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When healing turns into killing: religious and philosophical exemptions from parental accountability

Parents have a fundamental right to guide the upbringing of their children protected under the Due Process Clause of the U.S. Constitution. This includes the choice of medical care for the child. They also have a First Amendment right to the free exercise of their religious beliefs, including the right to care for their children in accordance with the tenets of their religion. In a better world, these rights would be exercised in a manner that is consistent with a reasoned selection of medical care among choices supported by the best available scientific evidence. If, for example, deeply religious parents choose to forego a treatment that had only a minimal chance of extending their child’s life and terrible side effects in favor of palliative care because they believe that their child would be better off in heaven we could all agree that their choice is constitutionally protected.

Unfortunately, that is not the case. Religious believers and those whose “philosophy” favors pseudoscience in child medical care (surveys bloviating about the popularity of CAM to the contrary) are in fact a tiny minority of the American population who influence public policy in a manner that far exceeds their actual numbers. This influence allows these special interest groups to cause needless suffering and death among children and their families. As well, their actions siphon off medical and legal resources that could more properly be directed toward the common good when states and medical institutions are put in the position of having to go to court to protect children from their parents. And, by giving parents false choices between a belief in magic and standard medical care, unnecessary complications are introduced into what are already difficult and heart-wrenching decisions by parents who truly want to act in the best interests of their children.

U.S. Constitutional protection of parental choices

As with all constitutionally-protected rights, religious freedoms are not absolute. Nor is the parents’ fundamental right (considered a liberty interest under the Due Process clause) to guide his child’s upbringing. But there is no constitutionally protected right to harm a child via the denial of medical treatment. As the U.S. Supreme Court said in Prince v. Massachusetts, decided in 1944 (emphasis added):

The family itself is not beyond regulation in the public interest, as against a claim of religious liberty. And neither rights of religion nor rights of parenthood are beyond limitation. Acting to guard the general interest in youth’s well being, the state as parens patriae may restrict the parents’ control by requiring school attendance, regulating or prohibiting the child’s labor, and in many other ways. Its authority is not nullified merely because the parent grounds his claim to control the child’s course of conduct on religion or conscience. Thus, he cannot claim freedom from compulsory vaccination for the child more than for himself on religious grounds. The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.

Why, then, do we fairly regularly see media reports about the “rights” of parents to choose faith healing or quack remedies for their children being litigated in the courts? Well, one reason is that these cases make for compelling news stories. There are plenty of run-of-the-mill child abuse and neglect cases circulating through the courts on a daily basis but these generally don’t have the David v. Goliath news value of the loving, God-fearing parents v. reductionist, Pharma-shill medical establishment/nosy, liberty-denying state authorities story. Nobody wants to defend the stereotypical drug-addled welfare mom who won’t take her sick child to the doctor. However, make that Christian Science parents whose child is wasting away from lack of effective medical treatment. Or, the parents who want to use “natural” remedies instead of chemotherapy for their child. Front page news! And plenty of people who’ll stand up for the “right” of these parents to harm their child.

In a better world, all three of these cases would be treated the same legally. The state could press charges of child abuse and neglect, seek to remove the child from the home and/or put him under a medical guardianship. The state attorney could criminally prosecute. And mitigating circumstances could be taken into account, as they are in all cases where issues such as intent to harm and possibility of future harmful conduct are an issue. The mom might agree to go into drug rehab and take parenting classes. The other parents might agree to rational medical treatment in the future and thereby avoid separation from the child and any criminal proceedings.

But that is not the case if a state attempts to intervene on behalf of a child whose parents refuse medical treatment on religious grounds. If the parents object to care on the basis that their First Amendment rights are being violated, their chance of succeeding depends on the extent of possible harm to the child with and without medical treatment as well as the likelihood of success with treatment and the treatment’s side effects. In other words, a religious barrier is erected between rational medical judgment and the child, although the deference to parental wishes is not insurmountable. One court ruled that state could not order treatment where the treatment was “risky, extremely invasive, toxic with many side effects, and/or offers a low chance of success.”

However, the court recognized that it is nevertheless

well-settled that the state may order medical treatment for a non-life threatening condition, notwithstanding the objection of the parents on religious grounds, if the treatment will, in all likelihood, temporarily or permanently solve a substantial medical problem.

