Parents indicted in Massachusetts child-treatment case

An indictment by a Massachusetts grand jury raises the question of the rights of parents to rely on prayer, rather than medical care, for healing children. The grand jury indicted David and Ginger Twitchell on manslaughter charges in connection with the death of their 2-year-old son, Robyn.

Robyn died of what was diagnosed as bowel obstruction. His parents, lifelong Christian Scientists, say they had acted in accord with their faith - and state law - in relying on spiritual means to heal him.

An arraignment is set for May 2.

Massachusetts, like some 40 other states, exempts Christian Scientists from some of the requirements of child-care statutes to accommodate their views on spiritual healing.

Suffolk County district attorney Newman Flanagan, however, holds that this exemption does not exempt parents in extreme situations.

``In order to sustain a manslaughter charge, the district attorney must show reckless disregard for human life,'' points out Rikki Klieman, lawyer for the Twitchells. ``But nothing the Twitchells did put them on notice that they had violated the law,'' she adds.

The prosecution of parents whose children have died after reliance on spiritual means for healing, rather than medical treatment, is raising constitutional and social questions. Among them:

Does the First Amendment protect the right of families to use religion and prayer in the care of their youngsters?

Do state child-abuse and neglect statutes that allow exemptions to those who depend on God for help preempt prosecution of parents when a child dies?

Are such exemptions a guarantee for religious freedom or a violation of separation of church and state?

Should the law permit alternatives to medical treatment of children in cases of extreme illness?

In cases that involve Christian Science care of children and are in the courts or about to enter the judicial process, California and Florida authorities have claimed that medical treatment must take preference over parental religious practice when a child's life is at stake.

It is the position of the Christian Science Church, however, that its teachings are a viable alternative to medical treatment and constitute loving and nurturing care of children - and by no means parental neglect.

Nathan Talbot, Christian Science Committee on Publication, points out that there is strong evidence of ``people who would not be alive today'' were it not for the effectiveness of spiritual treatment - based ``not on faith alone, but on a deeper understanding of God's presence, love, and care.''

Mr. Talbot and others, including non-Christian Scientists, say prosecution of parents for manslaughter or felony child endangerment (as has sometimes occurred after a child died under spiritual care) for following their religious tenets is totally inappropriate.

They point out that to sustain a manslaughter charge, reckless disregard for human life must be proved.

Recently, the Committee on Bioethics of the American Academy of Pediatrics (AAP) called for state legislatures and regulatory agencies to remove religious exemptions from child-abuse statutes.

But the AAP panel said it does not advocate punishment of parents as a solution to alleged child abuse and neglect.

An argument used by prosecutors in a case now before California's Supreme Court is that existing exemptions for Christian Scientists and others from statutes requiring medical care for children constitute an unconstitutional favoring of one religion over another.

The case involved Shauntay Walker, who died three years ago, at age four, of what an autopsy diagnosed as bacterial meningitis. Her mother - a Christian Scientist who relied on prayer for healing - was charged with involuntary manslaughter and felony child endangerment. Lawyers for Ms. Walker have argued that a California state law bars criminal prosecution of parents who choose spiritual means - taught by a recognized religion - over medical care.

But the state attorney general insists that the statute in question is not intended to protect parents from criminal liability. Prosecutors also say that a religious exemption from child-care laws requiring medical attention is in violation of the establishment clause of the United States Constitution.

Defendants argue, on the other hand, that such an exemption guarantees against religious discrimination and is in the spirit of the US Constitution.

The California court will likely decide in several months whether the Walker case should proceed to a jury trial.