child to smile, and to smile and laugh with the child.The CCD intervention sensitizes children to pay attention to their own personal qualities and preferences, and to use both as a primary point of reference to relate to and with others; to see themselves in control of events and therefore able to change them in ways most suited to their needs and wants; and to define and negotiate relationships from their point of view.These positive parenting skills, and the children they aim to raise as self-contained and self-focused, accord with what the UN Convention on the Rights of the Child (CRC) expects of par-ents and children. We draw attention to the CRC because it serves as the basis of all of UNICEF’s work (UNICEF, n.d.-a, n.d.-b). Children’s rights are based on what childhood is believed to be like, the leading assumption being that it is uniform across the world in the ways imagined (e.g., Burman, 1996, pp. 51-53 for a recounting of the political agendas that attended its writing—espe-cially the undue influence of the U.S. delegation in its drafting). Taken together, the 42 CRC Articles that spell out children’s rights make clear that “The child is entitled to care, security and an upbringing that is respectful of his or her person and individuality” (Pečnik & Lalière, 2007, p. 23). Parents (or guardians) are expected to ensure these rights, and, as a result, they should receive the assistance they need to do so (Hodgkin & Newell, 2007). A notable feature of the CRC is that children’s rights have priority over parents’ rights. However, this priority is unfamil-iar for many communities where children are not viewed as separate individuals outside of their families, but are, instead, nested within the identity of their parents, wider kin group, or commu-nity at large. In such contexts, the notion of separating the rights of children from the family or community circle would be deeply and structurally—indeed, ethically—problematic.The Case for Ethical ConcernsThe CCD intervention is burdened by assumptions about child rearing that are widely held by people with Western lifestyles. One is that primary caregivers (usually mothers) typically and regularly play and talk with children, and they do so in certain ways (e.g., face-to-face, mutual gaze). These are presumed to be important contexts for maternal expressions of sensitive and responsive care, and, therefore, critical learning opportunities significant to a child’s attachment and, thereby, a child’s development (UNICEF, 2012; UNICEF/WHO, 2012b). The cross-cultural record shows, however, that adult–child play and talk are less common among people in rural, subsistence communities, and when they take place, they usually do not follow the typical inter-actional script (e.g., exclusive, distal, dyadic exchanges) of Western lifestyle communities (Lancy, 2007; Paradise & Rogoff, 2009). Consider this example of talk. Adults tend to use talk judiciously

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Morelli et al. 11with children, and a lot of talk between adults and children is in the service of carrying out an ongoing activity (Morelli, Rogoff, & Angelillo, 2003). Children, on the other hand, talk a lot with one another, and, indeed, they may spend more time talking with one another than they do with adults (Rogoff, Morelli, & Chavajay, 2010; Scheidecker, 2017). Children mostly chit-chat among themselves as they relax and hang out, or talk as they play, do chores, and help out.Another assumption is that the child’s primary caregiver, usually the mother, is the person with whom the child spends most of his or her time and who provides the widest range of care for the child. As such, the mother is the person who provides that child’s primary learning experi-ences. But mothers may spend less time with their children than the combined collective input of all other caregivers (e.g., Morelli & Tronick, 1992; Weisner et al., 1977), and mothers may care for children in circumscribed ways (e.g., in rural Madagascar, mothers only attend to their chil-dren’s physical needs; Scheidecker, 2017). Thus, with an exclusive focus on mother and child, important learning experiences provided by many other social partners, especially children (e.g., Weisner et al., 1977), would be missed.A third assumption is that children should develop a sense of self as independent and self-contained individuals. As we discuss next, many in communities with rural, subsistence lifestyles hold different views. Often, children in such communities are expected to develop a sense of self as connected with others, and the care that best accomplishes this is usually at odds with positive parenting practices. Despite that, positive parenting is the care model used by the CCD interven-tion to teach caregivers how to care for children, with little appreciation for their communities’ lifestyles. This inattention to local circumstances undermines efforts to uphold the principle of respect and thereby renders honoring the principle of beneficence difficult if not impossible.Ways of Caring for Children in Rural, Subsistence LifestylesPeople living rural, subsistence lifestyles expect children to be fundamentally connected to oth-ers such that they are “defined and made meaningful in respect to such others” (Markus & Kitayama, 2010, p. 423). Accordingly, care in these communities sensitizes children to pay atten-tion to the needs and interests of others, and to the community as a whole; and it encourages children to see themselves and the world as others do. People are children’s primary referent for action, and control is about changing oneself in the interest of others to meet relational and other social obligations (Rothbaum, Morelli, & Rusk, 2011).Caregivers support children’s learning of this relational sense of self by helping children fit into the social goings-on in the moment, and