State Religious Exemptions and Child Medical Neglect: Ambiguity in Child Welfare Policy and Procedures

Abstract

The liberty interest of parents and the state’s role as parens patriae conflict in cases of re-ligious based child medical neglect. All 50 states, District of Columbia, and Puerto Rico provide some form of religious exemption against prosecution for religious based child medical neglect. State religious exemptions related to religious based denial of medical treatment contain one or more intervention thresholds based on parental liberty interest, best interest of the child, and harm standard.Using the 2010 National District Attorneys Association’s National Center for Prosecution of Child Abuse Religious Exemption Statutes, an in-depth examination of state medical neglect religious exemption legislation prior to August 2010 was conducted for the 50 states in the continental U.S., District of Columbia, and Puerto Rico. The study sample consisted of 16 states identified as including only a parental liberty interest provision in their state religious exemption statutes. A comparative analysis method was used to compare state child welfare agency/child protective services policy and procedure manu-als to determine: (a) which states provided guidelines for investigating religious based child medical neglect and (b) specific procedural requirements for investigating and re-sponding to cases of suspected or observed religious based child medical neglect. The best approach to balance parental liberty interest and states’ obligation as parens patriae to protect a child’s liberty interest of health and well-being is through policies based on the harm principle as the threshold for state intervention rather than the best interest or the liberty interest standard.