Why Parents Shouldn’t Be Able to Refuse Medical Treatment for an Ill Child
[One of 50 articles written and published for Demand Media in 2013]
Legally, refusal to provide or access medical care for children can be termed medical neglect. According to the latest available national statistics, documented child abuse and neglect in 2011 affected more than 675,000 children, or nearly 1 in a 100 kids. On average, 3 percent was stemmed from medical neglect in 41 reporting states. Some states average higher. Arkansas’ medical neglect rate is 7.5 percent, while the District of Columbia, Georgia, New York and Puerto Rico all average about 5 percent. The lowest rates are in Delaware and Utah at 0.04 percent and 0.02 percent respectively, plus both Wisconsin and Nebraska at 0.01 percent.
Medical neglect can have several causes, including economic hardship, lack of access to care or health insurance, family chaos and disorganization, lack of awareness, knowledge or skills, lack of trust in health care workers, impairment of caregivers, caregivers’ beliefs and children’s behavior, according to a 2007 article in the journal “Pediatrics.” Of these causes, two can involve active refusal of care: caregivers’ belief systems and children’s behavior.
In most instances, medical neglect is legally actionable. The exception is faith-based exemptions, which are written into law in most states, according to Childhealthcare.org. These exemptions vary in scope. Forty-eight states permit exemption from immunization programs. Most states permit exemption from metabolic testing of newborns that can detect developmental problems, including some that can be prevented with treatment. Ten states have religious exemptions for eyedrops that can help prevent blindness in children who contact a venereal disease carried by their mothers. Seventeen states have religious exemptions to felony crimes against children.
A study titled “Child Fatalities from Religion-Motivated Medical Neglect” in the American Academy of Pediatrics journal found that of 172 cases of child fatalities attributed to faith-based medical neglect, 140 had excellent (90 percent positive) prognosis with standard treatment. Many of the remaining 32 children were treatable, with good outcomes likely. The consequences of not participating in immunization programs can be widespread. In 1991, “The New York Times” reported on an outbreak of 492 measles cases in Philadelphia that led to the deaths of six children, two of them unrelated to the Faith Tabernacle and First Century Gospel churches at the center of the outbreak. A later check of the Faith Tabernacle school found 201 of the children in attendance had never seen a doctor.
Most faith-based cases of medical neglect leading to illness and death are preventable. The nonprofit educational charity Children’s Health Care Is a Legal Duty lists other treatable conditions that resulted in the deaths of children in the care of Christian Science parents between 1974 and 1994; five by meningitis, three of pneumonia, two of appendicitis, five of diabetes, two of diphtheria, one of measles, one of septicemia, one of a kidney infection, one of a bowel obstruction, and one of heart disease. In the Philadelphia outbreak, three children were hospitalized under court order to ensure treatment. However, as long as religious exemptions remain in place, the justice system has legal limits on what they can do.
American Academy of Pediatrics: Religious Objections to Medical Care
U.S. Department of Health and Human Services, Administration for Children and Familes: Child Maltreatment 2011 report
U.S. Department of Health and Human Services, Administration for Children and Familes: Child Neglect: A Guide for Intervention
American Academy of Pediatrics: Recognizing and Responding to Medical Neglect
American Medical Association: Miracle vs. Medicine: When Faith Puts Care at Risk