Art Caplan on children's medical care and prayer
In his latest column for MSNBC, Art takes on cases where parents don't seek medical care for their children because of religious objections:
Ava Worthington is dead. She was only 15 months old when she died. The people responsible are her parents, who relied only on prayer as their child expired before their eyes. The question is whether they deserve to be put on trial for doing so. I think they do.
Ava succumbed on March 2 to bronchial pneumonia and a blood infection, problems easily treated with antibiotics. But Ava's parents, Carl and Raylene Worthington of Oregon City, Ore., do not believe in antibiotics. As Ava struggled for days to breathe, her parents prayed, never calling a doctor, an ambulance or 911.
The Worthingtons belong to a small fundamentalist sect, The Followers of Christ Church. The Followers believe that faith will heal all and that death, if it comes, it is God's will.
In fact, death has come often to the children of the Followers. Before Ava, other children died in circumstances where simple, well-proven medical treatments might have saved them. According to an investigative report done some years back by Mark Larabee of The Oregonian newspaper, at least 38 young children lie in graves in the church's cemetery in Oregon City. And the Followers have reported a suspiciously high number of stillborn deaths in recent years.
Ava Worthington is not the only child to become a victim of prayer in recent weeks. Madeline Neumann, 11, of Weston, Wis., died March 23 from an easily treatable form of diabetes after her parents chose to rely on prayer. According to news reports, Madeline spent a month suffering from nausea, excessive thirst, vomiting and and loss of mobility before she died.
So far, nothing has been done to punish the Neumanns. Rarely do the authorities take action, because many states have laws that permit exceptions to required medical care if prayer is involved. That sad circumstance may be about to change.
Oregon authorities have charged the Worthingtons with manslaughter and criminal mistreatment in connection with Ava's death. They should. Not to punish her parents but to make it clear that Americans will not tolerate the neglect and abuse of children in the name of religion.
Any adult has and should have the right to refuse medical care. That option is sometimes chosen by Jehovah's witnesses who refuse blood transfusions, Christian Scientists who prefer to rely on faith, or others who don't want to use Western medicine and would rather follow another healing philosophy.
Such decisions make little sense in light of the data showing the ability of modern medicine to treat diabetes, acute trauma, deadly infections, and other life-threatening diseases and injuries. But they are decisions that ought to be respected nonetheless. The same legal and public policy stance should not extend to children.Parents do not have the right to watch a child wither away while they pray. Parents do not have the right to watch a child convulse in pain while they pray. Parents should understand that if a child is in agony, if a child is slowly dying before their eyes, that they have an absolute duty, the same as any other parent - religious or not - to call the police, an ambulance or emergency services.
Society must make the protection of children a core value. The way to do that is to make it clear that child neglect is still neglect, even when performed under the cover of religious faith. So, the authorities in Oregon should prosecute Ava's parents. It is important, even if they never serve a day in jail.
We need to send the right message to parents - you can rely on prayer, but not when your child's life clearly hangs in the balance. When it comes to children, faith must have limits.
Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.
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- by www.Watchtower.org on Apr 1, 2008 at 6:35 AM | link
Don't belive "in" antibiotics, or don't believe they *should* be used? That seems like a big difference to me.
- by emily on Apr 1, 2008 at 9:20 AM | link
Everybody doesn't believe in Western medicine. Western medicine is not all that effective to begin with. Who is to say that the girl would have lived if given antibiotics? How many times has a placebo been as effective or more effective then Western medicine? Shouldn'ta parent have a right to refuse medicine for their child? They did birth the child and have legal guardianship over the child. If this is the case, we should allow hospitals or law to make all of our decisions regarding life.
- by Kenyata Truth on Apr 3, 2008 at 7:18 AM | link
Rational people should believe in 'Western' medicine that reliably works as demonstrated by the experimental method, as it would have in this case. Moral people should take responsibilty for depriving their children of this effective medicine *even when they believe that was the right choice*.
We all have the right to our beliefs, but society does not always allow us to kill or allow people to die based on them.
- by emily on Apr 3, 2008 at 10:24 AM | link
Who is to say that the girl would have lived if given antibiotics?
-Doctors
How many times has a placebo been as effective or more effective then Western medicine?
