When does the failure of a parent to provide a child with appropriate medical care become a matter of concern for the state? This is a difficult question that rears its head from time to time.
Last year it arose when the family of a young girl from the Six Nations First Nation near Brantford, Ontario abandoned chemotherapy as treatment for her leukemia, despite the fact that continuing such treatment was the difference between probable survival and certain death.
The legal proceedings were distracted by the issue of the family’s right to use traditional aboriginal medicine when in reality they had opted for unproven treatments offered by a dubious alternative health clinic in Florida. Despite winning the right to refuse chemotherapy in the courts, last reports were that the little girl is again receiving the life-saving conventional treatment.
More recently, a very different case with similar themes has been in the news. A couple of Albertan parents are in the midst of a criminal trial for not obtaining proper medical assistance for their child.
Despite being warned by a family friend who was a nurse that the boy may have meningitis, the parents continued to treat him with herbal supplements and maple syrup. The child later died of bacterial meningitis, an infection that - not unlike the leukemia faced by the girl from Six Nations First Nation - is almost always fatal if left untreated.
Such cases raise complicated questions about the fundamental nature of the parent-child relationship. Our society is generally quite deferential to parental choice, and for good reason, but if and where we draw the line between parental rights and child endangerment is a hotly contested issue.
Is the parent-child relationship sacrosanct and absolute, immune from interference by society or government? Are our children the equivalent of chattels that we can deal with as we please?
Or is parenting more akin to a sacred trust, where our broad discretion is subject to the overriding right of society to intervene when that child is put in danger by our acts and omissions?
Whether we care to admit it in the context of the cases mentioned above or not, I think most of us ascribe to the “trust” theory. Few of those who might defend parental rights in the cases above would reject the need for child protection authorities to intervene when a child is being subjected to physical abuse by a parent. And few would defend the rights of a grossly intoxicated parents to leave an infant without any sort of caregiver (although such defenders certainly exist).
Yet for some reason when it comes to medical care we are much more hands-off as a society, and the parents in the cases above have found a surprising levels of support interspersed with the overwhelming anger directed towards them.
Defenders of parental rights attempt to differentiate medical neglect cases from the more traditional situations that child protection authorities deal with. They say that a parent making medical choices for a child is acting in good faith and with the best interest of their child in mind and ought to be left alone.
There are two objections to this line of reasoning. First, the intentions and motivations of the parent make no difference to the child who dies from bacterial meningitis or leukemia rather than some other form of abuse or neglect.
Second, it involves classist assumptions about “those” people - I mean those we traditionally associate with the child welfare system - many of whom also love their children but struggle with issues stemming from issues related to mental health and addictions, exacerbated by poverty and a lack of social support.
When it comes to matters of proper medical treatment I’ll readily admit that I come to this issue with a significant bias. I’m skeptical of many of the bold claims of “alternative” medicine that cures for serious illnesses lie with everyday products like cinnamon, turmeric or honey. Unfortunately, the proven treatments for serious conditions like meningitis and cancer are powerful drugs that are sometimes accompanied with powerful side effects.
This isn’t to say that there isn’t a lot of room for individualized decision-making in the world of medical treatment. The weighing of pros and cons for a particular course of treatment for a particular person with their own tolerances and preferences is not always a purely objective, scientific process. Moreover, there is often little harm in using unproven products, so long as more we don’t forego those that we know work.
But evidence-based medicine isn’t a matter of opinion or point of view, either. There is a point where refusing a particular course of treatment in favour of unproven alternatives is foolish and dangerous. Foregoing proven treatments for conditions like leukemia and meningitis is as reckless to the life and wellbeing of a child as anything else that the child protection concerns itself with.
Also, I don’t subscribe to romanticized notions that entrance into the world of parenthood means we’ve suddenly acquired an expertise in all areas in which one needs to be knowledgeable. Yes, parents generally know our own children best because we spend more time with them than anyone else and have known them their entire lives.
But we should not be so arrogant as to assume that this is the same as knowing what is best for them. The meme of “parents know best” is narcissistic nonsense - the product of a hyper-individualistic culture where flattery of our own abilities is ubiquitous in media.
Good parenting means knowing when to defer to the skill and expertise of others, so that we don’t allow our children to suffer as a result of our own hubris and self-assuredness.
If we fail to recognize our own limitations and put a helpless human being’s life at risk, it is incumbent on someone else to step in.
Kyle Carruthers is a born-and-raised Yukoner who lives and practises law in Whitehorse.