The medical ethics principle of autonomy justifies letting competent adults reject lifesaving medical care for themselves because of their religious beliefs, but it does not extend to rejecting medical care for children.
We have written a lot about people who reject science-based medicine and turn to complementary/alternative medicine (CAM), but what about people who reject
the very idea of medical treatment?
Faith healing is widely practiced by Christian Scientists, Pentecostalists, members of the Church of the First Born, the Followers of Christ, and myriad
smaller sects. Many of these believers reject all medical treatment in favor of prayer, anointing with oils, and sometimes exorcisms. Some even deny the
reality of illness. When they reject medical treatment for their children, they may be guilty of negligence and homicide. Until recently, religious shield
laws have protected them from prosecution, but the laws are changing, as are public attitudes. Freedom of religion has come into conflict with the duty of
society to protect children.
The right to believe does not extend to the right to endanger the lives of children. A new book by Cameron Stauth (2013), In the Name of God: The True Story of the Fight to Save Children from Faith-Healing Homicide, provides the chilling details of the struggle. He is
a master storyteller; the book grabs the reader’s attention like a fictional thriller and is hard to put down. He is sympathetic to both the perpetrators
and the prosecutors of religion-motivated child abuse, and he makes their personalities and their struggles come alive.
Rita Swan: From Christian Scientist to Crusader
Rita and Doug Swan were Christian Scientists who firmly believed that disease was an illusion and that “the most dangerous thing they could do was to show
lack of faith in God by relying on medical treatment” (Stauth 2013). (One wonders just how strong their belief was, since when an ovarian cyst caused
intractable pain, Rita had surgery to remove it.) When their baby Matthew developed a fever, they paid a Christian Science practitioner to come to their
home and pray over him. She told them fever was just fear, and indeed, Matthew recovered.
At the age of sixteen months, Matthew developed a fever again and this time he didn’t improve with the practitioner’s prayers. Rita and Doug were worried
but unwilling to reject the lifelong beliefs that made sense of their lives. Rather than taking Matthew to a doctor, they compromised by calling in a
second Christian Science practitioner. The practitioner accused Rita of sabotaging her work with fear, and both parents believed that “defects in their own
thoughts” were responsible for Matthew’s illness. Eventually they called in a Christian Science “nurse” (trained in metaphysics, not medicine). She did
nothing except talk to Rita. Shortly after she left, Matthew began having convulsions. The desperate parents found an escape strategy: they would take
Matthew to a doctor with the complaint of a broken bone (something the Church allowed to be treated by a doctor), and would not mention the fever. He was
quickly diagnosed with bacterial meningitis and a brain abscess. They had waited too long. Despite intravenous antibiotics and surgery to relieve pressure
on the brain, Matthew died.
That happened in 1977. The Swans promptly resigned from the church. They filed a wrongful death lawsuit, but the case was dismissed. Ever since then, Rita
Swan has devoted her life to preventing the deaths of other children from faith healing. She founded the Matthew Project, which developed into a foundation
called CHILD (Children’s Healthcare Is a Legal Duty). She exposed case after case of child abuse that would otherwise have gone unnoticed and reported
outbreaks of polio and measles in Christian Science schools and camps. She documented preventable deaths of Christian Science children from meningitis,
diabetes, diphtheria, measles, kidney infection, septicemia, cancer, and appendicitis. The Church fought her at every step, but the surrounding publicity
only contributed to the ongoing decline in Church membership (they don’t announce membership numbers, but the number of U.S. churches has fallen from 1,800
to 900, and by one estimate they have fewer than 50,000 members in the entire world).
As time passed, Rita Swan turned her attention to similar abuses in other religious sects. A one-woman tornado, she cut a swath across America. She headed
a child advocacy organization, published a quarterly newsletter, wrote articles, became a media presence, spoke at conferences on child abuse, lobbied and
testified in states where proposed bills would help or hinder her cause, and even moved to Oregon for a time during the campaign to pass effective
legislation there. She was eventually instrumental in getting religious shield laws changed in several states.
