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Parentally Mandated Religious Healing for Children: A Therapeutic Justice Approach

Published online by Cambridge University Press:  24 April 2015

Sana Loue
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Significant controversy surrounds individuals' reliance on religious healing approaches to the treatment of illness, particularly when such efforts focus on the provision of care for children. These approaches, rooted in organized religions and their theologies, encompass a wide range of practices, ranging from prayer, meditation, and the laying on of hands, to exorcism, speaking in tongues, Spiritism, shamanic intervention, and various rituals of Santería. Numerous faith communities espouse one or more forms of religious healing while discouraging reliance on conventional medical treatments: These communities include the Christian Science Church, the Church of the First Born, End Time Ministries, Faith Tabernacle, Followers of Christ Church, Bible Believers' Fellowship, Christ Assembly, Christ Miracle Healing Center, Church of God Chapel, Church of God of the Union Assembly, Holiness Church, Jesus Through Jon and Judy, “No Name” Fellowship, Northeast Kingdom Community Church, and The Source.

Others, such as the Assemblies of God, have moved away from an exclusive reliance on religious healing practices to a more holistic approach that combines religious-healing with at least some aspects of biomedicine. For many of these listed groups, health and illness represent the physical manifestation of moral concerns relating to salvation, which can only be addressed through religious healing.

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Journal of Law and Religion , Volume 27 , Issue 2 , January 2012 , pp. 397 - 422
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Copyright © Center for the Study of Law and Religion at Emory University 2012

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References

1. Religious healing is to be distinguished from the concept of spiritual healing. Although spiritual healing encompasses religious healing, it extends significantly beyond what might be considered religious healing to encompass healing efforts that involve “the intentional influence of one or more people upon one or more living systems without utilizing known physical means of intervention.” Benor, D.J., Spiritual Healing: A Unifying Influence in Complementary Therapies, 3 Complementary Therapies in Med. 234, 234 (1995)CrossRefGoogle Scholar. As such, it may include prayer and the laying on of hands, but also includes approaches such as massage therapy and reiki, a form of energy healing. Kennedy, Pat, Working with Survivors of Torture in Sarajevo with Reiki, 7 Complementary Therapies Nurse Midwifery 4 (2001)CrossRefGoogle ScholarPubMed.

2. Prayer may assume a variety of forms. These include intercessory prayer to ask a higher power, however identified, to intervene on behalf of an identified individual; supplication, to achieve a specified outcome; and nondirected prayer. Astin, John A., Harkness, Elaine & Ernst, Edward, The Efficacy of “Distant Healing”: A Systematic Review of Randomized Trials, 132 Annals Internal Med. 903, 903-04 (2000)CrossRefGoogle ScholarPubMed; Halperin, Edward C., Should Academic Medical Centers Conduct Clinical Trials of the Efficacy of Intercessory Prayer?, 76 Acad. Med. 791, 792 (2001)CrossRefGoogle ScholarPubMed. Both the Old and the New Testaments provide examples of the power of prayer to heal. For examples, see 2 Kings 20:2-5 and the frequently relied-upon Epistle of James 5:14-15. For a discussion of the various interpretations of the Epistle of James, see Moo, Douglas, Divine Healing in the Health and Wealth Gospel, 9 Trinity J. 191, 205-06 (1988)Google Scholar.

Some denominations, such as the Christian and Missionary Alliance, the Vineyard movement, various Pentecostal churches, and others that comprise the health and wealth gospel require that their adherents engage in positive confession following prayers for healing. Id. at 191-92. The “health and wealth gospel” emphasizes “the physical blessings that believers can—and should—experience in this life” (emphasis in original). Id. at 191. This belief has been criticized as an unrealistic expectation that miracles will be performed as frequently today as they were during the “apostolic age.” Id. at 195. Through positive confession, adherents thank God for the healing that has occurred, even if they continue to experience physical symptoms. It is believed that only the individuals' lack of faith or ignorance stands in the way of God's fulfillment of the promise of well-being. Id. at 192.

