All states try to protect children from neglect, abandonment and mistreatment, such as deprivation of clothing, shelter, food and medical care. This includes civil laws which permit the removal of a child from the home and other protective interventions. Criminal laws protect children as well by, for example, making nonsupport a misdemeanor or criminal neglect a felony.
Washington State law prohibits criminal mistreatment of children and other vulnerable persons, such as the frail elderly, by their caregivers. Criminal mistreatment is defined as the “deprivation of the basic necessities of life:”
food, water, shelter, clothing, and medically necessary health care, including but not limited to health-related treatment or activities, hygiene, oxygen, and medication.
Mistreatment can be either a misdemeanor or felony, depending on whether the defendant’s conduct amounts to criminal negligence or recklessness and the degree of harm caused to the victim. Punishment ranges from 90 days in jail and a $1,000 fine to 10 years in jail and a $20,000 fine.
Unfortunately, parents and other caregivers in Washington have what amounts to an almost literal “get out of jail free” card if the mistreatment takes the form of “treatment” by “duly accredited” Christian Science practitioner:
It is the intent of the legislature that a person who, in good faith, is furnished Christian Science treatment by a duly accredited Christian Science practitioner in lieu of medical care is not considered deprived of medically necessary health care or abandoned.
In other words, if a parent negligently or recklessly fails to get adequate medical care for his diabetic child, the parent could be prosecuted for criminal mistreatment. But if the parent calls in a “duly accredited” Christian Science practitioner to pray over the child instead, his conduct may be excused, even if the child suffers “great bodily harm,” in the words of the criminal mistreatment statute.
Washington law also requires the reporting of suspected child abuse or neglect to child protective services and law enforcement, who can take action to protect the child and institute criminal proceedings against the alleged abuser. Abuse or neglect includes activity that presents a danger to the child’s health, welfare or safety. Here, again, parents who employ Christian Science practitioners are given a legal pass:
A person who is being furnished Christian Science treatment by a duly accredited Christian Science practitioner will not be considered, for that reason alone, a neglected person for the purposes of this chapter.
Two bills currently pending in the Washington Legislature would repeal this special treatment for parents and caregivers who deny their children and other vulnerable people proper medical care by hiding behind a religious exemption. We’ll return to those bills in a minute.
The Christian Science political juggernaut
Christian Science is a small, secretive denomination that holds beliefs unique to Christianity and whose operations fulfill several requirements for characterization as a cult. Its association with the illness and death of children due to withholding medical care is well chronicled. Save for a few other small, fringe sects, no other Christian denomination so thoroughly rejects medical care or views faith healing and medical care as mutually exclusive. In fact, no other religious denomination period endorses these strange beliefs. It is therefore a testament to the Christian Science political lobby that its influence so outstrips its ability to deliver votes.
Even though religious exemptions from medical care, including immunization, are not constitutionally required, Christian Scientists enjoy legal exemptions that are exclusive to their religion in a number of states, such as Washington. In a majority of other states, they and the parents who employ them are protected by virtue of numerous state laws exempting faith healing from civil and criminal liability.
Christian Science lobbyists have had outsized success in gaining insurance coverage of their services as well. Jerry Coyne has written a good summary of health insurance coverage, including Medicare, Medicaid, and federal employee insurance benefits for Christian Science “nursing” and faith healing. Your tax dollars at work!
Hypocritically, Christian Science lobbyists have, at the same time, sought to exclude their believers from purchasing health insurance. The reliably pseudo-science-friendly Sen. Orrin Hatch and Sen. John Kerry supported an amendment to the original Affordable Care Act bill prohibiting an insurer from denying benefits for “religious or spiritual health care” that is recognized as deductible by the IRS. (Sen. Kerry represented Massachusetts, where the Christian Science “Mother Church” is located, in Boston.) A similar amendment was included in the House bill. Fortunately, due in part to intense lobbying by CHILD (Children’s Healthcare is a Legal Duty) and other organizations, the amendments did not survive. And, yes, that’s another benefit faith healing enjoys: religious or spiritual health care is a deductible medical expense under federal income tax regulations.
