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Relying on prayer instead of medicine, part II

About a month ago, I wrote about an unbelievably sad story of a 12-year-old girl in Wisconsin who died of untreated diabetic ketoacidosis because she had been unfortunate enough to have been born into a family in which the parents believed in prayer rather than medicine. I say “unbelievably” because I find it truly difficult to believe that anyone in this day and age would willingly eschew effective medicine for their suffering child in favor of wishful thinking. Tragically and not surprisingly, prayer didn’t work, and their child died. One of the unresolved issues at the time of the incident was whether or not the parents would be charged with a crime. You may think this would be a no-brainer for at least a charge of child neglect, but such is the sway of religion (at least Christian religion) in this country that deciding whether or not to prosecute the parents for even that small a charge is anything but straightforward.

In a bit of good news, it turns out that the authorities in Wisconsin are going to try to prosecute the parents for second degree reckless homicide:

WESTON, Wisconsin (AP) –– Two parents who prayed as their 11-year-old daughter died of untreated diabetes were charged Monday with second-degree reckless homicide.

D.A. Jill Falstad announces charges against parents who didn’t seek medical attention for a diabetic child.

Family and friends had urged Dale and Leilani Neumann to get help for their daughter, but the father considered the illness “a test of faith” and the mother never considered taking the girl to the doctor because she thought her daughter was under a “spiritual attack,” the criminal complaint said.

It turns out that the story was even worse than it sounded when it was first reported. Before, we didn’t know a lot about the full course of the girl’s illness and ended up having to speculate based on the known course of untreated diabetic ketoacidosis. Now, we have many more details, and it’s not pretty. Apparently, the parents were begged by not one but several relatives to take their daughter to a doctor for treatment as her health deteriorated:

Randall Wormgoor, a friend of the Neumanns, told police that Dale Neumann led Bible studies at his business, Monkey Mo Coffee Shop, and believed physical illness was due to sin, curable by prayer and by asking for forgiveness from God, the complaint said.

Wormgoor said he and his wife, Althea, were at the Neumann home when Madeline — — called Kara by her parents — died. Wormgoor said he had urged the father to seek medical help and was told the illness “was a test of faith for the Neumann family and asked the Wormgoors to join them in praying for Kara to get well,” the complaint said.

Althea Wormgoor said she “implored” the parents to seek medical help for the girl, the complaint said.

Leilani Neumann, 40, told the AP previously she never expected her daughter to die. The family believes in the Bible, which says healing comes from God, but they have nothing against doctors, she said.

Dale Neumann, 46, a former police officer, has said he has friends who are doctors and started CPR “as soon as the breath of life left” his daughter’s body.

According to court documents, Leilani Neumann said in a written statement to police that she never considered taking the girl, who was being home-schooled, to a doctor.

“We just thought it was a spiritual attack and we prayed for her. My husband Dale was crying and mentioned taking Kara to the doctor and I said, ‘The Lord’s going to heal her,’ and we continued to pray,” she wrote.

The father told investigators he noticed his daughter was weak and slower for about two weeks but he attributed it to symptoms of the girl reaching puberty, the complaint said.

Things rapidly became more serious:

Meanwhile, Leilani Neumann told police that by Saturday, “Kara was laying on the couch. Her legs looked skinny and blue. I didn’t realize how skinny she was. We took her to my bed where I got her warm. I thought it was a spiritual attack. We stayed by her side nonstop and we prayed.

“I asked Kara if she loved Jesus and she shook her head yes.”

Later Saturday, “Kara got up to go to the bathroom and fell off the toilet,” Leilani Neumann told police.

Dale Neumann told police he thought his daughter was getting better on Sunday but that at one point he tried to sit her up but she was unable to remain up.

The investigator said he used the term “unconscious” to describe the girl’s condition, according to the report, while Dale Neumann “preferred to say that she was ‘in sleep mode.’ ”

Dale Neumann said Kara couldn’t communicate and wasn’t taking any water.

By noon, the family contacted another couple, Randall and Althea Wormgoor.

The Wormgoors had followed the Neumanns from California to Wisconsin, a relationship apparently stoked by religious as well as potential business ties. There was talk of opening a second coffee shop in the area that the Wormgoors would operate, the police report says.

The Wormgoors arrived at the home 30 minutes before Kara stopped breathing, Dale Neumann said.

Randall Wormgoor encouraged Dale Neumann to call for medical help but the father “said he remained confident and steadfast in his belief that prayer would heal Madeline,” according to an interview Dale Neumann gave to police.

Dale Neumann said he heard a “commotion” coming from the room where his daughter was lying down and that he began CPR efforts. One of the Wormgoors called 911.

Dale Neumann told investigators that “given the same set of circumstances with another child, he would not waiver in his faith and confidence in the healing power of prayer,” according to the interview statement.

And that, alone, is reason enough why the Neumanns should never, ever be allowed to raise a child again. Particularly horrific is her father’s last-ditch attempt to get help:

Police also said an e-mail Dale Neumann sent at 4:58 p.m. on March 22, the day before Kara’s death, showed that the parents were aware their daughter was very ill.

The subject line of the email was: “Help our daughter needs emergency prayer!!!!” The e-mail was send to AmericasLastDays, an online ministry run by David Eells.

Yeah, that’ll work. Whatever happened to “God helps those who help themselves” or the belief that God gave humans minds to figure out all these wonderful modern medical treatments and that He wants people to take advantage of them?

