Healing or homicide? The use of prayer to treat sick children

Capital Times, Wisconsin/August 13, 2008

Last Easter Sunday, an 11-year-old Wisconsin girl died of untreated diabetes after her parents chose to pray for her recovery rather than seek medical help. Madeline Kara Neumann's parents, Dale and Leilani Neumann, are scheduled to be arraigned in Marathon County next week on charges of second-degree reckless homicide.

The Wisconsin case is only the latest in a grim procession of hundreds of such cases stretching back to the late 1800s in England, when a sect called the Peculiar People ended up on trial for allowing generations of children to die as a result of their decision to spurn doctors and medicine.

Few realize just how common the use of faith healing still is in our state and elsewhere, and how many children's lives are at stake. Except for the by-now predictable flurries of media attention every time another child dies due to what experts call religion-based medical neglect, there has been surprisingly scant attention paid to the accumulative toll of these deaths. That is one reason UW history instructor and author Shawn Francis Peters decided a couple of years ago to research the controversial topic.

"When Prayer Fails: Faith Healing, Children, and the Law" is the first book to look unflinchingly at the tragic cases of children who have died because their parents place absolute faith in the power of prayer rather than in the efficacy of modern medicine. The book, published this spring by Oxford University Press, came out just weeks before Kara -- as she was called -- died in Weston, propelling Peters into the national spotlight.

In his book, Peters uses trial transcripts, judicial opinions, news accounts, and police and medical reports to explore the views of all the players involved in these cases and the complex challenge of reconciling conflicting values. How does society balance the rights of parents to practice religious freedom and raise their children as they see fit with the rights of children to be protected from neglect, abuse and even death?

The answer: imperfectly. Wisconsin statutes for child neglect and abuse, like laws in most other states, often provide a shield for parents like the Neumanns because of an exemption for faith-healing practices. The result, Peters says, is that children like Kara keep dying. Here are excerpts from a recent conversation.

CT: What made you decide to write this book?

Peters: I'm interested in what happens when really devout individuals run up against the state's power. What are the limits of state power and religious behavior? What happens when religious behavior goes beyond what is acceptable? Where's that line?

Most people believe in the power of prayer. But most people also believe that medicine can and should complement prayer. And most people do not believe that young children should be allowed to die because their parents refuse to seek medical treatment. Yet, there has been a pattern over and over again of children dying from these kinds of cases. It shows the persistence of healing practices, and the difficulties society and laws have trying to regulate them. We're so attached to the principle of religious liberty, we're reluctant to apply manslaughter and abuse laws.

CT: What did you hope to accomplish with this book?

Peters: Recently, this scholarly guy elbowed me at this academic gathering and told me my book was more like journalism than anything else. I saw it as a kind of compliment as opposed to this being 400 pages of theoretical jargon. When I'm writing, I want the people I'm writing about to be able to pick up the book and read it. I want this book to start a sort of conversation about this topic. As it turned out, sadly, this book was timely. I didn't know when I wrote it, of course, that Kara would die, but I suspected that sooner or later, something like this was going to happen in Wisconsin.

CT: You did? Why?

Peters: Because it's a pattern that happens again and again and again.

CT: Does Wisconsin tend to have more of these types of religious groups than other parts of the country?

Peters: Wisconsin is pretty average. Often times, individuals who live in these communities isolate themselves to protect their beliefs and practices from public scrutiny. Many of these people tend to live in rural areas with few neighbors and home-school their children, like Kara. ... And so the possibility of a teacher or someone else reporting a problem is diminished. Often, their children die from untreated illnesses and are simply buried in some church graveyards. So the cases we know about are just the tip of the iceberg. Many members do not report the true cause and numbers of these deaths. The only way we find out about them is if word leaks out, or a relative calls the authorities, which is what happened in the Neumann case.

CT: The Neumanns were involved with an online church called Unleavened Bread Ministries and opened a coffee store in Weston where they ran a sort of ministry. How does this fit in with other cases you've researched?

