Role of healthcare in utilizing parenting programs to support childhood development: a bioethical analysis

Early childhood development is a uniquely sensitive time period which is shaped by social disparities. Environmental inputs including caregiver interactions mediate developmental outcomes. Parenting programs were created as an educational resource for parents to help foster child development. In Chapter 1, the current research on early development is explored including the plasticity of this time period and how parenting interactions can affect outcomes. Evidence shows these programs are effective tools for improving child developmental outcomes. These programs have an even stronger impact on children who experience inequities. Despite their equitable effectiveness, medicine still utilizes them in a reactive manner rather than as anticipatory guidance. Primary care is a key access point into supporting child development yet this lack of incorporation of parenting programs into standard care results in the underutilization of these programs. Chapter 2 examines this information utilizing a bioethical lens. The four foundational ethical principles of Justice, Beneficence, Non-maleficence, and Autonomy are examined regarding how these programs should be used to uphold the ethical responsibilities of physicians. Ethical reasoning supports the claim that these programs should be provided to all parents as a standard option for anticipatory guidance. There are several tangible avenues for physicians to support these programs including incorporation, advocation, and normalization. Ethical analysis reveals that given the critical window for child development, effects of disparities, and equitable outcomes of programs, supporting these programs goes beyond best medical practice and becomes a bioethical obligation.