Courts have refused to defer to the parents’ religious beliefs where the treatment is likely to succeed against an otherwise- fatal disease, even though the treatment can have terrible side effects. This was true of the highly publicized Daniel Hauser case, in which Daniel and his mother temporarily fled the court’s jurisdiction to avoid further chemotherapy. Daniel’s parents wanted to treat him with “natural healing” modalities instead as, they claimed, their religious beliefs dictated. (Although Minnesota, where Daniel lives, has certain statutory protections from state intervention, as discussed below, it is not clear to me they were applicable in this case. The parents did invoke, however, their constitutionally protected parental rights.)

Fortunately, where the parents claim only a liberty interest protected by the Due Process clause, the parents’ choices are typically given less deference, as was true in the Sarah Hershberger case, although a lot of good that did her. And quackery occasionally scores a total win. In the Matter of Joseph Hofbauer pitted the parents’ fundamental right to select their child’s medical care against science-based medicine. Joseph, age 7, was diagnosed in 1974 with Hodgkin’s disease, which is almost always fatal if left untreated. Joseph’s physician recommended sending him to an oncologist or hematologist for further treatment, which would include radiation and possibly chemotherapy. His parents’ preferred treatment by a physician who instituted a course of nutritional therapy and injections of laetrile.

This “duly licensed” physician treating Joseph, Dr. Michael Schachter, testified at the subsequent neglect proceedings instituted by the county. Naturally, Joseph’s condition had worsened, as testified to by two physicians conducting independent examinations. Dr. Schachter, on the other hand, thought that Joseph was progressing nicely under his treatment regimen, one that he considered effective and beneficial in cancer cases such as Joseph’s, although he did not rule out conventional therapy “if the boy’s condition appeared to be deteriorating beyond control.” A biologist also testified that a study showed “significant regression” in cancerous tumors in mice treated with laetrile, vitamin A, and proteolytic enzymes. The New York Court of Appeals agreed with the lower courts that it could not be said that the parents failed to give Joseph legally adequate medical care, although regular consultations with another physician were part of that decision.

Joseph died two years later (of Hodgkin’s disease). I don’t know if it’s the same person, but a Dr. Michael Schachter, who has been practicing since 1974, practices pseudoscientific “integrative” medicine in New York, not far from where Joseph was treated.

This is not an ideal situation, of course, but reliance solely on the First Amendment or Due Process Clause means that the child’s best interest must be weighed against the parents’ constitutional rights, and though it may require an extended court battle, ill-informed treatment choices that endanger a child rarely win out. Importantly, the Constitution provides no immunity from prosecution for neglect, abuse or the child’s death no matter how fervent the parents’ religious or philosophical belief.

Statutory medical and philosophical exemptions: immunity from criminal responsibility and more

However, if the parents live in one of the many states where the legislature has enacted the numerous medical exemption laws shielding parents’ harmful medical choices for their children, the results can be dramatically different. (Harriet Hall recently discussed how these laws negatively impact children’s health and efforts to repeal them.) These exemption laws have no basis in the constitution and go far beyond what would be allowed if denial of medical testing, preventive measures and treatment for children were simply based on constitutionally-protected parental rights.

CHILD (Children’s Healthcare is a Legal Duty) is a terrific non-profit organization that opposes medical mistreatment of children on religious grounds as well as parents’ use of quackery on their children. CHILD tracks the numerous cases where children are injured or killed by these practices as well as promotes the end of religious exemptions and other laws that might deny children access to proper medical care. (They do a lot more too and you should familiarize yourself with their work. It is a testament to what one small, dedicated organization can do to prevent health care based on prescientific thinking.)

Their website lists the many ways states protect parents who harm their children. While many people are aware of the vaccine exemption laws and their connection to the contraction of vaccine-preventable disease, the problem actually extends far beyond vaccination. A brief summary of religious and philosophical exemptions from medical testing and preventive care for children include:

  • Prophylactic eye drops (to prevent blindness), Vitamin K, metabolic testing, and hearing tests for newborns
  • Testing children for lead
  • Testing and treatment for TB (includes testing teachers)
  • Vaccination, school physicals, and wearing bicycle helmets
  • Medical examination, testing, treatment, and vaccination during public health emergencies (applies to everyone)
  • Learning about disease in public school

In addition, many states provide an exemption from civil and criminal liability for failure to provide medical care. Again, from CHILD:

