The Bucharest Early Intervention Project: A Study in Romanian’s Institutionalized Children

 Located in Eastern Europe, Romania was a communist country under USSR influence throughout the 1940’s-late 1980’s. It wasn’t until 1989 that Romania began to overthrow it’s Soviet leader, Nicolae Ceaușescu, and started an era of democracy that continues to this day. However, throughout that span of USSR influence and leadership under Ceaușescu, many policies were enacted that created massive problems for the country that are still seen at the present. One such policy was the mandatory five children per woman, in order to increase the workforce. However, a lot of these children were given up after the democratic government was implemented, giving families freedom from prior enforced policies, and due to the fact Romania faced a lot of economic instability from the previous communist rule and many families could not afford five plus children. The orphanages then became overcrowded and were already underfunded (Zeanah, 2006).

Life within these orphanages and institutions wasn’t ideal. Many of the children suffered from health conditions, both physical and mental, including social/behavioral abnormalities, attachment disorders, hyperactivity, amongst other things. Many researchers were beginning to look at childhood development, specifically, how living conditions correlate to behavioral and physical abnormalities, and the attention turned to Romania. The Bucharest Early Intervention Project (BEIP) was founded to study the children in institutions and how being raised in these institutions affects their development. Another part of the study included taking some children, at random out of institutionalized care, and into homes, and studying their development. The BEIP did not help in institutionalized care, but also did not prevent the children from care if granted by another source (Zeanah, 2006).

Joe Vukov, a professor at Loyola University Chicago in the Department of Philosophy, engaged in a discussion of the ethics behind this study. Is this an ethical study? The participants were selected at random, and those in the home study were cared for. However, it’s the children in the institutionalization care that pose the ethical objection. They did not receive help, they were simply monitored. One could say that they would have spent time in the institution anyway, so they BEIP did not have responsibility. Another argument includes, that the BEIP made these children a part of their study and therefore, have a responsibility to help them, or bring in an outside party to help them if they don’t have the funds, when they see that the children need help. A final argument says that the study could’ve been put together better overall. Vukov posed an ethical comparison. You are on a ship that is sinking slowly, and you get onto a raft, and there are other people in the water that have been in the water for different amounts of time. You start pulling as many people into the raft as possible, until you can’t hold anymore. You also decide to study the effects of the water on those in the raft and those outside the raft. Is this ethical? All three arguments could be seen here, that yes, you saved as many people as you could, and now you are simply doing a study. No, it’s not ethical, you should call for help and try to get as many people out as possible. Or the third option, it’s not a fair comparison, the study should’ve been set up better, a crisis situation does not compare (Zeanah, 2006). 

However, the exposure the Bucharest Early Intervention Project gave to the conditions of institutionalized care and the effects on children is admirable. More research has been done into the topic, and it is not just a problem in Romania. Children can suffer from, “post-institutional syndrome,” (a term not yet fully recognized). This syndrome comes from continuous neglect, lack of a stable careperson, and bare minimum physical/social/behavior needs met. Researchers argue that this can lead to the developmental issues seen in the BEIP and cannot be undone. The institutions these children are usually in have a high children to staff ratio, ranging from 8:1 or 31:1, and these staff are often not properly trained to be caregivers and do not provide the kind of rounded care each individual child needs. These children have stunted physical growth and higher than average numbers of cognitive disabilities. Researchers believe that more funding into these programs, lower children to staff ratio, and proper training would help a lot of these problems (van IJzendoorn, 2011).

Overall, the ethical questions raised by the Bucharest Early Intervention Project are difficult to untangle. It’s easy to criticize the study, but difficult to find a solution that would help all the children. It did find some important data into children’s development and the importance of caregivers and having needs met, confirmed by other researchers.

Citations:

van IJzendoorn, Marinus H et al. “Children in Institutional Care: Delayed Development and Resilience.” Monographs of the Society for Research in Child Development vol. 76,4 (2011): 8-30. doi:10.1111/j.1540-5834.2011.00626.x

Zeanah, C. H., Koga, S. F., Simion, B., Stanescu, A., Tabacaru, C. L., Fox, N. A., &

Nelson, C. A. (2006). Ethical considerations in international research collaboration:

The Bucharest early intervention project.Infant Mental Health Journal,

27(6), 559-576. doi:10.1002/imhj.20107