A legislative working group recently held hearings regarding whether to amend an Idaho statute that protects parents who choose prayer over allopathic medicine. The issue gained considerable media attention when Dan Sevy, a leader of the Followers of Christ church, testified that “medicine is a product from Satan” and promised to resist any changes to the law.
According to the statute, as it now stands, “a parent or guardian who chooses for his child treatment by prayer or spiritual means alone shall not for that reason alone be construed to have violated the duty of care to such child.” Supporters of reform have characterized this as an issue of child welfare, citing several preventable deaths; opponents see repeal of “faith healing” protections as a threat to religious freedom. So far, compromise is elusive.
As a general principle, American law requires parents to accept essential health care for their children. Courts follow a dictum laid out by Supreme Court Justice Wiley Rutledge in the seminal case of Prince v. Massachusetts: “Parents may be free to become martyrs themselves. ... [I]t does not follow they are free ... to make martyrs of their children before they have reached the age ... when they can make that choice for themselves.”
However, in that same case, Justice Robert Jackson — who later gained fame for prosecuting Nazi war criminals — articulated an alternative approach to such matters. He proposed that “religious activities which concern only members of the faith are and ought to be free,” but the state ought to intervene wherever “activities begin to affect or collide with liberties of others or of the public.” (For comparison, we allow the Amish — but not others — to teach their children cabinet-making instead of American history.)
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Sevy has argued that rejecting medicine affects only church members. Yet, this is always clear. An infant might perish from an untreated cardiac defect. Alternatively, she might survive to adulthood and require a costly, taxpayer-funded heart transplant in her 20s.
Another factor is whether families and doctors share a common understanding of the facts. One can distinguish between a parent who refuses lifesaving care, knowing their child might die but fearing medicine will interfere with salvation, from a parent who insists that modern medicine simply does not work. Jehovah’s Witnesses, for example, acknowledge blood transfusions can save lives, but believe the result would be eternal damnation.
The Jehovah’s Witnesses parent’s calculus regarding medicine is fundamentally different from a parent who claims, against empirical evidence, that medication lacks efficacy.
Advocates for and opponents of the “faith healing” statute share a common goal: the welfare of children. Both sides are sincere in their beliefs. Yet parents and families are those individuals who have to deal most acutely with the suffering of pediatric illness, the grief of loss and the perceived moral choice between physical health and spiritual well-being. Some, but not unlimited, deference is due their poor but well-intentioned choices.
One solution might be for the Legislature to narrow the current exemption to cases where two criteria are met: 1) a judge finds that the decision will not have an impact outside the child’s insular community; and 2) when all parties agree to the underlying medical facts, merely disagreeing on the morality of treatment, rather than its efficacy. Idaho could help set a national example by embracing this middle ground.
Jacob M. Appel is a physician, attorney and bioethicist based at the Mount Sinai School of Medicine in New York City. He has published and taught extensively on the relationship between religious minorities and medicine.