Distrust of authority is now the American norm. In 1964, 77 percent of Americans said that they trusted the government to do the right thing most of the time or all of the time. In 2012, only 22 percent of Americans agreed that the government could be trusted. When I was growing up in the 1960s, if a priest came into a crowded restaurant, he was often ushered to the front of the line. If you watch a press conference with President Eisenhower or President Kennedy, you will be struck by the respect and deference shown by reporters in that era, quite different from what Barack Obama now routinely encounters, and George W. Bush before him. In the Ohio public schools I attended, it was customary for students to address teachers as “Sir” and “Ma’am.” If a teacher accused a child of wrongdoing, the parents typically accepted the teacher’s verdict without question and were likely to impose a punishment at home more severe than any imposed by the school. Today, if a teacher accuses a child of wrongdoing, the parents are likely to swoop in like attorneys, demanding evidence and mounting a defense.

This mistrust of authority, and the corresponding unwillingness to exercise authority, now pervades almost every sphere of American life, including the home. As recently as forty years ago, most American parents told their kids how to dress, what to eat, how to behave. Today, American parents typically ask. The very notion of commanding rather than asking seems old-fashioned or just downright wrong.

I am a practicing physician. I earned my medical degree from the University of Pennsylvania, graduating in 1986. Over the past three decades, in more than 90,000 office visits, I have seen children, teenagers, and their parents from a wide variety of backgrounds and circumstances. I have observed, from the intimate yet objective perspective of the family physician, profound changes in American life over the years. I have witnessed firsthand the collapse of parenting.

For example: A mother and father recently brought their six-year-old daughter to see me. The child had a fever and a sore throat. I examined the ears, which were fine. I said, “Next I’m going to take a look at your throat.” But before I could proceed, mom asked, “Do you mind if the doctor looks in your throat for just a second, honey? Afterward we’ll go and get some ice cream.”

This mother thought she was doing the right thing, being sensitive and caring, but her intervention derailed the visit. The little girl paused and then burst into tears, wailing, “I don’t want to!” What should have been a two-second exam became an ordeal lasting several minutes, requiring an assistant to restrain the child. The mother’s goal may have been to ease the girl’s discomfort, but in fact she made it worse.

Don’t negotiate with a six-year-old—that’s my rule. In a quarter century of clinical practice, I have learned that the key to effective examination of a sick child is simply to do the exam. If a child has a fever and a sore throat, then I’m going to do a Strep test. The child doesn’t get a vote. Here, the mother burdened the child with the illusion that the child had a decision to make. Her intervention changed my command into a negotiable request and turned the negotiation into a bribe. The authority of the grownups was undermined. When asked “Do you mind if the doctor looks in your throat?,” the six-year-old heard a bona fide question, and the answer to the question was I do mind and I won’t let him. This sort of episode just did not occur when I began my medical career thirty years ago.

Why are we now so uncomfortable with the notion of authority? Part of the answer, I think, lies in the infiltration of political sensibilities into family relationships. Politically, the story of the past fifty years can be summarized as the empowerment of the previously disenfranchised. People of color were promised equal rights under the law. Women gained wider ­access to the workplace and protection from overt sexism. Institutionalized discrimination was lifted, public accommodations were opened to all, women poured into universities, and welfare programs were expanded. The concepts of hierarchy and authority ­became suspect, politically incorrect. Nobody stopped to say: “Yes, it is right that women, people of color, etc., should have equal rights relative to white males. But what is true for adults in their relations with other adults may not be true for parents in their relations with children.” Empower everybody! Why not ­children, too?

Because the first job of the parent is to teach the children, not to consult them. When the doctor says that you have to get a Strep test, then you get a Strep test. You have to eat your vegetables before you eat dessert. School is a place to learn, not a fashion show or a social club, and you must dress and behave accordingly. These are essential lessons.

Parents must also teach their children right from wrong. No child is born knowing right from wrong. Children have to be taught the difference, which means (in this context) accepting instruction as authoritative truth. And authoritative teaching requires authority.