into the social group as a whole. Fitting-in goes hand-in-hand with children’s keen awareness of and inseparable connection to others that defines them and their reality. Children can learn this sense of connectedness in various ways, and there is a great deal of diversity among communities in how this learning is supported. One way takes advantage of the great amount of time children typically spend nearby or in physical contact with the (sometimes many) people with whom they keep company. Physical closeness provides regu-lar and plentiful opportunities for children and caregivers to use touch, posture, gaze, gestures, facial expressions, and other nonverbal ways to communicate (Keller et al., 2009). These valued, proximal modes of communication are inclusive of other activities as well as other people, and they make it possible for children to engage in multiparty, ongoing, simultaneous activities (Rogoff, Mistry, Goncu, & Mosier, 1993). In this manner, children engage others as expected, without interrupting, dominating, or monopolizing whatever else caregivers are doing (Otto & Keller, 2015).Children who fit in are often expected to be calm, well-behaved, well-mannered, respectful, and obedient (Harwood, Miller, & Irizarry, 1995; Morelli, Ivey Henry, & Foerster, 2014; Otto & Keller, 2014; Quinn & Mageo, 2013). Caregivers may dampen or discourage expressions of emotions—positive as well as negative ones—to support these qualities (e.g., Diener, 2000;
12 Journal of Cross-Cultural Psychology 49(1) LeVine & LeVine, 2016). The emotional expressiveness as encouraged in the CCD (e.g., affec-tively engaging), however, is seen, oftentimes, as undermining them, and, by doing so, disrupting relational harmony (Kitayama, Karasawa, Curhan, Ryff, & Markus, 2010).Children’s inseparable connection with others is amplified in other ways. For one, children’s attention and activities are usually other-centered—blurring, at times, self–other boundaries. This happens in many ways. Caregivers orient children outward by placing them in the same direction in which they are facing (Ochs & Izquierdo, 2009). Caregivers lead children in activity, and chil-dren follow their lead (Keller, Borke, Lamm, Lohaus, & Yovsi, 2011). Caregivers speak on chil-dren’s behalf (Gottlieb, 2004; Schieffelin & Ochs, 1986). And caregivers rely on children’s subtle cues (e.g., postural shifts) to address children’s needs, or to anticipate them, rather than waiting for children to make them explicit (Chapin, 2013; deVries & deVries, 1977; Friedlmeier & Trommsdorff, 1999; Harwood, 1992; Keller, Kärtner, Borke, Yovsi, & Kleis, 2005).In these care contexts that support children’s fitting-in with and orienting to others, children develop a heightened sense of self as connected with others, and children learn to see themselves as others see them. In other care contexts, in other communities with rural, subsistence lifestyles (e.g., various Amerindian groups), practices support the development of self as distinct, indepen-dent, and autonomous. However, even in these communities, the sense of self is never a starting or ending point in development, and corresponds to an individual autonomy that permits and is embedded in social relationships (Course, 2011; Murray, Bowen, Segura, & Verdugo, 2015; Overing, 1989, 2003).Parenting Intervention Programs Raise Ethical ConcernsEthical principles require practitioners to respect people and their values, perspectives, and beliefs, and to do no harm and to benefit children’s welfare. So, it is worrisome that parenting interventions, such as the CCD intervention, implemented in low- to middle-income countries in communities with rural, subsistence lifestyles encourage caregivers to radically shift their care from one kind of care to another kind of care. These caregivers typically direct children to notice and attend to others, accentuate children’s social interdependencies, direct children to be part of events—often many at the same time, lead children in activity, and rely often on nonver-bal forms of communication. But, instead, this intervention trains caregivers to give children their full and undivided attention, to treat children as distinctive, to follow children’s leads in activities, to respect children’s wishes and needs, and to talk with children on topics of interest to them. And, by extension, to raise children who have their own interests and needs in mind, even when they are growing up in a community of people who may instead prioritize the inter-ests and needs of others.Improving the life chances of children in low- and middle-income communities is a worthy goal. But do parenting interventions accomplish this, and, if so, at what risk to child, family, and community? There is the view that children’s “lack of early learning opportunities and appropri-ate caregiver–child interactions contribute to loss of developmental potential” (Walker et al., 2011, p. 1330). However, evaluations of parenting interventions that aim to provide significantly better learning opportunities and more appropriate child–caregiver interaction in these countries are inconclusive at best; indeed, they are mostly neutral with regard to documenting even short-term social (and cognitive) gains (Morelli et al., in press; Weber et al., 2017; Yousafzai, Rasheed, Rizvi, Armstrong, & Bhutta, 2014). Even if evaluation research was able to claim intervention “success,” it is difficult to figure out what success actually means in terms of the lived lives of these children and families. More so, it is difficult to figure out how social and relational dynam-ics between children and others change as a result of these programs, or the effect this change may have on community functioning. The information we need to understand how parenting interventions “fit” into (or not) community life is insufficient, difficult to gather, or ignored.