Peters: It's really a sort of interesting spiritual entrepreneurism. What's out there is not good enough, so these groups start something better. People in these cases don't tend to belong to big, mainstream churches. Often, they're just small groups praying around the kitchen table. They do need some sort of structure, though, and the Web can serve as a kind of glue to bind people together spiritually, while still letting them be physically isolated and distant from the corruption of modern society. The development of new media affects religion profoundly; look at televangelism. TV came along, and religions spread through the TV. The Web can work both ways: Prayer can spread through Web sites, but by the same token, people can avail themselves of scientific information. In fact, Dale looked up Kara's symptoms on the Web.

CT: But his response while she was dying was to pray. Are these people just crazy or stupid?

Peters: No! It's easy to ridicule these people, but we do so at our own peril. Belief in the healing power of prayer is hundreds of years old. One of the reasons Christianity caught fire is that it offered a system of healing, and there was a sort of religious market for that. What sets these more extreme groups apart is the actual renunciation of medicine. Two-hundred years ago, prayer was actually a pretty good alternative to being bled or given huge doses of mercury. As medical science improved in the mid- and late 19th century, and especially with antibiotics, medical science progressed.

CT: Do the deaths of their children persuade these parents that they were wrong about prayer?

Peters: When I started working on my book, I thought there would be lots of people who would lose their kids, and then they would have a revelation. But actually, that's the exception rather than the rule. There have been parents who have had multiple children die. You would think that would be a transformative experience and shake their faith, but for lots of people, the opposite happens. It only reinforces their beliefs. What they will articulate is that God's plan for Kara was to pass away, they were powerless, and why would they have any regret about God's plan? Many of these people believe their children have left the corrupting Earth for a better place.

CT: What do you believe will happen now to the Neumanns in the courts?

Peters: There's a good possibility of a deal being reached. It will be a huge drain on the local DA's time and resources. If it does go to trial, it will probably be appealed to the Supreme Court. The fact that Wisconsin has an exemption in one part of the criminal code but (another part) is not protecting that same conduct raises an issue of due process of law. This has come up repeatedly in other states when there are religious exemptions for faith healing. I do think if it comes to trial, the Neumanns will be convicted by a jury of their peers. Folks are incredulous about the facts of this case and about what the parents failed to do. It's not like the child needed any heroic stuff to get better; she just needed some basic treatment. There's a sense of outrage at what they did.

CT: Do you feel that sense of outrage?

Peters: Yes. Well, not outrage, sadness. This has been a really depressing book to write. I still am horrified by the facts in these cases. I still get sick to my stomach when I read about them. Having kids myself, I would do whatever it takes to stop their suffering when they are sick! But then I step back from that and try to think about how these parents get to this point. We can say it's misguided and ridiculous, but within their world view, they are doing everything they can to help their children. They did what they did because they love their children. To an outsider, of course, it's not love; it's abuse. That's what makes this so tragic. I've looked at hundreds of these cases, and parents never meant to harm their children. It's not even that they were neglectful. They believed that what they were doing was in the best interest of their children. They are Christian, and they interpret what the Scriptures say literally. There's all sorts of stuff in the Bible about miraculous healings. The Epistle of James prescribes prayer and anointment with oil as treatment for illness, rather than the work of physicians.

CT: Wasn't there a big case a few years ago in Wisconsin where a child died during an exorcism?

Peters: In the Cottrell case in Milwaukee, a child died in a religious ritual meant to heal rather than harm. Authorities were restrained by the state law that protects religious healing practices. The case demonstrated the need for reform, but our politicians didn't take any action.

CT: Why not?

Peters: I don't know why the child welfare advocates aren't addressing this, or why there is not more public outrage. Maybe there's not enough momentum; it's like Jonestown in slow motion. There's scattered cases in Wisconsin, but not a big flurry like in other states. I had really hoped that just from embarrassment, the legislators might lurch into action like some other states. But I guess our local politicians are more focused on important issues, like whether or not to keep the state plaid tartan.

CT: Would getting rid of the exemptions to child abuse and neglect laws in Wisconsin be a deterrent?

Peters: Not necessarily. Parents will lose multiple children even after being prosecuted. That's what makes this so hard as a public policy issue. What do you do when people believe there is a higher law? Many of them believe they are being persecuted for following the law of God, and that is a sign that they are right. They believe that the modern world is filled with Satanic evil. They wear their ideology as a badge of honor.