When parents abdicate their authority, they set their children adrift. Kids need firm guidance. When their parents don’t provide it, they look to peers or social media or the Internet. What they find is Miley Cyrus, Justin Bieber, Akon, Eminem, Nicki Minaj, Kim Kardashian, and Lady Gaga. It’s a confusing mélange of sex, selfies, and the endless striving for popularity and attention. What really counts in that world is who’s sexy and who has the most followers on Twitter and the best photos on Instagram.

Legitimate authority establishes a stable moral universe for children. It provides an alternative to the popular culture that has become a culture of disrespect: disrespect for parents, for teachers, for one another. This culture of disrespect leads young people even to disrespect themselves: hence the growing propensity of American teens to post photos on social media of themselves in various states of undress. This new norm—the casual obscenity of sexting—would have been unthinkable even twenty years ago. “Everybody does it” is what kids tell me, with a shrug. “It’s no big deal.” Without clear adult authority to guide them, they live in an unstable moral universe in which everything is relative, in which self-worth is contingent on the opinions of same-age peers.

American parents are vaguely aware of these problems, but they usually blame surface culprits: Too much sugar in the diet. Too much time online. Too many video games. Too little sleep. Those factors, important as they are, nevertheless are symptoms of a bigger and deeper problem, which is: We’re raising our children wrong. Parents don’t exercise authority, and so they allow their young to absorb the ambient American culture of disrespect. Instead of instructing kids in the Golden Rule, parents ask their kids, “How would you feel if someone did that to you?” And parents don’t know what to say when their son answers, “If someone did that to me, I’d kick him in the nuts.”

Diana Baumrind, a psychologist, has been studying parenting in the United States for more than forty years now. She has found that the most effective parents, as measured by long-term outcomes, are those who are both strict and loving. She has also found that many of today’s parents don’t understand that pairing. They don’t believe that “strict” and “loving” can go together. They think you can be either strict or loving, but not both. They opt for loving and shirk their duty to be strict.

The results are not good. Children are more likely to become defiant and disrespectful. And that’s not healthy. Children who are defiant and disrespectful are three times more likely to become obese compared with the children of authoritative parents. The children of permissive parents are more likely to cheat in school. They are less resilient and more fragile. To fail to be strict, to refrain from exercising parental authority, turns out to be a most unloving thing for a parent to do.

Over my three decades as an American physician, I have been involved professionally in a handful of cases of sexual assault, each with a girl or young woman as the victim. In one instance, as I sat with the mother after the fact, she said, “I knew I shouldn’t have let her go. She’s just fifteen years old. It was a party at the college. I knew I shouldn’t have let her go.”

One part of me wanted to shake her and yell, “Then why did you let her go?” But of course I didn’t do that. I already knew the answer. This mom wanted her daughter to like her. She didn’t want her daughter to be upset with her. She was uncomfortable exercising parental authority.

I am not suggesting a return to the 1950s. Every era has its shortcomings. But we need to recognize that the collapse of American parenting has had unhappy consequences for American kids.

What to do? I have several recommendations, based on my observations of healthy families. Here are a few:

In scheduling your child’s time, make the family the highest priority. In many American families, playdates and soccer practice now routinely take precedence over the family meal together. The family meal at home is more important than piling on afterschool and social activities.

Participate in a church or synagogue that teaches respect for authority.

Model a culture of respect within the home.

Instead of boosting self-esteem, teach humility. Fight the contemporary cultural imperative to be “awesome.”

Reduce or eliminate screens when you are with your child. Put your cell phone away. No devices at the dinner table. Teach the art of face-to-face conversation.

If you follow this tack, your neighbors or your child may not consider you to be a “nice” parent. But we now know that the children of “nice” American parents are more likely to grow up anxious and depressed, to be more fragile, less healthy, less creative, and more disrespectful compared with the children of authoritative parents. There’s nothing nice about that.

Fifty years ago, Americans trusted the public schools, the government, and the president to an extent that seems naive to us today. Every era has its flaws and injustices. But one element of that now long-past culture of authority needs to be recovered. Children must accept the authority of their parents, and parents must humbly assert and exercise that authority—for the sake of their children.

Leonard Sax is a practicing physician and the author of The Collapse of Parenting.