  • From non-criminal action, such as child neglect sufficient to allow protective custody, in 38 states
  • From felony prosecution in 17 states, including, in some instances, manslaughter and murder
  • From misdemeanor prosecution in 15 states

As pointed out by both law professor Shirley Darby Howell and CHILD, the enactment of religious exemption laws in a lot of instances was due to a 1974 federal law providing states with funding to establish programs aimed at reducing the incidence of child abuse and neglect. (A pdf of Prof. Howell’s article can be located by searching for her name in Google Scholar.) Unfortunately, the law ensured that child abuse for religious reasons was exempted by stating that parents could not be considered negligent if they did not provide medical treatment due to religious beliefs. That did not, however, preclude the state from stepping in and ordering medical services. Based on the belief that these funds would not be available unless they enacted religion-based medical exemptions, the states complied. In 1983 the law was amended to allow states to abolish their religious exemptions without penalty to their funding. Unfortunately, few states have done so.

Pediatrician Seth Asser, M.D., and Rita Swan, who founded CHILD, assessed the impact of religiously-motivated child medical mistreatment and reported their findings in a 1998 article published in Pediatrics. Of 172 deaths of children when medical care was withheld on religious grounds, they concluded that 140 of the children would have had at least a 90% likelihood of survival with medical care. Eighteen more had expected survival rates of >50% and all but 3 of the remainder would likely have had some benefit from clinical help. In short, religious exemptions from medical care are deadly.

One of the ironies of religious exemptions is that the substitution of religiously-dictated practices for medical care is so rare in American religious belief. (In all world religions, actually.) Some religions and their various denominations consider faith an important part of healing but they don’t consider it a substitute for medical care. As best I can tell, Jews and Muslims do not hold the belief that medical care for children should be foregone in favor of faith healing. And among Christians the denominations supporting rejection of medical care are small and widely considered outside the fold by both mainstream and evangelical Christians, such as Christian Scientists and Jehovah’s Witnesses.

Further efforts to further medical neglect of children

Yet Christians Scientists have had an outsized effect on public policy through their vigorous lobbying, which continues to this day. Again, this is ironic because their votes – unlike, for example, the religious right in certain jurisdictions – are not essential to electing a candidate because there are so few of them. There are presently before the U.S. Congress two bills, HR 1814 and S 862, heavily lobbied by the Christian Science church, the deceptively named Equitable Access to Care and Health (EACH), which exempt everyone with “sincerely held religious beliefs” from the Affordable Health Care Act’s mandate to buy health insurance. Of course, this fits nicely with the intense hatred of Obamacare by Congressional Republicans, who will do anything, no matter who sponsors it, to undermine the law. This bill would obviously interfere with one of the central purposes of Obamacare – ensuring that children get a defined set of preventative services without cost and adequate medical care. Hypocritically, Christian Scientists have successfully lobbied for, and gotten, insurance coverage for their faith healing practitioners.

The Christian Science church sponsored a “call-in” day on Tuesday, asking members to contact their Representatives and Senators to support the bills. They were successful in the House, although that may have had more to do with procedural shenanigans than the call in. S 862 is still before the Senate.

There is also a movement afoot among conservative groups ostensibly directed at preventing the adoption by the United States of the U.N. Convention on the Rights of the Child and Convention on the Rights of Persons with Disabilities, which they view as undermining, among other things, parental rights. The group behind this, ParentalRights.org, vehemently opposes restriction or elimination of religious and philosophical exemptions to vaccination and the “right” of parents to choose quackery as a substitute for responsible medical care for their children, and they want those rights enshrined in the constitution with an amendment. (Orac blogged about this over on Respectful Insolence). An amendment, in their view, would make it much harder for the state to intervene in cases where parents are guided by their own religion and philosophical whims instead of rational, evidence-based information, no matter how much these beliefs trespass on the child’s health and welfare.

Coincidentally, Justina Pelletier has emerged as the perfect poster child for their cause. Justina’s case is a rare instance where the parents’ choice between two seemingly-conventional medical diagnoses and recommended treatment regimens has landed them in the courts. As is often the case, the facts are more complicated than parentsrights.org’s loving parents v. the evil state presentation. (The story is covered by the Boston Globe here and here.) Nevertheless, Justina’s story deflects attention from the fact that the choices in the more typical parents’ rights cases are between totally ineffective methods and conventional medical care.