3. Mindfulness meditation is increasingly advocated as a strategy to reduce stress and pain and to promote healing. For a discussion of its use, see generally Ott, Mary Jane, Mindfulness Meditation: A Path of Transformation and Healing, 42 J. Psychiatric Nurs. & Mental Health Serv. 23 (2004)Google ScholarPubMed; Kabat-Zinn, Jon, Coming to our Senses: Healing Ourselves and the World Through Mindfulness (Hyperion 2005)Google Scholar.

4. Prior to the 16th century, the focus of the Christian church was on spiritual healing such as through the laying on of hands. It is only after this time that clergy espoused the view of sickness as God's punishment for having sinned. Furniss, George M., Healing Prayer and Pastoral Care, 38 J. Pastoral Care 107, 109 (1984)CrossRefGoogle Scholar; Wuthnow, Sara, Healing Touch Controversies, 36 J. Religion & Health 221, 223 (1997)CrossRefGoogle Scholar; Porterfield, Amanda, Healing in the History of Christianity 5 (Oxford Univ. Press 2005)CrossRefGoogle Scholar. The laying on of hands is said to involve the transfer through a healer of energy from a higher power to effectuate a healing in the body of the sufferer. Grad, Bernard R., The Laying On of Hands: Some Clinical and Experimental Concerns, 17 J. Religion Psychical Res. 182, 183 (1994)Google Scholar.

The laying on of hands as a mechanism of healing has been rejected by some Christian groups. As an example, the Nurses Christian Fellowship (NCF) perceives healing touch as the “manipulation of [evil] spirits” that are intent on our destruction. Nurses Christian Fellowship, This We Believe About Energy-Based Theories and Therapies (2009), http://ncf-jcn.org/membersonly/twbaet.pdf.

5. Exorcism rests on the belief that malevolent spirits both exist and have the power to invade, control and impair the health of the individual. Twelftree, Graham H., In the Name of Jesus: Exorcism Among Early Christians 25 (Baker Acad. 2007)Google Scholar. Exorcism, which played a significant role in early Christianity, is said to represent a vehicle by which the evil spirit can be expelled from the person and effectuate a cure. Id. at 26. It remains even today a method of healing in some denominations, such as some Catholic Pentecostal groups. Csordas, Thomas, Elements of Charismatic Persuasion and Healing, 2 Med. Anthropology Q. 121 (1988)CrossRefGoogle Scholar. As recently as 2009, it was utilized by the Manifested Glory Ministries in an attempt to “cast out” “the homosexual demon” believed to be inhabiting an adolescent boy. ‘Gay Exorcism’ Video Sparks Outrage, FoxNews.com (June 25, 2009), http://www.foxnews.com/story/0,2993,528960,00.html. While some denominations reserve exorcism only for various mental illnesses, others utilize the procedure for any type of illness. Anderson, Allan, Pentecostal and Charismatic Theology, in The Modern Theologians: An Introduction to Christian Theology Since 1918, at 589, 602-03 (Ford, David F. ed., 3d ed., Blackwell Publ'g 2005)Google Scholar.

6. Gift of tongues, also referred to as speaking in tongues and as glossolalia, has been termed the most intimate form of communication with God. It may assume either a public or private form and is often used in conjunction with prayer to effectuate healing. Sequeira, Debra-L, Gifts of Tongue and Healing: The Performance of Charismatic Renewal, 14 Text Performance Q. 126, 130-31 (1994)CrossRefGoogle Scholar. For an in-depth discussion of speaking in tongues, see Anderson, supra note 5, at 591-94. Glossolalia has been the subject of intense study in a variety of disciplines. It has been variously explained as reflecting a trance state or an altered state of consciousness, Goodman, Felicitas D., Speaking in Tongues: A Cross-cultural Study of Glossolalia 59 (Univ. Chi. Press 1972)Google Scholar; a psycho-pathological phenomenon resulting from a cycle of repression, release, and regression, Laffal, Julius, Pathological and Normal Language (Atherton Press 1965)Google Scholar; and a form of infantilism. Newton, H. Maloney & Lovekin, A. Adams, Glossolalia Behavioral Science Perspectives on Speaking in Tongues 42–34 (Oxford Univ. Press 1985)Google Scholar. It has also been explained as a “culturally anticipated and socially structured” performance reflecting prescribed roles and norms. Sequeira, supra note 6, at 135.

