Complementary and alternative medicine Medicine Quackery Religion

Relying on prayer instead of medicine

This happened last week when I was feeling under the weather, and somehow I never got around to it. Fortunately, however, I’ve learned that there may indeed by justice in the case of Madeline Neuman, the 11-year-old child whose parents let her die of diabetic ketoacidosis. This story was widely reported thusly:

“We just believe in the Bible, that’s all. This is our faith,” said Leilani Neumann, the mother of 11-year-old Madeline Neumann, who died from a treatable form of diabetes after her parents chose to pray for their daughter in place of seeking medical attention.

Madeline Neumann had been ill for about 30 days and as her insulin level slowly dropped, she became worse. Her parents, Leilani and Dale Neumann, had no idea that their daughter was going to die on Sunday. Instead, they thought she was getting better:

“We just noticed a tiredness within the past two weeks,” Leilani explained.

Of all the religious idiocy I’ve seen, this is among the worst. It’s a clean kill of an innocent child. Actually, it’s a not-so-clean kill, because the child underwent a prolonged and undoubtedly highly unpleasant death due to diabetic ketoacidosis while her parents stood by and watched, begging God to save her while they did nothing concrete to help:

Everest Metro Police Chief Dan Vergin said Madeline Neumann died Sunday.

“She got sicker and sicker until she was dead,” he said.

Vergin said an autopsy determined the girl died from diabetic ketoacidosis, an ailment that left her with too little insulin in her body, and she had probably been ill for about 30 days, suffering symptoms like nausea, vomiting, excessive thirst, loss of appetite and weakness.

The girl’s parents, Dale and Leilani Neumann, attributed the death to “apparently they didn’t have enough faith,” the police chief said.

They believed the key to healing “was it was better to keep praying. Call more people to help pray,” he said.

This is negligent homicide, plain and simple. It’s also different from (and even worse than) another case that I’ve written about, namely the case of a teenage Jehovah’s Witness with cancer refusing life-saving transfusions. I’m referring, of course, to Dennis Lindberg, a 14-year-old with leukemia who started induction chemotherapy for his disease but refused transfusion when his blood counts dropped precipitously, as they tend to do during induction chemotherapy for this particular disease. That case bothered me quite a bit, even though the disease was life-threatening and the boy was in that grey area of age where he’s almost old enough to be considered competent to make the decision to refuse treatment. In the preseent case, it was an 11 year-old girl who was suffering, getting sicker and sicker while her parents denied her access to the medical care that would almost certainly have saved her life. Unlike the case of Lindberg, whose cancer was sufficiently advanced at the time he began his therapy that there was a not insignificant chance of his dying even with treatment (particularly given that he refused any sort of transfusion), Neumann would almost certainly have been saved with timely intervention and proper medical care. Moreover, she could have expected to live a reasonably long life with careful medical management of her childhood diabetes.

What most disturbed me about this case, as you might imagine if you’ve read about it before, was the initial reaction of the police:

The girl has three siblings, ranging in age from 13 to 16, the police chief said.

“They are still in the home,” he said. “There is no reason to remove them. There is no abuse or signs of abuse that we can see.”

The girl’s death remains under investigation and the findings will be forwarded to the district attorney to review for possible charges, the chief said.

The fact that this sort of behavior, in which the parents allowed their daughter to suffer and die in the name of their religion, did not trigger an immediate removal of the other children from the house as being in an abusive environment, demonstrated just how much privilege we accord delusions of highly religious Christians over other forms of delusion. If the parents had said that they had denied their child proper medical care because voices in their head told them to, they’d be regarded as dangerously deluded–and rightly so. However, because they say that God tells them that they should not rely on medicine and that faith would save their child it protects them from having their children taken out of the home or their immediately being thrown in jail for criminal neglect.

Or maybe not:

The parents and social services experts agreed that removing the other children from the home would be best for everyone, Everest Metro Police Chief Dan Vergin said. The children, aged 13 to 16, are staying with relatives, though they were not in danger, he said.

It’s a start, although I hope the relatives don’t also follow the faith that killed Madeline Kara, which would then make the removal of the children a case of going from the frying pan into the fire. Sadly, Madeline is not the only child who’s died recently because of this sort of religious excess, but at least this other recent case that I’ve heard about shows hope that justice can prevail:

OREGON CITY, Ore. — A couple whose church preaches against medical care are facing criminal charges after their young daughter died of an infection that authorities said went untreated.

Carl and Raylene Worthington were indicted Friday on charges of manslaughter and criminal mistreatment in the death of their 15-month-old daughter Ava. They belong to the Followers of Christ Church, whose members have a history of treating gravely ill children only with prayer.

Ava died March 2 of bronchial pneumonia and a blood infection. The state medical examiner’s office has said she could have been treated with antibiotics.

Dr. Christopher Young, a deputy state medical examiner, said the child’s breathing was further hampered by a benign cyst on her neck that had never been medically addressed, The Oregonian reported.

