Parents who deny their children essential medical care based on religious beliefs should be subject to investigation by child abuse agencies and health officials, the American Academy of Pediatrics (AAP) Committee on Bioethics said in a policy statement released Monday.
The statement comes in response to the many exemptions whereby a caregiver can withhold lifesaving treatment on religious grounds without facing negligence charges. States that permit these exemptions should repeal them and prosecute all parents who cause harm by substituting established treatment with alternative healing practices, the physicians wrote. In addition, public healthcare funding should no longer cover spiritual therapies, such as those offered at Christian Science sanatoriums.
"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 Armand Antommaria, director of the Ethics Center at Cincinnati Children’s Hospital Center and lead author of the statement. "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."
“These other uses aren't appropriate [based on] that criteria," he added.
While the authors are not opposed to the continued practice of alternative medicine, they argue that it should never be allowed to interfere with established treatments – especially in cases where the denial of such treatment will necessarily lead to adverse health outcomes for the child. "The main considerations would be whether the lack of medical treatment would cause death or serious disability," Antommaria told Reuters.
John Lantos, director of the Children’s Mercy Bioethics Center at Children’s Hospital in Kansas City, Mo., agrees with the physicians’ recommendations to restrict Medicare and Medicaid coverage of ineffective therapies, but believes that all types of health care should be evaluated in terms of outcome rather than method. "The question would be, not so much whether they are science-based or faith-based, but whether they work," he told reporters. "There are some complementary and alternative treatments that work and therefore ought to be covered, I think."
Should more states begin to prosecute parents who withhold treatment, the judiciary will ultimately have the last say. An important precedent may have been set earlier this month, when an appeals court ruled in favor of a lawsuit seeking to restore chemotherapy to Sarah Hershberger – the 10-year-old Amish girl whose parents opted to treat her aggressive non-Hodgkins lymphoma with natural medicine like herbs and vitamins.