Race, Family Policing, & Medicine with Dorothy Roberts

On today’s episode, Dorothy Roberts joins me and UVA Law 3Ls Darius Adel and Julia D'Rozario to discuss her work on race-based medicine and the child welfare system. Dorothy Roberts is the George A. Weiss University Professor of Law and Sociology and the Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at the University of Pennsylvania School of Law. Professor Roberts’ work focuses on urgent social justice issues in policing, family regulation, science, medicine, and bioethics. Her major books include Torn Apart: How the Child Welfare System Destroys Black Families--and How Abolition Can Build a Safer World (Basic Books, 2022); Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century (New Press, 2011); Shattered Bonds: The Color of Child Welfare (Basic Books, 2002), and Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (Pantheon, 1997). She is also the author of more than 100 scholarly articles and book chapters, as well as a co-editor of six books on such topics as constitutional law and women and the law.

Her work has been supported by the American Council of Learned Societies, National Science Foundation, Robert Wood Johnson Foundation, Harvard Program on Ethics & the Professions, and Stanford Center for the Comparative Studies in Race & Ethnicity. Recent recognitions of her scholarship and public service include 2019 Rutgers University- Newark Honorary Doctor of Laws degree, 2017 election to the National Academy of Medicine, 2016 Society of Family Planning Lifetime Achievement Award, 2016 Tanner Lectures on Human Values, and the 2015 American Psychiatric Association Solomon Carter Fuller Award.

Show notes:

Dorothy Roberts Full Bio, University of Pennsylvania https://www.law.upenn.edu/faculty/roberts1

Torn Apart: How the Child Welfare System Destroys Black Families--and How Abolition Can Build a Safer World (Basic Books, 2022)

Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century (New Press, 2011)

Shattered Bonds: The Color of Child Welfare (Basic Books, 2002)

Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (Pantheon, 1997).

Transcript

Taboo Trades, Season 4 Episode 6: “Race, Family Policing, & Medicine with Dorothy Roberts”

Transcript edited by Darius Adel and Julia D’Rozario

[00:00] Dorothy Roberts: It's all based, though, on this same myth that there is a free market for babies and it's a win win situation. So, people who have babies that they didn't want to have can just give up their babies now supplying enough infants for those who want to adopt. So it's not that people are going to voluntary give up their children. In fact, we know from the takeaway study that most people who are forced to give birth who wanted to get an abortion keep their babies. What's more likely to happen is that they will be forced to give up their children or their children will be taken from them because of the increased economic hardship they'll face because they were forced to give birth to a baby they weren't economically prepared to take care of.

[01:07] Kim Krawiec: Dorothy, with your reference to a free market for babies, you fully brought this episode around to the main topic of taboo trades. That is our core theme.

[01:18] Dorothy Roberts: Okay, well I'm glad that on your last episode we could tie it together.

[01:23] Kim Krawiec: Tie the whole thing together.

[01:25] Dorothy Roberts: Tie the whole thing together.

[01:28] Kim Krawiec: Hey, hey everybody. Welcome to the Taboo Trades podcast, a show about stuff we aren't supposed to sell but do anyway. I'm your host, Kim Krawiec. My guest today is Dorothy Roberts, the George A. Weiss University Professor of Law and Sociology, and the Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at the University of Pennsylvania School of Law. Professor Robert's work focuses on urgent social justice issues in policing, family regulation, science, medicine, and bioethics. Her major books include Torn Apart: How the Child Welfare System Destroys Black Families--and How Abolition Can Build a Safer World, published by Basic Books in 2022, Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century, published by New Press in 2011, Shattered Bonds: The Color of Child Welfare, published by Basic Books in 2002, and Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, published by Pantheon in 1997. She is also the author of more than 100 scholarly articles and book chapters, as well as a coeditor of six books on topics such as constitutional law and women and the law. Her work has been supported by the American Council of Learned Societies, National Science Foundation, Robert Wood Johnson Foundation, Harvard Program on Ethics and the Professions, and Stanford Center for the Comparative Studies in Race and Ethnicity. Recent recognitions of her scholarship and public service include 2019 Rutgers University Honorary Doctor of Laws Degree, 2017 election to the National Academy of Medicine, 2016 Society of Family Planning Lifetime Achievement Award,2016 Tanner Lectures on Human Values, and the 2015 American Psychiatric Association Solomon Carter Fuller Award.

[03:41] Kim Krawiec: So why don't you guys introduce yourselves to our audience.

[03:42] Julia D'Rozario: Hi, I'm Julia D’Rozario. I’m a 3L.

[03:45] Darius Adel: And hi, I'm Darius Adel. I'm also a 3L.

[03:47] Kim Krawiec: So, as you know, we have Dorothy Roberts with us today, and both of you volunteered to be the co-host for this particular episode. Can you talk a little bit about why you wanted to be the host for this particular topic or author?

[04:00] Julia D’Rozario: So, I'm really excited to talk to Dorothy, particularly about her article on the child welfare system. I actually worked with children in out of home care before law school, so the subject is really close to my heart. I was working outside of the US in a more homogeneous society, so I didn't witness the same racial harms as the US system faces. So, for that reason, I'd be really interested to hear more about the racial harms of the child welfare system in the US.

[04:25] Kim Krawiec: And what about you, Darius?

[04:28] Darius Adel: Yeah, so I did a little bit of movement work focusing on racial disparity before law school, but I never had the opportunity to learn about the welfare system or race-based medicine, so I thought this would be an excellent way to educate myself.

[04:42] Kim Krawiec: So, I guess the next question I have is, what are you guys hoping to learn from Dorothy today? Is there anything specific you want to ask her or hope to learn from her about her work on this topic?