The travesty about these sorts of cases is that they all too frequently go unprosecuted. The reason, of course, once again is that religious beliefs are privileged and viewed as being above criticism. It turns out that the church to which Carl and Raylene Worthington belong has been implicated in the deaths by medical neglect of at least 38 children, and it has been noted that the sect has a much higher than usual rate of stillborn births. The reason for the reluctance of prosecutors to press charges in such cases, as bioethicist Arthur Caplan discusses in this editorial that mentions both the Worthington and Neuman cases, is that many states have laws that that permit exceptions to requiring proper medical care for religious reasons–even in the cases of children.

Competent adults, of course, have the right to self-determination and autonomy when it comes to what happens to their own bodies. They can and do refuse treatment for whatever reasons they see fit, be they religious reasons, reasons of conscience, or simply because they are tired and do not wish to undergo treatment. They can, in fact, refuse treatment for even the dumbest of reasons, a common one being faith in quackery’s ability to help them over that of scientific medicine. Make no mistake about it, though, fundamentalist religion that tells one that prayer should be relied upon before medicine in the face of serious disease is also the dumbest of reasons to refuse treatment.

Freedom of religion is one of the core bedrock values upon which this nation was founded and one of the great freedoms guaranteed us in the Constitution. However even that freedom should not be absolute. It is the parents’ duty to provide their children food, shelter, and proper medical care. If their religion leads them to deny any of these necessities to their children, particularly in such egregious cases as that of the Neumanns, whose religious fanaticism led them to watch their child wither and die over the course of at least several days, if not a few weeks, then they should forfeit their right to be parents, as they have demonstrated themselves in the most egregious and unequivocal way possible to be unreliable guardians for their children. We generally view faith as a virtue, but when that faith leads parents to let their children suffer and die of straightforward-to-treat medical conditions, then faith becomes an evil. I fail to see how anyone can view it otherwise.

Arthur Caplan put it quite well:

Parents do not have the right to watch a child wither away while they pray. Parents do not have the right to watch a child convulse in pain while they pray. Parents should understand that if a child is in agony, if a child is slowly dying before their eyes, that they have an absolute duty, the same as any other parent — religious or not — to call the police, an ambulance or emergency services.

Society must make the protection of children a core value. The way to do that is to make it clear that child neglect is still neglect, even when performed under the cover of religious faith.

I would change the wording to “especially when performed under the cover of religious faith” because it’s hard to imagine a more pointless reason to let one’s child die than because a parent thinks that God told him or her to pray instead of seeking out effective medical therapy. It is just and right that authorities in Oregon are prosecuting the Worthingtons, and I hope against hope that Wisconsin authorities will follow suit with the Neumanns. I have my doubts, though, that anything will happen, if the attitude that permeates this jaw-droppingly idiotic editorial holds sway:

Even assuming what police say is true — and there’s no reason not to — it’s still not as clear a case as one might believe.

Kara hadn’t been to a doctor since she was 3 years old, police said. So perhaps her family knew she was ill but didn’t know that her recent symptoms were an indication of a worsening condition as opposed to, say, a bad case of the flu. The manifestations of a diabetic reaction include nausea, vomiting, diarrhea, excessive thirst and fatigue.

And though police say Kara was ill for at least 30 days, maybe her condition worsened so quickly that no one was aware of how serious it was.

There’s a lot we don’t know.

We can, however, make some safe assumptions.

We can assume Kara’s family loved her deeply and wanted only the best for her.

We can assume they believed they were doing the right thing and that their faith would play a role in her recovery. That’s not an outlandish belief; people are praying for the health and recovery of friends and loved ones every day, all the time.

You can almost hear this editorial writer’s bones cracking as he contorts himself to make excuses for the malignant stupidity of Kara’s parents. It is irrelevant how much the parents loved her and wanted the best for her if they are so deluded that they think that prayer alone is an adequate response to serious illness. I also can’t help but retort that “most people” who pray for the health and recovery of loved ones “every day” do not while praying deny their loved ones the very medical care that would maximize the chances of that recovery occurring. Kara’s parents did just that. Did they never hear the saying “God helps those who help themselves”? It was a common saying I often heard during my Catholic upbringing which I always used to interpret in essence, to mean “Yes, have faith in God, but having faith in God doesn’t mean you should eschew using the tools He provides for you to help yourself and those you love.” The editorial concludes with a mind-numbingly vacuous reminder “to hug our own children a little tighter tonight, and to thank God for every day they’re with us, and pray that another child’s death might be prevented by someone reading about Kara’s death.”

Prosecuting the parents for criminal child neglect as a reminder that society will not tolerate this sort of behavior would do far more than any prayer to save future victims of such religious stupidity.

Fundamentalist Judeo-Christian religion has a privileged position. If one just claims that one’s actions were because of one’s “faith” or “belief” in God or Jesus, one can get away with amazing lapses like this, and useful idiots like the writer of the editorial quoted above will do everything they can to give one the benefit of the doubt. If, as one commenter after the above quoted editorial stated, the Neumanns had said that they worshiped the Sun God Ra and expected that he would send his healing rays down to cure their daughter, no one would be defending them. No, they’d be rightly dismissed as members of a a dangerous cult. But make them members of a fundamentalist Christian sect saying in essence exactly the the same thing, and suddenly society bends over backwards to make excuses for their neglect and piously intones that we must show their beliefs “respect.” I’m sorry, but nothing in my reason tells me that I have to “respect” a religion that so callously consigns a young girl to suffering and a completely unnecessary death.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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