Law and Religion: Refusing Medical Care and Vaccinations for Religious Reasons

Most religions believe in the power of faith and prayer to comfort and heal the sick. For most of these sects, religious healing accompanies conventional medical care.

A few of these sects rely exclusively on religious healing. They oppose medical care. They put their trust in God. To rely on human medical treatment is to deny their faith.   

A few rules can be distilled from the plethora of legal cases involving the issues of religious refusal of medical treatment.  

General Rule No. 1: Adults

The courts will uphold religious adults’ refusal of medical treatment for themselves regardless of whether the condition is life threatening.

A fundamental right of healthcare is that a patient can refuse medical treatment

About a third of the states allow a religious “mature minor” to refuse medical treatment. The factors include:
(1) the maturity of the minor,
(2) the sincerity of the religious belief,
(3) the odds that the treatment will be successful, and
(4) the seriousness of the medical condition.

For example, in a Washington case, a 14-year-old Jehovah’s Witness boy died after he was allowed to refuse a blood transfusion that would have saved his life.

General Rule No. 2: Children – Life Threatening

When a child’s life is threatened, the courts will order medical treatment over the objections of the religious parents.   

Courts usually defer to parental authority and allow parents to refuse routine treatment for their minor children. However, the authority is not limitless.

The government has a compelling state interest in:
(1) protecting children,
(2) preserving life,
(3) preventing suicide, and
(4) maintaining the integrity of medicine

When dealing with a life-and-death situation with a child, the state’s interests will outweigh the religious and parental rights.  

The U.S. Supreme Court announced, “While parents may be free to become religious martyrs themselves, they are not free to make martyrs of their children.” (Prince v. Mass., 321 U.S. 107)

General Rule No. 3: Children – Not Life Threatening

When the child’s condition is not life threatening, the courts may or may not, order medical care over the parent’s religious objections. The courts are divided on this issue.

On the one hand, American courts have compelled medical treatment over the religious objections of the parents for: cyst removal, sickle-cell anemia, serious burns, concussion with possible brain damage, malignant eye growth, and leg deformity.

On the other hand, American courts have refused to compel medical treatment over the religious objections of the parents in cases of: epileptic seizures, congenital cleft palate, and polio.

Rule No. 4: Vaccinations and Communicable Diseases

One exception to the religious right to refuse medical treatment involves mandatory vaccinations for communicable diseases. 

The U.S. Supreme Court resolved this issue in 1905. The state of Massachusetts mandated vaccinations in an effort to eradicate the small pox pandemic. Failure to get vaccinated was a crime subject to a fine. The defendant refused on religious grounds. The defendants also claimed the vaccines were untested and unsafe.

The U.S. Supreme Court noted that the issue was not just the religious freedom of the individual, but also the health and welfare of the general public. The Court ruled that ensuring the health and safety of the general public was within the powers of the state, and outweighed the individual’s freedom of religion.

 “On any other basis organized society could not exist with safety to its members.  Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy.” “Upon the principle of self-defense, of paramount necessity, a community has the right to protect itself against an epidemic of disease which threatens the safety of its members.”  (Jacobson v. Massachusetts, 197 U.S. 11 (1905))

Children are often required to be vaccinated for small pox, polio, mumps, measles, and other communicable diseases in order to attend public schools. However, some legislatures have granted religious exemptions to vaccinations. But according to the Jacobson case, such exemptions are not compelled under the Constitution.

Rule No. 5: Parental Criminal Liability

Refusal to provide medical care for children because of religious objections of the parents can subject the parents  to criminal liability.

Over the last decades, scores of parents have been criminally prosecuted for withholding necessary medical treatment from their children. 

For example, in California, a Christian Scientist mother relied solely on a church health practitioner to treat her daughter for flu-like symptoms.  After receiving religious treatment instead of medical care, the child died.  She had meningitis. The mother was prosecuted for involuntary manslaughter and felony child endangerment. The California Supreme Court held that the compelling state interest in preserving life outweighed the mother’s right to practice her religion. (Walker v. Superior Court, 47 Cal.3d 112 (1988)

Another example, in Florida, Christian Scientist parents were convicted of child endangerment.  Their daughter was treated by a Christian Science nurse through faith healing, without medical care.  The daughter died from untreated juvenile diabetes. (Hermanson v. State, 604 So.2d 775 (1992)

Another example, in Pennsylvania, parents were convicted of involuntary manslaughter and child endangerment when their infant son died from the brain tumor.  The parents were members of the Faith Tabernacle Church which relied exclusively on God for healing.  The church believed that to seek medical treatment jeopardized the eternal welfare of parents and children. (Commonwealth v. Barnhart, 497 A.2d 616 (1985)

Rule No. 6: Parental Civil Liability

Refusal to provide medical care for children, because of religious objections of the parents, can subject them, and others, to civil liability.  

For example, in Minnesota, a man sued his former wife, a Christian Scientist, for failure to provide medical treatment for their son who died from diabetic ketoacidosis. The jury awarded a $1.5 million dollar verdict against the mother, several Christian Science practitioners, and against the First Church of Christ, Scientist.  In addition, the jury also awarded punitive damages against the Church in the amount of $9 million. (Lundman v. McKown, 530 N.W.2d 807 (Minn.App. 1995).

Exception; Parental Immunity Statutes

The majority of states have enacted exemptions for religious healing from criminal and civil liability.

Some of these statutes provide total immunity, and some provide partial immunity.  Some protect parents only from misdemeanor crimes, while others protect against felonies including manslaughter and murder.   

Some states never enacted a statutory exemption. Some states have repealed their exemptions. The statutes and court rulings are different in each state.

Jehovah’s Witnesses and Blood Transfusions

Jehovah’s Witnesses’ refusal of a medical procedure is narrow and unique. They only oppose blood transfusions. They interpret the Bible’s prohibitions against eating and drinking blood to mean any “ingestion.” This includes blood transfusions. Witnesses refuse blood transfusions even in life-and-death situations.  Some Witnesses will allow transfusion of plasma or other non-whole blood products.

The same general rules apply.  The adults can refuse blood transfusions for themselves even if to do so is life threatening. But when it comes to their children, courts will force blood transfusions under life threatening conditions. If the condition is not life threatening, the court will generally defer to the parental authority.

(Brett London, “Law and Religion: Cases and Materials,” 6th ed. Chapter 7, “Religious Beliefs and Medical Treatment,” (1998); Shaakirah, “Religious Healing Exemptions and the Jurisprudential Gap Between Substantive Due Process and Free Exercise Rights,” UCI Law Review, Sep 10, 2018; Rosato, “Putting Square Pegs in a Round Hole: Procedural Due Process and the Effect of Faith Healing Exemptions in the Prosecution of Faith Healing Parents,” 29 U.S.F. L. Rev. 43, 59 (1994); “Christian Science,” “Jehovah’s Witnesses,”  “Jehovah’s Witnesses and Blood Transfusions,” Wikipedia.)

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