Killing by praying
Dale and Leilani Neumann are Pentecostal Christians. Their 11 year old daughter, Kara, fell ill. In fact she had (undiagnosed) diabetes. Her parents refused to obtain medical help. Instead they prayed.
‘Kara’s father testified that death was never on their minds. He testified that he knew Kara was sick but was “never to the alarm of death,” and even after she died, her father thought that Jesus would bring Kara back from the dead, as he did with Lazarus.
The parents and friends testified that the parents took tangible steps to help Kara. The mother tried to feed Kara soup and water with a syringe, but the liquid just dribbled out of Kara’s mouth. The father tried to sit Kara up, but she was unable to hold herself up. At some point, Kara involuntarily urinated on herself while lying unresponsive on the couch, so they carried her upstairs and gave her a quick sponge bath while she lay on the bathroom floor.
At one point, Kara’s maternal grandfather suggested by telephone that they give Kara Pedialyte, a nutritional supplement, in order to maintain the nutrients in her body. The mother responded that giving Kara Pedialyte would be taking away the glory from God. Kara’s mother had told another visiting friend that she believed that Kara was under “spiritual attack.”
Friends Althea and Randall Wormgoor testified that they arrived at the Neumanns’ home on Sunday at approximately 1:30 p.m. The Wormgoors saw that Kara was extremely ill and nonresponsive. Her eyes were partially open but they believed she needed immediate medical attention. Randall Wormgoor pulled Kara’s father aside and told him that if it was his daughter, he would take her to the hospital. The father responded that the idea had crossed his mind, and he had suggested it to his wife, but she believed Kara’s illness was a test of faith for their family and that the Lord would heal Kara….’ 
But the Lord did not. Or at least not physically. Kara died from diabetic ketoacidosis. The evidence was that, with conventional medical care, she would have lived.
The parents were prosecuted for reckless homicide. Both were convicted. Both appealed. The appeals were dismissed. Much of the judgment of the Supreme Court of Wisconsin, which heard the appeal, is concerned with the construction of local law, and with points about the adequacy of the direction to the jury. But the case raises, very painfully, the perennial questions about parental rights over and duties towards their children, the propriety of state interference with the parent-child relationship, and the degree of respect that should be afforded to religious beliefs.
I hope and presume that few will have any problem in principle with the convictions. But what should be the framework of our thinking about such problems? I suggest the following:
(a) A child, at least from the moment it is born, is an entity with rights entirely distinct from those of its parents.
(b) Parents have no rights whatever over their children.
(c) Parents have a fiduciary duty to act in the best interests of their children. The exercise of that duty is appropriately policed both by the civil and the criminal law.
(d) What constitutes ‘best interests’ is a question which, at least in theory, is capable of being objectively determined. It is, however, a question whose objective answer has to take account of the circumstances in which the child happens to find itself. That crucially includes the family, and hence the subjective views of the family about what constitutes good living. It does not imply that there is a notional ideal family into which children, having been taken from their birth families, should ideally be transplanted. There are, though, distinct limits to the deference that should be accorded to context. This case is a classic illustration.
(e) Parents will usually be in the best position to determine what constitutes their child’s best interests. This is because they are likely to know their child better than other potential determiners. They are also (although this isn’t a point relevant to the reliability of their determination) likely, because of their parental love and concern, to take particular care to ensure that they act in the child’s best interests. There should accordingly be a presumption that a parent’s decision about a child is a decision in the child’s best interests.
(f) That presumption is quite easily rebuttable. The status of the parents is simply that of witnesses who unusually well placed to give evidence about where their child’s best interests lie.
(g) It is usually relatively easy to determine whether a particular decision will affect a child’s physical integrity. But not always. What about a parent who feeds her child junk food, where she knows or should know that it is harmful, and where it is economically feasible to feed non-junk food. Isn’t she doing something that is not in the child’s best interests? The difference between this and beating a child is only a matter of degree. Should the court be able to interfere? It’s arguable. Indeed I have argued it here. But in practice, if only to avoid clogging the courts, some threshold criteria have to apply. Not giving your moribund child medical treatment is of course well over the threshold.
(h) Questions impinging on social and psychological integrity are more difficult. A BMW-driving banker or a homophobic Creationist from Tennessee will daily serve up to their children portions of ideological toxin that are far more damaging than any number of merely physical bacon double cheeseburgers. Yet one should be very slow to snatch children from an ideologically toxic family, on four grounds: First, the business of snatching is always traumatic, and may well do more harm than continued exposure to the toxins. Second: a decent liberal will doubt her own ability to make the diagnosis of ideological toxicity. Third, even if the diagnosis is made, there will be a deep distaste, based on respect for autonomy and dignity, to prescribe the treatment that it might be thought is necessary. And fourth: although parental rights never trump those of the child, parents do have rights of their own – to family life, for instance, as recognised by the ECHR.
(i) It may be (it is) intellectually unsatisfactory to draw a neat line between physical and psychiatric welfare. But practically it has to be done.
(j) As for snatching, so for other sanctions, such as a direction by the court that such and such should be done, or a criminal sanction against the parents.
(k) Thus in the case of plainly misguided religious belief, a threat to the physical integrity of the child should result in prompt state intervention. Yet some distinctly sub-optimal, psyche-and society-threatening environments will just have to be tolerated. Education, not law, is the only remedy for such ills. It should be unusual, absent physical threats, to cart off the children of fundamentalist missionaries for liberal re-education, or cart off their parents to reflect in a prison cell on the lessons of Enlightenment scholarship.