Faithvs MedicineSuzetteReilleyGogebicCommunity College                    Issues surrounding theability of a parent to deny medical care for their child has emerged as acontentious subject in health law policy. Parents often refer to religiousreasons or personal preferences for alternative medical treatments as validationto refuse medical treatment for their child. Although the ability of a parentto consent to potentially life-saving medical treatment for their child is anestablished law the ability to refuse life-saving treatment is less defined.

(Kasprak) “The basic legal premise for compellingtreatment in this country rests on a court-made distinction between religiousbeliefs and practices. The 1879 U.S. Supreme Court case of Reynolds v.U.S. (98 US 145) which involved polygamous marriage practices, set aprecedent that, while guaranteeing the free exercise of religious beliefs,permits the state in certain circumstances to limit religious practices.Generally, when the state can demonstrate a compelling interest in thepreservation or promotion of health, life, safety, or welfare religiouspractices may be curtailed.

” (Kasprak)Failure to provide children with essentialmedical care has been increasingly recognized as a form of neglect. (Bioethics2013) According to the Michigan Department of Health and Human Services neglectis defined as: Harm or threatened harm to a child’s health or welfare by aparent, legal guardian, or any other person responsible for the child’s healthor welfare that occurs through either of the following: Negligent treatment, including the failure to provide adequate food, clothing, shelter, or medical care. Placing a child at an unreasonable risk to the child’s health or welfare by failure of the parent, legal guardian, or other person responsible for the child’s health or welfare to intervene to eliminate that risk when that person is able to do so and has, or should have, knowledge of the risk.

(Michigan Department of Health and Human Services) In 1983, the US Department of Health and HumanServices amended its definition of negligent treatment to include failure toprovide adequate medical care. Many factors are important when evaluating forsuspected medical neglect. Some factors include likelihood and magnitude of theharm of forgoing medical treatment and the benefits, risks, and burdens of theproposed treatment. (Bioethics 2013) For example, the risk of one unimmunizedchild contracting a contagious vaccine-preventable disease may be low if immunizationrates in the community are high and disease prevalence is low. (Bioethics 2013)Many parents cite religious beliefs as a reason to withhold medical treatment.Some examples are, “Followers of Christ refuse all medical treatment in favorof prayer, anointing with oil, and the laying on of hands. Christian Scientistsmay use dentists and doctors for “mechanical” problems like setting bones orchildbirth but consider most illnesses to be the result of the individual’smental attitude and seek healing through spiritual means, such as prayer.

” (Bioethics2013) Other religions only forbid certain medical interventions such as, Jehovah’sWitnesses only forbid the use of blood and blood transfusions.             Overthe years court decisions have led to development of laws concerning parentswho refuse medical treatment for their children. Courtswill generally distinguish between children requiring immediate treatment andthose needing only non- emergent care.

Courts usually authorize medical carefor the children requiring immediate medical treatment. In passages from itsrulings, the US Supreme Court stated, “The right to practice religion freelydoes not include liberty to expose the community or the child to communicablediseases or the latter to ill health or death” and “Parents may be free tobecome martyrs themselves. But it does not follow they are free, in identicalcircumstances, to make martyrs of their children before they have reached theage of full and legal discretion when they can make that choice for themselves.”When a parentrefuses medical treatment based on conflicting religious beliefs actions can betaken under child welfare or other laws to have the child removed from thecustody of the parent. This way the person or agency that the court appoints toact as guardian can authorize the needed medical treatment.

The capacity for thecourt to intercede in these cases is rooted in both constitutional and commonlaw. In the Reynolds case, the Supreme Court distinguishedbetween religious beliefs and practices. “The court held that the FirstAmendment protects religious belief, but the state may impose restrictions onpractice. Thus, a religious practice jeopardizing the health, safety, orwelfare of the person can be limited.” (Kasprak)There is another basisfor intervention by the courts, “parens patriae” power.

Parens Patriae powermeans that parents are presumed by law to provide for the necessities of liferequired by their child. If a parent fails in this, such as by refusing medicaltreatment, the state may intervene to protect the child and ensure that thechild gets the proper medical care.(Kasprak) For example, the limits of parent’s right torefuse life- saving medical treatment based on religious beliefs was tested inthe following two legal cases-one in Oregon and the other in Philadelphia. Thetwo cases differ in circumstances but not medical outcome.

They both deal withthe issue of refusing medical treatment based on religious beliefs.  In the Oregon case a child died from lack ofmedical treatment for a “treatable” disease (diabetes mellitus). The parentswere arrested and charged in criminal court. The girl died in February 2013from a complication of the diabetes, diabetic ketoacidosis. The parents, Wenonaand Travis Rossiter, were members of the Church of the First Born inBrownsville, Oregon. The church practiced faith based healing. Both parentsstated that they did not know their daughter was diabetic and therefore werenot responsible.