An Indiana Case
One of the first deaths Rita discovered that was not related to Christian Science was in Indiana. As Stauth tells the story:
4-year-old Natali Joy Mudd was found dead by detectives in her own home, with a tumor in her eye that was almost as big as the rest of her head. At the
horrific scene, a police sergeant found horizontal trails of blood along the walls of the house. The trails matched the height of the girl’s head. Natali
had apparently been leaning against the wall as she dragged herself from room to room, blinded, trying to find a way to freedom, before the tumor killed
her. (Stauth 2013)
Natali’s parents belonged to the Faith Assembly Church, a Pentecostal offshoot. They didn’t believe in medical care, and they were not prosecuted because
Indiana had strict religious shield laws. Two years later, Natali’s five-year-old sister died from an untreated tumor in her stomach the size of a
The Faith Assembly Church was responsible for as many as 100 childhood deaths and for a maternal childbirth mortality rate that was 870 times the usual
rate. The most common cause of death was infant mortality in home births; something that is now rare in Christian Science because it now supports prenatal
care and hospital births attended by doctors.
The Faith Tabernacle Church
The Faith Tabernacle Church is a sect that has been responsible for deaths from exorcisms in several countries. One believer strangled her five-year-old
son to death and kept his body for several days hoping for his resurrection. One couple in Pennsylvania lost six children, all under the age of two, to
untreated illnesses. A measles epidemic involving 491 people resulted in the deaths of six children. One couple was prosecuted for letting their
sixteen-year-old daughter die of untreated diabetes, but their sentence was only two years’ probation and community service at a hospital (and the hospital
didn’t want them).
The Pediatrics Article
In 1998, pediatrician Seth Asser and Rita Swan published an article in the medical journal Pediatrics titled “Child Fatalities from
Religion-motivated Medical Neglect” (Asser and Swan 1998). They documented 172 faith-healing deaths over a twenty-year period, involving twenty-three
different sects in thirty-four states. The true numbers were undoubtedly much higher, since these cases were collected informally rather than
systematically and some deaths are never reported. In most of these cases the prognosis would have been excellent with medical care. Asser later
characterized some of the cases as babies literally being tortured to death. In one case, a mother died in childbirth after the infant’s head had been at
the vaginal opening for more than sixteen hours. The infant’s corpse was so foul smelling that it was inconceivable that anyone attending the delivery
could have not noticed.
In 1988, the American Academy of Pediatrics had called for elimination of religious exemption laws, and in 1983 the federal government had removed
religious exemptions from federal mandate; but at the time of the study there were only five states that had no religious exemptions either to civil abuse
and neglect charges or criminal charges.
The Followers of Christ in Oregon
In 1997, twenty years after Matthew Swan’s death, a six-year-old boy in Oregon died from a necrotic bowel due to a hernia that could easily have been
treated. The pathologist’s first reaction was “Not again!” He and his associate had compiled evidence of eighteen children who had died over the last ten
years from curable diseases in a Followers of Christ congregation of 1,200 people. That worked out to twenty-six times the usual infant mortality rate. And
it wasn’t just children: followers’ wives were dying in childbirth at 900 times the usual rate. One died of a type of infection that hadn’t killed anyone
in America since 1910.
Nothing could be done about it, because Oregon had one of the strongest religious shield laws in the country. It protected parents from allegations of
religious intolerance and gave them the right to withhold medical care for their children. In fact, the shield had just been beefed up: a new law to
increase the punishment for murder by spousal or child abuse specifically prohibited prosecution for manslaughter if the person responsible was acting on
A TV reporter named Mark Hass was told that there had been a cluster of preventable deaths among the Followers of Christ in Oregon City. He looked into it,
but there were no criminal complaints, no police investigations, and the county DA was uninterested. When his investigation seemed to have reached a dead
end, someone suggested he visit the local cemetery. He counted the graves of seventy-eight children, far more than expected for a community that size. He
launched America’s first major series of TV reports on faith-healing abuse on KATU in Portland.
The Psychology of Believers
Even Rita and Doug Swan found it hard to break away from the seductive premise that the power of belief itself could heal, a create-your-own-reality idea
that is echoed by Rhonda Byrne in The Secret and by a host of other New Age gurus.
The faith-healing sects truly believe they are doing the right thing when they let their children die; they accept it as God’s will. Some believers even
refuse to wear seat belts. Their inconsistent behavior shows that they tend not to have thought things through very carefully. They hypocritically accept
care from eye doctors and dentists. Adults often clandestinely seek medical care for both major and minor medical problems while children don’t have that
option. In some cases parents saw a doctor for hangnails or mole removal for themselves yet refused to take their child to a doctor for a fatal illness.
