The trouble with thresholds: Rationing as a rational choice in child and family social work

Devaney, John

doi:10.1111/cfs.12625

Cited by 25 publications

(13 citation statements)

References 19 publications

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“…Our findings demonstrate the necessity of research into the barriers associated with help-seeking by perpetrators, friends and family, as well as the obstacles for agency referral and timely service provision. Austerity has also affected the availability and delivery of public services amid increasing demand (Devaney, 2019).…”

Section: Discussionmentioning

confidence: 99%

Beyond intimate partner relationships: utilising domestic homicide reviews to prevent adult family domestic homicide

Bracewell

Jones

Haines-Delmont

et al. 2022

Journal of Gender-Based Violence

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Increasing evidence documents domestic violence and abuse (DVA) and domestic homicide of adults killed by a relative in non-intimate partner relationships. Most literature focuses on intimate partner violence and homicide, yet non-intimate partner homicides form a substantial but neglected minority of domestic homicides. This article addresses this gap by presenting an analysis from 66 domestic homicide reviews (DHRs) in England and Wales where the victim and perpetrator were related, such as parent and adult child. Intimate partner homicides are excluded. These 66 DHRs were a sub-sample drawn from a larger study examining 317 DHRs in England and Wales.The article contributes towards greater understanding of the prevalence, context and characteristics of adult family homicide (AFH). Analysis revealed five interlinked precursors to AFH: mental health and substance/alcohol misuse, criminal history, childhood trauma, economic factors and care dynamics. Findings indicate that, given their contact with both victims and perpetrators, criminal justice agencies, adult social care and health agencies, particularly mental health services, are ideally placed to identify important risk and contextual factors. Understanding of DVA needs to extend to include adult family violence. Risk assessments need to be cognisant of the complex dynamics of AFH and must consider social-structural and relational-contextual factors.<br />Key messages<br /><ol><li>Understanding of domestic violence and abuse needs to include adult family violence.</li><br /><li>Risks and dynamics of adult family homicide are complex and must consider social-structural and relational-contextual factors.</li><br /><li>Criminal justice agencies, social care, substance misuse and mental health services provide opportunities for prevention.</li></ol>

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Section: Discussionmentioning

confidence: 99%

Beyond intimate partner relationships: utilising domestic homicide reviews to prevent adult family domestic homicide

Bracewell

Jones

Haines-Delmont

et al. 2022

Journal of Gender-Based Violence

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“…In particular, income inequality exacerbates existing socioeconomic inequalities, mirroring the kind of relationship identified by Eckenrode, et al (2014) and demonstrating the need for child protection to be included in wider discussions about inequality and social problems. This is just one part of a growing body of evidence that highlights the way that the ordering of many parts of children's services provision is associated with socioeconomic status including, for example, the funding of and recent cuts to children and young peoples' services Hood, et al, 2016;Devaney, 2018;Jones, 2018).…”

Section: Discussionmentioning

confidence: 99%

Untangling child welfare inequalities and the ‘Inverse Intervention Law’ in England

Webb

Bywaters

Scourfield

et al. 2020

Children and Youth Services Review

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This article addresses some potential limitations of key findings from recent research into inequalities in children's social services by providing additional evidence from multilevel models that suggest the socioeconomic social gradient and 'Inverse Intervention Law' in children's services interventions are statistically significant after controlling for possible confounding spatial and population effects. Multilevel negative binomial regression models are presented using English child welfare data to predict the following intervention rates at lower super output area-level: Child in Need (n = 2707, middle super output area [MSOA] n = 543, local authority [LA] n = 13); Child Protection Plan (n = 4115, MSOA n = 837, LA n = 18); and Children Looked After (n = 4115, MSOA n = 837, LA n = 18). We find strong evidence supporting the existence of a steep socioeconomic social gradient in child welfare interventions. Furthermore, we find certain local authority contexts exacerbate this social gradient. Contexts of low overall deprivation and high income inequality are associated with greater socioeconomic inequalities in neighbourhood intervention rates. The relationship between neighbourhood deprivation and children looked after rates is almost five times stronger in local authorities with these characteristics than it is in local authorities with high overall deprivation and low income inequality. We argue that social policy responses addressing structural determinants of child welfare inequalities are needed, and that strategies to reduce the numbers of children taken into care must address underlying poverty and income inequality at both a local and national level.

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“…This has been a popular approach in paediatrics and in particular interest has coalesced around the ‘harm threshold’ [ 146 , 147 ]. The increasing scrutiny that has fallen upon the harm threshold as a result indicates ongoing problems with both the conceptualisation [ 148 , 149 ] and the mutability [ 150 ] of that threshold. These criticisms seem to have purchase far beyond the harm threshold itself, raising the possibility of more general limitations to principles in providing decipherable boundaries of practice.…”

Section: The Rise Of Relational Approachesmentioning

confidence: 99%

The theorisation of ‘best interests’ in bioethical accounts of decision-making

Birchley

2021

BMC Med Ethics

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Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three themes emerged. The first placed best interests within the structure of wider theory, noting relationships with consequentialism, deontology, prudential value theory, rights and political philosophy. The second mapped a typology of processes of decision-making, among which best interests was ambiguously positioned. It further indicated factors that informed best interests decision-making, primarily preferences, dignity and quality of life. The final theme considered best interests from a relational perspective. Conclusions Characterisation of best interests as strictly paternalist and consequentialist is questionable: while accounts often suggested a consequentialist basis for best interests, arguments appeared philosophically weak. Deontological accounts, found in law and Kantianism, and theories of political liberalism influenced accounts of best interests, with accounts often associating best interests with negative patient preferences (i.e. individual refusals). There was much more emphasis on negative interests than positive interests. Besides preference, factors like dignity and quality of life were held to inform best interests decisions, but generally were weakly defined. To the extent that preferences were unable to inform decision making, decisions were either made by proxy authority or by an intersubjective process of diffuse authority. Differing approaches reflect bifurcations in liberal philosophy between new liberalism and neo-liberalism. Although neither account of authority appears dominant, bias to negative interests suggests that bioethical debate tends to reflect the widespread ascendancy of neo-liberalism. This attitude was underscored by the way relational accounts converged on private familial authority. The visible connections to theory suggest that best interests is underpinned by socio-political trends that may set up frictions with practice. How practice negotiates these frictions remains a key question.

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The trouble with thresholds: Rationing as a rational choice in child and family social work

Cited by 25 publications

References 19 publications

Beyond intimate partner relationships: utilising domestic homicide reviews to prevent adult family domestic homicide

Beyond intimate partner relationships: utilising domestic homicide reviews to prevent adult family domestic homicide

Untangling child welfare inequalities and the ‘Inverse Intervention Law’ in England

The theorisation of ‘best interests’ in bioethical accounts of decision-making

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