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updated 3/31/2008 5:12:22 PM ET 2008-03-31T21:12:22
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Ava Worthington is dead. She was only 15 months old when she died. The people responsible are her parents, who relied only on prayer as their child expired before their eyes. The question is whether they deserve to be put on trial for doing so. I think they do.

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Ava succumbed on March 2 to bronchial pneumonia and a blood infection, problems easily treated with antibiotics. But Ava’s parents, Carl and Raylene Worthington of Oregon City, Ore., do not believe in antibiotics. As Ava struggled for days to breathe, her parents prayed, never calling a doctor, an ambulance or 911.

The Worthingtons belong to a small fundamentalist sect, The Followers of Christ Church.  The Followers believe that faith will heal all and that death, if it comes, it is God’s will. 

In fact, death has come often to the children of the Followers. Before Ava, other children died in circumstances where simple, well-proven medical treatments might have saved them.  According to an investigative report done some years back by Mark Larabee of The Oregonian newspaper, at least 38 young children lie in graves in the church’s cemetery in Oregon City.  And the Followers have reported a suspiciously high number of stillborn deaths in recent years.

Ava Worthington is not the only child to become a victim of prayer in recent weeks. Madeline Neumann, 11, of Weston, Wis., died March 23 from an easily treatable form of diabetes after her parents chose to rely on prayer.  According to news reports, Madeline spent a month suffering from nausea, excessive thirst, vomiting and and loss of mobility before she died. 

So far, nothing has been done to punish the Neumanns. Rarely do the authorities take action, because many states have laws that permit exceptions to required medical care if prayer is involved. That sad circumstance may be about to change.

Oregon authorities have charged the Worthingtons with manslaughter and criminal mistreatment in connection with Ava’s death. They should. Not to punish her parents but to make it clear that Americans will not tolerate the neglect and abuse of children in the name of religion.

Any adult has and should have the right to refuse medical care. That option is sometimes chosen by Jehovah’s witnesses who refuse blood transfusions, Christian Scientists who prefer to rely on faith, or others who don’t want to use Western medicine and would rather follow another healing philosophy.

Such decisions make little sense in light of the data showing the ability of modern medicine to treat diabetes, acute trauma, deadly infections, and other life-threatening diseases and injuries.  But they are decisions that ought to be respected nonetheless. The same legal and public policy stance should not extend to children.

Parents do not have the right to watch a child wither away while they pray.  Parents do not have the right to watch a child convulse in pain while they pray.  Parents should understand that if a child is in agony, if a child is slowly dying before their eyes, that they have an absolute duty, the same as any other parent — religious or not — to call the police, an ambulance or emergency services. 

Society must make the protection of children a core value. The way to do that is to make it clear that child neglect is still neglect, even when performed under the cover of religious faith.  So, the authorities in Oregon should prosecute Ava’s parents. It is important, even if they never serve a day in jail.

We need to send the right message to parents — you can rely on prayer, but not when your child’s life clearly hangs in the balance.  When it comes to children, faith must have limits.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.

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