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II.
HHS Policy Jeopardizes the Lives of Children
HHS
Policy of Transferring Responsibility From Parents to the
Reporting System, Coupled With the Reporting System's Inherent
Difficulty in Detecting Medical Neglect, Flagrantly Jeopardizes
the Lives of Children
The
flagrant contradiction in HHS policy is to absolve parents
from civil responsibility to provide medical care, no matter
how serious the child's condition, while at the same time
placing children's lives in the hands of a system that cannot
reliably detect their need for care.
Herein
lies the (literally) fatal flaw in HHS's "reformist" efforts,
and herein lies the stark the imperative that HHS must undo
its original, tragic mistake and insist that states repeal
their religious exemption laws. Only repeal will actually
provide religiously neglected children with the same proper
legal standard of care available to all other children.
The
plain truth is that HHS's policy cannot protect many of
the children who are victims of medical neglect because
of the practical impossibility of adequate detection. At
the same time, state reporting and treatment systems can
never be expected to function as an exclusive substitute
for parental responsibility and protection for an entire
class of children. Parents have 24-hour care of their children
and are in the best position to know their condition. State
systems simply cannot monitor the health of an entire class
of children.
In order
to understand why the state bureaucracy cannot be successful
in preventing religiously-based childhood death, it is necessary
to understand why the system is doomed to fail in adequately
detecting religious medical neglect.
The
Detection Problem
HHS
policy is to require total reliance on the civil reporting
and treatment system for providing life-saving medical care
to victims of religious medical neglect. Such care cannot
be provided unless the system can detect such cases.
The critical problem is: who will know the condition of
the child, and will the person(s) who know make a timely
report?
There
are two distinctly different classes of children for whom
the detection issue is relevant:
- those whose need for care will occur within the medical
system, and
- those whose illnesses occur entirely outside the system.
For
the first group, detection is usually routine, and the child's
life is generally protected. The children of Jehovah's Witnesses
fall within the first category.
Jehovah's
Witnesses usually take their children to doctors and do
not object to most medical procedures; the objection is
only to blood transfusions. Children of Jehovah's Witnesses
who need a transfusion are known to doctors who can and
routinely do seek court orders.
The
illnesses of Christian Science children and children of
certain faith-healing sects often occur entirely outside
the medical and reporting systems. Often the families and
other church or sect members are the only ones who know
of the child's serious condition. The religious imperative
of Christian Science and other sects is, in most cases,
to entirely reject medical care and to rely exclusively
on prayer healing. In Christian Science, childhood illnesses
usually occur within an entirely separate "healing system"
which includes spiritual healers, Christian Science nurses
(with no medical training), as well as church officials.
This entire structure effectively insulates the parents
and the child from accessing the medical or reporting systems.
Church peer and authority pressures aid in this insulating
effect.
The
following is a direct quotation from the Christian Science
manual for parents, Legal Rights and Obligations of Christian
Scientists in California, 1984 Edition:
If a child is being given Christian Science treatment
for an illness, inquiries made by school or other public
officials as to care of the child should be answered with
assurance that such child is being given good care and is
having treatment for the illness. Otherwise, such officials
may conclude that the child is a neglected child. In talking
with such officials, a parent should stay clear of statements
such as "belief of illness" or "claim of sickness" which
may result in the officials thinking that the illness is
being ignored or treated as a fanciful aberration of some
kind. (emphasis in original)
The
Church, effectively, is instructing parents on how to avoid
detection of their children's illnesses by the reporting
system.
Church
Healers Do Not Make Neglect Reports
Christian
Science spiritual healers cannot be expected to report the
serious illnesses of Christian Science children. These healers'
sole treatment consists of prayer. Often they treat over
the telephone "at a distance" (sometimes across state lines)
and have no on-the-scene knowledge of the child's condition.
The
Church specifically tells its practitioners and "nurses"
not to report suspected communicable diseases to Public
Health, saying they "must avoid any appearance of attempted
diagnosis, since to do so would be to engage in the unlawful
practice of medicine." (Legal Rights and Obligations
of Christian Scientists in Minnesota, 1976 edition,
p. 14). Christian Science practitioners utilize a method
of "spiritual healing" which relies exclusively on prayer
to heal all forms of childhood illness. Practitioners have
no training in medical diagnosis or treatment methods. Moreover,
many states have statutes treating Christian Science treatment
as "privileged religious communication", thereby exempting
from reporting much of the practitioner's communications
with the family and child.
It will
be extremely difficult, perhaps impossible, for states to
get religious healers, who make their living encouraging
parents to rely on their methods and who believe them to
be divinely ordained, to report children under their care
as suspected abuse and neglect cases. And many charismatic
groups arising in recent years have no ordained clergy.
What language will mandate reporting within such groups?
Even
when state laws specifically require Christian Science practitioners
to report serious illness, the experience is that they do
not do so. For example, Pennsylvania law requires Christian
Science practitioners to report medical neglect. However,
in 1981, Kris Ann Lewis died of bone cancer. The Christian
Science practitioner who "treated" Kris Ann for many months
testified in Court that she did not report the case to state
officials because she did not believe the child was neglected.
The practitioner was not prosecuted.
In 1986,
7-year-old Amy Hermanson of Florida died of diabetes because
her Christian Science parents would not provide her medical
attention and life-saving insulin. She had been clearly
ill for over a month and no one, not her teachers or her
parents' friends, made a report. It was not until a day
before her death that her aunt reported the situation to
authorities. A hearing was held but Amy died at home before
the state could order medical care. Florida has an ironclad
law that Christian Science practitioners must report sick
children deprived of medical care. Despite this law, the
practitioner who treated Amy made no report. The parents
retained a practioner in Indiana to treat Amy "at a distance."
The State of Florida did not charge the practitioner with
failure to report since it could not extradite for a misdemeanor.
Exemptions
Encourage Shieldings of Children's Illnesses From the Reporting
System
Religious
exemptions both in the civil and criminal codes significantly
reinforce parental incentives for non-cooperation with the
reporting system.
The
civil exemptions, by either appearing to allow exclusive
parental reliance on spiritual healing or, at least by permitting
such reliance within hard to determine limits, explicitly
encourage parents to avoid detection of their children's
illness. The exemptions and HHS policy send the message:
if you do it, it's okay; but if we find out, then it may
not be okay and you may not be able to do it. So the natural
inclination is to try to defeat the reporting system by
avoiding detection.
Return
to top.
Table
of Contents:
-
HHS Policy on State Religious Exemptions
- HHS
Policy Jeopardizes the Lives of Children
HHS Policy on Transferring
Responsibility for Providing Medical Care From Parents
to the Reporting System, Coupled With the Reporting System's
Inherent Difficulty in Detecting Medical Neglect, Flagrantly
Jeopardizes the Lives of Children
- Civil
Exemptions Undermine Parental Legal Responsibility
Despite Denials by HHS, Civil Exemptions Undermine
Parental Legal Responsibility to Provide Care
- HHS's
Current Attempts to Clarify Are Limited and Problematic
HHS's Current Attempts to Clarify the Impact of the
Exemptions on State Reporting Systems are Meeting With
Only Limited and Problematic Results and May Be Intrinsically
Incapable of Success
-
Conclusion
Appendix:
Cases
of Childhood Deaths Due to Parental Religious Objection
to Necessary Medical Care
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