7. Spiritism, or Espiritismo as it is known is Spanish, involves ritual practices that require “working” with spirits. Mediums become possessed by spirits or illnesses that are believed to have attached themselves to the sufferer; essentially, the medium uses his or her body to bring the spirit to the individual who is suffering. Koss-Chiono, Joan D., Spirit Healing, Mental Health, and Emotion Regulation, 40 Zygon 409, 410-11 (2005)Google Scholar. The medium then assists the sufferer in harmonizing with and forgiving the spirits, which makes possible a change in the sufferer's emotions, lifestyle, physical symptoms, or destiny. Id.

8. Shamanic intervention involves entry into an altered state of consciousness by a shaman, who then uses that state to contact spiritual entities to assist the client in overcoming evil, conteracting hexes, and restoring good health. The role of shaman has been analogized to that of a psychotherapist and the strategies utilized have been likened to behavior modification and cognitive restructuring. de Rios, Marlene Dobkin, What We Can Learn from Shamanic Healing: Brief Psychotherapy with Latino Immigrant Clients, 92 Am. J. Pub. Health 1576, 1576-77 (2002)CrossRefGoogle Scholar.

9. Santería originated in Africa, was brought to Cuba by slaves from Western Africa, and was later brought to the U.S. in the 1940s by immigrants from Cuba. Santería is a complex faith that, unlike Western religions that rely on doctrine and liturgy contained in sacred texts, relies on the performance of rituals by santeros and santeras and the fulfillment of rituals and practices by its followers. Santería's primary purpose is to assist the individual to live in harmony with his or her destiny. For a discussion of the faith, its rituals, and its use in healing, see Baez, Annecy B. & Hernandez, David, Complementary Spiritual Beliefs in the Latino Community: The Interface with Psychotherapy, 71 Am. J. Orthopsychiatry 408 (2001)CrossRefGoogle ScholarPubMed; Toree, Miguel A. De La, Santería: The Beliefs and Rituals of a Growing Religion in America (William B. Eerdmans Publ'g 2004)Google Scholar.

10. Asser, Seth M. & Swan, Rita, Child Fatalities from Religion-Motivated Medical Neglect, 101 Pediatrics 626 (1998)CrossRefGoogle ScholarPubMed; Hickey, Kenneth S. & Lyckholm, Laurie, Child Welfare Versus Parental Autonomy: Medical Ethics, the Law, and Faith-Based Healing, 25 Theoretical Med. 265 (2004)CrossRefGoogle ScholarPubMed; Hughes, Richard A., The Death of Children by Faith-Based Medical Neglect, 20 J.L. & Religion 247 (2004)CrossRefGoogle ScholarPubMed; McGuire, Meredith B., Words of Power: Personal Empowerment and Healing, 7 Cult., Med., & Psychiatry 221 (1983)CrossRefGoogle ScholarPubMed. It should be noted that some of the denominations listed refer to their practice as faith healing, while others, such as the Christian Science Church, utilize the term spiritual healing. These various churches may or may not recognize the legitimacy of the practices advocated by and relied upon by the others. See, e.g., Hoekema, Anthony A., Christian Science 64 (William B. Eerdmans Publ'g 1963)Google Scholar. See also Groothuis, Douglas R., Unmasking the New Age: Is there a new religious movement trying to transform society? (Inter-Varsity Press 1989)Google Scholar. Their practices are all referred to here as religious healing because of their direct reliance on and interpretation of Biblical passages as the foundation of their healing practices. As an example, Christian Science is “founded squarely upon the Scriptures, and that it was in fact continuous with Biblical revelation.” Gottschalk, Stephen, The Emergence of Christian Science in American Religious Life 284 (Univ. Cal. Press 1973)Google Scholar.

11. In a study of 1,827 adherents from twenty-one Assemblies of God, 82% of the study participants indicated that they consult a physician for health problems at least occasionally; only 17% said that they never consulted a physician. Poloma, Margaret M., Pentecostal Prayer within the Assemblies of God: An Empirical Study, 31 Pneuma 47, 50–51 n.4 (2009)CrossRefGoogle Scholar.