The father was quoted as saying that based on his religiousbeliefs he would not have done anything differently. He also stated that if hisdaughter had requested to go the hospital he would have tried to talk her outof it. The church believed that doctors are for people who don’t believe inGod. The mother claimed they believed that their daughter simply had the flu.The state however, maintained that they should have been aware of theirdaughter’s medical condition, and that a reasonable person would have soughtmedical care before the condition became serious enough to cause their child’sdeath (citation).

On the day the child died she was extremely thirsty anddehydrated. She had been vomiting and urinating all day and couldn’t even standup. She had also lost a lot of weight and appeared frail and emaciated. Theparents in this case were convicted of manslaughter.            In the Philadelphiacase, a couple were convicted of involuntary manslaughter when their 2-year-oldson died of pneumonia. They believed that they could cure their son through prayerand did not seek medical treatment. They received 10 years of probation. Theirpastor stated that the child died from a lack of spirituality in the parent’slives.

In April 2013 the couple had another child die. Again, this time, it wasfrom pneumonia. The parents again asserted that their religion says you shouldpray and not seek medical treatment. This time the parents were convicted andwere sentenced to three and a half to seven years in prison.Many states have “religiousexemptions” to their child abuse and neglect laws. The exemptions come inresponse to the Child Abuse Prevention and Treatment Act of 1974. The actstates “Provided, however, that a parent or guardian legitimately practicinghis religious beliefs who thereby does not provide specified medical treatmentfor a child, for that reason alone shall not be considered a negligent parentor guardian.

” The states put the religious exemptions in place because it was acondition for the states to receive federal child abuse grants. In response tothis act the Department of Health and Human Services stated that reports ofmedical neglect should only be filed when there is harm or a grave risk ofharm, and religious exemptions should be a matter of state discretion ratherthan federal imposition. (Bioethics 2013)            It isimportant to also note that public money can be used to pay for religious andspiritual healing practices. For example, Medicaid and Medicare cover careprovided at Christian Science sanatoria and other religious nonmedical healthcare institutions and exempt these from medical oversight requirements.

(Bioethics2013) Coverage for these non-evidences based treatment practices should beterminated. Public funds should be used for evidenced based practicetreatments. Furthermore, the fact that these institutions receive public moneyseems to legitimize them. Parents are less likely to seek out competent medicalcare if they believe they are receiving care from a legitimate source.

TheAmerican Academy of Pediatrics recognizes the importance of addressing thespiritual needs of children as part of a comprehensive care plan, but itopposes public funding of religious or spiritual healing practices.             TheAmerican Academy of Pediatrics gives the following recommendations:1.     Pediatricians,pediatric medical subspecialists, and pediatric surgical specialists shouldrespect families and their religious or spiritual beliefs and collaborate withthem to develop treatment plans to promote their children’s health. 2.

     Pediatricians,pediatric medical subspecialists, and pediatric surgical specialists shouldreport suspected cases of medical neglect to state child protective servicesagencies, regardless of whether the parents’ decision is based on religiousbeliefs.3.     Pediatricians,pediatric medical subspecialists, pediatric surgical specialists, and the AAPand its chapters should work to repeal religious exemptions to child abuse andneglect laws and to prevent public payment for religious or spiritual healingpractices.                           References Philadelphia couple,who says they seek prayer not doctors, in court after second child dies; nocharges yet. (n.d.).

Retrieved January 27, 2018, from http://www.foxnews.com/us/2013/04/23/2nd-child-pa-couple-who-seek-prayer-not-doctors-dies-violates-probation-no.html Faith versus Medicine:When a Parent Refuses a Childs … (n.d.

). Retrieved January 27, 2018, from http://www.bing.com/cr?IG=1F8A31110D1D4526B1A5DCA7E1296CF0&CID=03466BE5789F60CB2554606179306198&rd=1&h=Aukzgd87ufIJF_838eY7APWr6ntWSWP_svHGr6xOcSY&v=1&r=http%3a%2f%2fwww.law.uh.edu%2fhealthlaw%2fperspectives%2f2009%2f(BP)%2520Faith.pdf&p=DevEx,5067.

1 Bioethics, C. O. (2013,November 01). Conflicts Between Religious or Spiritual Beliefs and PediatricCare: Informed Refusal, Exemptions, and Public Funding. Retrieved January 27,2018, from http://pediatrics.

aappublications.org/content/132/5/962 Kasprak, J. (n.d.).Retrieved January 27, 2018, from https://www.cga.

ct.gov/PS99/rpt/olr/htm/99-R-0180.htm MDHHS Adult& Children’s Services Abuse & Neglect. (n.

d.). Retrieved January 27,2018, from http://www.michigan.gov/mdhhs/0,5885,7-339-73971_7119-21208–,00.html  

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