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Issues surrounding the ability of a parent to deny medical care for their child has emerged as a contentious topic in health law policy. Parents often cite religious reasons or personal preferences for alternative medical treatments as justification to refuse medical treatment for their child. Although the ability of a parent to consent to potentially life-saving medical treatment for their child is an established law the ability to refuse life-saving treatment is less defined. The basic legal premise for compelling treatment in this country rests on a court-made distinction between religious beliefs and practices.
Supreme Court case of Reynolds v. U.S. (98 US 145) which involved polygamous marriage practices, set a precedent that, while guaranteeing the free exercise of religious beliefs, permits the state in certain circumstances to limit religious practices. Generally, when the state can demonstrate a compelling interest in the preservation or promotion of health, life, safety, or welfare religious practices may be curtailed. (Kasprak) Failure to provide children with essential medical care has been increasingly recognized as a form of neglect. (Bioethics 2013)
According to the Michigan Department of Health and Human Services neglect is defined as: Harm or threatened harm to a child’s health or welfare by a parent, legal guardian, or any other person responsible for the child’s health or welfare that occurs through either of the following: Negligent treatment, including the failure to provide adequate food, clothing, shelter, or medical care. Placing a child at an unreasonable risk to the child's health or welfare by failure of the parent, legal guardian, or other person responsible for the child's health or welfare to intervene to eliminate that risk when that person is able to do so and has, or should have, knowledge of the risk.(Michigan Department of Health and Human Services) In 1983, the US Department of Health and Human Services amended its definition of negligent treatment to include failure to provide adequate medical care.
Many factors are important when evaluating for suspected medical neglect. Some factors include likelihood and magnitude of the harm of forgoing medical treatment and the benefits, risks, and burdens of the proposed treatment. (Bioethics 2013) One example is the risk of one unimmunized child contracting a contagious vaccine-preventable disease may be low if immunization rates in the community are high and disease prevalence is low. Many parents cite religious beliefs as a reason to withhold medical treatment. Some examples are, Followers of Christ refuse all medical treatment in favor of prayer, anointing with oil, and the laying on of hands. Christian Scientists may use dentists and doctors for “mechanical” problems like setting bones or childbirth but consider most illnesses to be the result of the individual’s mental attitude and seek healing through spiritual means, such as prayer. (Bioethics 2013) Other religions only forbid certain medical interventions such as, Jehovah’s Witnesses only forbid the use of blood and blood transfusions.
Over the years court decisions have led to development of laws concerning parents who refuse medical treatment for their children. Courts will generally distinguish between children requiring immediate treatment and those needing only basic or elective care. Courts usually authorize medical care for the children requiring immediate medical treatment.
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