Jun 12, 2008

A Child's Death And a Crisis for Faith

Suzanne Sataline
Wall Street Journal
June 12, 2008

The recent death from untreated diabetes of an 11-year-old Wisconsin girl has invigorated opposition to obscure laws in many states that let parents rely on prayer, rather than medicine, to heal sick children.

Dale and Leilani Neumann of Weston, Wis., are facing charges of second-degree reckless homicide after their child, Madeline Kara Neumann, died on Easter after slipping into a coma. The death, likely preventable with insulin, has renewed calls for Wisconsin and dozens of other states to strike laws that protect parents who choose prayer alone in lieu of medical treatment.

The case also has frustrated the Church of Christ, Scientist, the main promoter of prayer as therapy, which says a few tragic cases have unfairly tarred a practice that can restore health. The Neumanns, a Christian couple who run a prayer group out of their coffee shop, are not Christian Scientists. The National Center for Health Statistics, a federal agency,
estimated in 2004 that more than 2% of the population uses prayer rituals.  "No one should be presumed to be guilty or innocent ... because they've chosen spiritual care," says Phil Davis, a Christian Science church spokesman.

Lawyers nationwide say they are eager to see if the Neumann case sparks more changes in state laws. It raises a "national discourse as to whether children can be medically neglected legally," says Marci Hamilton, a professor at the Benjamin N. Cardozo School of Law in New York who writes about children's rights. In another recent case, a 15-month-old child in Oregon died in March from a form of pneumonia and a blood infection after her parents opted to try to heal her with prayer. Oregon law provides no defense for parents charged with causing the death of a child through neglect or maltreatment, and the couple has been charged with second-degree manslaughter and criminal

There's been a small, steady pushback against state provisions protecting spiritual healing. A Massachusetts bill that would have protected parents who used prayer in lieu of medical treatment stalled in committee last year, despite the measure's broad sponsorship by 33 lawmakers.

In Maryland, lawmakers in 2005 repealed part of a law that had protected parents from losing custody if they withheld medical treatment because of religious belief. And in Maine that year, legislators amended several laws regarding religious treatment, and repealed part of its family law that stated that children couldn't automatically be considered abused
solely because they were treated "by spiritual means by an accredited practitioner." Evert Fowle, the district attorney in Augusta, Maine, said the amendments would now allow him to bring charges against guardians should a child be harmed after being treated with prayer alone.

The Wisconsin case against the Neumanns also highlights an obscure area of child-protection law that will force judges to weigh seemingly conflicting laws: If a state permits people to employ prayers for healing, can it then hold a parent criminally liable if those prayers fail?

The recent deaths of children have spotlighted the little-known lobbying work of the Church of Christ, Scientist, a denomination with anywhere from 60,000 to a half-million members, according to various estimates. The group believes that health can be restored through a stronger connection with God -- in effect, willing the body to be healthy. The
church is the largest that supports relying on prayer for healing, though other small sects do, as well. Of course, many religious denominations advocate prayer in conjunction with medical treatment.

The Christian Science church doesn't provide guidance on whether members may seek medical care, says Mr. Davis, the church spokesman. He says the church does not bar members from getting medical care, nor does it advise members when they should do so.

Church founder Mary Baker Eddy believed it was "fear that creates the image of disease and its consequent manifestation in the body." Spiritual practitioners, who are trained by the church to heal through prayer, get patients to think differently about their relationship with God, says Mr. Davis, who also is a spiritual practitioner. "It's an affirmation [of truth],"
Mr. Davis says. "It's that understanding that restores harmony."

The church's Christian Science Journal prints monthly testimonies that prayer has wiped away prostate cancer, a breast lump, leukemia and other illnesses. Brian Talcott, a practitioner in Berkeley, Calif., says he has seen cases of glaucoma and cataracts disappear.