[04:54] Julia D’Rozario: So, as well as the racial harms of the systems, which I just mentioned, I'm really interested in learning about practical strategies for reforming both the medical and the child welfare systems. Since the problems with these systems stem from really deep-rooted societal issues, reform, or abolition, is likely to be a really big undertaking. So, I'd love to hear more from Dorothy about how we can go about achieving this.

[05:17] Darius Adel: Yeah, and for me, I just want to learn a little bit more about what abolition means to Dorothy. I know it can take a lot of different forms for a lot of different people, so I just want to get her take on it.

[05:30] Kim Krawiec: Okay let’s join the others then.

[05:32] Dorothy Roberts: Hello. 

[05:33] Kim Krawiec: Hi, thanks so much for doing this. It’s so good to see you. It's been a while.

[05:37] Dorothy Roberts: Sure, good to see you, too. It's been a long, long, long, long time.

[05:42] Kim Krawiec: Yes, it has. I told the students about how when we first met, you were already really fancy and I was a nobody, and you were really nice to me. And, so I remembered it ever since. You're, of course, still really fancy, and I'm still comparatively a nobody.

[05:59] Dorothy Roberts: No no, none of that is true.

[06:02] Kim Krawiec: I Think that we’re starting off with Julia.

[06:06] Julia D'Rozario: Hi, Dorothy. Thank you so much for joining us. We are so incredibly excited to have you. To start off, we have a lot of questions for you about your call to abolish the child welfare system, which you wrote about in your article, Why Abolition. For our listeners who may not have read your article yet, would you like to give a brief summary or elevator pitch for your proposal?

[06:34] Dorothy Roberts: Sure. So, I think most people in America who haven't been involved with the child welfare system believe the propaganda that it has, including its very name, that it protects children and improves their welfare. But, I've been doing research for a long time on this topic over two decades, including a lot of service work and advocacy work. So, I have been involved in a lot of reform efforts as well. And I have reached the conclusion, which I document in that article, but also in my recent book, Torn Apart, that this system is really a family policing system. And by that, I mean it's not designed to protect children and improve their welfare. It's designed to accuse family caregivers, to investigate them, regulate the families very intensively, often separate children from their families, and even destroy their families. And it targets the most marginalized families in America, almost exclusively impoverished and low-income families, but also very disproportionately black and indigenous or native families. And from its very beginnings, the family policing system has either ignored black children or targeted them for control and criminalization. So black children are at very high risk of being torn from their families and placed in the foster system, which is well documented to drive many of them to juvenile detention and prison. So, if we really want to protect children and improve their welfare and support their families, we would have to replace this system, because its very design is to oppress families and is steeped in foundational racism. And so, we need to replace it with a radical new vision that actually meets children's needs and moves away from surveillance and punishment and coercion toward a reimagined meaning of safety that centers the needs of children and their families and figures out how to meet their needs. And also, as our nation is grappling with police violence and mass incarceration, we should include family policing, along with other carceral systems that should be part of the attention of growing abolitionist movements. And so we can begin this vision of abolition, which means both dismantling, but at the same time replacing it with ways of actually meeting children's needs and supporting families, like diverting the billions of taxpayer dollars that are spent on investigating and separating families and maintaining children away from their families, toward providing concrete resources directly to family caregivers, building voluntary community based supports for families, and also working on transformative justice practices that can address violence in families. Even though most of the children that are taken from their families are taken on grounds of neglect related to poverty. But we can also reimagine better ways of addressing violence in families. So, my argument then, is why continue a system well documented to harm children, to be based on racist and settler colonial ideologies, and to have a clearly racist impact on families, and instead work toward a vision of child welfare that actually meets children and families needs?

[11:13] Kim Krawiec: Dorothy, can I just ask you a follow up? 

[11:16] Dorothy Roberts: Sure.

[11:17] Kim Krawiec: You mentioned the huge cost of the system. Do you have a rough estimate of what sort of in the aggregate we spend on this? I mean, it's a much larger number than I would have imagined, quite frankly.

[11:27] Dorothy Roberts: Yeah, so it's somewhere between 30 and 40 billion dollars of federal, state, and local spending on formal child welfare services, most of which is maintaining children outside their home. Ten times as much money goes to foster care, and some of it also goes to adoption services, but far less goes to services to intact families with children remaining in their homes. And so that money would be better spent directly in the hands of families. And also, there should be even more money spent. I mean, on the one hand, 35 billion dollars is a lot of money to keep children away from their families, but to really address the needs of children in America, we should spend even more. But one of my arguments is that by pretending that the child welfare system is meeting the needs of children, that it's what the government does to protect children and keep them safe, we divert attention from the needs of even more children who, because of the way our society is structured, are living in poverty and aren't at all addressed by the system. So it's not just replacing the system by defunding it and putting that money into the hands of families. It requires a broader and even more radical change in how we think about public support for families. If we had better schools, if we had adequate housing, food, and all the things that people need, daycare, other kinds of childcare, the kinds of things that families need, we could use that to replace the punitive system we have now that's doing a terrible job of keeping children safe.

[13:43] Kim Krawiec: Thank you.

[13:45] Julia D'Rozario: Thank you so much for that explanation. We have a lot of further questions on abolition from the class and on societal attitudes towards abolition. Our first question is from Darius.

[13:55] Darius Adel: Hi, Dorothy. Very nice to meet you.

[13:57] Dorothy Roberts: Thank you.

[13:59] Darius Adel: So, abolitionists of any type encounter the same challenge of having to justify what others perceive as an extreme solution to a problem. Many people prefer that kind of incremental experimentation and change, fearing that too drastic a shift will make the current system worse, not better. Do you think their fear is misplaced? If so, how can we go about changing their minds?

