Child Welfare Versus Parental Autonomy: Medical Ethics, The Law, and Faith-Based Healing

Abstract

Over the past three decades more than 200 children have died in the U.S. of treatable illnesses as a result of their parents relying on spiritual healing rather than conventional medical treatment. Thirty-nine states have laws that protect parents from criminal prosecution when their children die as a result of not receiving medical care. As physicians and citizens, we must choose between protecting the welfare of children and maintaining respect for the rights of parents to practice the religion of their choice and to make important decisions for their children. In order to make and defend such choices, it is essential that we as health care professionals understand the history and background of such practices and the legal aspects of previous cases, as well as formulate an ethical construct by which to begin a dialogue with the religious communities and others who share similar beliefs about spiritual healing. In this paper, we provide a framework for these requirements.

Faith healing in paediatrics: what do we know about its relevance to clinical practice?

“…Professionals may need encouragement to engage with families around their spiritual practices to prevent further rejection of conventional medical care. As health professionals, we must balance protecting the welfare of children with maintaining respect for the rights of parents to practise their chosen religion and to make important decisions for their children (Hickey & Lyckholm 2004). In the UK, (Working Together to Safeguard Children 2010) has clear guidelines to help with this.…”

How can clinical ethics guide the management of comorbidities in the child with Rett syndrome?

“…Patient autonomy includes being informed and engaged in discussions as to the course of health care, the provision of consent or otherwise and engagement as care proceeds, processes that cannot occur with severe cognitive impairment . Parents usually take the role of decision‐maker on behalf of their child's best interests, although there are examples of parental autonomy resulting in decisions not being made in the best interests of the child . The best interests of the child are not always the same as the interests of the parents, which may be swayed by guilt, unresolved grief or fear.…”

Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical, and Clinical Issues in Decision-Making

“…Although collaboration among parents and health care providers is seen as the ideal, when conflict exists, parents' wishes should prevail unless the harm threshold at which referral to child protection services is required is met. 25,26 Different clinicians or teams may judge this threshold differently. One of the authors (Dr Harrison) has worked with team members who disagree about whether to call child protection services regarding children who are obese and whose parents resist advice about diet and exercise, children with asthma whose parents continue against medical advice to smoke in their presence, and children for whom parental treatment decisions do not place them at risk of harm now but may result in significant harm for them as adults.…”