12. McGuire, Meredith B., Ritual Healing in Suburban America 247 (Rutgers Univ. Press 1988)Google Scholar. See also McGuire, Meredith B., Health and Healing in New Religious Movements, in 3 Religion and the Social Order 139-55 (Jai Press 1993)Google Scholar.

13. Sataline, Suzanne, A child's death and a crisis for faith, The Wall Street J. (06 12, 2008) at D1, http://online.wsj.com/article/SB121322824482066211.htmlGoogle Scholar.

14. Id.

15. Associated Press, Faith-healing parents guilty in teen son's death, MSNBC (02 2, 2010), http://www.msnbc.com/id/35207710Google Scholar. The issue is not, however, confined to the United States. A health ministry in Guyana is now under investigation following the death of a 14-year old girl who is alleged to have died during a pastor-led exorcism designed to “get the demon out from she womb.” Lana Seales, ‘Exorcism’ was physical, maintains grandmother. Stabroek News (Apr. 14, 2010), http://www.stabroeknews.com/2010/archives/04/14/.

16. E.g., Chen, Jennifer E., Family Conflicts: The Role of Religion in Refusing Medical Treatment for Minors, 58 Hastings L.J. 643 (2007)Google Scholar; Collins, Jennifer M., Crime and Parenthood: The Uneasy Case for Prosecuting Negligent Parents, 100 N.W.U.L. Rev. 807 (2006)Google Scholar; Dodes, Ivy B., Note, “Suffer the Little Children …,” Toward a Judicial Recognition of a Duty of Reasonable Care Owed Children by Religious Faith Healers, 16 Hofstra L. Rev. 165 (1987)Google Scholar; Goldstein, Jared A., Is There a “Religious Question “ Doctrine? Judicial Authority to Examine Religious Practices and Beliefs, 54 Cath. U. L. Rev. 497 (2005)Google Scholar; Lamparello, Adam, Taking God Out of the Hospital: Requiring Parents to Seek Medical Care for Their Children Regardless of Religious Belief, 6 Tex. F. On C.L. & C.R. 47 (2001)Google Scholar; Nobel, Barry, Religious Healing in the Courts: The Liberties and Liabilities of Patients, Parents, and Healers, 16 Puget Sound L. Rev. 599 (1993)Google ScholarPubMed; Catalano, Emily, Comment, Healing or Homicide? When Parents Refuse Medical Treatment for Their Children on Religious Grounds, 18 Buff. Women's L.J. 157 (2010)Google Scholar; Hiraswa, Kei Robert, Student Note, Are Parents Acting in the Best Interests of Their Children When They Make Medical Decisions Based on Their Religious Beliefs?, 44 Fam. Ct. Rev. 316 (2006)CrossRefGoogle Scholar.

17. Dwyer, James G., Parents' Religion and Children's Welfare: Debunking the Doctrine of Parents' Rights, 82 CAL. L. REV. 1371, 1397 (1994)CrossRefGoogle Scholar. Many of these laws were originally promulgated in response to a directive of what was then the United States Department of Health, Education and Welfare, pursuant to the Child Abuse and Treatment Act (CAPTA) of 1974 (CAPTA), P.L. 93-247, that directs states to develop exemptions from child abuse and neglect provisions for parents who relied on prayer in lieu of medical care for the treatment of their children's illnesses. Merrick, Janna C., Spiritual Healing, Sick Kids, and the Law: Inequities in the American Healthcare System, 29 Am. J.L. & Med. 269, 277 (2003)Google ScholarPubMed. Most recently, Oregon eliminated spiritual treatment as a defense against charges of homicide following the death of a child whose parents were members of the Followers of Christ Church, a denomination in which multiple children have died following parental refusal of biomedical care for their children. Anon., Kitzhaber Signs Faith Healing Bill Into Law, KATU.com (July 17, 2011), http://www.katu.com/news/local/124122544.html.

18. Ohio Rev. Code Ann. § 2919.22(A) (2011). In this context relating to child abuse and neglect, it is clear that both courts and legislatures are able to distinguish between conducting a constitutionally prohibited inquiry into the truth or falsity of the parents' beliefs on the one hand and, on the other, engaging in an objective assessment of a youth's need for medical care, and the adequacy of the parents' acts, notwithstanding the parents' religiously-founded beliefs as to the cause, nature, or cure of that illness.