Morelli et al. 13Some studies, however, hint at the types of changes we might expect when caregivers in rural, subsistence lifestyles adopt positive parenting practices prevalent among people with Western lifestyles. Much of this research examines the role of social change on children’s psy-chological competencies, characterized typically as a transition from rural, subsistence to Western lifestyles. Education, as part of this change, is often a factor of interest. This is rele-vant to parenting interventions in low- and middle-income countries because components of positive parenting (e.g., talking to children) are implemented to foster children’s success in Western-style schools (Weber et al., 2017), which most children attend. Success in these schools is measured by gains in a child’s cognitive skills and knowledge acquisition (Serpell, 2011). But this metric, and dominant school discourse (e.g., communication style, competi-tiveness, individual achievement: see Rogoff, 2003), may undermine the socially responsible intelligence (e.g., respect, obedience, cooperation) that is expected of children and supported by people in many rural, subsistence lifestyle communities (e.g., Serpell, 2011). Jukes and col-leagues found evidence of this in their study of Mandinka and Wolof adolescents of Gambia (Jukes, Zuilkowski, & Grigorenko, 2018). Adolescents, who as children dropped out of Western-style primary school and remained in their villages, were rated as less respectful and obedient by adult community members. In addition, Chavajay and Rogoff (2002) and Jukes, Zuilkowski, Okello, and Harris (2013) observed a relation between maternal education (in Western-style schools) and child engagement. In the former, Guatemalan Mayan indigenous mothers with less schooling were more likely to participate in multiparty, collaborative engage-ments with their children than were mothers with more schooling. In the latter, in the Kwale district of Kenya, parents with less schooling were more likely to favor adult authority over children than parents with more schooling.In our view, a deep and comprehensive understanding and appreciation of people’s lifestyles, and the care of and aspirations for children these lifestyles represent, is a necessary precondition to designing and implementing interventions in ethically responsible ways. Without core knowl-edge of local beliefs and practices, how can we respect people and how can we determine harm or benefit? We say this mindful that UNICEF and WHO (and other agencies) have policies in place to help ensure culturally relevant programming, in part, by including community involve-ment in planning, implementing, monitoring, and evaluating programs (e.g., UNICEF/WHO, 2012b; UNICEF/WHO, 2012a, 2012b). Even so, as we have shown, the CCD intervention is unlikely to honor these ethical codes. How can this be? We suspect that positive parenting is deeply rooted in the practices of these agencies because of their steadfast institutional support of the CRC and because there is little reason to question claims made by attachment theorists that positive parenting supports strong child developmental outcomes. We have shown that these claims are not universally relevant.Is It Fair to Target Poor Communities for Parenting Interventions?So far, our primary concern about the ethics of parenting interventions has been the unintentional lack of respect and potential harm inherent in encouraging caregivers to adopt practices that are prevalent among Western lifestyle communities but that are not predominant in their own com-munities. We turn now to the ethical principle of fairness and justice as relevant to the people who are targeted for such interventions. Even though the CCD intervention is meant to improve the life chances of all children in low- and middle-income countries who are considered vulnerable, it is regarded as being “another tool to reduce the cycle of . . . poverty which passes from one generation to another. . .” (WHO/UNICEF, 2013, p. 5). Therefore, poor people and impoverished communities are often the target of parenting intervention programs, maybe unfairly so.
