When should the state override parents on the issue of a child’s health care?

I’ve been pondering the above question after reading two different news items about parents who either have refused or are refusing mainstream medical treatments for their kids. The first news item is about a court ruling against Colleen and Anthony Hauser of Minneapolis, Minnesota who had opted not to have their son, Daniel Hauser, receive chemotherapy for cancer in preference for “alternative” medical treatments:

In a 58-page ruling, Brown County District Judge John Rodenberg found Daniel Hauser has been “medically neglected” by his parents, Colleen and Anthony Hauser. The judge allowed Daniel to stay with his parents, noting they love him, but he gave them until Tuesday to get an updated chest X-ray of Daniel’s tumor and select an oncologist.

If the tumor has not grown and if Daniel’s prognosis is still as optimistic as doctors testified last week, then chemotherapy and possible radiation appear to be in Daniel’s best interest, Rodenberg wrote.

“The State has successfully shown by clear and convincing evidence that continued chemotherapy is medically necessary,” he wrote, adding he would not order chemotherapy if doctors find the cancer has advanced to a point where it is “too late.”

If chemotherapy is ordered and the family refuses, the judge said, Daniel will be placed in temporary custody.

The cancer in question is Hodgkin’s lymphoma and Daniel’s doctors say there’s a 90% chance he’ll survive if he receives chemotherapy, but only a 5% chance if he doesn’t. He’s had one round so far after which the parents sought a second opinion only to have the same treatment suggested. They’ve since opted to go with the alternative medicine approach claiming it’s part of their religious beliefs:

Court testimony indicated Daniel’s tumor shrank after the first round of chemo, but has since grown. His mother, Colleen Hauser, testified last week: “My son is not in any medical danger at this point.” She has been treating his cancer with herbal supplements, vitamins, ionized water, and other natural alternatives—despite testimony from five doctors who agreed Daniel needed chemotherapy.

Five doctors have concurred and the woman insists on using bullshit treatments based on her religious beliefs. Just what are those beliefs anyway?

The Hausers, who have eight children, are Roman Catholic and also believe in the “do no harm” philosophy of the Nemenhah Band. The Missouri-based religious group believes in natural healing methods advocated by some American Indians.

Rodenberg wrote that Daniel claims to be an elder in the band, but does not know what that means. Daniel also says he is a medicine man under Nemenhah teachings but can’t say how he became a medicine man or what teachings he has had to become one.

He also noted that at age 13, Daniel can’t read.

“He lacks the ability to give informed consent to medical procedures,” Rodenberg said.

[…] According to Daniel’s court testimony, he believes the chemo will kill him, and said: “I’d fight it. I’d punch them and I’d kick them.”

How’s that for kooky? Roman Catholic mixed with Native American pseudo-shamanism. A kid who is illiterate yet claims to be a medicine man and who has stated he will actively resist any attempts to use mainstream treatments on him. Obviously the parents have gotten this kid pretty damn delusional to the point that he is willing to risk his own life. Should the state have any say in the matter or should they respect the family’s religious beliefs no matter how suicidally stupid they are?

I’m leaning towards the opinion that they should let the family do what they want in this regard and then, if the parent’s inaction results in the death of the boy, charge them with negligent homicide. That’s what is happening in the case of the parents that tried to pray away their daughter’s diabetes. The mother is now facing charges because of her death:

Neumann is charged with second-degree reckless homicide in the Easter 2008 death of her 11-year-old daughter Madeline from undiagnosed diabetes. The charge carries a maximum penalty of 25 years in prison.

Neumann has said her family believes in the Bible, which says healing comes from God, and she never expected her daughter to die.

According to the criminal complaint, Madeline’s father considered the girl’s illness “a test of faith” and Neumann never considered taking the girl to the doctor because she thought her daughter was under a “spiritual attack.”

The family does not belong to an organized religion or faith, Neumann has said.

During opening statements, Assistant District Attorney LaMont Jacobson told the jury this case isn’t about religious freedom or religious rights.

“This case is about Madeline Neumann’s needless suffering and death,” he said.

In both cases the families are relying on their beliefs over modern medical practice as a means of treating their kid’s illnesses. One family has already been shown how poor an approach that is and the other is about to learn the same lesson, but perhaps that’s a lesson that some folks just have to learn the hard way. Madeline’s diabetes was easily treatable and she could have had a long and happy life. Daniel’s cancer is also treatable with a high survivability rate when handled properly. It’s a shame their parents are so wrapped up in their religious bullshit that they’re willing to let their kids die rather than have them treated for their conditions, but I suppose it does cut back on the possibility of those memes being spread to yet another generation in that family tree.