[14:23] Dorothy Roberts: Well, I think that many people have a misconception of what abolition means, so I think that it does mean incremental change. Obviously, we're not going to be able to tear down this multibillion-dollar industry that many people are invested in financially and ideologically in any short period of time. So, abolition doesn't mean and it couldn't possibly mean ending any of these oppressive systems quickly. And also, it would have to include building the replacement at the same time. And this is another misconception about abolition, that somehow it means ending protections for children in this case, or ways that we are trying to keep people safe in our society, whether we're talking about prisons, police, other kinds of surveillance by the state. But let's focus on family policing. That it means ending it and just leaving children abandoned with unmet needs. No, not at all. It's the opposite of that. I and other abolitionists, all the ones I know who want to end this system, want to end it to do a better job of meeting children's needs and supporting families, do a better job of keeping children safe. And so, it's not about tearing down what we have now and leaving children to suffer with unmet needs or from abuse in the home. It's simultaneously with reducing the power that the system has now to harm families. To create, build, imagine probably in the opposite order. Imagine, build, and create the ways of actually meeting children's needs, actually providing concrete supports for families. So the fear, I think, is largely based on a misconception of what abolition means. So that I think clarifying what abolition means might reduce the fears that people have that it's going to leave children unprotected. And then not only that, the vision of abolitionists is to care for even more children, because the system now, even though it's taking away far too many children, it takes away hundreds of thousands of children every year from their families. And half of black children in America will be subjected to a child welfare investigation before they reach age 18. So, it is intensively involved in surveillance and destruction of families, but it still only addresses a fraction of children in America living in poverty. So, the vision of abolitionists is to, instead of relying on this system that harms children and doesn't address the needs of the vast majority of children in America, we would replace it with an approach that would provide what children need.

[18:34] Darius Adel: I think next up we have Anu.

[18:36] Anu Goel: Hi, Dorothy. Thanks so much for being here. 

[18:40] Dorothy Roberts: Of course.

[18:40] Anu Goel: I actually have two questions, but I'll start with my first. So in Why Abolition, you refer to the child welfare system as the family policing system. I just wanted to know what are some of the similarities between this system and the policing or criminal justice system? And if you run into any skepticism or criticism from people involved in the system or even uninvolved in the system for using this kind of language.

[19:02] Dorothy Roberts: Yeah. So, there are multiple ways in which the child welfare system mirrors the criminal legal system and police law enforcement, and also is entangled with it. So, it mirrors it and this is why I call it a policing system. In the way it accuses and detains, separates family members, puts them into involuntary confinement, monitors them. And I'm talking about both parents and children. So, it's an accusatory system. It is a coercive system, just like the criminal legal system. It's a punishment system. It's a system that punishes impoverished families for failing to meet the needs of their children. That's the main thing that this system does. And it punishes them by taking children away from their families and putting them in substitute care, or even if it's just the investigation, the investigation alone is traumatizing and is a form of punishment along with the long lasting harms as a result both of being accused of being a child maltreater, your name is put into a registry that means you cannot have a job that deals with children, and that's childcare workers, bus drivers, nurses, doctors. There are economic harms to parents in addition to the psychological trauma of having your child taken from you and put often in the custody of strangers. And then for children, it's a system that criminalizes children in multiple ways, so it increases their risk that they're going to be involved in the juvenile legal system. And it is structured to put children in juvenile detention because it puts children in conflict with foster caretakers and other children in foster care, especially if you're put in congregate care. And then the response of staff or foster caretakers is much more likely to be to call the police than children experience in their own homes. So many children end up leaving foster care to go into juvenile detention. Now, once you're at the attention of the juvenile legal system as a child in foster care, you are more likely, by being in foster care, to get a harsher sentence, to be left longer in the juvenile legal system. Children who are in foster care, who get in trouble with the law, are perceived to be more delinquent than children who aren't in foster care, they're perceived to need more supervision, more coercive supervision, and there are lots of ways, but I'll just end with one more way that it criminalizes children is many children are placed in what are called residential treatment facilities, which are supposed to be for children who have mental health or behavioral problems. But in some states, because of the lack of sufficient homes to place them in, especially black teenagers, queer teenagers, they are put in these facilities even though there's no medical need to put them there. And many of them are like prisons. Children report that they feel like they're caged, and children have been killed by staff in these places. So, children are criminalized by foster care. And then there's also just the carceral logic of it, that the logic of police and prisons is the same as the logic of the foster industrial complex, which is the way that we meet human needs, is to punish the people with those needs. The policies that ended the federal entitlement to welfare and that increased the building of prisons, and the funding of police departments were promoted and passed at the same time as a package with legislation to move children from foster care into adoptive homes to terminate. Let's be clear. That means terminating the rights of parents whose children are in foster care. I could go on and on about the history. The history of the explosion of foster care, especially the disproportionate involvement of black children in foster care, is absolutely entangled with the effort to keep black people off of welfare and the same stereotypes, but the policies were very much entangled. So, we have to see criminal law enforcement and family policing as intimately related in terms of their logics and policies. And I'll just mention one other thing, which is the way in which case workers and police officers work hand in hand. Case workers will often call police officers for backup when they go to investigate a home. And so, you have police moving into homes without a warrant, because case workers rarely get a warrant, even though they should under the Fourth Amendment. And so, it expands the power of police to enter people's homes without judicial authorization. And at the same time, it gives case workers more power because they have an armed officer coming into a home, demanding entry into a home, and investigating a home, adding to the terror of the experience. And then they call police officers again when they want to remove children from their homes, adding to the terror of having government agents coming to your home and snatching your children away from you.

[26:17] Darius Adel: Dorothy, it's interesting you mentioned that. I actually started reading The Autobiography of Malcolm X a while ago. And the beginning of the book is just talking about the intimidation of the police officers and the welfare state how they go hand in hand.

[26:32] Dorothy Roberts: Yes, absolutely.

[26:33] Darius Adel: Yeah, I totally agree.

