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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….’ [1]

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.                      


1. Judgment of the Supreme Court of Wisconsin, paras 22-25

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10 Comment on this post

  1. How can children be protected from the misguided beliefs of their parents? In the case of Dale and Leilani Neumann it is doubtful that any word from any doctor could have deterred them from the course of inaction that resulted in their daughter’s death. However, there are some things that can be done to reduce the chances of similar events happening in future. The medical profession needs to publicise such cases in the general community. It would also be helpful to contact religious bodies and point out that if people rely on prayer alone to cure illness, similar tragedies are likely to happen again.

    Appealing to religious bodies might seem to be counter-intuitive. However, the people most likely to suffer from bad publicity are those religious bodies that contain members who have the misguided belief that prayer is a sufficient substitute for medical help in the case of sickness. Appeals by doctors may miss the mark with fervent but misguided believers; the same appeals coming from spiritual advisers may well have more sway with those whose faith is most likely to overwhelm their common sense and prudence. Such publicity should not be confined to minor sects. The next case may well come from a family that worships with a mainstream religious group.

    in the case of junk food and other toxic situations, that may affect a child’s welfare general publicity is likely to alert parents and others to these issues. General publicity may seem to be a weak response to something like the consumption of junk food, and yet it is surprising what a difference it can make over a period of time. The changing attitudes to smoking are a good example of how incremental changes can have a significant impact.

  2. I disagree with a lot of your statements. First you state “The evidence was that, with conventional medical care, she would have lived.” This is based on the assumption that conventional medical care works in the majority of cases. This is reasonable, but technically you have no way of knowing for sure whether or not the child would have lived if she received medical care, because it never actually took place. You cannot call a statistical assumption “evidence.”

    Second, you say that “Parents have a fiduciary duty to act in the best interests of their children.” And that “what constitutes ‘best interests’ is a question which, at least in theory, is capable of being objectively determined.” You cannot objectively determine what constitutes best interests without first looking at the positives of both sides of the equation. You refer to faith healing from a negative stance, which is fine, but you conclude that these parents are “misguided,” yet there are in fact examples out there of faith healing working and benefiting the health of those who choose to pray. Obviously, you might argue that there isn’t substantial evidence in this regard or that modern medicine still outweighs faith healing; but I doubt that every time a person experiences faith healing they are immediately inclined to alert statisticians and medical professors. Those that do are immediately written off as quacks. Instead of focusing on death and associating it with religion alone, why not consider the fact that thousands of people die in hospitals seeking medical attention on an annual basis?

    You even say yourself that this is can be objectively determined, “at least in theory.” Everything you have here is based on “theory.” You may consider the possibility that an individual who uses faith healing only needs one substantial experience of healing in order to rationally determine that it can be effective for him. If that individual wishes to pursue faith healing based on his experience, that is his choice. If he believes it is within his best interests, then it may be logical to assume that it is within his daughters best interests as well.

  3. Michael: many thanks. I agree with all that you say. There’s nothing flabby about saying that general publicity should be the main response. The situations where courts will have to grapple systematically with the issues, as envisaged in my post, are mercifully few.

  4. Matt: thank you for your comments.
    Re your para (1): the medical evidence was that, given the treatment she would have had her parents taken her to hospital, she would have lived.
    Re your para (2): You ask: ‘Instead of focusing on death and associating it with religion alone, why not consider the fact that thousands of people die in hospitals seeking medical attention on an annual basis?’ Because that’s not what this post was about.
    Re your para (3): I’m not clear what you’re saying. Do you really support the decision of these parents to pray for their moribund daughter instead of taking her to hospital? Are you suggesting that that was in the daughter’s best interests?

  5. At times, oblivious, desperate remarks such as those made by the esteemed Mr. Edwards amaze me. But not so much in this instance. Compared to the hideous act of homicide committed by the Neumanns, the sad attempts at justification that Matt is spewing are very pedestrian indeed.

    Matt Edwards, you are a coward and an enabler of tragically harmful behavior. Your comment is barely worthy of response due to its ineptitude, inanity, and the incredibly low quality of your logic. My only wonder is…do you actually believe any of it yourself? I’m sure that the Neumanns are telling themselves they didn’t do anything wrong, but is there not even a small voice in the back of your conscious that tells you it’s wrong to kill an eleven year old girl? What good does it do your cause or your god to prevent an innocent girl from receiving vitally important medical care? There is no excuse for what these people did.

    The interesting thing here is that, once again (despite the lunatic cries of zealots to the contrary) the supposed “moral superiority” of Christian belief fails to ring true. As it most often does, being that religious mania leads frequently to this kind of dangerous behavior. It is shameful that so many of our leaders refuse to hold vile criminals responsible for their acts as long as they hide behind a holy book and the harmful ignorance that it protects.

  6. Charles: I realize that your post isn’t ‘about’ death in hospitals, I merely suggested that you should personally consider the percentage of deaths in hospitals in comparison to death and prayer. My attempt was to get you to see the other side of the argument. In regards to 3: I would say yes and no. In this particular case, the parents seemed negligent, but that doesn’t mean all those who practice faith healing are equally as negligent. I support the idea that these parents have the right to believe what is in their child’s best interests. However, in this extreme case it would seem that they should have done more than just ‘thought’ about medical help.

    Dead: I don’t think desperation is quite the word I would use to describe my comments. And I suppose if I were a coward I wouldn’t have bothered arguing with Charles at all. You spoke of ‘harmful ignorance’ in regards to religious mania. I understand that point of view. My goal was to point out that there are and always have been accounts of positive benefit to health from prayer. I simply want people to see both sides. I’m not asking you to change what you believe. I am not in support of negligence. In this case I do agree it would seem at some point the parents should have considered an alternative to prayer.

    Consider this: A man has been diagnosed with cancer and after months of multiple forms of treatment, a medical examiner claims that the man will be dead within a week. With nothing else to resort to, the man begins to pray. Those who are proponents of faith healing are no different than this man, they just choose to pray first. And in some cases, there is no need for additional help. All I suggest is that this isn’t as black and white as people make it out to be.

  7. Tony Schumacher Jones

    Surely it is reasonable to assume that, on the basis of research, current literature and scientific evidence, faith healing is less efficacious than medical science in solving medical problems? Whilst it does not matter if the medical problem is the common cold, it does matter if the medical issue is life threatening. Confronted with a possibly life threatening illness, parents should always, based on their duty to a child in their care, seek medical care and not substitute faith healing for medicine. That is surely ‘the reasonable approach’.

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