Christian Science healing of minor children: spiritual exemption statutes, First Amendment Rights, and fair notice.

• Author: Merrick, Janna C.

In August 1993, the Supreme Judicial Court of Massachusetts overturned the manslaughter convictions of David and Ginger Twitchell in the death of their two-year-old son, Robyn.(1) This became the latest in a series of prosecutions and appealed verdicts involving Christian Science parents who relied solely on spiritual healing and whose children died of illnesses generally recognized as highly treatable with conventional medicine.(2)

These trials have raised a host of legal and ethical questions that are not easily resolved. Most have directly confronted questions relating to first amendment guarantees of freedom of religion and fourteenth amendment guarantees of due process, specifically fair notice of potential criminal conduct. Equal protection also lurks as a constitutional issue, and broader issues of parental control of children, potential conflict of rights between a parent and child, and government intrusion into the privacy of the family also are integral to the debate.

At the heart of the debate is a dispute regarding the meaning and implementation of the first amendment, which simultaneously provides that the government "shall make no law respecting an establishment of religion" and no law "prohibiting the free exercise thereof."(3) This nation was founded by immigrants seeking relief from religious persecution, and the Constitution is clear in its intent to prohibit such persecution. The Church of Christ, Scientist, was founded on the theological principle of healing the body through devout prayer in lieu of conventional medical care. As will be discussed below, most states have clauses in their child medical neglect statutes that allow exemptions for spiritual healing in lieu of conventional medical care.(4) This raises the question of whether such exemptions violate the first amendment's prohibition on laws respecting the establishment of religion.

An equally important issue is whether the exemptions shield parents from prosecution under involuntary manslaughter statutes. Has the fair notice requirement of due process been violated because of the seeming contradiction between the spiritual healing exemptions, which appear to recognize prayer as a form of healing, and the requirement of gross negligence that is necessary to support a manslaughter conviction? Specifically, may Christian Science parents who eschew conventional medical care for their children and rely instead on prayer be prosecuted for manslaughter if a child dies? This seeming paradox is addressed in every case to reach the state supreme court level.

While the first amendment and due process issues have dominated the legal arena thus far, questions of equal protection also merit discussion. In some states he exemptions apply only to members of organized religious groups that rely on spiritual healing. In these states protection is not afforded to parents who may have a personal belief in spiritual healing but do not belong to organized religions that, as part of their theology, advocate reliance on spiritual healing.(5) In these states, for example, Christian Scientists could claim protection of religious freedom when they refuse medical care for a child, but theoretically Catholics and Methodists could not because reliance on spiritual healing is not part of their theologies.

Even in states whose spiritual exemption clauses do not specifically reference organized religions, a claim of violation of equal protection could be made because the law provides to one class of citizens what it denies to others. That is, the law allows parents who rely on spiritual healing to avoid conventional medical care for their children but mandates it for other parents. For example, in 1984 Congress enacted the so-called "Baby Doe" amendments to the Child Abuse Prevention and Treatment Act, the same statute that provided the basis for the regulations containing the spiritual exemption clauses.(6) These amendments require treatment for newborns under certain circumstances.(7) Thus parents claiming reliance on prayer can refuse conventional medical care for their newborns even if it results in death, while other parents who object to treatment because they disagree with the child's diagnosis or prognosis are denied the right to forgo conventional medical care.(8)

Moreover, it is important to ask if the children involved in these cases have been denied the equal protection of the law.(9) The child of Christian Science parents may be denied access to conventional medical care, which in some cases means denial of potentially lifesaving treatment, based on parental religious beliefs, while theoretically the child of the Catholic or Methodist parent will receive conventional medical care. It is important to note that, in the cases to reach state supreme courts, parents chose to rely on spiritual healing based on their own beliefs. None consulted their children, and in fact none of the children in question was a member of the church because all were too young to join.

A discussion of the rights of children to equal protection of the law leads naturally to a discussion of parental rights, potential conflict of rights between parent and child, and privacy of the family. It has long been established both ethically and legally that an adult patient can refuse to consent to medical treatment even if such refusal results in his or her death.(10) Treatment of an adult without consent constitutes civil battery by the physician against the patient.(11) The law is much less clear, however, regarding the treatment of children. Typically, consent for children is given by their parents or guardians. When parents refuse consent to potentially lifesaving therapy, physicians and hospitals have often sought court orders to coerce treatment. Such intrusion into the privacy of the family is problematic because it introduces third-party actors, usually government officials, into family matters.

Even if one accepts the proposition that government agencies should intervene in these matters, a special dilemma exists regarding Christian Science parents. Since Christian Scientists eschew conventional medical care (with a few exceptions discussed below), their children do not come into contact with the health care delivery system, and therefore physicians, hospitals, and social welfare agencies may be unaware of their medical needs. Obviously, then, government agencies will not intervene.

The Church of Christ, Scientist, is on a collision course with the state and the medical community over how the children of Christian Science parents will be treated for illnesses. Increasingly the church, its officials, and its members are under fire both in the news media and in the courts. In 1993, the divorced father of a child who died in 1989 won a $14.2 million wrongful death suit against his former wife, her husband, church officials, and the church itself.(12) With the great visibility that these cases have drawn, it is likely that more cases will develop in the future. Typically, public policy operates in response to social controversies, rather than in anticipation of them. It is time for public policy to squarely address the apparent conflict between spiritual healing exemptions and manslaughter statutes. This article will analyze the theological foundations of the Christian Science Church, discuss the adoption of spiritual exemption laws, and analyze the four Christian Science cases decided by state supreme courts. The article will conclude with a call for the abrogation of spiritual healing exemptions.

Principles of Christian Science Theology

The Church of Christ, Scientist, was founded in 1879 by Mary Baker Eddy. In keeping with the biblical injunction not to "number the people," the church does not keep membership records, and therefore accurate statistics on church membership are unavailable. The Mother Church (the church's headquarters) is located in Boston and has more than three thousand branch churches and societies worldwide. The church does not ordain clergy and relies on its lay members to conduct church duties.(13)

Healing through prayer is at the center of Christian Science theology. Eddy experienced chronic illness during her young adult years and was bedridden much of the time. Her search for a cure ended in 1866, when she was suddenly healed from injuries received in a severe fall. This healing occurred, she believed, as a result of reading the New Testament, and it not only cured the injuries from the fall, but also cured her other chronic ailments and led to her belief that spiritual healing was a natural part of Christian life.(14)

Christian Science parents do not view spiritual healing of children as sacrificing their children's health needs. Despite the common characterization that they are making their children martyrs to their own religious beliefs, they pursue this form of healing because they believe it to be the most effective. While Christian Scientists do not deny that disease has physical manifestations, they believe God does not cause or permit it, and therefore it is wrong to resign oneself to being ill.

The basic Christian Science 'diagnosis' of disease involves the conviction that whatever apparent forms the disease assumes, it is in the last analysis produced by a radically limited and distorted view of the true spiritual nature and capacities of men and women. To take a medical analogy, a Christian Scientist regards all forms of disease as symptomatic of an underlying condition that needs to be healed. This is the healing, or spiritual wholeness, that he or she seeks to effect through prayer.(15)

According to Eddy, "[Jesus] proved by his deeds that Christian Science destroys sickness, sin, and death."(16) Thus healing results from drawing close to God by following a way of life involving deep prayer, moral regeneration, and an effort to live in accord with the teachings and spirit of the Bible.(17)

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