One of the most important aspects of human rights law for children is the recognition that the state has positive obligations to protect them from harm, including harm suffered in the home. Child protection is one of the most important areas for protecting children’s rights, but also one of the most difficult. As well as the right to protection from harm, children and parents also have a right to protection of their family life together. This chapter considers the extent to which the law and process of child protection protect the rights of children at risk from harm. It considers the importance of supporting families and the difficulty of deciding when to intervene. It then considers child protection proceedings and the extent to which children’s rights are protected in the law concerning child protection orders. Finally, it considers children’s own perspectives and the extent to which they are heard in the process.

Child protection has been focused on detecting and preventing abuse in Sweden since the 1950s. An extensive and efficient implementation of knowledge on SBS/AHT took place from the late 1990s and intensified during the years from 2002, led by paediatricians, neuroradiologists and ophthalmologists supported by government agencies, the parliament and regional health councils. Shaken baby syndrome/abusive head trauma was presented in textbooks, professional society’s guidelines, conferences, and teaching. A taskforce for child protection was created by the Swedish Paediatric Society and child protection teams were created subsequently at the university hospitals. A steep increase in infant maltreatment diagnoses occurred concomitant to this implementation, also an increase in out-of-home care for infants with SBS/AHT findings. The SBS/AHT knowledge still prevails in the guidelines by the professional societies. However, a decline in infant maltreatment diagnoses has occurred during recent years, which might indicate a burgeoning de-implementation process related to a decision in Swedish Supreme Court (2014) and the SBU-report on traumatic shaking (2016).

Attachment theory is relevant in decision-making in out-of-home care as children’s early life experiences and relationships affect their wellbeing, sense of security, and future relationships (Bowlby, 1969). This chapter describes the development of attachment theory and key concepts, cultural considerations, use of attachment theory in child protection practice and practice examples of how attachment theory may be misunderstood and misapplied in out-of-home care. Attachment is a theory of how humans develop the capacity to form and maintain emotional relationships, and how these relationships influence our development and sense of self and others. In early life, attachment figures are typically parents, but over the course of development attachments can also form in other significant relationships. Children learn to regulate their emotions and behaviour through the attachment relationship. An attachment figure provides a ‘secure base’ and ‘safe haven’ from which to explore. In response to patterns of interaction, the child forms an attachment type, which is an adaptation to caregiver behaviour.

A growing number of adults with intellectual disability aspire to be parents. The research is conclusive; intellectual disability per se is not a barrier to parenting. Parents with intellectual disability do as well as their non-disabled peers when they are appropriately supported. However like other families in vulnerable contexts when left under-resourced and reliant on discriminatory and/or unsafe support they are highly susceptible to factors that place children at risk. Drawing on international research, this chapter will provide an overview of current knowledge about parents with intellectual disability and their children. The chapter uses a broad definition of intellectual disability which captures two groups of parents. The first is those that were assessed as having intellectual disability as a child and report being in a special class or having classroom support while at school. The other group are those who do not identify as having intellectual disability. This may be because they have never had a formal diagnosis or were not told about it as a child.

This chapter discusses the right to respect for ones family life and the right to marry as protected by the European Convention on Human Rights, other Council of Europe instruments, in EU law and in international instruments. Attention is also paid to topics such as adoption, legal parentage, best interests of the child and same-sex marriage. In the final section, a short comparison between the different instruments is made.

During armed conflict, children are protected both generally (as persons) and specifically (as children) by international humanitarian law and by international human rights law. Their protection under IHL during the fighting is first and foremost in their capacity as civilians, although special protection is also afforded to children against recruitment, as well as when they are detained by an enemy or are otherwise in its power. International human rights law offers parallel protection to children and, when IHL is not applicable, will be the primary source of protection under international law as this chapter describes.

The persistence of state violence perpetrated against Aboriginal and Torres Strait Islander families is evident from first contact to contemporary child welfare interventions. These interventions have been authorised by laws and policies which have forcefully separated children from their families and communities legally and illegally, separated families through exerting control over where they could live, who could marry whom, and how their identity was legally defined. These laws and policies have also systematically excluded Aboriginal and Torres Strait Islander families from opportunities and benefits for wealth creation, laying the foundations for inter-generational experiences of poverty and trauma. The shift from formal discrimination under the auspices of ‘protection’ to assimilation saw an increase in interventions and removal of Aboriginal and Torres Strait Islander children from their families. There is continuity across different laws and policies in the presumptions about western family superiority, the embedding of non-Indigenous priorities and aspirations in law and policy, and the failure of the state to take responsibility for inter-generational harms perpetrated, or a willingness to relinquish power exercised over Aboriginal families.

The Conclusion draws together the major contributions that the monograph makes. It recognises orphanage trafficking intersects with child protection, tourism and development and argues for a comprehensive approach to the issue.

This chapter provides a basis for nursing students to understand the ways in which children and young people’s rights are upheld in Australia and New Zealand, particularly within the healthcare systems. It provides insight into the ways in which human rights, and particularly child rights, inform paediatric nursing policy and practice. It begins by looking at the international agreements and covenants regarding the protection of child rights that have been endorsed by Australia and New Zealand, before moving on to examine the national legislation and the implications for health and social support systems. The second part of the chapter looks at some of the ethical challenges regarding child and family rights that you will consider as a paediatric nurse. In particular, we look at issues surrounding access to family, advocacy and consent to treatment of specific diseases in some situations. It provides a basis for understanding the way in which children and young people’s rights – including the right to be protected from all forms of violence and neglect – are upheld in Australia and New Zealand, particularly within the health and welfare systems.

Key Learning Points

1. 1. Safeguarding and child protection are the responsibility of all professionals involved in the care of children.

2. 2. If a child is suspected of being at risk of harm, a referral to the local authority must take place.

3. 3. Abusive head trauma is the most common form of death amongst children as a result of abuse.

4. 4. Specific clinical findings are strongly associated with abusive head trauma in young children.

5. 5. In the UK, a statutory process is in place to respond to the death of a child.

While many children are born into families where parents generally care for their health and education and strive to provide them with safe and happy home lives, other children are not as fortunate and are subject to maltreatment such as abuse or neglect (Australian Government, Department of Social Services, ). Most parents have the capacity to provide love, care and support for their children while others need extra help along the way. There are parents who may appear to neglect their child; however, they may be struggling with a disability and poverty through a work or health situation (Australian Institute of Family Studies, ). Responding to the children in such vulnerable families is an integral focus of Australia’s welfare system (Fernandez, ).