Their beliefs come from groupthink and social consensus rather than from reasoned theology or the Bible. Many of them have not read the Bible; when a
whistle blower did, he was surprised to learn how much it differed from what he had been taught. They have a supportive, close-knit community and face
overwhelming peer pressure. If they resort to medical care, they are shunned by everyone they know and may never see anyone in their family again.
There has never actually been a single extraordinary healing among the Followers, only ordinary recoveries from common illnesses; however, that’s enough to
convince them prayer works—if only their belief is strong enough. Confirmation bias is a powerful thing, and when a child dies the death is considered
unavoidable and is attributed to God’s will. An insider said he thought that if a few Followers were punished, the rest would rationalize that going to
doctors was okay after all and would come up with a new doctrine. He thought most of them would be happy to change if everybody else did. When courts have
ordered blood transfusions for the children of Jehovah’s Witnesses, they have sometimes seemed more concerned about what their co-religionists would think
than about the religious implications of the transfusion itself.
Progress in Legislation
The first state to repeal a religious shield law was South Dakota. Then CHILD won a federal lawsuit in Minnesota, arguing that taxpayers should not be
required to subsidize Medicare and Medicaid payments for Christian Science nursing. Unfortunately, Senator Orrin Hatch negated their win by getting a new
law passed that provided for Medicare payment for “religious non-medical health care.” CHILD sued again but this time they lost. In 1999, a compromise bill
was passed in Oregon eliminating religious shields for murder by abuse, murder by neglect, first- and second-degree manslaughter, and criminal
mistreatment. After this, no followers died of medical neglect for the next five years, and there were major modifications in the shield laws in several
Examples of Prosecutions
Josef Smith, eight years old, was beaten to death during an exorcism in Tennessee. His parents, members of the Remnant Fellowship, were found guilty of
murder and sentenced to life in prison plus thirty years.*
A mother who beat and smothered her child was sentenced to life in prison for first-degree murder. She gladly accepted her punishment as part of God’s
The people who starved a sixteen-month-old to death for failing to say “Amen” and then absconded with his corpse in a suitcase were sentenced to fifty
years each for second-degree murder.
A test case was needed in Oregon, but DAs were reluctant to prosecute, and even church members who no longer approved of their own churches were too
frightened to provide inside information. Finally Patrick Robbins turned whistle blower after the death of his newborn baby led him to doubt the teachings
of the Church. His assistance led to several prosecutions.
In 2008, fifteen-month-old Ava Worthington died from a softball-sized lump on her neck that obstructed her breathing and caused pneumonia. Investigation of
the case was difficult, because witnesses denied having observed any signs that the child was in distress. Her parents were the first to be tried under the
revised 1999 law. The jury was sympathetic to the parents. The father was convicted of misdemeanor criminal mistreatment but not of manslaughter; he spent
two months in jail. The mother was found not guilty.
The Beagleys were convicted of criminally negligent homicide in the death of their sixteen-year-old son Neal for complications of a congenital urinary
tract anomaly that could have easily been repaired. They each served sixteen months (consecutively, so one of them was always home to care for their other
Eighteen-month-old Alayna Wyland nearly went blind from an untreated enlarging hemangioma that obstructed her left eye. She was rescued just in time for
pediatric ophthalmologists to save her eyesight, and her parents were tried for first-degree criminal mistreatment of their child. They got ninety days in
jail and three years’ probation.
These are tragic cases. No one likes to see children taken away from their parents, and these parents loved their children and truly believed they were
doing the right thing. They were victims too.
Oregon’s 2011 Law
The Oregon 1999 compromise bill was not enough; it had repealed five of the nine religious shield exemptions but left four others in place. After five
years without a death, three more Followers’ children died in 2008 and 2009. In 2011, after extensive lobbying by Rita Swan and others, Oregon passed a new
law to eliminate religious beliefs entirely as a legal defense and allow prosecutors to seek murder charges against parents who deny their children medical
care for religious reasons. There are only five other states with no religious exemptions for sick and injured children: Hawaii, Nebraska, Massachusetts,
Maryland, and North Carolina.