CT: So is it hopeless? Is there a solution?

Peters: I don't know. Right now, there's no dialogue about the relationship between faith and medicine between devoutly religious individuals, law enforcement and authority, and regular people who believe in secular laws. America's view of how to resolve these problems is to pass a law and enforce it, but courtrooms are terrible places to resolve these kinds of intractable problems. It is possible for religious beliefs to evolve and change -- for individuals who are faith healers to adopt a different view of the world -- but it will not happen in a really adversarial context. You can't just say to these people, 'You're an idiot. You killed your own child.' I mean, they can say and will say that people die in hospitals every day. We have imperfect medicine and we have imperfect faith, so why persecute the faith healers and not the doctors?

CT: Is that reasonable?

Peters: The answer to that argument is it's like me saying I'm as good a hitter as someone like Babe Ruth because we both have imperfect batting averages. The fact is that medicine still has a much better batting average than faith healing. There is no doubt that Kara Neumann would have lived if she had just been given some insulin.


Not much about these tragic cases has changed over the past century: A child becomes ill, devout parents refuse modern medical intervention and instead pray for healing, and the child dies. More often than not, the grieving parents then escape legal punishment because of the loopholes for spiritual healing that still snarl most states' child neglect and abuse laws, including Wisconsin's. Here is a timeline of prominent cases. For every case listed, dozens more children have suffered deaths that follow a similar pattern.

1901: The clash of religion, law and child welfare begins in America when two children of J. Luther Pierson die after the New York railroad clerk treats their illnesses with prayer. A benchmark ruling finds Pierson guilty of withholding medical care and creates the legal doctrine that parents, whatever their religious beliefs, have a legal duty to provide adequate medical treatment to their children.

1944: In Prince v. Massachusetts, a case involving the Jehovah's Witnesses, the U.S. Supreme Court rules that the First Amendment's guarantee of religious liberty does not give parents blanket authority: "Parents may be free to become martyrs themselves. But it does not follow that they are free, in identical circumstances, to make martyrs of their children ..."

1967: A Massachusetts court convicts Dorothy Sheriden of involuntary manslaughter after she treats her daughter Lisa's pneumonia with prayer. Sheriden's Christian Scientist Church lobbies successfully to change guidelines for federally funded child protection programs to require states to add religious exemptions to statutes concerning child abuse and neglect. Over the next decades, confusion reigns as more than 40 states -- including Wisconsin -- add religious exemptions to laws while other states repeal them.

1980: Natali Joy Mudd, 4, dies in Indiana from a malignant tumor near her eye. Investigators discover smears of blood along the walls of her home where the little girl, blinded by a tumor as big as a second head, leaned and groped her way around. Outrage over this case and nearly three dozen other preventable deaths among children of Faith Assembly church lead to successful criminal prosecutions of parents and ministers, and reform of Indiana's confusing spiritual healing law.

1982: Jessica Lybarger, 5 weeks old, dies of pneumonia in Colorado after her father insists that "God is the best help." John Lybarger is charged with criminal child abuse. The third effort to convict Lybarger ends in a mistrial, hung up on Colorado's spiritual healing exemption. The loophole is later repealed.

1986: Robyn Twitchell, 2, dies in Massachusetts from a bowel obstruction. Neighbors report hearing screams of pain for days, but the boy's Christian Scientist father, David Twitchell, tells a jury his son's suffering was an illusion. "Pain has no right to exist because God did not authorize it," he says during his trial for manslaughter. The state Supreme Court overturns Twitchell's guilty verdict in part because of the state's spiritual healing exemption, which legislators later repeal.

1987: Wisconsin's child abuse laws are amended to include a spiritual healing exemption.

1988: Ashley King, 12, dies in Phoenix of untreated bone cancer. A detective finds the girl in bed with a tumor the size of a watermelon on her leg. The state hospitalizes Ashley against the wishes of her Christian Scientist parents. The stench of her decaying flesh fills the ward, and she dies.

