Medical Ethics: Faith Healing vs. Child Medical Rights

Introduction to the Medical Dilemma

This paper reviews and responds to a medical ethics dilemma presented as a case study. The situation involves a divorced couple with a mutual child. The child suffers a sudden onset of vomiting and convulsions and is eventually diagnosed with meningitis. The treating physicians request authorization to begin treatment immediately. The mother — who is not the biological parent of the child but holds primary custody — insists that no medical treatment take place. This position is consistent with her identity as a Christian Scientist; she believes that modern medical intervention is contrary to her religious convictions. The biological father, who resides in another state, demands that treatment be administered and requests that an alternative physician consult with the existing medical team to verify the diagnosis and assist in determining the appropriate course of care.

The ethical dilemma here is essentially two-fold. First, there is the question of whether the mother has the right to determine treatment options for the child in the way she is attempting to do. Second, there is the question of which parent should be permitted to make medical decisions given that the two parents are clearly in disagreement about how to proceed.

In both cases, the mother's decision cannot be accepted. She may assert her religious beliefs with respect to her own medical care, but refusing treatment for her son is not permissible. Physicians have the right — and the professional obligation — to override her directive (Hall, 2016). This would be true regardless of whether she is the biological mother (she is not) and despite the fact that she holds primary custody. She could, as the father requests, seek an alternative medical opinion, but treatment is urgently needed. For that reason, the father's position should be honored, including his request for a consultation from a second physician. That second physician would presumably confirm the diagnosis unless there is a clear indication that something is wrong with the current assessment. The father's request is reasonable given the severity of the child's condition. He is not asking for treatment to stop — he simply wants assurance that the proposed course of treatment is correct. Presumably, he would not seek to halt treatment unless the secondary physician's opinion differed markedly from the original diagnosis (CHOP, 2016).

The Ethical Questions at Stake

The decision-making framework applied here is straightforward. In most circumstances, when a single parent or guardian holds primary custody, that person has primacy over medical decisions concerning their child. The critical exception to that primacy arises when the parent's decision is neglectful, harmful, or illegal. As noted above, the mother is invoking her personal religious beliefs as justification for withholding life-saving treatment from her child. This is not legally or ethically permissible. The evidence and progress of modern medicine demonstrate that her reasoning is gravely flawed, and that withholding treatment will almost certainly result in the child's death. Because the mother's decision constitutes medical neglect, and because the father has put forward a request that is both legally and ethically sound, it is appropriate to honor the father's directive (AJOB, 2016).

Given the illegal nature of the mother's position, the mother and child should be separated and the father's request for immediate treatment should be honored without delay. If the mother becomes disruptive or threatening, security personnel or law enforcement should be called to remove her from the child's vicinity. A second medical opinion will be arranged, either at the hospital's discretion or at the father's preference — whichever the father chooses. The one practical constraint is the availability of the consulting physician. The physician providing the second opinion should conduct an in-person examination, or at a minimum should be able to review video of the patient and access the child's full medical records and clinical data.

The doctrine of parens patriae supports the state's — and by extension, the medical institution's — authority to intervene when a parent's decision places a child's life in danger. Courts in the United States have consistently held that a parent's religious freedom does not extend to denying their child necessary medical care, particularly in life-threatening situations.

The following represents the appropriate communication to each parent regarding the medical team's decision.