But a 2006 study in the American Heart Journal concluded that prayers for patients recovering from bypass surgery had no effect. The study was led by researchers at Massachusetts General Hospital.

Every state forbids child abuse and requires parents to provide health care. But in the 1970s and 1980s, many states added provisions offering legal protections to parents who used prayer treatment. Many of these statutes were passed after Congress in 1974 began offering money to bolster child-protection agencies. But there were strings. Federal health
and welfare officials, pressed by Christian Scientists, made the funding contingent upon the requesting state legislating legal safeguards for those opting to treat with prayer.

In all, 45 states offer some legal accommodations in child-protection laws for parents who use spiritual healing, according to the Christian Science church. The laws vary widely, with some states protecting parents or guardians from felony abuse or murder prosecutions, while others exempt prayer practice only in misdemeanor cases, according to Children's Healthcare Is a Legal Duty Inc., a nonprofit group based in Sioux City, Iowa, that opposes such laws.

Wisconsin has three statutes providing religious healing exceptions: one in the child-abuse laws, one in the laws concerning crimes against children, and one that bars the state from forcing medical care on someone who chooses Christian Science prayer. The state's child-abuse laws were amended in 1987 to say: "A person is not guilty of an
offense ... solely because he or she provides a child with treatment by spiritual means through prayer alone for healing." The wording was requested by the local Christian Science government-relations office, according to the Wisconsin Legislative Council, a state agency.

A 1998 study in the journal Pediatrics, by Rita Swan, president of Children's Healthcare Is a Legal Duty, and Seth Asser, a Rhode Island pediatrician, reported that 172 children died with no medical care because of religious reasons in the two decades after states began exempting faith healing. Of those, 140 children had a greater than 90% chance of survival
if they had been treated medically, the researchers found. "Some of the religious defenses to felonies are a chilling betrayal of children," says Ms. Swan, a former Christian Scientist who lost a child to spinal meningitis in 1977 after initially relying on church practitioners before finally seeking medical help.

Although many states allow medical personnel to seek court orders to provide emergency care if a sick child is denied treatment, parents who rely on religious healing often don't inform doctors and hospitals of their children's condition.

Since 1982, states have filed criminal charges in the deaths of 65 children whose parents practiced faith healing, according to Ms. Swan's count. The prosecutions have had mixed results.

In California, the state Supreme Court in 1988 upheld the conviction of a mother found guilty of involuntary manslaughter and felony child endangerment after she used a Christian Science healer to care for her 4-year-old daughter. The child died of meningitis. The justices found that the religious-healing clause in the state child-neglect statute was not a defense in a felony death case.

But three years later, Minnesota's Supreme Court reached the opposite conclusion. The court dismissed second-degree-manslaughter charges against Christian Scientists William and Kathleen McKown. Her son, Ian Lundman, died at age 11 of diabetic ketoacidosis, or severe, untreated diabetes. The justices ruled that the government couldn't allow someone
to "depend upon" Christian Science healing methods "then attempt to prosecute them for
exercising that right."

The court will have to wrestle with a similar legal dilemma in Wisconsin. The judge will have to decide if the Neumanns believed they were acting lawfully in choosing to treat their child with prayer. The district attorney's office declined to comment and the lawyer for the Neumanns didn't return phone calls. The judge has imposed a gag order in the case.

Christian Science church members nationwide have lobbied lawmakers not just to allow spiritual healing, but to exempt members from mandatory health insurance and to allow insurance carriers to reimburse spiritual healers. And believers in spiritual healing have chalked up some recent wins. Iowa last year allowed parents for religious reasons to opt out of mandatory childhood screenings for lead poisoning.

Massachusetts, the only state that requires residents to have health insurance, allows residents to opt out of buying medical insurance for religious reasons.

Church lobbyists are now asking that the state allow insurance plans to reimburse prayer practitioners, who can charge $20 to $50 for a day's worth of prayer, says Wanda Jane Warmack, the church's legislative manager.

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