14 Journal of Cross-Cultural Psychology 49(1) In trying to change parenting practices mostly in poor communities, are those programs mak-ing the following two unproven assumptions: one, that poor parents parent poorly, and two, that these interventions will be beneficial despite the fact that they do not address the underlying causes of poverty in the community? Even if agents of change do not make those assumptions, their focus on poor communities can lead to the stigmatization of poor people in regard to their parenting abilities.To illustrate the risks of targeting poor communities in parenting intervention programs, we turn to a previous historical episode examined by medical historian Michal Raz in her 2013 book What’s Wrong with the Poor? Psychiatry, Race, and the War on Poverty. Here, she shows that child psychologists played a key role in supporting a “cultural deprivation” framework to con-ceptualize the needs of children from low-income homes in the United States during the 1960s. But, she argues, the belief that poor children suffered from cultural deprivation was based on White middle-class views about maternal deprivation.The notion of maternal deprivation was introduced by John Bowlby (1951) in his widely influ-ential WHO report “Maternal Care and Mental Health”. Bowlby argued that children deprived of maternal care and love would later suffer from profound psychological and emotional problems. Vicedo (2013) has shown that Bowlby was criticized for relying on a small number of studies, conflating cases of maternal separation and deprivation, and extrapolating results from children under conditions of severe sensory and maternal deprivation to everyday family conditions. In fact, in 1962, the WHO published a volume revealingly titled Maternal Care: A Reassessment of Its Effects (WHO, 1962), which included various criticisms of Bowlby’s ideas.Yet, as Raz has documented, the concept of deprivation continued to be widely employed by researchers and reformers who examined the effects of sensory deprivation and often equated it with maternal deprivation. After some scholars questioned the exclusive focus on mothers, the framework was expanded to include “cultural deprivation.” The basic idea was that children in culturally deprived communities did not receive sufficient intellectual stimulation and educational opportunities. The seemingly common-sense view that cultural deprivation existed mostly in poor communities led reformers to focus on “two overlapping sections of American society: poor and black” (p. 6). As a result, the discourse of cultural deprivation stigmatized Black families. However, as Raz shows, “Much of the theory of cultural deprivation relied on race- and class-specific inter-pretations of normative mothering and what constituted maternal deprivation” (p. 40).By faulting caretaking practices that deviated from the White middle-class norm for not pro-viding for children, the specific interventions promoted in the 1960s helped perpetuate the Euro-American middle-class family as “the scientifically sanctioned approach to child rearing” (Raz, 2013, p. 74). The focus on deprivation emphasized what was missing in a specific community rather than on what was provided or what worked well. This approach often led to see differences as deficiencies. But as Raz concludes, many of the programs designed by well-intentioned researchers and policy makers aimed “to provide the poor with things they in fact did not lack or did not need” (Raz, 2013, p. 170).In addition, reformers’ focus on poor communities had other detrimental consequences. One, it created a negative image of the parenting abilities of Black families and thus led to their stig-matization. Two, as their critics pointed out, “emphasizing the pathological home and family life of individuals from low-income backgrounds” became “a method of shifting blame and respon-sibility onto the poor” (Raz, 2013, p. 40). That is, this approach blamed the victims, and justified interventions to change the victims of social injustice, rather than changing society itself.We have presented this historical case at some length because it provides a “cautionary tale about the risks of using seemingly neutral theories of child development and mental health in attempts to address social problems” (Raz, 2013, p. 175). With the benefit of hindsight, we see the problems with those interventions in the 1960s. They tried to modify parenting practices in groups without respecting their own parenting goals and social visions. They stigmatized poor
Morelli et al. 15communities. And they helped governments and societies avoid their responsibility in addressing the complex socioeconomic causes of poverty.More recent parenting intervention programs in poor communities are also perceived as quite problematic. For example, analyzing interventions in the United Kingdom, Val Gillies has argued that,Without help, poor parents are seen as destined to transmit their cultural deficits . . . through an intergenerational “cycle of deprivation” (ODPM 2004). In pursuing this reasoning, policies have been orientated towards reforming the lifestyle and conduct of the poorest and most vulnerable in society in order to “save” the next generation. (Gillies, 2008, p. 1081)In sum, parenting interventions targeting poor communities raise difficult ethical issues. We need to make sure they respect the principles of fairness and justice toward groups with different lifestyles. Many questions remain: How can researchers avoid compromising the cultural sover-eignty of people? Do parenting interv

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