Paediatricians and child abuse agencies should step in when
parents' religious beliefs keep kids from getting necessary medical care,
In a policy statement, the American Academy of Paediatrics
Committee on Bioethics also said states should repeal any exemptions to child
abuse and neglect laws.
Those exemptions mean some states don't always consider
parents negligent if they forgo medical treatment for a child because of their
religious beliefs. Finally, the committee said public healthcare funding should
not be used for religious or spiritual healing.
That would mean Medicare and Medicaid would no longer cover
services at Christian Science sanatoriums, for instance. People with
government-funded insurance could still get care at hospitals run by religious
groups. "I think it's important that all children get appropriate medical
care, that state policies should be clear about the obligations to provide this
care and that state monies directed toward medical care should be used for
established and effective therapies," said Dr Armand Antommaria.
Refusing medical care
Antommaria directs the Ethics Centre at Cincinnati
Children's Hospital Medical Centre in Ohio and is one of the lead authors of
the statement. He told Reuters Health that cases of parents refusing medical
care for their child due to their religious beliefs persist.
People of certain faiths, including many Christian
Scientists, advocate prayer before or instead of medical treatments when a
person is ill. Jehovah's Witnesses do not accept blood transfusions. Parents
have the right to weigh the risks and benefits of possible treatments and make
medical choices for their children, the Committee writes in the journal
But that's no longer the case if their choices rise to the
level of medical neglect and abuse. "The main considerations would be
whether the lack of medical treatment would cause death or serious
disability," and whether good treatment is available, Antommaria said.
In one recent case, an Ohio court ruled that a hospital
could force a 10-year-old Amish girl with leukaemia to resume chemotherapy. Her
parents had decided to forgo the treatment in favour of "natural
medicines". The family had been told the girl had an 85% chance of
survival with treatment but would die within the year if she did not receive it. That part of the committee
statement reiterates an earlier policy, Antommaria said.
Child abuse laws
So does the
recommendation that states overturn religious exemptions to child abuse laws.
What is new is the call for government-run insurance not to cover unproven
spiritual and religious therapies. Those include services provided at
sanatoriums and other religious nonmedical health care institutions, as the
Committee calls them.
"Part of it is the issue of, if the public funds are
going to be used for medical care, they should be used for established
effective therapies," Antommaria said. "These other uses aren't
appropriate (based on) that criteria. "When it comes to public funding for
health services, "The question would be, not so much whether they are
science-based or faith-based, but whether they work," Dr John Lantos said.
He is director of the Children's Mercy Bioethics Centre at
Children's Mercy Hospital in Kansas City, Missouri, and was not involved in the
new recommendations. "There are some complementary and alternative
treatments that work and therefore ought to be covered, I think," Lantos
told Reuters Health. "There are others that have never been shown to work."
He said Medicare and Medicaid should not cover any service until it has been
Antommaria said government coverage for religious nonmedical
institutions could also be seen as unfair. That's because people may get
services there like custodial care that aren't available to Medicare and
Medicaid patients at medical facilities. A spokesperson for The First Church of
Christ, Scientist said the organization had no comment on the statement.