19. Ala. Code § 26-14-7.2(a) (2011). Utah law provides another example: a parent may not be considered unfit where the parent's failure to provide medical treatment for the child is premised on parental religious beliefs. Utah Code Ann. § 78A-6-508(3) (2011).

20. As an example, the court in Hall v. State, 493 N.E.2d 433, 435 (Ind. 1986) held in a case involving the death of a youngster who was ill with pneumonia that “prayer is not permitted as a defense when a caretaker engages in omissive conduct which results in a child's death.” The parents had maintained that the devil was engaged in a spiritual battle with God and had caused the sickness, which could only be cured through prayer. See also Commonwealth v. Twitchell, 617 N.E.2d 609 (Mass. 1993). The Twitchell parents were charged with involuntary manslaughter following the death of their two and one half year-old son Robyn that had resulted from an obstructed bowel, a condition that could have been treated successfully with surgery. Id. at 612. The Massachusetts state legislature later repealed the religious exemption statute on which the Twitchells had premised a defense. Massachusetts Citizens for Children, History of the Massachusetts Religious Exemption Law, http://www.masskids.org/index.php?option=com_content&view=article&id=176&Itemid=178&d4dad6935f632ac35975e3001dc7bbe8=529be6d87191583b378bf05d993dfa27 (last visited May 12, 2011).

It has been argued that the prosecution of parents for the death of their child following reliance on religious healing violates due process because the exemption of religious healing from the child abuse and neglect statutes fails to provide notice of potential culpability should the child die. See, e.g., Clark, Christine A., Religious Accommodation and Criminal Liability, 17 Fla. St. U. L. Rev. 559 (Spring 1990)Google Scholar. See also Ciullo, Allison, Prosecution Without Persecution: The Inability of Courts to Recognize Christian Science Spiritual Healing and a Shift Towards Legislative Action, 42 New Eng. L. Rev. 155, 176-77 (2007)Google Scholar.

21. Courts have recognized a fundamental right of parents to make decisions regarding their children, Troxel v. Granville, 530 U.S. 57 (2000), and presume that parents do act in their children's best interests. Parham v. J.R., 44 U.S. 584 (1979). Nevertheless, courts have recognized that the state as parens patriae may restrict parental control despite parental free exercise rights, Prince v. Mass., 321 U.S. 158, 166 (1944), when a child's physical health or safety is endangered as a result of parental religious belief or practice. Jehovah's Witnesses v. King County Hosp., 278 F. Supp. 488 (W.D. Wash. 1967), aff d per curiam, 390 U.S. 598 (1968). In general, however, courts have been less willing to override parental free exercise rights in situations in which the health condition in question is not life-threatening, e.g., In re Green, 292 A.2d 387 (Pa. 1972), or the potential treatment is unlikely to effectuate a cure without significant risk Newmark v. Williams, 588 A.2d 1108 (Del. 1990).

22. Cantwell v. Conn., 310 U.S. 296, 303-04 (1940). It has been suggested that such infringement can be justified in situations in which (1) better reasons exist to act on the overriding norm, here care for children, than the infringed upon norm, here the religious beliefs; (2) “the moral objective justifying the infringement has a realistic prospect of achievement,” e.g., a high probability of successful treatment with medicine; (3) “no preferably alternative actions can be substituted;” (4) the method of infringement to be exercised is the least possible to achieve the desired goal; and (5) there is an attempt to minimize the impact of the infringement. Hickey & Lyckholm, supra note 10, at 272-73.

23. Benor, supra note 1, at 237; Sequeira, supra note 6, at 135.

24. Sequeira, supra note 6, at 135.

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26. McGuire, supra note 10, at 233-34.

27. Id. at 235.

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34. Investigation into the efficacy of religious healing is not to be construed either as an attempt to verify or disprove the existence of God, a divine power, or another spirit. As has been noted,

No experiment can prove or disprove the existence of God, but if in fact [mental] intentions can be shown to facilitate healing at a distance, this would clearly imply that human beings are more connected to each other more responsible to each other than previously believed. That connection could be actuated through the agency of God, consciousness, love, electrons, or a combination. The answers to such questions await further research. Targ, E. & Thomson, K.S., Can Prayer and Intentionality Be Researched? Should They Be?, 3 Alternative Therapies Health & Med. 92, 94–95 (1997)Google Scholar.

