In a small Illinois town during the summer of 1977, 15-month-old Matthew Swan came down with a fever, headache and stiff neck, unmistakable signs of bacterial meningitis. This was a medical emergency, but Matthew’s parents, both college professors with Ph.D.s, were Christian Scientists.
They took the child to a hospital only two weeks later, after local Christian Science practitioners had failed to help him. He died shortly afterward, pockets of pus scattered through his brain.
The Swans were irremediably furious at their church and at themselves. Matthew’s mother, Rita, ultimately became one of the country’s most visible and vocal opponents of religious prohibitions against medical care.
“We do not believe that society should have allowed us to do what we did to our child,” she said.
But the Swans are hardly the only victims of their beliefs. In a groundbreaking 1988 article in the journal Pediatrics, Ms. Swan and a co-author summarized almost 200 cases similar to Matthew’s. Now Dr. Paul A. Offit, a pediatrician at the University of Pennsylvania, details many more in a new book, “Bad Faith,” (Read excerpt.) deploring the use of prayer as a substitute for standard pediatric care.
The book’s tone is angry from beginning to end — not at religion itself, as Dr. Offit takes pains to emphasize, but at those who use it for this purpose, and the system that lets them do it.
Adults are more or less free to doctor themselves as they like, but children are captives. Some of those described by Dr. Offit, like Matthew, were healthy children who died from treatable bacterial infections. Some were diabetics who died without insulin. Some had one of the curable cancers of childhood and died without treatment.
Perhaps the most appalling case was that of a 2-year old girl who ate a small piece of banana and began to choke: Her parents urgently convened a prayer meeting while the child turned blue and died.
You’d think there’d be a law, and in some countries there is. In the United States, where freedom of religion is a fundamental guarantee, the long struggle to abolish this particular form of child abuse continues. Dr. Offit’s overview of these efforts is gripping.
He begins with a brief summary of the long, complicated relationship between Western religion and disease. In the Old Testament, illness was generally considered punishment for sin or, as in the case of Job, a test of faith. The New Testament eliminated these metaphors, introducing a more modern view of illness, devoid of moral overtone, often simply the result of bad luck.
Still, even as Christianity forged deep alliances with orthodox medical practice (medieval monasteries were the forerunners of the modern hospital), faith healing gained and retained huge popularity.
Dr. Offit theorizes that its continuing appeal stems from an innate human craving for mystery and magic, both hard to find in modern religion and modern medicine. Also, he points out dryly, faith healing can work quite well.
The feel-good brain chemicals called endorphins that accompany religious ecstasy may help a sick person feel better without affecting his disease. In addition, illnesses eventually heal themselves often enough to reinforce the apparent power of prayer.
But, as Rita Swan learned when she left the Christian Science faith and began to learn about medicine, illness that never heals itself may look just like illness that does. Cases of bacterial and viral meningitis, for instance, can be very difficult to tell apart: Children can look and feel equally sick with either. There is one big difference: Viral meningitis may appear to respond to prayer, because it is a self-limited disease. Cases of bacterial meningitis, left untreated, are generally fatal.
Child abuse has become a well-studied and regulated part of pediatrics, with legislation in every state. When it comes to the religious-based withholding of medical care by parents, however, legislators have been remarkably skittish.
The Supreme Court, Dr. Offit reports, has never weighed in on a faith-healing case, though in a 1944 child labor case with religious overtones, Justice Wiley B. Rutledge wrote in the majority opinion that “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.”
State courts have consistently upheld the right of hospitals to give lifesaving blood transfusions to the children of Jehovah’s Witnesses, although transfusion violates the tenets of that religion. The Supreme Court affirmed these rulings in 1968. A few years later, however, the wording of a federal child protection act was tweaked specifically to allow religious exemptions for what might otherwise be deemed neglect.
On matters other than transfusion, state law is all over the place. As of 2013, Dr. Offit reports, 41 states allowed religious exemptions to vaccination; 38 states and the District of Columbia allowed religious exemptions in civil cases of child abuse, and 17 states allowed them in criminal cases.
Dr. Offit’s home state of Pennsylvania permits a religious exemption to the wearing of bicycle helmets, and is one of a few that permit parents with religious objections to medical care to adopt children.
In places where these exemptions do not existincluding Canada, Britain and, as of 2011, Oregon, medically avoidable deaths among children ascribed to parent’s religious beliefs have essentially disappeared. In most of the United States, they continue to occur.
“Bad Faith” is the most recent volume in what seems to be the small encyclopedia that Dr. Offit is producing on irrational incursions into modern medical practice. His last book, “Do You Believe in Magic?” in 2013, investigated the claims of alternative medicine, and several previous books were devoted to the antivaccine movement.
With “Blind Faith,” perhaps even more than with his previous books, Dr. Offit is probably preaching only to the choir. That doesn’t make his message any less important.
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