[26:36] Dorothy Roberts: Yeah. He is so perceptive, as he always is in everything he wrote, right where he says it is a form of legal slavery. That's how he saw it. And, in fact, we can trace the origins of separating black families to the slavery system, where white enslavers had absolute authority over black children and did separate them at will, whether it was to pay off a debt, to make more money just because they felt like it, to pay as a gift for whatever reason, or on the auction block where different family members could be auctioned off to different enslavers for sale. And so, yes, Malcolm X was very astute in his analysis of the destruction of his own family when his mother had trouble taking care of the family after his father was killed. And instead of providing for the family, what he calls the welfare people, intimidated the family and eventually got a judge to break up the family, place the children separately into different foster homes. You also asked about what people think about that analogy. Well, it goes back to the false perception that most people have no fault of their own. They just haven't encountered the system and they've only heard good things about it, or they assume a child welfare system would be protecting children. So it creates a kind of cognitive dissonance to hear that case workers act like police officers because they think case workers are kind people who help families take care of their children. That's what social workers are supposed to do. So, when they hear that, actually, they often come to homes with police officers and act in very coercive, degrading ways toward families. It doesn't make sense to them. But there are so many examples. I mean, this is something I do in my book, Torn Apart. I give lots of examples of families that have been intimidated by case workers who routinely violate the constitutional rights of families and work with police officers. There are many agencies in America now that have entered into agreements with police departments. They train together. They work together in multiple ways. They surveil families together. But it's not a coincidence. It's because the system is designed to target those neighborhoods, just like criminal law enforcement is designed to target those neighborhoods.

[29:54] Darius Adel: Thank you so much for that, Dorothy. I think up next, we have a question from Mary Beth about the pro adoption community.

[30:04] Mary Beth Bloomer: Hi, Dorothy. Thank you for joining us today.

[30:07] Dorothy Roberts: Sure.

[03:08] Mary Beth Bloomer: So, I think it's fair to say that the adoption industry is not centered around what's best for the child, but it is centered around giving or allowing, I guess, families to get a child. So I wanted to hear, I guess, your opinion on what needs to happen within the adoption agency industry. Does it need to be abolished, what needs to occur to abolish the child welfare industry? And kind of maybe more about how those two go hand in hand.

[30:51] Dorothy Roberts: Yeah, they do go hand in hand. I haven't studied adoption in depth the way I have family policing, including investigations, supervision, family separation, and foster care. But I have done research on and written extensively about the connections between the two. And one major connection, of course, is that you cannot adopt a child unless their birth parents’ rights are terminated. And so adoption from foster care means terminating the rights of parents. And I think the adoption industry has sent a message that's parallel to the message of the child welfare system. So, the message of the child welfare system is we're going in and saving children. And then the message of the adoption industry is we are now taking those children that were saved and putting them in better homes. And so, it's all about saving children. And, of course, there's a lot of white saviorism in both of these realms, which go along with the ideology and the stereotypes about dysfunctional and harmful black families. I mentioned briefly in my elevator speech. And, of course, this has come throughout my comments, that this is very much rooted in racism. And the idea of saving children has underneath it, the idea that there are families that aren't good for children, and they should be placed with families that are assumed to be better for children. And what is a good family and what's a bad family is heavily racialized. So black families have been subject from the time of slavery to this stereotype that we are neglectful, we're dysfunctional, we don't know how to care for children. Black children are better off under anyone's care rather than black parents and families, and some even say communities. And the best people to care for children are white people. So, I mentioned the federal law that incentivizes terminating parental rights and placing children up for adoption. And that law, the Adoption Safe Families Act, it passed in 1997, a year after the law abolishing the federal entitlement to welfare was passed. That law was promoted explicitly by many of its advocates as a law designed to terminate the rights of black mothers, whose fault it was that black children were languishing in foster care. At that time, black children were the largest group in foster care. It was the top of an explosion of foster care that began in the 1960s, and mostly because of the massive influx of black children into foster care. And so there was a recognition of this problem that there were all these black children in foster care. And the solution that Congress came to when Bill Clinton signed this law was, and Hillary Clinton promoted it, was that black mothers' rights should be terminated to free, and this is the language, to free these children from their parents so they could be adopted. And some people even advocated explicitly, they would be better off adopted by white people. You know, the federal law that governs foster care in America is a law that was promoted in a way that completely connected foster care and adoption and was based on these racist stereotypes about black families. So yes, adoption and foster care are very much entangled. I'll mention another way they're entangled is. And I mean, this may be a little bit off topic, but I think it's important to connect all these dots by the Dobbs decision that overturned Roe v. Wade and allows for states to ban abortion. In the oral argument, Justice Amy Coney Barrett asked the attorney for abortion clinics, why do we need Roe v. Wade when people who have babies can just turn them over to safe havens for adoption? So, the solution to banning abortion is just to, and the harm to the pregnant person is just to let them turn over their baby. Why do we need protection for abortion? Why do we need a right to abortion? Well, then Justice Alito mentions this argument in the opinion and has the nerve to drop a footnote that refers to the supply of adoptable infants, as if banning abortion is going to be a solution for the dearth of infants for people to adopt. So, there's this connection between banning abortion and adoption. That's explicitly in the Dobbs opinion. And, of course, there were people outside the oral argument with signs saying, “I will adopt your baby.” This has long been an argument by anti-abortion activists that adoption is a solution for compelled birth. And Alito says, in the opinion that anyone who gives up their baby for adoption can rest assured that the baby will find a suitable home. So, it's all based, though, on this same myth that there is a free market for babies, and it's a win-win situation. I think it's very likely that forcing people to give birth to children that they weren't economically prepared to take care of is going to increase the removal of those children. So, it's not that people are going to voluntarily give up their children. In fact, we know from the takeaway study that most people who are forced to give birth, who wanted to get an abortion keep their babies. What's more likely to happen is that they will be forced to give up their children, or their children will be taken from them because of the increased economic hardship they'll face because they were forced to give birth to a baby they weren't economically prepared to take care of. And so that's another connection.