-Never
Shouldn'ta parent have a right to refuse medicine for their child?
-No
If this is the case, we should allow hospitals or law to make all of our decisions regarding (a child's) life.
-Not neccesarily true, but sometimes.
Adults are free to do whatever idiotic thing to themselves that pops up in their heads, but children deserve protection until their old enough to make their own decisions. A child isn't your property to do with as you like.
- by Drekab on Apr 3, 2008 at 7:36 PM | link
I don't support withholding medical treatment from children. Happily, my religious beliefs don't ask me to.
But let me throw this out there.
My daughter suffered horribly from ear infections until 3rd grade. She had tubes twice, and had enough antibiotics to stop a plague, and still she went through agonies and ended up with measurable hearing loss. I've had an ear infection once since reaching adulthood and could not believe the pain. Did I worry about the antibiotics? Of course, but I couldn't let her go through all that without the one thing that seemed to help. So why did all of this stop abruptly in 3rd grade? Because we happened to see a new doctor, about something else, and he suggested taking her off of dairy products. Bingo.
In her teens, my daughter developed rheumatoid arthritis, probably as a result of all of that antibiotic use. Did I take her to a rheumatologist and get her started on all that scary toxic stuff you can find on the internet? Hell no, we let that pediatrician who solved her ear infection problem help us manage it, with glucosamine and turmeric, a food ingredient which is also a natural anti-inflammatory. Happily, her symptoms have been declining in the past couple of years. She goes for weeks without pain, and sometimes her knuckles actually look normal.
I guess the point is that sometimes western medicine is wonderful (couldn't do without my primidone for essential tremor and my nadolol for migraine) and sometimes it isn't all that. For me to be very judgmental about a parent who doesn't seek medical attention for his/her kid I'd have to be convinced that the parent knew that the kid's condition was life-or-death and that the condition had an effective treatment.
One article says, "The girl's mother, Leilani Neumann, said the family believes in the Bible and that healing comes from God, but she said they do not belong to an organized religion or faith, are not fanatics and have nothing against doctors."
This looks to me like a tragic case of poor judgment.
- by Laura(southernxyl) on Apr 3, 2008 at 7:49 PM | link
But wasn't the doctor with the nutritional advice also part of 'Western medicine'.
Medicine, which is not necessarily western anyway, is the use of therapeutics proven to work through empirical study--not synonymous with 'artifical pharmaceuticals'.. Choosing not use use a proven therapy is something that IMHO should only be done for strong reasons, and the legal system may overide people sometimes even then.
Suggesting the subsitition of proven medicien for prayer alone is okay because medicine doesn't work beggars beleif. Even if it doesn't work 100% there is not reason not to do both based purely on efficacy above baseline levels.
Refusal to use medicine in this case must come down to the idea that even lifesaving treatment sof this type are somehow immoral?
- by emily on Apr 4, 2008 at 3:12 PM | link
There is a difference between treating chronic conditions with good nutrition and lifestyle adjustments and treating acute symptoms with medication. It is true that antibiotics would relieve the ear infection, but it was ultimately more effective to use deductive reasoning (a Western logical method often used in science and medicine) to find the root cause - dietary issues. Just because a chronic condition was corrected with a lifestyle change doesn't mean that "Western medicine" is ineffective; it simply wasn't appropriate to permanently fix what was wrong. Prayer, on the other hand, is not a lifestyle change, nor is it supported by any sort of logic or reasoning other than an acceptance that it is okay to let your child die while you stand by. If the parents' faith is that strong, then they should be willing to face criminal charges if their child dies since their religion carries more weight in their minds than any Earthly authority.
My mom figured out the dairy issue on her own for my brother by selectively eliminating certain food from his diet and observing. She believes that parenting means you use logic and reasoning to set up a good environment for your child. But when he went into anaphylactic shock from ingesting an allergen, you bet she called 911 immediately and kept epipens around after that.
- by SabrinaW on Apr 6, 2008 at 1:29 PM | link
I respect faith, but child neglect is still child neglect even when performed under a religious cover. They say it's "God's will" but, I don't think God would want his children dying. If it's anything to lose, it shouldn't be our beloved future.
- by Ilga on Apr 24, 2008 at 4:24 PM | link