A small bit of irony during the first day of Neumann’s trial. She suffered a medical emergency and they called 911:

Prosecutors had begun laying out their case against Leilani Neumann, 41, on Saturday morning. About 20 minutes in to their opening statement, as they described the girl’s condition the day before she died, Neumann put her head in her arms on the table.

Moments later her attorneys expressed concern, asking for a recess so they could get her some air. She appeared visibly weak as her husband and others escorted her from the courtroom to a downstairs office.

Judge Vincent Howard ordered court security to call 911 and have Neumann medically evaluated.

While she was being examined by paramedics in the office, her defense attorney, Gene Linehan, told the judge Neumann was suffering a total physical and emotional breakdown.

“She claimed she has no feeling in her arms and legs,” Linehan said, telling the judge Neumann could not participate in her defense in her current state.

The judge agreed to a recess, saying Neumann “needs a medical evaluation, not a judicial one, at least at this stage.”

Why didn’t they just have her husband pray away her breakdown instead of calling in paramedics? If it was good enough for her daughter than surely it would be good enough for Mrs. Neumann.

Her husband’s trial, by the way, is scheduled to start July 23rd.

28 thoughts on “When should the state override parents on the issue of a child’s health care?

  1. With the Minnesota case the argument is bogus because their religious beliefs didn’t stop them from doing the first round of treatment, it is only after the first round did the kid change his mind because he felt ill and pain.

    Of course, it’s normal par for course that all religious people pull out the religion card to justify their decisions.

    Personally, I say leave them alone and let the kid die, then charge his parents with neglect and sterilize them both so they cannot reproduce again.

    Weed their genes out of the gene pool.

  2. As to the first one…even though he is a kid, I think they should let him make the choice.  Ok, so he is illiterate.  Explain it to him as best as you can and let him decide.  He is 13 years old.  I have a hard time justifying forcing someone into something they don’t want to do.  That goes with parents too…I don’t believe parents should force something on a kid just because they are parents.

    With that said, the whole thing is hokey.  How can he be a medicine man and an elder?  Young people aren’t elders…they haven’t had enough life experience yet and how could he be a medicine man?  Again, not enough experience even if he started training at an early age. 

    And the whole “I’m Native American” thing…wth.  So you have someone in your family tree that was Native American. So what. That is like me saying that I am Irish Royalty because I have an Irish King in my lineage.  Give me a break.  You guys are muts dude…like most Americans. 

    As for the little girl…that is just plain neglect.  They didn’t even get her diagnosed when she started showing signs of illness.  That is a lot different than a kid denying treatment. I do feel sorry for her mom though.  It is sad she let her religion get in the way of her love of her child.  She probably really thought she was doing the right thing.  They should still be prosecuted though, so no one else will think it is ok to just pray the disease away.

  3. It’s a tough call to be sure. I think an argument can be made in the first case that Daniel’s judgment has been so polluted by the religious nonsense his parents have fed him that he’s incapable of making a rational decision, but then there’s no law against making irrational decisions.

    Probably for the best as we all make them from time to time.

  4. If one has a religious slant then why not go with “God is great; he provides us with these wonderful technologies such as modern medicines, blood transfusions, and chemotherapies which allow us to escape satan’s evil clutch”?

    But that’s just me. I love my kids and want my family to be happy and healthy with whatever technologies and resources we have available.

  5. Of course he can not give informed consent: he is 13- a minor. The US, like most western countries, has whole rafts of laws to protect children from the fact they can not make informed choices.  I can hardly think that anyone would support “I have explained to my child the consequences of breaking the law.  I will therefore not attempt to discipline him if he causes any trouble”.

    “Let him die, then prosecute the parents” helps him how? Should we not protect children, but instead of just picking up the pieces afterwards?  Do you disband social services and go with “We knew the kid would die from neglect, but decided if that was the parents’ choice we would just prosecute if the child did die”?

    Personally, I say leave them alone and let the kid die, then charge his parents with neglect and sterilize them both so they cannot reproduce again.
    Weed their genes out of the gene pool.

    Given the amount of work that is done when creationists quote-mine Darwin, you are not really helping.

  6. The kid should be made a ward of the court and have an attorney represent him. Hopefully the attorney will not be a religious whack job, also.

  7. I have to consider this one a nightmare situation. I would not want to see Hauser die, but as a parent, the last people I’d want making decisions for how I raise my child is the government.