[38:54] Kim Krawiec: Dorothy, with your reference to a free market for babies, you fully brought this episode around to the main topic of taboo trades. That is our core theme.

[39:05] Dorothy Roberts: Okay well, I’m glad that on your last episode, we could tie it together.

[39:10] Kim Krawiec: Tie the whole thing together.

[39:16] Dorothy Roberts: I'll be honest, I have been thinking a lot more about the question of whether adoption should be abolished. And I have not taken that position. I'm not sure yet if it's a position that flows logically from my position on family policing. It very well might. And I have very clearly written that adoption, the adoption industry, is one that takes babies and children from less privileged people and gives them to more privileged people. It is clearly governed by hierarchies of power, which are oppressive. And so the way it operates now, I think, should be abolished and replaced. Now does that mean that adoption should never take place? To be honest, I wish I didn't have to answer the question, but I want to be forthright about it. I have come closer to that decision because there is a growing movement of adoptees, people who have been adopted, who are calling for the abolition of adoption, and they are saying, our voices haven't been heard. We have been forced. We've been taken from our families, almost always under coercive conditions, whether it's the state taking it or because of economic insecurity or other kinds of political inequities that force people to give up their children or have their children taken from them. And so, the conditions of adoption are always unjust conditions.

[41:33] Darius Adel: I think next we can move into a couple more questions about the practicality of abolition and the specifics of what that entails. I think Julia had a question for us.

[41:45] Julia D'Rozario: Hi again. 

[41:47] Dorothy Roberts: Hello.

[41:48] Julia D'Rozario: I have a question about the proposed ban in your paper on involuntary drug testing of pregnant parents and newborns. I was really alarmed to read how incredibly biased the family policing system is at every step of the decision-making process. You give an example in the article of black parents being screened and reported for drug use during pregnancy, while white parents are less likely to be screened or reported for a positive result. It's really unfair, and I completely agree that parents shouldn't be treated differently for the same behaviors. But with a procedure like prenatal or newborn drug testing, my intuition is that the problem isn't with the procedure itself, but with the fact that it's being used in a really discriminatory way. I worked with children in the past and have cared for newborns with prenatal substance exposure, and I feel that testing newborns for drug exposure can be important in some circumstances. So, I guess my question is, when creating non reformist reforms, how do you decide which procedures need to be scrapped entirely and which just need clearer guidance on how to avoid discriminatory enforcement?

[42:56] Dorothy Roberts: Yeah, thanks for that question. So, I think certainly we don't want to enforce a procedure in a discriminatory fashion. And as you pointed out, and as it has been long well documented and continues to be documented in multiple studies, black newborns and pregnant people are much more likely to be tested and reported than their white counterparts, especially if they're wealthy. Okay, that's a given. But then I think we have to ask, well, why is that? Does that tell us something about the practice itself and the need for the practice? Because right now it is very unlikely that a wealthy white person is going to be forcibly tested and reported. So why is that? There must be something bad about it. This is what I think about family policing in general. If it's focused on the most disadvantaged, marginalized people and the most privileged people are exempt, it's probably because it's not good to experience it. Otherwise, we would have the most wealthy and privileged people experience it and not the most disadvantaged. So that was the first clue to me that this was a racist system. When I went into Chicago and saw that all the families being separated were black families. Well, of course that's not a good system then. It must be a bad system. Otherwise, I'd see all white families in there and wealthy white families in there. It was so wonderful. So why is it that doctors are able to care for wealthy white patients without forcing drug testing on them and without reporting them to child protective services? Now, I'm not a doctor. You may know more about this because you worked in that field than I do. But my intuition is that they figured out ways of caring for their wealthy white patients that don't require coercive practices and punishing their families. And so, my first instinct would be, well, let's see how they do it for the most privileged people. How do they care for those infants? Because, believe me, it is not true that only impoverished black people use drugs while they're pregnant. I mean, studies have also shown that it cuts across socioeconomic and racial lines. And we know that it occurs.

[46:04] Kim Krawiec: I mean not to mention alcohol. A different problem, but one that's still--

[46:07] Dorothy Roberts: Well but alcohol can be even more damaging. 

[46:10] Kim Krawiec: Yeah, right. 

[46:11] Dorothy Roberts: The use of drugs, depending on. There are mothers, just recently in New York City, the Bronx Defenders and Arnold & Porter represented a black mother who had her baby and children taken from her because of a positive test of the newborn, that the newborn tested positive for marijuana, for cannabis. And New York happened to have recently passed a law legalizing it. But they took her children anyway, and they settled eventually because Bronx defenders and Arnold & Porter got involved. They settled for 75,000 dollars, I think, and gave her, her children back.

[46:48] Kim Krawiec: What’s seventy-five grand to have your children taken away, Dorothy.

[46:52] Dorothy Roberts: I know. There's no way it repaired the damage. Hopefully, they'll stop doing it, though, as a result of this. Who knows? But of course, there are wealthy white women in New York who smoke marijuana while they're pregnant, who drink alcohol. We know this, who use other kinds of drugs, and doctors have figured out how to care for them. The other thing I would say is, if the harm is greater than the benefit, then we have to figure out better ways. So, we know also that there is a harm in coercive drug testing of pregnant patients and newborns, which is it deters people from getting prenatal care. And so not to mention the harm of taking the newborn away from their mother, which may very well cause more harm than whatever the harm of the drug use is. And as you know, it depends on how much drugs were used, what the drugs know. A positive toxicology could be somebody smoked marijuana during pregnancy.

[48:14] Darius Adel: I think next up, we have Joseph with a question.

[48:16] Joseph Camano: Hi, Dorothy. Thank you for joining us.