But Oregon law still allows religious exemptions for caregivers of dependent adults, and it still allows religious exemptions for immunizations, metabolic
screening (for conditions like PKU), newborn hearing screening, vitamin K and prophylactic eye drops for newborns, and bicycle helmets. Ashland, Oregon,
has the highest school vaccine exemption rate of any U.S. city; in one school in Eugene, 76 percent of students had rejected one or more vaccines for
religious reasons. The religious exemption for bicycle helmets is particularly puzzling: where in the Bible does it say “Thou shalt not wear bicycle
helmets” or even “Thou shalt take no precautions against injury”? The reasoning seems to be that if God wants a child to die from a head injury, we
shouldn’t get in his way.
The Oregon law is being enforced. Later in the very year the law was passed, 2011, Dale and Shannon Hickman were found guilty of second degree manslaughter
in the death of their infant son, prematurely born at home with only unqualified midwives in attendance. They were sentenced to six years and three months
in jail, followed by three years supervised probation.
The Tide Turns
A few months later, when Oregon members of the Church of the First Born were accused of negligent homicide for the death of their son from a treatable
condition, they didn’t even try to fight but pled guilty. They agreed to provide medical care for their other children and were sentenced to probation with
Some members of the Followers of Christ sect were starting to accept medical treatment and even wondering what all the fuss had been about.
In Philadelphia, Herbert and Catherine Schaible were put on ten years’ probation after their two-year-old died of untreated bacterial pneumonia. The terms
of their probation required them to purchase medical insurance and put their other children under the care of a pediatrician. They callously disregarded
the terms of probation and their eight-month-old son died of untreated bacterial pneumonia when they failed to seek medical care for him. They were charged
with third-degree murder, involuntary manslaughter, conspiracy, and endangerment. They were jailed and denied bail because the judge feared their
co-religionists might hide them in other parts of the country. They pled “no contest.” Their pastor said the father “…knows he has to obey God rather than
man.” He said the children died because of the parents’ “spiritual lack.”
Following the Followers to Idaho
Investigative reporter Dan Tilkin of KATU News covered the Oregon court cases, and he has recently reported on ten more dead children of the Followers of
Christ in Idaho, where religious shield laws are still in place. Of the marked graves in the Peaceful Valley Cemetery, more than 25 percent are children.
Sadly, his report ends by saying, “No significant move to change the laws is underway” (Tilkin and Lane 2013).
The medical ethics principle of autonomy justifies letting competent adults reject lifesaving medical care for themselves because of their religious
beliefs, but it does not extend to rejecting medical care for children. Society has a duty to override parents’ wishes when necessary to protect children
from harm. It is not uncommon for the courts to order life-saving blood transfusions for the children of Jehovah’s Witnesses or cancer treatment against
parents’ wishes. But thirty states still have religious shield laws, and every state but Mississippi and West Virginia allows religious and/or
philosophical exemptions for school vaccination requirements. Those laws should be repealed. The Affordable Care Act (“Obamacare”) requires insurance
companies to cover “nonmedical” health care such as prayers by Christian Science practitioners. That provision should be removed.
It has been argued that most of the increase in human lifespan is due to advances in hygiene rather than to advances in medicine. The estimates of a
twenty-six-fold increase in infant mortality and a 900-fold increase in maternal mortality among the untreated Followers of Christ demonstrate just how
valuable modern medical care really is.
Another valuable source is available free online: the newsletter archives of CHILD (Children’s Healthcare Is a Legal Duty, http://childrenshealthcare.org).
It describes many more tragic cases of children who have been harmed or have died from religion-motivated child abuse and neglect.
* Update: The fatal beatings that killed Josef Smith occurred in Georgia not Tennessee. Joseph and Sonya Smith deny that the beatings were part of an exorcism.
Asser, Seth M., and Rita Swan. 1998. Child fatalities from religion-motivated medical neglect. Pediatrics 101(4): 625–29.
Stauth, Cameron. 2013. In the Name of God: The True Story of the Fight to Save Children from Faith-Healing Genocide. New York: St. Martin’s Press.
Tilkin, Dan, and Dusty Lane. 2013. Fallen followers: Investigation finds 10 more dead children of faith healers. KATU News (November 7). Online at