1991: Measles kills five young members of the Faith Tabernacle church in Philadelphia after parents reject conventional treatment and vaccinations. In an effort to contain a bigger outbreak, health authorities force church members to submit to hundreds of at-home visits. The city's district attorney obtains court orders mandating medical treatment for several sick children and vaccinations for others.

1995: Shannon Nixon, 16, dies in Pennsylvania of diabetes, an illness treatable with insulin. "The devil is fighting me hard," the young Faith Tabernacle member says before vomiting, losing consciousness, and falling into a coma. Shannon's parents were on probation for involuntary manslaughter after her brother, Clayton, died of an untreated ear infection. This time, the Nixons are sent to prison for 2 and a half years.

1997: Dean Michael Heilman, 22 months old, cuts his foot in his Philadelphia area backyard. His parents, members of Faith Tabernacle, anoint the child with oil and pray. After vomiting, bleeding, and crying for 19 hours, Michael stops breathing in his mother's arms. The toddler lost nearly half his blood and was a hemophiliac. The Heilmans are each sentenced to 17 years of probation for involuntary manslaughter and child endangerment, fined $2,000, and ordered to attend parenting classes and provide medical care to their two remaining children.

1998: A study of religion-based medical neglect in the journal Pediatrics documents 172 child fatalities over 20 years among 23 religious denominations in 34 states. Faith Assembly in the Midwest leads, with 64 deaths. The Christian Science Church is second, with 28. The study calls the cases the "tip of the iceberg," since many are never reported. The vast majority of these deaths were avoidable.

1998: Bo Philips, 11, dies in Oregon state from diabetes. A detective finds members of the Followers of Christ praying over the dead child, who is underweight and clad in an adult diaper. A local newspaper investigates his case and the deaths of more than 60 other children buried in the Follower's Cemetery since 1955. More than half died before age 1, at least a third died from treatable illnesses, and none of the deaths resulted in charges being filed against parents. Authorities cite exemptions for spiritual healing as one reason why. Oregon reforms the statutes.

2001: Amanda Bates, 13, dies in Colorado from complications of diabetes, including gangrene in her buttocks and genitals. Other parents in their Church of the First Born had been prosecuted for medical neglect, but Amanda's parents nevertheless treat their daughter with only prayer and are convicted of child abuse.

2003: Terrance "Junior" Cotrell, 4, suffocates in Milwaukee's Faith Assembly church during an exorcism. Minister Ray Hemphill attempts to "release the demons" and lays on top of the boy while Junior's mother prevents the boy from moving. When Hemphill gets off Junior two hours later, the minister is drenched with sweat, and the child is dead. Milwaukee County District Attorney E. Michael McCann charges Hemphill with felony child abuse, fearing the more serious charge of murder won't stick because of spiritual healing protections in Wisconsin state law.

2004: Hemphill is sentenced to 30 months in prison and 7 and a half years of probation. He is also temporarily barred from performing exorcisms. Advocates hope the case spurs Wisconsin legislators to reform the spiritual healing exemption to the state's child abuse statute, following the lead of politicians in Massachusetts, Indiana, Colorado, and Oregon. No Wisconsin legislator takes action.

2008: On March 2, Ava Worthington, 15 months old, dies of pneumonia and a blood infection in Oregon state. The baby's parents, who belong to the Followers of Christ Church, chose treatment with prayer and not antibiotics. Carl and Raylene Worthington await trial for manslaughter and criminal mistreatment.

2008: On March 23, Madeline Kara Neumann, 11, dies of diabetes in her home in Weston, Wis. Parents Dale and Leilani Neumann e-mail a Web site called Unleavened Bread Ministries a desperate request for emergency prayers. When Kara stops breathing, her parents believe she will be resurrected. She is not. The Neumanns are scheduled to be arraigned on Aug. 19 on charges of second-degree reckless homicide. Unleavened Bread Ministries is raising money for their defense. Leilani says on the site that the Heavenly Father will champion their case. Local experts say what might save them instead is the faith healing exemption in Wisconsin's child neglect and abuse statutes.

Shawn Doherty

Information was compiled from "When Prayer Fails" by Shawn Francis Peters, newspaper clips and the Web.

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