[48:18] Dorothy Roberts: Sure.

[48:19] Joseph Camano: In why abolition? You state that 16 percent of children enter foster care because they were physically or sexually abused. So, in a post abolition society, where community support is the only available solution, what happens then to these children in situations where members of their own community or family have failed and harmed them? Is the removal of a child from their community or situation ever an appropriate response, in your opinion?

[48:41] Dorothy Roberts: Yeah. So, first, I would say if we reimagined caring for children, providing for their needs, supporting families, there would also be far less physical and sexual abuse of children, especially physical abuse, we know, is often tied to the stress of poverty. And that's not to say that poverty causes people to abuse their children, but studies have shown this, and it's also just logical to conclude that if somebody is under extreme economic stress, they are more likely to freak out when the children in disciplining their children. So, if we met the economic needs of children and families, there would be less physical abuse. Also, it would be easier for people in abusive homes to leave those homes right now. For example, when a mother is, and it's usually a mother who is herself experiencing physical abuse, and the child may be as well, or even if the child isn't, she is at risk of having her children taken from her because she herself is a victim of violence. And so that deters mothers who are experiencing intimate partner violence from getting help. And also, if they get involved in CPS, that puts all sorts of impediments to them becoming economically secure and able to get out of a violent situation. So in multiple ways, the system we have now puts children at risk of experiencing violence. And so, again, doesn't mean that there won't be cases where there needs to be some kind of intervention, but those cases will be radically reduced under an abolitionist vision of caring for families. I'm not sure what this world will look like, what the society will look like, as we incrementally move toward dismantling this system and creating community based ways of addressing families needs. But I believe that there will be ways, and these are practices that transformative justice experts and advocates are working on to hold people accountable for violence, separate people who are experiencing violence from perpetrators of violence and getting to the root causes of violence. So abolition doesn't mean ignoring violence in homes. It means creating more effective ways of intervening, of reconciling, of keeping people safe. And we have to work on doing that.

[52:37] Darius Adel: I think we’ll move on to the next question, which we have from Aamina.

[52:40] Dorothy Roberts: Okay.

[52:41] Aamina Mariam: Yeah, hi. So I think you kind of touched on this previously and in the last question, but obviously, abolition isn't this 100 percent take down everything overnight. And so, you mentioned the reform bills that were in New York in your article. But aside from those kind of New York reform bills, what are some other examples of meaningful reforms that we can enact to reduce harm in the short term? 

[53:02] Dorothy Roberts: Yeah. Well, I should say that Texas has enacted some reforms that are similar to what's being proposed in New York, which the New York state legislature hasn't passed and the Administration for Children's Services opposes, like providing Miranda warnings, telling parents what their rights are. And let's see, I believe also moving from anonymous reporting to confidential reporting and these kinds of legal procedures that give family caregivers more power to prevent the removal of their children. Another which I think is really helpful is the development of family defender units in legal aid or legal services offices. So multidisciplinary units within legal services that include attorneys who are trained and experienced at defending families from child protection, investigation, and removal. But importantly, they also include social workers who can help to get the families the resources they need. The idea behind it is both protecting the rights of parents against the state, but also providing the resources that families need so that the children don't have to be removed. And social workers play an important role there. And then also they include peer advocates. So, adults who have been involved in the system either because their children were taken or they experienced foster care themselves to give support and advice and encouragement to the client. And I think that is really important, including funding for it, so that it's always available to parents who have been accused of child maltreatment in order to avoid their children being taken from them, and again, to uphold the rights that they have under the Constitution and federal law and sometimes state statutes that aren't being enforced. So that's one. And then another is the proposal. I know Connecticut has proposed this, some other states as well, of having a different number that people can call if they need help or if they suspect that their children in need of help. That's not the child abuse hotline, where the goal would be to provide help to the family. Now, one concern I have is that if this different supportive hotline, and some people are calling for, instead of mandated reporters, mandated supporters, instead of the child abuse hotline, if we have this supportive hotline, is it connected, though, to the child welfare department? Because if it is, people will be deterred from calling it if they know that their call might be transferred to the coercive family policing. And often these departments, I've mentioned their big databases and their predictive analytics. They share a lot of information across schools and hospitals and police departments to identify children at risk who can now be subject to investigation. And so if they're sharing, then it might have the opposite effect, which is instead of shrinking the numbers of families entangled in family policing, it expands it, because now you have more people willing to call because they think that families are going to get help. And in fact, some portion of them are transferred to the child protection services, increasing the numbers of families who are under surveillance. But if there could be a separate way of providing resources to families disconnected from the coercive system, then I think that that's something to be explored and expanded on. And then I think also just any policies that increase affordable housing, that make it easier for people to get on Medicaid and to get food stamps and other kinds of resources, expanding childcare, affordable or free, mean a universal health care and childcare.

[58:48] Julia D'Rozario: We all really enjoyed your piece on race based medicine, and we have several questions for you about it. And our first question is from Dennis.

[58:57] Dennis Ting: Yeah, thank you again so much for being here, just echoing what everyone else said. It's been a real pleasure listening to your thoughts. We read your article about race based medicine. I found it particularly interesting because in my last life as a journalist, I've done a good bit of reporting on health inequities in predominantly black communities, mostly in Louisville, Kentucky. And so, I'm curious why you believe race based medical practices still exist. I understand when you have issues with redlining and discriminatory practices that have shaped, impacted access to health care, that's one thing. But this is discriminatory practices inside healthcare. And since there's so much scholarship and literature about why this isn't true and science could be a very fact logic based field, how is it that we're still dealing with these things?

