Challenging Medical Authority : The Refusal of Treatment by Christian Scientists

As a member of a hospital ethics committee in a city with a very large Christian Science population, I have seen firsthand the stalemate between Christian Scientists and physicians, especially concerning the treatment of Christian Science children. Physicians claim that it is a violation of their professional duties to allow suffering that could be prevented by medical treatment. Christian Scientists claim that it contravenes their religious freedom to be forced to subject their children to medical treatment in violation of their religious beliefs. The stalemate is made more tragic since neither physicians nor Christian Scientists want children to suffer or die, yet Christian Scientists refuse even to have their sick children diagnosed for fear that the physicians will try to force them to accept medical treatment. Unlike most discussion of this topic, in this paper I will consider the Christian Science refusal cases as exemplifying a conflict of groups over authority within a pluralistic society. Two Christian Science Refusal Cases From the medical perspective, the Christian Science community simply cannot be respected. What Christian Scientists understand as doing what is best for their children physicians perceive as serious threats to the fundamental rights of those children. Let us consider a case that most doctors and lawyers take to be a good illustration of why we should not recognize the authority of Christian Science parents or give equal respect and treatment to the Christian Science community. On a Thursday evening in early April of 1986, two-year-old Robyn Twitchell ate a normal dinner but experienced severe pain and vomiting shortly afterward. The pain and vomiting continued into Friday and Robyn's parents, both committed Christian Scientists, consulted several Church officials who determined that his pain was in his lower abdomen. After another day of intense pain and vomiting, on Saturday a Christian Science practitioner, Nancy Calkins, came to the Twitchell house to pray for Robyn. Robyn was still unable to hold down food or liquids, and so on Monday a Christian Science nurse was called who also ministered to Robyn. By Tuesday evening Robyn Twitchell died. An autopsy was conducted and it was determined that Robyn had a bowel obstruction, which, in the opinion of one physician, "could have been readily corrected by surgery with an almost one hundred percent chance of success."[1] The mainstream position in medicine and law is that even in a pluralistic society a line needs to be drawn at the point where respecting a religious minority culture clearly jeopardizes the well-being of children. What makes the case of Robyn Twitchell so tragic is that a relatively simple operation could have saved his life. The fact that his parents refused even to secure a medical diagnosis meant that they were completely unaware of how seriously ill their son was. Indeed, in another highly publicized case, the parents whose failure to secure a medical diagnosis and simple treatment resulted in the death of their child have subsequently left the Christian Science Church and lobbied against statutory religious exemptions to the child abuse and neglect laws.[2] In the case of Robyn Twitchell, it seems clear to most physicians that respecting the beliefs and choices of Christian Scientists meant that Robyn's right to life and his right to minimally adequate health care were jeopardized. From the medical perspective, he may as well have been left alone by his parents to die, given what little they did to save his life. On such a view, respecting the wishes of these Christian Science parents meant that Robyn Twitchell was the subject of child neglect. When the Twitchell case is used as a model, Christian Science seems to be the kind of community that cannot and should not be given equal respect with the other communities in our pluralistic society. Consider another case of Christian Science refusal that is perhaps more representative of die clash between medical and Christian Science perspectives. …