    Hell, they can’t even get the food pyramid right. ( http://www.commondreams.org/views05/0506-24.htm )

    I’d much rather the state treat parents as adults, unless they’ve been proven otherwise. If I choose not to have my child given certain treatments that “conventional wisdom” says I should, then I shouldn’t be forced, with the understanding that I am fully responsible for the outcome.

    Every time we allow the state to take over from the parents is just another step closer to when the state will be in loco parentis all the time.

  8. I’m not sure if I buy this whole story seen going around, if they are so anti-medicine then why go to doctor at all? seems odd to me…listen, if its a 50/50 chance to die or live with chemo…some people might choose die..however, bringing religion into it in hopes of a miracle is wrong…

  9. Billy, if all we need to do to undermine science is refer to it as ‘conventional wisdom’ then we can throw lots of stuff out the window.  But science is by definition unconventional wisdom.  In medicine it’s obtained by double-blind studies – in other words protected from expectations.

    The food pyramid isn’t in the same class as accepted medical standards.  I think everyone knows it’s what corporate America thinks you should eat.

    Billy, re-read the post.  The odds aren’t 50/50 by any stretch.

    The current topic on my own blog has subjected me to Google ads for “colon cleansing” nonsense.  I’d hate for any parent to read that twaddle and think it was good for their kids.

  10. Yesterday, on another post, I got called an asshole for even pondering the possibility that keeping government out of health issues for consenting kids is better than increasing further the power of the nanny state.  But most atheists (or at least blogging ones) believe in the government as the possible savior of humanity.

  11. This is another of those cruxes where there are no good answers, but just hard questions.

    Sabio: I’m an atheist, and I don’t believe in the government as the possible savior of mankind.  If there’s any savior, imho, it’s in the combination of education and enlightened self-interest (by “enlightened”, I mean of course “extended”, in the sense of including the entire Earth.)  But no matter how one looks at it, there are no easy answers.

  12. @decrepitoldfool – But science is by definition unconventional wisdom.  In medicine it’s obtained by double-blind studies – in other words protected from expectations.

    Except when there are competing interests, such as big pharma. When we had our kid, the “doctor recommended” inoculations at birth included Hep B.

    Shooting a newborn with a Heb B. vaccine is carp unless the mother has Heb B., but guess how many people just nod their heads and say “okay”—and big pharma says “Cha-ching!” 600 babies a week where we had ours.

    Yes, science is science, but nearly all of medicine has no absolutes. Will this drug cure this disease? Will this treatment work on this person? Hard to say.

    Either way, it will be a cold day in hell before I allow some petty bureaucrat to decide what is best for my child. They try, though.

    I’m not “all-vaccinations are bad,” just that there are limits to what I will allow as reasonable. I wouldn’t allow the state to make me give my kid Ritalin without my consent, either.

  13. Every time we allow the state to take over from the parents is just another step closer to when the state will be in loco parentis all the time.

    The problem with this is that it’s a slippery-slope argument, and slippery-slope arguments can be used against absolutely everything.  Any imaginable course of action, no matter how reasonable, could conceivably be used to justify something less reasonable, and so on until the slippery slope leads to something completely unacceptable.  The fact is, humans have the ability to exercise judgment and distinguish different types of cases in which different responses are warranted.

    In a case like this, the very high risk of a child dying if the rights of clearly-delusional parents are not temporarily suspended easily outweighs the absolutely negligible risk that doing so would somehow help justify suspending the rights of all parents everywhere at some time in the future.

  14. Ooooo. The big pharma arguement.

    Personally I am praying for snow in the 7th circle.

    In a representative democracy Government is the people. Given that these parents are obviously unable to give adequate care – the proof being they are taking a path that they have been repeatedly told will cause the child to die – the a third party has to fight for the child’s interests.

    The old ‘petty government bureacrat’ arguement. That petty bureacrat is likely to be a trained social worker, who gets to interact daily with the bottom of society, and knows what the score is. Preventing a child from receiving medical attention is child abuse. If they were beating a child because of personal beliefs, of sexually assaulting a child because of personal beliefs, then no one would say “It’s a parents right to”. But leave a child to die, and the anti-intellectual streak comes to the fore.

    5% of adults have IQ less than 75. And these people have exactly the same rights as the top 5%.

  15. That’s the thing though, isn’t it.  I don’t believe in making a kid go through medical treatment they don’t want…it is, after all, their body…but they really need to know exactly what is going on.  This kid doesn’t want the treatment…but like what has been mentioned before, he may not (actually probably doesn’t at all) totally understand his decision to forgo treatment in part because of his parents. 

