An ethical strength of the proposed solution is found in section 1.01 of the NASW Code of Ethics where it mentions a social workers commitment to clients and mentions their needs should be primary.  This bill is to get foster children the type of mental health care they deserve.  Section 1.03 mentions informed consent, which would be another strength of HB 428 since patients or their guardians would need to give consent to administer the medications they are prescribed.  Section 6.04 says Social workers should act to expand choice and opportunity for all people, with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups.  Foster children are vulnerable and disadvantaged which may lead to their oppression or exploitation.  This is why if HB 428 passes, someone will be accountable for their mental health care treatment.

A weakness may be section 1.07 where it mentions confidentiality.  If patients’ records are kept in a National Database, confidentiality may be compromised.   Also 3.04 states Social workers should take reasonable steps to ensure that documentation in records is accurate and reflects the services provided and the documentation should protect clients’ privacy to the extent that is possible and appropriate and should include only information that is directly relevant to the delivery of services.  Then it goes on to say Social workers should store records following the termination of services to ensure reasonable future access. Records should be maintained for the number of years required by state statutes or relevant contracts.  The storage and keeping up with this amount of documentation seems like another tedious and impossible task for the already overworked social worker.

Ethical dilemmas which might occur as a result of implementing this bill would be the right to confidentiality of the child.  While it is important the right people know about what psychotropic medication the child is taking, certain people may tend to discriminate against a child who has a diagnosed mental condition.  The child also may be stigmatized as a result.

Sadly, it appears that policies are made in reaction to specific events.  The shooting at Ft. Hood, the suicide of a child, the committing of a crime while on medications are all events that trigger looking more closely at psychotropic drugs.   The value a psychotropic drug has for an individual or foster child in this particular case,  is not taken into account.  People react to influence legislators who depend on citizens for votes.  Secondly, money is most often what generates policy making.  It is not about the individual person.  Pharmaceutical firms are not held accountable for their advertising of drugs.  They provide Doctors with free samples and put out literature that popularizes the drugs.  The well-being of the individual person is not as important as the politics and money surrounding a Bill.

My position on the bill is I agree with many of the stipulations.  I believe it is important to not over-medicate children;  especially foster children who already have so many issues to deal with.  I believe someone needs to be held accountable when it comes to over-medicating, mixing drugs, and writing prescriptions for children who do not need prescriptions.  I also believe more alternatives should be given.   A national database would be a good idea to be able to track what medication the children are taking, but confidentiality needs to be established so the children do not run the risk of being stigmatized as a result.  Also, further documentation should be made easier for case workers and foster parents.  Instead of having to write report after report, there should be a faster and more efficient way to report and administer medications.  Lastly, prescriptions written need to have FDA approval and the guardian of the child needs to be made aware of all potential risks and give his or her approval prior to the administration of the drug.

This bill will resolve the problem of over-medicating foster care children since it will monitor the use of psychotropic drugs and require someone to be accountable for these children; although it may not be the correct person.  Foster parents and caseworkers are not the only ones who should be accountable for these children.  Drug companies, physicians, and psychiatrists should be made accountable as well.  This bill should be modified to include them as well.  Portions of this bill which should be protected are:  obtaining written consent from the child’s legal guardian before they begin taking psychotropic medications, a record kept on each child taking medication which contains his/her diagnosis, the dosage, and potential side effects, a consultation with a child psychiatrist before a prescription can be filled, a creation of psychotropic medication utilization parameters for all children, and the encouragement of therapy in addition to or in place of medications.

This bill enhances social justice for the targeted individuals who do not currently have a voice.  Foster children have no idea whether or not they should be taking psychotropic drugs.  They take them because they have to; they are not given a choice.  This bill aligns with my personal value of caring for others.  Although in some cases psychotropic drugs may help children; to use them to simply keep a child sedated when there is no medical reason, is a human rights violation.

An insight I gained on policy was somewhat discouraging.  I learned the only thing which the legislature needs to pass is the budget.  Many bills which would actually benefit people are swept under the rug; or get other bills attached to them which make them no longer beneficial.   It makes me wonder what the point of the whole process is.  Why even introduce a bill which will never be passed?  Is it simply to get people to vote for you? This process definitely made me question our representatives and the entire legislative process.