The organization firmly denies that it is anti-vaccination, using the sort of weasely language often found in the anti-vaccination crowd.

We at ParentalRights.org neither endorse nor condemn vaccines. We simply hold that informed parents are in the best position to make medical decisions for their child.

Of course, misinformed parents, such as those who believe in propaganda from the National Vaccine (Mis)information Center, are not in the “best position” to make that decision. (The NVIC is listed as an “Allied Organization” and is a source specifically cited by ParentalRights.org in a plea for support sent to another organization.) But if you want to ditch science as the standard for medical care, I suppose all information a parent considers, no matter how misguided or flat-out wrong, is a sufficient excuse to deny children protection against illness and death caused by vaccine-preventable diseases.

The pro-quackery position is not in evidence at all (that I could find) on their website, yet the organization has issued a call for support (reprinted on another organization’s website) of Colorado Senate Bill 14-032 which would eliminate the restrictions on naturopaths and “alternative medicine” providers (basically anyone who declares, sua sponte, that he or she is an alternative medicine provider, including felons convicted of sex crimes).

Conclusion

All children deserve rational, science-based medical care. The U.S. Constitution does protect, to a limited extent, the parents’ choices in the child’s medical care. Preferably those choices would never be dictated solely by religion (to the extent it is not in the child’s best interest) or pseudoscience. Fortunately, the well-being of the child is paramount when the two conflict. Most of the harm to children from denial of medical care is done because state laws allow parents to make religious and philosophical decisions endangering the child’s well being. Yet these laws are contrary to the moral sensibilities of the vast majority of Americans, who do provide preventive care for their children, including vaccinations, and adequate medical care when they are sick. Children are being held hostage by a small minority of politically active zealots. All religious and philosophical exemption laws should be repealed. It would be especially useful to this cause if religious leaders who reject religion as a pretext for denial of medical care spoke out against this tyranny of the minority, as the American Academy of Pediatrics has done.

Posted in: Cancer, Epidemiology, Legal, Medical Ethics, Politics and Regulation, Religion, Vaccines

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86 thoughts on “When healing turns into killing: religious and philosophical exemptions from parental accountability

  1. Bob says:

    Perhaps some phrase other than “drug addled welfare Mom” could be employed to make your point. I haven’t encountered any tales in the media about such a phenomenon.. How about “drug-addled CEO”?”

    1. Jann Bellamy says:

      I think you are missing my point: that a mom on welfare whose judgment is clouded by her drug use and her sick child don’t get the same media attention or public sympathy as the parents whose judgment about their child’s medical care is clouded by religious beliefs. (Actually, perhaps you make my point by saying that you haven’t seen such a phenomenon in the media.) The media and the public tend to find the latter much more worthy of defense and they are given a special status in the legal system. Yet, in my view, their situations are basically the same. Both should be treated the same by the legal system by holding them responsible for their actions while at the same time offering them assistance in solving their problems in a manner that is in the best interest of their children’s health. I don’t know what you mean by your reference to a drug-addled CEO, although they do exist and I wouldn’t hesitate to use that phrase if it were an appropriate analogy. Because of the general public attitude towards drug- using welfare moms whose conduct adversely affects their children, which seems to range between apathy and condemnation, I thought it was an appropriate contrast to the other parents, who tend to get a pass from certain segments of our society.

      1. jacobv says:

        I don’t disagree with your point; in fact I whole heartedly agree with your entire post. I do however have a problem with your choice of words. In the 27 years that I’ve worked in child welfare, including over 20 years investigating child abuse, neglect and maltreatment I can assure any reader that indeed most of the clients that CPS investigates are poor and often dependent on public assistance to make ends meet. More often than not there are many issues that lead to this kind of endemic poverty and it’s usually a combination of issues typically related to issues like racism, non-supportive fathers, poor education, mental health issues, and yes drugs are often an issue but very rarely the only issue. However your use of the phrase, “drug addled welfare mom” is a gross mischaracterization of mothers who find they need public assistance. Also “Welfare mom” is a phrase regularly used by conservative and poorly informed politicians who want to cast aspersions on a whole group of people. I’m very disappointed to see this kind of language used at SBM regardless of its intent to provide an illustration because people often remember the illustrations long after they forget the message. And while the use of this kind of language is insensitive, it also appears to demonstrate something about the considerable privilege and lack of knowledge the writer possesses about how and why people use drugs. I would suggest the author may want to read “High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society”, by Dr. Carl Hart.