    I am also curious why they took him to the Dr in the first place then of a sudden didn’t want to take him anymore.  If he decided he didn’t want to do anymore treatment on his own…ok…but there is a big difference between supporting your kid through a tough time and trying to make him understand his disease and then just letting him call all the shots…but then again the article kinda proves that they are kooky to begin with if the mom is saying that he isn’t in any immediate danger, yet there are scans saying his tumor has spread…

  16. I do believe that the government should stay out of people’s private lives as much as possible.

    However given that society has rules protecting children from alcohol, tobacco, sex, drugs etc I don’t see the problem with protecting them from religion.

  17. Zilch: Indeed, no easy answer, but the courts decide the answer.

    Billy: I had the exact same thing with my kids.  We agree.  If you are a skeptic, consider visiting “Libertarian Skeptics”.

    PS – 1) I am registered with Gravatar, so why doesn’t my icon show up. 2) And what is “Location”—this is the only site that requests Location—it is a vague question.

  18. However given that society has rules protecting children from alcohol, tobacco, sex, drugs etc I don’t see the problem with protecting them from religion.

    You mean child abuse laws MAY trump priest privilege? OMG! What is this world coming to?  tongue wink cheese

  19. Sabio, as long as you’re using the same email address you registered with Gravatar it should show up fine. Location is an optional field for folks who like to list whereabouts they hang their hats. It’s not used for anything and can be ignored.

    And it does appear that Daniel and his mom have hit the road to avoid chemo:

    Daniel and his parents, Colleen and Anthony Hauser, were due in court Tuesday to tell the judge results of a chest X-ray. But Daniel’s father was the only one to appear. He told Rodenberg that he last saw Colleen Hauser on Monday evening, and she told him she was leaving. He said that was all he knew.

    The family’s doctor, James Joyce, testified that Daniel’s tumor has grown and he needs immediate assessment by a pediatric cancer doctor.

    Sure seems like those vitamins and herbs are doing wonders for the boy, eh?

  20. Maybe it is case sensitive—let me try.  (because it is the same e-mail)

    It is indeed sad that the boy will die.  Boy’s lost and Mom will have a life time to face herself.

  21. So we have to make a choice: which is more important, my physical death or my spiritual death? Guess we know where the fundies stand on this one. What a pity!  downer

  22. Funny, I argued the State vs. Parent rights against my colleague (an M.D.) and he agreed with everyone here—the State trumps stupid parents. 
    However, then I got to vaccines and he agreed with me “Vaccines should be voluntary”.  Funny, us humans, all sorts of inconsistency, all sorts of areas where we think are sane friends have lost it.  I am sure many feel here that I lost it.  But at least I don’t think you guys are going to hell, eh?  Smiling.

  23. I don’t have a problem with letting the parent’s decisions overrule the State’s with regards to a child’s medical care so long as the parents are held accountable for the death of their kids if such should be the result of the parent’s stupidity.

    That said I think the mandatory vaccines policy is a good thing. It’s not just your kids that may be affected by them not being vaccinated. In which case the State has an overriding interest in making them mandatory.

  24. My view is that you either go all the way in protecting the child or you let the parent’s do what they want.  The kid is NOT legally entitled to his opinion on the matter.  His parents will decide what’s best for him or.. if the state thinks the parents are negligent, then the state decides what’s best for him.

    However, if the state thinks the parents are douche-baggy enough to make the decision, then they should punish the parents severely for endangering their child, not simply make the decision and then walk away.  The child’s LIFE is at stake.  If the parents aren’t doing anything wrong, then leave them alone to kill their kid if they want to.  If the state has to step in to save the child’s life, then what they are saying is that the parents are not qualified to make certain decisions other parents are allowed to.

    That’s some serious trouble.  How do you trust the parents to do the right thing after you walk away if they don’t suffer any consequences after screwing up the first time?

  25. My view is that you either go all the way in protecting the child or you let the parent’s do what they want.

    That would be a reasonable position if the world were simple.  The world is not simple, however.  For instance, in cases concerning what parents do and don’t do with their kids, there is a continuum of balance between rights and responsibilities of parent and state, and thus there will be places where the line is hard to draw.  This particular case is pretty far over my line: the parents have failed, and the state should step in to protect the child’s life.  Other cases, for instance vaccinations, are not so clear cut.

    Making hard decisions is not made easier by the realization that there is no absolute right and wrong to go by; but at least some of the acrimony around defending or criticizing such decisions can perhaps be ameliorated, if we sympathize with those who must make such hard decisions, and with those who must abide by such hard decisions.

  26. Pingback: Daniel Hauser is now cancer free. « Stupid Evil Bastard

  27. Pingback: Stupid Evil Bastard » Daniel Hauser’s father now has leukemia.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.