In any event, negligent homicide sounds pretty close to correct to me. In the U.S., we have freedom of religion. We also have freedom of self-determination. If a competent adult wishes, he or she can refuse medical care for religious reasons or virtually any other reason. If an adult wants to sacrifice his or her life on the altar of religion by refusing medical care for a life-threatening illness, the law and tradition permit that. Children, however, are a different case. Because they are not yet competent to decide such weighty matters for themselves, tradition and the law both give the ultimate authority to their parents or guardians to make such decisions for them. The assumption behind this, however, is that the parents or guardians will act in the best interests of the child. No doubt the Neumanns thought they were acting in the best interest of their their daughter, but any objective observer would occur otherwise. Part and parcel of acting in a child’s best interest includes providing adequate food, shelter, clothing, and medical care. Withholding effective care for a very treatable condition to the point where the child died when her life was eminently salvageable is a gross neglect of that duty. Bioethicist 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.


We need to send the right message to parents — you can rely on prayer, but not when your child’s life clearly hangs in the balance. When it comes to children, faith must have limits.

That is why I am heartened to see the Neumanns prosecuted, even though it may well be an uphill battle to obtain a conviction. So great is our deference to religion in this country that I am not at all confident that the Neumanns won’t get off scot-free and even ultimately regain custody of their other children to have another chance to do it again. As was discussed in an episode of Freethought Radio by Shawn Francis Peters, author of When Prayer Fails: Faith Healing, Children and the Law, various fundamentalist religions, led by primarily by Christian Science and Jehovah’s Witnesses, have managed over the years to protect exemptions from prosecution for neglect if parents choose prayer instead of medicine for their children. Sadly, here have been many cases of children who died because medical treatment was withheld in favor of prayer, a few of which are documented here. One may wonder why the prosecutor is choosing to prosecute for negligent homicide rather than abuse and neglect. That’s because prosecuting for abuse or neglect is not an option under Wisconsin law, statute 948.03:

(6) TREATMENT THROUGH PRAYER. A person is not guilty of an offense under this section solely because he or she provides a child with treatment by spiritual means through prayer alone for healing in accordance with the religious method of healing permitted under s. 48.981 (3) (c) 4. or 448.03 (6) in lieu of medical or surgical treatment.

Basically, the prosecutor appears to have done the best she could, given the crappy law in Wisconsin, a law that religious supporters of the Neumanns, in a despicable and deranged website set up to defend the Neumanns plan to try to milk for all it’s worth. (If you want concentrated religious craziness at a high dose, click; but you have been warned. You will lose brain cells.) Sadly, this deference to religion and its resultant exemption of “treatment through prayer” (i.e., no treatment at all) for children from prosecution for abuse and neglect. As documents, most states have similar laws on the books, laws that leave children vulnerable. The number and breadth of religious exemptions for medical care affecting children are truly disturbing. Here are a some examples:

  • 48 states have religious exemptions from immunizations.  Mississippi and West Virginia are the only states that require all children to be immunized without exception for religious belief.
  • The majority of states have religious exemptions from metabolic testing of newborns. Such tests detect disorders that will cause mental retardation and other handicaps unless they are treated. 
  • Colorado, Delaware, Florida, Idaho, Iowa, Maine, Michigan, Minnesota, Nevada, and Pennsylvania have religious exemptions from prophylactic eyedrops for newborns. The eyedrops prevent blindness of infants who have been infected with venereal diseases carried by their mothers.
  • Delaware, Illinois, Kansas, Maine, Massachusetts, New Jersey, and Rhode Island have religious exemptions from testing children for lead-levels in their blood. 
  • California allows public school teachers to refuse testing for tuberculosis on religious grounds.  Ohio has a religious exemption from testing and treatment for tuberculosis.  It lets parents use “a recognized method of religious healing” instead of medical care for a child sick with tuberculosis.
  • Thirty-nine states and the District of Columbia have religious exemptions in their civil codes on child abuse or neglect, largely because of a federal government policy from 1974 to 1983 requiring states to pass such exemptions in order to get federal funding for child protection work.
  • Eighteen states have religious defenses to felony crimes against children.
  • Twelve states have religious defenses to misdemeanors.
  • States with a religious defense to the most serious crimes against children include: Iowa and Ohio with religious defenses to manslaughter; West Virginia with religious defenses to murder of a child and child neglect resulting in death; Arkansas with a religious defense to capital murder; Oregon with a religious defense to homicide by abuse.

To that I would add the example of Abraham’s Law in Virginia, which in essence strips any protection there was from the state away from teens 14-17 with a life-threatening illness, allowing parents to choose quackery, prayer, or whatever to treat them instead of evidence-based medicine.

It is true that the scope of religious exemptions varies widely from state to state and that many of the actual statutes have ambiguities that lead to differing interpretations. It is equally true that in far too many states children have little or no protection if their parents are religiously deluded into thinking that prayer is a substitute for medical treatment for serious illness. Once again, it must be emphasized that not just any religion qualifies for this exemption. Rather, it is primarily Christian sects. If the Neumanns had worshiped Poseidon and sprinkled their daughter with sea water, expecting that their god’s holy power would thus act through it and heal her, does anyone think there would have been as much resistance to prosecuting them or that the authorities would have dithered as long before coming to a decision? But have a Christian sect say the same sort of thing, and suddenly there’s a huge question over what is the right thing to do. Although I strongly believe in the freedom of religion, like any freedom religious freedom is not without limits. Like any other freedom, it has to be balanced against the rights of others, and if there’s one right that children must have, it’s the right to the necessities of life, including proper medical care.

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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