Well-intentioned but wrong

In my blogroll this morning, I found a blog post on a subject that I think is both complicated and very important: parents who make incorrect medical decisions on behalf of their children, against the advice of their physicians.  I felt the best way to work through my thoughts was to write it up here.  I hope we can get a productive discussion going!

Let me start with two similarly heartbreaking stories to illustrate the issue.  The first involves a couple who are currently being tried for manslaughter for the death of their infant.  The girl had pneumonia and a blood infection, and although these problems are serious we often successfully treat them with antibiotics.  Her parents, however, decided to forgo medical treatment and simply pray for her instead.  I will step lightly around the subject of these peoples’ guilt or innocence: the reason we have courts instead of stonings at whim is mainly that each case is surrounded with complexities and mitigating circumstances.  These people were probably loving parents doing the best they could, and now in addition to losing their child(!) they are enduring a court case and the social stigma that surely is attached to all of this.  Their lives are in ashes.  Just let this example raise the question: should parents be legally obligated to seek treatment by the medical community for life threatening conditions their children suffer?  If your answer is “yes,” let us ignore for the moment the nature of the punishment and focus on understanding why this is the government’s duty.  If you think they shouldn’t be so obligated, let’s focus on understanding why the government should not attempt to protect children from situations like this, or how they can protect them differently.

The second story presents a slightly different case.  A couple in Australia lost their one-month-old infant for reasons entirely beyond their control.  The baby caught and died from whooping cough, which was apparently contracted because other parents elected not to vaccinate their children from it.  This disease has been effectively battled with vaccines, and has reached the point where almost no first world country has many cases.  There has been an outbreak in Australia during the last couple of years, however, because many people have been choosing not to vaccinate.

The question of whether to vaccinate has grown complicated lately.  A few years back, a British physician announced results tying a then-common (and now uncommon) ingredient in certain vaccines to autism.  His research has since been discredited – he seems to have been trying to sell an alternative product and to have falisified results to scare people into buying in.  It’s kicked off a wave of frightened parents, though, who seem to think that autism is worse than death.  It’s also kicked off a wave of research, which has concluded (whether or not an individual chooses to accept the results) that there is no causal link between vaccines and autism.  As these events have transpired, parents who choose not to vaccinate have gone from “frightened by a guy on the radio” to “concerned about an open question in medicine” to “concerned despite the opinion of the medical community.”  Let us treat vaccination as an example, though, so that the truth of its connection to autism is irrelevant to this discussion.  Even the matter of parents and children is slightly beside the point here.  The question it raises is, “Should people be legally obligated to take actions that the medical community believes will protect the larger community?  If not, how can citizens legally defend themselves and their charges against individuals who choose not to take these actions?”

Both of these cases are tied closely to a world of complicated questions.  How do you decide what’s true?  Should there be legal ramifications for well-intended but deadly mistakes (as in the case of manslaughter through car accidents)?  How much risk should a caregiver be legally entitled to take on behalf of his or her charges?  How do you tell an honest expert from an expert who’s lying for financial gain?  Should religious authorities be giving medical advice (and “just pray for her” or even “praying for someone can be an effective cure” are absolutely medical advice)?  Should religious authorities be legally restricted from giving medical advice, or legally obligated to state that they are not medically qualified without receiving formal medical training?

Hard, hard questions.  I have my opinions, but I’m not sure I’m wise enough to find answers worth legislating.  What do you think?