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36. Porterfield, supra note 4, at 13-14; Astin, Harkness, & Ernst, supra note 35, at 904; Grad, supra note 4, at 183; Jonas, Wayne B. & Crawford, Cindy C., The Healing Presence: Can It Be Reliably Measured?, 10 J. Alternative Complementary Med. 751 (2004)CrossRefGoogle ScholarPubMed.

37. For example, churches that espouse the use of religious healing strategies would have greater access to information relating to the numbers and demographic characteristics of individuals who rely on religious healing in lieu of conventional medical care, the conditions from which they are suffering, the characteristics of the healers involved in the healing efforts, and the nature of the processes utilized in an attempt to bring about healing. Although Christian Scientists have reported more than 50,000 spiritual healings since 1900, the statistic cannot be verified because members are infrequently diagnosed by physicians who can verify the illness, no written records of membership and healings are maintained, and unsuccessful healings may not be reported or recorded. Hickey & Lyckholm, supra note 10, at 267.

38. Swan, Rita, Spiritual Healing and the Law: A Dispute, 105 The Christian Century, 10 19, 1988, at 926-28Google Scholar.

39. Asser & Swan, supra note 10, at 625-26. Harm can also occur due to the refusal of medical treatments even in the absence of religious healing efforts. In 1972, eleven children in a Christian Science boarding school suffered paralysis following refusal of immunization against polio. Merrick, supra note 17, at 274.

40. American Academy of Pediatrics, supra note 30, at 279.

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44. One individual, writing from the vantage point of both his personal and his professional experience as a mental health provider for survivors of ex-gay groups, described the impact of such religion-based cures on the targeted individuals:

They are often taught not to trust their own instincts. They become convinced that, due to their sinful brokennness, they cannot trust or believe in themselves …. When the ex-gay struggler admits to his or her defective sinfulness, fundamentalist Christians are quick to confirm this and offer strict guidelines and conditional acceptance …. [E]x- gays develop a victim mentality.

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The American Psychological Association concluded in 2009 on the basis of its task force report that such “treatments” could result in harm to the individual and that the results of scientifically valid research provide little evidence of the effectiveness of these approaches. American Psychological Association, Press Release: Insufficient Evidence that Sexual Orientation Change Efforts Work, Says APA (Aug. 5, 2009), http://www.apa.org/news/press/releases/2009/08/therapeutic.aspx.

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Pure coercion can be effective only for a minority and requires the willing consent of the majority to give it leverage. If not intellectually, then at least emotionally, most of the members of the majority require an authoritative statement of the standards of conduct which are expected of them. With the decline of religion and the disintegration of small communities and groups, the main public source which is left is the state and its primary instrument is the criminal law.

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57. Hughes, supra note 10, at 255. Christian Science conceives of illness as “an image of thought externalized,” Eddy, Mary Baker, Science and Health with a Key to the Scriptures 411 (Trustees under the Will of Mary Baker G. Eddy 1934)Google Scholar, so that even bones “have only the substance of thought.” Id. at 423. The disease or illness is not real, Wardwell, Walter I., Christian Science Healing, 4 J. Sci. Study of Religion 175, 180 (1965)CrossRefGoogle Scholar, but is, instead, a form of evil, and evil is an illusion. Peel, Robert, Spiritual Healing in a Scientific Age (1987)Google Scholar. Accordingly, the patient “suffers only as the insane suffer, from false beliefs.” eddy, supra at 420-21. This reflects the Gnostic belief, simplistically stated, that matter is evil and spirit is good; this belief became known as dualism. Cf. Clasquin, Michel, Gnosticism in Contemporary Religious Movements: Some Terminological and Paradigmatic Considerations, 5 J. Study Religion 41, 45 (1992)Google Scholar. Contra Gottschalk, Stephen, The Emergence of Christian Science in American Religious Life 284 (1973)Google Scholar. Medicine is viewed as ineffective and drugs as no better than placebo. Eddy, supra at 158. In contrast, it is believed that prayer can change the person who prays and/or the person for whom the prayer is offered. The restoration of health is said to signify a communion with God and God's answers to the prayer, rather than a cure of the underlying disease. Id. at 2. One writer observed that this approach “constitutes a radically different approach to healing from that which underlies medical practice, and neither from the standpoint of Christian Science nor from that of medicine is it in the best interests of the patient to try to combine them.” Talbot, Nathan A., The Position of the Christian Science Church, 309 New Eng. J. Med. 1641, 1643 (1983)CrossRefGoogle ScholarPubMed. See also Janet, Pierre, Psychological Healing 84 (Paul, Eden & Paul, Cedar trans., Unwin Bros. 1925)Google Scholar. For a description of the training received by Christian Science practitioners, see generally Hickey & Lyckholm, supra note 10, at 266-57; Wardwell, supra at 175.