Failure in their first go-round has not stopped the Christian Scientists from lobbying for amendments to the ACA. In the last Congress, bills were sponsored at their behest to exempt everyone with “sincerely held religious beliefs” from the ACA’s mandate to purchase insurance. While the House bill passed, the Senate bill did not. Efforts to pass similar bills in this Congress may prove more successful in the Republican-controlled Senate.
Whatever you may think of the ACA, it does give children a defined set of insurance benefits, including preventative services, provided without cost to the insured. These preventative services include vaccinations. No doubt the anti-vaccination crowd will be thrilled to see those benefits denied to children whose parents chose to duck their responsibility via claiming “sincerely held religious beliefs,” an excuse they also employ in states granting immunization exemptions for religious reasons. And parents who choose “pediatric chiropractic” or naturopathy for their children wouldn’t have to pay for coverage of other evidence-based “allopathic” preventive services or care their CAM practitioner doesn’t offer.
Repealing special privileges for faith healing
Washington Senate Bill 5408 would repeal provisions of state law giving Christian Science practitioners and their clients special privileges. First, the bill repeals the statement of legislative intent, quoted earlier, shielding those who deprive children and other vulnerable persons of adequate medical care from a charge of criminal mistreatment. Providing faith healing from a “duly authorized” Christian Science practitioner will no longer be considered an excuse. This doesn’t mean these parents will necessarily be criminally liable, just that they won’t receive special consideration other parents charged with criminal mistreatment of their children don’t get.
Second, the bill removes the provision, also quoted above, granting special consideration to parents who choose faith healing over medical care in cases of suspected child neglect. No longer will the fact that the child is being “treated” by a Christian Science practitioner be a barrier placed between a legitimate determination that a child is being neglected and the ability to take action to protect the child. Again, this doesn’t mean that child authorities will necessarily intervene or that parents will face charges; they will simply be treated the same as other parents in the same situation.
The bill received a unanimous “do pass” from the Senate Committee on Human Services, Mental Health and Housing on February 2. It is now before the Rules Committee, which will decide whether it goes to the floor of the Senate for discussion. I am cautiously optimistic as several of the bill’s sponsors are on the Rules Committee, including one who is the Democratic Caucus Vice Chair, a leadership position. There is also a companion bill, House Bill 1476, with bipartisan sponsorship but it has not yet been heard in the Judiciary Committee, where it will make its first stop.
One wonders at Christian Scientist lobbying successes considering the weak testimony opposing the bill, summarized here in the Human Services, Mental Health and Housing Committee’s Report [PDF]:
The existing language was put into law after working with the Attorney General’s Office. Proponents are working under false premises, not all religions are created equal. Spiritual healing is the premise of Christian Science so if this language is repealed, what do the Christian Scientists have left? Concerns raised involved another church that does not have a good record with faith healing. Christian Scientists have practiced faith healing for generations. Getting medical help doesn’t ensure a better outcome.
Perhaps there is an RCT in the published literature, of which we are unaware, comparing Christian Science faith healing, the faith healing of “another church,” and “medical help” reporting statistically significant “better outcomes” for Christian Scientists. If you’ve got the citation, please post it in a comment.
(You can watch the committee testimony here starting at the 1:43:50 mark of the 2-hour hearing.)
Another provision of Washington law governing Christian Science practitioners won’t be repealed by this bill, but it is a good one. Along with other practitioners, day care centers, child welfare workers and the like, they have a statutory duty to report child abuse and neglect, including withholding of medical care, to the authorities. My interpretation of this is that they would have a duty to report their clients if the circumstances require.
Along with Rita Swan and the terrific folks at CHILD, these bills are endorsed by the State Medical Association, State Hospital Association, Washington Chapter of the American Academy of Pediatrics, and the Washington Association of Prosecuting Attorneys. I sense a general public weariness with claims of religious privilege when it adversely affects children. Perhaps the Disneyland measles epidemic has found the upper limits for tolerance of religious belief as a means of granting carte blanche to put the health of your children and others at risk.
You can voice your support for Senate Bill 5408 and House Bill 1476, although these comments appear to be limited to Washington residents. Otherwise, you can call or write the legislators. Contact information for Senators is here and for Representatives here.