— The U.S. Supreme Court ruled in Prince v. Massachusetts (1944) that parents’ religious beliefs do not give them a constitutional right to engage in practices that compromise a child’s health or safety. Why, then, does Pennsylvania have a religious exemption clause that protects parents from child abuse and neglect laws? Why is it that both pending Pennsylvania House and Senate bills, which are attempting to redefine child abuse, continue to endorse the religious exemption clause? This exemption has contributed to scores of preventable deaths of children. Some parents believe it is not only legal but safe to rely exclusively on faith for healing a child when the law appears to endorse the behavior. Some of our public officials have said Pennsylvania parents have a legal right to withhold medical care on religious grounds. Criminal charges have been filed in only three of the 24 deaths of Philadelphia-area children in faith-healing sects.
Consider, for example, the recent death of 9-year-old Benjamin Reinert. Someone reported his illness to Child Protective Services who visited the family twice, but the father, who believed in faith healing, told the social workers the boy just had “a sore foot.” The worker noted that the foot was “not swollen or bruised” and believed the father’s claim that the boy had only a minor injury. The next day the boy died of leukemia. The medical examiner found that the boy was severely anemic, his brain was swollen, and the cause of death was acute lymphoblastic leukemia. Acute Lymphoblastic Leukemia is the most common type of childhood cancer and has a cure rate of more than 90%. The Philadelphia Department of Human Services was quick to use the words of the statute to justify their actions on the case. Commissioner Alba Martinez said the DHS had “closely monitored the situation, but could not obtain a court order because the boy’s injuries did not appear life-threatening.” While they did not appear life threatening to the social workers, the symptoms would have concerned many others. A pale face along with pain so severe that the boy could not walk in addition to a boy who remained in bed and was too tired to talk should raise concerns. Most reasonable parents would at least call a health care professional for advice about those symptoms. The Pennsylvania law, however, exempts the faith-healing parents from civil abuse charges when they refuse to get medical help. Instead, it directs county social workers to “closely monitor” the sick child and to intervene only if long-term damage is threatened. But social workers cannot monitor a child’s condition as closely as parents can and should. Furthermore, social workers are not competent to diagnose. They do not have the training to know when a child has a life-threatening illness. In the Faith Tabernacle cases, they are dealing with children whose religion prohibits immunizations, well-child checkups, medication, medical diagnosis and even home monitoring of illnesses as with a thermometer. In cases similar to this it would be important to require child protection workers to consult with state-licensed health care providers when they are investigating reports of suspected medical neglect. It would also be important authorizing a court to order a medical diagnosis if the caseworker is unsure as to whether the child has a trivial, self-limiting illness. Under current law the child protection workers are directed to seek a court order only when the failure to provide medical care “endangers the child’s life or development or impairs the child’s functioning.” In many cases a medical diagnosis may be needed to make that determination.
Consider, for example, the death of 8 month old Brandon Schaible: His parents let Brandon’s 2yo brother Kent die of a vaccine-preventable pneumonia in 2009 without medical care because of their allegiance to the First Century Gospel Church. They were convicted of involuntary manslaughter and sentenced to ten years probation which required them to take their surviving children to doctors and get medical care if a child became sick. Probation officers visited this family of six or more children once a year. Baby Brandon was seen by a doctor once when he was 10 days old. He suffered for a week with diarrhea and respiratory difficulties before he died. After Herbert and Catherine Schaible let their toddler Kent die without medical care in 2009, they openly told Pennsylvania authorities both before and after they were convicted of manslaughter that they would do the same thing with another child. The religious exemption clause forced child protection services to withdraw from monitoring the Schaible family five days after Kent died. Longer term monitoring was certainly needed. The religious exemption to child abuse statute (23 Penn. Stat. 6303(b)(3) needs to be repealed. The Commonwealth needs to send a clear, consistent message that its children have equal protection under the law. Therefore, all parents must have a duty to provide medical care when needed to prevent substantial harm regardless of their religious beliefs.
Pediatrician Seth Asser has published a study of 172 deaths of children when medical care was withheld on religious grounds. He found that 140 of the children would have had at least a 90% likelihood of survival with medical care. Brandon and Kent Schaible as well as Benjamin Reinert died because their parents’ religious convictions would not permit them to seek medical attention. These children died of medical conditions that could have been easily treated. The parents’ rights were obviously followed but what about the rights of the children: Why is it that in our enlightened society one can harm a child by withholding common medical treatments and escape with relative impunity?
The American Academy of Pediatrics asserts that (1) the opportunity to grow and develop safe from physical harm with the protection of our society is the right of every child; (2) the basic moral principles of justice and of protection of children as vulnerable citizens require that all parents and caretakers must be treated equally by the laws and regulations that have been enacted by state and federal governments to protect children; (3) all child abuse, neglect, and medical neglect statues should be applied without potential or actual exemption for religious beliefs; (4) no statute should exist that permits or implies that denial of medical care necessary to prevent death or serious impairment to child can be supported on religious grounds; (5) state legislatures and regulatory agencies with interests in children should be urged to remove religious exemption clauses from statutes and regulations.
These are preventable deaths in our most innocent and vulnerable children. Please contact your legislators to have the religious exemption clause in the pending legislations repealed.
Dr. Pat Bruno, Selinsgrove