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59. McGuire, supra note 10, at 227.

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63. Porterfield, supra note 4, at 9.

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81. Id. at 385.

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96. Hughes, supra note 61, at 112-13.

97. McGuire, supra note 10, at 227.

98. Jonas & Crawford, supra note 36, at 752.

99. Id.

100. For a discussion by one Christian theologian of the nature of love, see Vacek, Edward Collins, Love, Human and Divine: The Heart of Christian Ethics 160-63 (Georgetown Univ. Press 1994)Google Scholar. Vacek has argued that love for another (agape) requires that love be directed to a specific object and that there be a particular act of love. Id. at 180. In this context, intention may be thought of as what a person predetermines to do (use religious healing to cure my child's affliction), whereas motive constitutes the reason why a person chooses that course of action (because he or she loves the child).

101. It has been observed that:

Parents motivated by a sense of religious obligation to oppose mainstream child-rearing norms might be, by virtue of that motivation, less likely to make decisions and act in a manner consistent with their children's welfare, even as they view their child's welfare from their own perspective. Because religious commands regarding child rearing are not necessarily dictated by what is best for children, even as seen from within the religious perspective from which the command emanates, a parent's sense of religious obligation might detract from or override the motivation, which a parent otherwise has, to do what is best for a child.

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102. It has been suggested that exorcism during the time of Jesus was utilized as a mechanism to facilitate the reintegration of outcasts into the community and the restoration of God's covenant and the Kingdom of God. Strecker, Christian, Jesus and the Demoniacs, in The Social Setting of Jesus and the Gospels 117 (Stegemann, Wolfgang, Malina, Bruce J. & Theissen, Gerd eds., Fortress Press 2002)Google Scholar. In such situations, the intended benefits may have been meant for both the individual and the community from which the individual came.

103. According to the American Association of Pastoral Counselors, “Pastoral counseling moves beyond the support or encouragement a religious community can offer, by providing psychologically sound therapy that weaves in the religious and spiritual dimension.” American Association of Pastoral Counselors, What is Pastoral Counseling?, http://www.linkedin.com/groups/American-Association-Pastoral-Counselors-3762448.

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107. Id. at 5.

108. Morrissey, Fagan & Cocozza, supra note 104, at 1211.

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110. 23 Pa. Cons. Stat. § 6303(b)(3) (West 2010). This provision has been found to be consistent with Pennsylvania's involuntary manslaughter statute in a case involving the refusal of medical care for a life-threatening illness by a minor child and her parents. Commonwealth v. Nixon, 718 A.2d 311 (Pa. Super. Ct. 1998), aff'd, Commonwealth v. Nixon, 761 A.2d 1151 (Pa. 2000).

111. 23 Pa. Cons. Stat. § 6303(b)(3) (West 2010).

112. Nationally, less than 40% of child welfare workers employed by state agencies are professional social workers, despite research findings suggesting that the outcomes for children within the child welfare system are much improved when their cases are handled by professionally trained social workers. Kelly, James J., Child Welfare Workforce's Burden, 56 NASW News 3 (02 2011)Google Scholar. This suggests the need for increased training and professionalization of child welfare workers if a system such as Pennsylvania's were to be adopted.

113. The American Association of Pastoral Counselors (AAPC) is an example of such an organization. The organization focuses both on diversity and on pastoral counseling. For additional information about the organization and its activities, see http://aapc.org/.

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116. Id. at 141-42.

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