Opinion ID: 2630325
Heading Depth: 3
Heading Rank: 2

Heading: The Trial Court Properly Rejected Killpack's Proposed Jury Instruction Regarding a Parent's Treatment Options for a Child's Medical Condition

Text: ¶ 32 Killpack's second proposed jury instruction is based on the medical treatment defenses provided for in the child abuse statute. Specifically, Killpack relied on the defense that [a] parent or guardian of a child does not violate this section by selecting a treatment option for the medical condition of the child, if the treatment option is one that a reasonable parent ... would believe to be in the best interest of the child. [17] ¶ 33 Killpack maintains that she was entitled to an instruction based on this defense for two reasons: (1) Reactive Attachment Disorder is a medical condition within the definition of the statute because it is listed in the DSM-IV (Diagnostic & Statistical Manual of Mental Disorders, 4th ed.), and (2) her actions (i.e., forcing Cassandra to drink an excessive amount of water) were the result of a course of treatment prescribed, recommended, and/or approved by the mental health providers. ¶ 34 In rejecting Killpack's proposed instruction, the trial court focused on the definition of medical condition in the child abuse statute and held that under these facts Reactive Attachment Disorder is not a medical condition. [18] While we affirm the trial court's decision to reject the proposed instruction, we wish to clarify that RAD is a medical condition for purposes of the child abuse statute. ¶ 35 Over the past several decades, healthcare professionals have made broad advances in the diagnosis and treatment of mental disease. Such illnesses are now recognized by both the medical community and the populace at large as conditions that may require medication and often intensive treatment by doctors. We find it unlikely that the legislature intended to exclude mental illnesses from the definition of medical condition. [19] Consequently, we hold that mental illnesses are medical conditions as that term is used in the child abuse statute. ¶ 36 Having determined that RAD fits within the definition of medical condition, the next question is whether Killpack presented evidence sufficient that a jury could find that a reasonable parent would employ forced water ingestion in the excessive amount employed by Killpack as a treatment method for Cassandra's RAD. Given the paucity of evidence presented by Killpack at trial, the answer is clearly no. As such, the trial court was correct in rejecting this instruction. ¶ 37 Killpack did present some evidence in support of her medical treatment defense. Killpack's husband testified that prior to the events of June 9, 2002, he had discussed with Cascade's therapists an incident where the Killpacks had forced Cassandra to drink water as punishment for misbehavior. According to Killpack's husband, the therapist told Killpack that two or three more times of that, and [Cassandra] should be fine. ¶ 38 Though minimal, this does constitute evidence on which a jury could have relied for finding that a reasonable parent would have used some measure of forced water ingestion as treatment for RAD. There is no evidence, however, on which a jury could have relied to find that a reasonable parent would have used the extreme amount of water Killpack forced into Cassandra on the night of June 9, 2002. Nor did Killpack present evidence to support a finding that a reasonable parent would have believed that such treatment was in the best interest of her child. [20] ¶ 39 Additionally, regardless of the jury instruction, Killpack was never precluded from mounting a full medical treatment defense based on the statute. Killpack had every opportunity to present evidence regarding Cassandra's medical condition, the treatment options she employed, and her belief in their efficacy and safety. In short, Killpack was permitted to fully present her defense that she was treating Cassandra's medical condition reasonably and doing so with the child's best interest at heart. ¶ 40 By finding Killpack guilty of child abuse homicide, the jury found that she recklessly disregarded a substantial risk of seriously injuring her child. In this case, the jury's finding of recklessness is incompatible with a conclusion that Killpack's treatment of Cassandra was reasonable. Consequently, even if we were to assume the trial court erred in rejecting Killpack's proposed instruction regarding reasonable treatment options for Cassandra's medical condition, Killpack was not harmed by the exclusion.