[01:00:00] Dorothy Roberts: Yeah, you would think that after 500 years of this ideology of the biological concept of race and the clear connection between it and slavery and settler colonialism and the promotion of it as a way of justifying slavery in the United States and all the science from the Human Genome Project and human evolutionary history and all of that, and just plain common sense that we would no longer have race based medicine in America. In fact, it would be clear that to advance medicine, we'd have to do away with those backward ways of thinking. And it is astounding that we continue to have these algorithms that automatically adjust diagnoses and measurements by race automatically embedded in the technology. And so, I think that part of it is that precisely because it's way of thinking that did exist for 500 years and was so essential to just to science in Europe and America, so essential to the institution of slavery, to, you know Jim Crow, to institutions that were so deeply embedded in the United States and globally and existed, for most of US history. If you think about it, the idea that race is not an innate characteristic, that it is a social construction, I like to say a political invention. I mean, that idea only took hold after World War II really. I shouldn't even say took hold. It became accepted science only after World War II. And really, it wasn't until after the civil rights movement and even, in a way, even with the Human Genome Project. But anyway, even then, though, researchers were looking to see whether you could identify race at the genetic level, and Clinton and Craig Venter and all the scientists and politicians who were declaring this was such an amazing expedition into the human genome and all of that they all also declared it shows that race is not real at the genetic level, but as if they had to dispel that common idea. So even into the 21st century, it still was considered this amazing discovery that human beings weren't naturally divided into races. So, when you have an idea that is so deeply embedded in know, popular culture, I think most people in America think race is a natural division of human beings, and doctors are part of our culture. They're influenced by our culture as well.

[01:04:00] Darius Adel: Yeah, I think that leads in well to Liam's question he had about the physical differences between ethnicities.

[01:04:08] Liam Bourque: All right, so my question was when discussing race-based medicine and the causes of group-based differences. While underlying group differences in health may be partly rooted in systemic racism, racism in general, there are nonetheless very real differences. For example, there are a number of differences. For example, sickle cell is primarily found in people from regions that have malaria. In Latin America and sub-Saharan Africa, diabetes risk is radically different based on, for example, diabetes risk for certain ethnicities, particularly south asian people, black people, certain Pacific Islanders at lower weights, they're far more prone to diabetes than white people are. And there are a number of other lists we could rattle down that do actually differ between races. While the lines might not be like, concentric circles that are separate from each other, and the lines between races are fuzzy, there are nonetheless very real health outcome differences. Is it ever okay to take race ethnicity, or this into account when diagnosing and or treating patients?

[01:04:55] Dorothy Roberts: Well first, I would say we have to make a distinction between race and ethnicity. So, ethnicity is a much smaller grouping of people. It usually involves ancestry and culture, and it's so much smaller than race. Race is a huge category of people that includes lots of different ethnicities, and there's no way to determine what race someone belongs to without looking at cultural, social, and political definitions. So even how you described the differences in the prevalence of certain diseases, you described it according to ethnicities. It's just not true, for example, that black people, as a so-called race, are predisposed innately or genetically to sickle cell disease. It's, as you pointed out. It's geographically based, which relates to the prevalence of malaria in certain geographic regions. But people from southern Africa don't have a higher rate of sickle cell disease than people whose ancestors are from, than people from southern Europe. So, to say that it is a disease that is related at all to black race is just too imprecise. It's not helpful, because who belongs to the black race is a completely political decision that has changed over time. It means something different in different nations. Many black people have more white or European ancestry than African ancestry. And so, with diagnosing them, we routinely would just diagnose them if we're going to take race into account as black, when their ancestry could be more European.

[01:07:35] Julia D'Rozario: Dorothy, on the note of ancestry, that actually transitions us so perfectly into Jenna's question, which is about Ancestry.com and 23andMe and commercial DNA testing. So, Jenna, if you'd like to, go ahead.

[01:07:51] Jenna Smith: Hi, thank you so much for joining us. I'm just curious if you have any thoughts about the commercial DNA testing services like Ancestry or 23andMe. Does testing DNA and giving somebody an exact breakdown of their ethnicities and geographic origin reinforce within society that idea that there are firm genetic distinctions between races?

[01:08:08] Dorothy Roberts: Yeah. Well, again, we have to be careful, as I was saying, in answer to Liam's question, to not conflate race, ethnicity and ancestry, each one means something different. Again, race is a political category that may have nothing to do with your ancestry. It just depends on what group you, according to the political and social rules at the time, in the place you're asking about it, you belong to, whether you're white. There was a time when Mexicans were determined to be white because of a treaty. And we routinely say that black people belong to the black race, even though, as I said, they may have more ancestry that's out of Africa rather than African ancestry. So, I would distinguish between ancestry testing companies that claim to be able to tell you your race, which they used to do. I think they've stopped doing as much as they used to, or what percentage of different races you are versus those that try to tell you what ethnicity, the different ethnicities in your ancestry. But I do believe that these companies do reinforce the view that race is biological. When people confuse ethnicity, ancestry, and race. So, if consumers are confusing those, I think that then when they get the results, it reinforces their view that race is biological. And it also reinforces the view that we can determine our ancestry definitively through genetic testing, which also isn't true. In fact, if you've gotten results from one of these companies, you probably have gotten updated results that are different from the past results, because your DNA doesn't have labels on it to tell you what your ancestry is, it has to be determined by the company, which is based on what databases they're using and their algorithms for how they determine whether your genes are similar enough to groups in their database to say you share a common ancestry with those people in the database. But if there's time both in answer to both your questions and Liam's as well, and maybe in general about race based medicine. Race is a real category. It is a real category that people are placed in and that does affect their health, but not because it is an innate natural division of human beings. It's because your race determines the privileges that you'll have in a society, the conditions you'll live under, your experience of both racism, but also your experience of conditions that affect your health. If you live in an impoverished, segregated black neighborhood, you're more likely to experience police violence, either yourself or other people in your community. You're more likely to be incarcerated. You're more likely to experience employment discrimination. You're more likely to be exposed to toxins. So, the main reason why we see health differences according to race is because of those differences in living conditions that are determined by structural racism. And again, to the extent that it has anything to do with ancestry, then we should be looking at ancestry, not race. It's ancestry that may make a difference. But when it comes to race, logically, just logically speaking, we know this is a political category. And again, the most obvious way to see that is that somebody who has one black grandparent, and three white grandparents is going to be determined to be black. So, if it has anything to do with ancestry, why would you look at race when they have more European ancestry? And if it is that they fall into a category of poorer health, it's probably because they experience some of these conditions of structural racism because they've been identified as black.