        1. Jann Bellamy says:

          I think we are actually making the same point: that too few people care about the unfortunate segment of society you describe. I added the observation that others in similar situations receive vastly different treatment because, to some people, they are more appealing. I was searching for a brief description that would convey “person society doesn’t care about” and this is what I came up with. It was in no way meant to convey the idea that a certain percentage of moms on public assistance use drugs. Obviously, I can’t get into the many complexities which bring our fictional mom to this situation in her life in a post of this length and one that is really on a wholly different subject. I am about to change the text to “stereotypical drug-addled welfare mom” to more accurately convey my purpose in making her up. I will take your comment about “the considerable privilege and lack of knowledge the writer possesses about how and why people use drugs” as the speculation it is because, obviously, you can’t possibly know those things.

          1. jacobv says:

            No, I can’t know that, and my qualifying “appears” was insufficient cover for some unnecessary snark. I was irritated and apologize. My book recommendation still stands!

            1. Jann Bellamy says:

              Thanks. The book sounds interesting and I’ll give it a look.

    2. BillyJoe says:

      I think you may need the whole paragraph a little more carefully…

      “Nobody wants to defend the drug-addled welfare mom who won’t take her sick child to the doctor. However, make that Christian Science parents whose child is wasting away from lack of effective medical treatment. Or, the parents who want to use “natural” remedies instead of chemotherapy for their child. Front page news! And plenty of people who’ll stand up for the “right” of these parents to harm their child”

      You seem to be actually agreeing with the author.

      1. BillyJoe says:

        Oops, I didn’t see Jann’s comment before posting.

  2. How about we work to end the scourge on humanity called religion. It makes alternative medicines look like Little League. A total fraud that is responsible for millions of needless deaths. And all this through fear and peer pressure without a shred of evidence. The sooner it is gone the better. Ramen.

    1. Greg says:

      Couldn’t agree more! Organized religion should be abolished.

      1. mousethatroared says:

        I’ve always suspected that the problem with organized religion was more the organized than the religion.

        Once a bunch of humans get together and decide one way is good and the other way is bad – better run.

        The only protection from that tendency I have seen is that some groups of humans got together and decided that it was good to let people believe what they wanted and bad to persecute them for their beliefs…this resulted in a spiritual paradox that has kept some of the more violent tendencies immobilized with indecision.

        The word of MTR.

        1. WilliamLawrenceUtridge says:

          One needs only look to Elevatorgate and Dr. Hall’s posts on gender issues to see how far skeptics are from being invulnerable to these tendencies. South Park’s GO GOD GO episodes were prescient, brilliant and only slightly exaggerated.

          1. mousethatroared says:

            True WLU – I’ll have to check out that episode.

            1. WilliamLawrenceUtridge says:

              It’s a two-parter, and keep in mind…it’s still South Park. Subtle as a brick in the face and a knife in the groin.

              I mean, spot-on, but definitely not subtle.

              1. mousethatroared says:

                Yeah, Some of my friends are fans. I watched it when it came out and it didn’t really click for me. Sometimes you’re just not in the right frame of mind. But a couple of episode are worth a try. I’ll have a martini first.

  3. windriven says:

    “The U.S. Constitution does protect, to a limited extent, the parents’ choices in the child’s medical care.”

    It is important that we work to dismantle state laws that underpin claims of religious and other exemptions to the requirement to provide competent medical care to children. In WA state religious conviction has largely been stripped away as a defense for withholding medical care from children – except for an exemption for Christian Scientists. We worked to eliminate that exemption with SB 6295. The bill was reported out of committee and made it through second reading with broad support but was recently ‘X’ listed (short hand for ‘ain’t gonna happen this session’) owing to lack of time and a burden of pressing fiscal issues. I’m beginning to prepare now for another run at this next session.

    These are not difficult bills to get started but there is little organized effort to get them going (CHILD was deeply involved in favor of 6295 here in WA). It is a perfect opportunity for SBMers to make a real difference in their communities. Learn what the laws are in your state. Act to make them serve the interests of your neighbors’ children.

