When should parents seek medical attention for their sick child?
That’s a question to consider as a trial is scheduled to resume today in a Canadian courtroom, where David and Collet Stephan are accused of failing to provide the “necessaries of life” to their son, Ezekiel, a toddler who died of meningitis in 2012, after they reportedly had been treating him with home remedies.
“I’m not saying they killed him, abused him or ignored him — they loved him,” crown prosecutor Clayton Giles said in his opening statement at the trial in Alberta, Canada, according to Global News. “They didn’t take him to a doctor until it was too late — far too late.” The Stephans say they are not guilty.
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This case has sparked much controversy and debate, on both sides of the border, over parental rights and responsibilities. Mainstream medical care versus alternative health care, and the pros and cons of vaccination have long been hot topics for many parents, especially since some forms of meningitis can be prevented with vaccines, according to the U.S. Centers for Disease Control and Prevention.
“The issue is how sick is your child? Very sick children should be seen by a health provider,” said Dr. James Mitchell, a pediatrician at the University of Chicago Medicine Comer Children’s Hospital.
Arthur Caplan, head of medical ethics at New York University’s
Langone Medical Center, agrees and thinks there should be a law.
“A very sick child, sick for more than 48 hours, must be taken to a hospital or have been seen by a mainstream doctor,” said Caplan, who has written about and commented on the Stephan case in other reports. “Sick children have to be brought to a legitimate medical authority.”
“The parents should be found guilty of neglect,” Caplan wrote in a Forbes article. Caplan said the case brought against the Stephans was about sending the message that parents of extremely ill children have “a duty to take them to a doctor or a hospital.”
Parents need to get a diagnosis from a doctor to establish what is wrong with their child, Caplan said, and then they can determine how to proceed.
The Stephans opted for naturopathic treatment instead of seeking medical care from a doctor.
Naturopathy is “useless hokum,” said Caplan. He said it is not about the parents’ beliefs, but what is right and best for the child.
Jaclyn Chasse, a Bedford, N.H.-based naturopathic doctor who is president of the American Association of Naturopathic Physicians, said parents need to work with a doctor they trust, whether the doctor is medical or naturopathic.
“Always err on the side of caution,” she said.
Putting the responsibility on the parents to get a diagnosis still means the parents must decide what to do, Chasse added, noting that an incorrect diagnosis could occur.
“That’s a challenging place for a parent to be with no medical background,” said Chasse, who believes there’s a mutual responsibility between doctors and patients in determining a course of care.
Parents have to use their “best judgment” when children can’t act on their own behalf, said Michael M. Burgess, professor and chair in biomedical ethics at the University of British Columbia’s Okanagan Campus in Kelowna.
“When your child is very sick, you need to consider the full range of what’s possible, including mainstream medicine,” Burgess said. And when it comes to “vulnerable populations,” including children, the obligation to do so is stronger, he said.
The debate stemming from the Stephan case, he said, is “at what point must we seek mainstream medical care?”
Mitchell, the pediatrician, believes the Stephan trial might make parents who are on the fence about mainstream medicine choose one side or the other. He said, however, those already staunchly in one camp likely won’t be swayed by the outcome.
Those who have firm beliefs will stick with them, he said, noting the perspectives of health care providers may be “respected” but will still be factored with other things parents believe in. Health care providers, he said, have to continue to work at communicating with families.
“At the end of the day, we want what’s good for the child,” he said.
Twitter @billdaley
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