[01:13:25] Darius Adel: Thank you so much for that, Dorothy. I love your energy. It’s so great. I think for our last question, we're going to go with one that I think fans of the podcast will see as a continuing saga of the Danville Covid trips. I know you might not know about this, Dorothy, but we've had a lot of similar questions. So, Kate, why don't you take it away?

[01:13:51] Kate Granruth: Absolutely. And I will say I am honored to be what is apparently the last question of this. So, this fits in really well with what you're talking about. Health outcomes, being determinative of where people are living and the access they're able to get. So, I attended UVA for undergrad as well, for background, and this question came up because of your article's discussion of the history of America experimenting on black people without their consent in the name of medical innovation. So when I was here in undergrad, Covid vaccines became available to the general public in the town of Danville, which is about an hour and a half away from Charlottesville long before they became generally available in Charlottesville. Danville's population is about 49 percent black, much higher than the average in Virginia. And many, mostly white UVA students though some, not white, UVA students, chose to drive to Danville to get their shots there. Facing criticism for taking the vaccine opportunity away from the black residents the program was aimed at, many responded to the criticism by saying vaccines were going bad in Danville, in part due to black people's justified distrust of government health initiatives due to this history that you had talked about. From what you had seen, does this level of distrust actually exist in black communities, or are people solely using this as an excuse to avoid targeted interventions that would assist these populations?

[01:15:15] Dorothy Roberts: Yeah, I think there is a level of distrust of government provided experiments. You know, what might be perceived as experimental in the sense that it hasn't been widely tested or used drugs and technologies. And again, justifiable given the long history of using black people and their bodies for medical experimentation, but and also distrust of government programs that dispense these technologies and drugs. As the syphilis experiment was a US government funded experiment on black people. But I believe that it does get exaggerated and misinterpreted. So often there's this idea that black people are afraid of science, or they're unscientific, or black people are non-compliant when it comes to health care regiments. And I think that is just a stereotype. There's so much research that could be done on this to get at the bottom of what is perceived as black people's wariness about medicine and science. I once wrote an article about this stereotype and pointed out that black people. In some studies. I don't know if this is still true, but in some studies, it's shown that black people are the most likely to ask for high tech lifesaving treatment for their relatives. When doctors say, we're going to shut off the lifesaving treatment, white people are more likely to comply than black people. Black people are more likely to say, no, we want more technology to keep grandma alive, and which may also be part of the distrust of why they want to take grandma off of life sustaining treatment. I'll also point out that now there have been recent studies showing that white people are more likely to avoid vaccines and other kinds of protections against Covid for political reasons. They are more likely to believe that the whole fear about Covid is a hoax, more likely to think that government promotion of vaccines is too much government interference. And this is one explanation that's been given for why the gap in death rates from Covid has gotten smaller since 2020, largely because white people have not been following protective measures and getting vaccinated at the rates that black people have. And some, this is very political. It tends to be Republicans. And again, I'm citing research I've read. I haven't studied it extensively, but I think that the political debate around vaccines would bear out that it's been white Republicans who have been calling for a halt to government promotion of vaccines now much more than black people are. So, I think that the idea that black people are afraid of medicine or don't believe science is definitely misinterpreted and exaggerated. And we have to look carefully at what are the political, political influences that shape people's views about medicine, and medicine and science need to be more trustworthy. I really don't like the idea that we have to get black people to trust science and medicine more. I think it should be that medicine and science need to be more trustworthy and in order to warrant the trust of black Americans and others as well. If I could say one more thing about University of Virginia that you did not mention, which is the study that I'm pretty sure I cite in that article of laypeople, medical students, and residents, where a substantial number of white medical students and residents believed false myths about black biological difference.

[01:20:55] Kim Krawiec: I did not realize that was at UVA.

[01:20:58] Dorothy Roberts: It was at UVA.

[01:21:00] Kim Krawiec: You did cite it, but I just did not.

[01:21:01] Dorothy Roberts: I know it was at UVA believing things like black people have thicker skin than white people, black people have less sensitive nerve endings than white people. And the researchers found an association between belief in those myths and their inadequate prescriptions for pain for black patients. And so going back to the question about why does race based medicine still exist, we have a recent study that was 2016 finding that residents who are treating patients hold a substantial number of this study, hold these false beliefs. And as I was saying, it is going to take a lot of work to upend these ideas that are so deeply embedded in racial concepts of disease and the biological concept of race.

[01:22:07] Kim Krawiec: Great, well that was our final question and our final episode for the season. So, thank you so much for doing this. Dorothy, it was great to see you again, and it was great to get a chance to talk to you about your work on this. As I told the students earlier, I feel like in some ways, the world is finally catching up to you. I know it doesn't feel that way to you, probably, but you've been making some of these arguments for decades now. And some of them, at least, I feel like, are becoming a little more mainstream. And you were ahead of your time to your credit.

[01:22:37] Dorothy Roberts: Oh, thank you. Thanks, Kim. It's good to connect with you again. And thanks for all your great questions. Great questions. Great questions.

[01:22:46] Kim Krawiec: Thank you so much.

[01:22:48] Julia D’Rozario: Thank you.

[01:22:49] Darius Adel: Thank you so much, Dorothy.