Social dominance, school bullying, and child health: what are our ethical obligations to the very young?
BACKGROUND
Recent research shows that by age 5, children form rigid social hierarchies, with some children consistently subordinated, and then later, bullied. Further, several studies suggest that enduring mental and physical harm follow. It is time to analyze the health burdens posed by early social dominance and to consider the ethical implications of ongoing socially caused harms.


METHODS
First, we reviewed research demonstrating the health impact of early childhood subordination. Second, we used philosophical conceptions of children's rights and social justice to consider whether children have a right to protection and who has an obligation to protect them from social harms.


RESULTS
Collectively, recent studies show that early subordination is instantiated biologically, increasing lifetime physical and mental health problems. The pervasive, and enduring nature of these harms leads us to argue that children have a right to be protected. Further, society has a role responsibility to protect children because society conscripts children into schools. Society's promise to parents that schools will be fiduciaries entails an obligation to safeguard each child's right to a reasonably open future. Importantly, this role responsibility holds independently of bearing any causal responsibility for the harm. This new argument based on protecting from harm is much stronger than previous equality of opportunity arguments, and applies broadly to other social determinants of health.


CONCLUSIONS
Social institutions have a role responsibility to protect children that is not dependent on playing a causal role in the harm. Children's rights to protection from social harms can be as strong as their rights to protection from direct bodily harms.
UC Berkeley-UCSF Joint Medical Program, School of Public Health, University of California-Berkeley, Berkeley, California; jhalpern@berkeley.edu.
Jodi
J
Halpern
UC Berkeley-UCSF Joint Medical Program, School of Public Health, University of California-Berkeley, Berkeley, California;
Douglas
D
Jutte
Regional Ethics Department, Kaiser Permanente Northern California, Oakland, California;
Jackie
J
Colby
Departments of Pediatrics and Psychiatry, School of Medicine, University of California, San Francisco, California.
W Thomas
WT
Boyce
D001675:Bioethics; D058445:Bullying / Q000523:psychology*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012930:Social Dominance; D012935:Social Justice; D012941:Social Responsibility
bullying; ethics; social dominance; social justice; stress