    And once a bill is started you cannot forget about it. You have to continue to lobby. Inertia is a far more powerful enemy to your bill than the religious nuts and mediquacks and cranks.

    Talking about SBM is important. Doing something about it is importanter ;-)

  4. Eugenie Mielczarek says:

    Jann, Thank you for this informative post. I lived next door to Christian Scientists. who refused to drive me to an emergency room when I required immediate treatment after a home accident. They did use eye doctors. and wore prescription glasses. Sadly the wife did die long and painfully refusing medical care . I was informed : Mary Baker Eddy , founder of Christian the Christian Scientist movement was buried with a telephone

  5. goodnightirene says:

    My parents were minimally educated, bible-thumping, John Birch Society idiots who constantly were at odds with my school over every perceived challenge to their “parental authority” (God-given, of course–no elitist education required).

    Thank the Universe that my teachers and school system stood up to them is all I can say. The only sad thing is that in those days, the system was more reluctant to actually remove a child from such a home.

  6. Keating Willcox says:

    The small problem you mention is correctly stated. Many fringe religious zealots deny critical care for their children, and manage to find the lawyers to enter lawsuits. Most of these fringe groups are simply opposed to a subset of medical practice, such as using donated blood.

    It is in this context that we see the real damage to children – in particular, the massive drugging of young children and massive over diagnosis of serious mental disease, including shock treatment to very small children. We we hear that Harvard medical School routinely takes away parental rights (Pelletier was only one of many cases) and used the term parentectomy, we know who thinks they are in charge. Children have been removed from their homes because they have head lice. “Now, children could receive as many as 24 shots by 2 years of age and five shots in a single visit.” and what is the result? Well, we know that since this massive increase in immunization, we have limited some disease, but we also know and cannot explain the truly massive increases in asthma, allergies, autism, ADHD and other childhood problems.

    The US is a world leader, along with japan in such illnesses…”Low autism prevalence is not confined to poor countries. A handful of small studies in France, for example, have found rates around 5 cases per 10,000 people. One study in Germany calculated it to be 1.9, and another in Portugal 16.7.”

    The United States has the highest number of mandated vaccines for children under 5 in the world (36,
    double the Western world average of 18), the highest autism rate in the world (1 in 150 children, 10 times
    or more the rate of some other Western countries), but only places 34th in the world for its children under
    5 mortality rate. What’s going on?
    ………………There is an intense debate over the correlation
    between rising autism prevalence and the United States
    vaccine schedule. The vaccine schedule for children
    aged 5 and under has nearly tripled in 25 years. In 1983,
    the Centers for Disease Control recommended 10
    vaccines for this age group. Today, the
    recommendation is 36 vaccines.

    So the all-wise government and Big Pharma enjoy and mock concerned parents who are looking at this obvious evidence and dare to question the massive profits vaccines offer. When you complain about folks who are skeptical at this massive increase in vaccines, at the massive increase of drugs for ADHD (20 times the EU rate) and note that when Harvard took over the Childrens pediatric Mental health, they were able to find an eight times increase in BiPolar diagnoses among children under three. Oh, and the Harvard scientist was brought to trial over Big Pharma kick backs and cooked research…”By 1993, the first year of the Olfson et al study, about a quarter of 1% of the national childhood population were receiving antipsychotic prescriptions during office visits. The percentage for adolescents was about three quarters of 1%. By 2009, these figures had increased to 1.83% and 3.76% respectively.”

    Don’t tell me this is all about good medicine. For every instance of religious quack with a screwy way to treat their children, there are thousands of doctors lining their wallets and handing out dangerous and evil medications to a population of unsuspecting parents and children.

    You are a complete fraud as a doctor. You have no problem finding the few number of religion based screwballs, yet you are silent on the problems of evil doctors and Big Pharma.

    1. Jann Bellamy says:

      It is hard to respond to what is essentially a rant, instead of a well-reasoned argument with citations in support of the claims made, but I’ll give it a try. First, I am not a doctor, I am a lawyer. Second, what you say about the supposed connection between vaccination and diseases such as autism is complete nonsense and has been refuted by good-quality evidence many times. You can find much more information on this blog about these issues. I suggest you give it a look.
      Third, you apparently know little about the many protections for parents and children when the state attempts to intervene to protect children from their parents. I’ll bet you can’t even recite the steps that must be taken to initiate these proceedings and what happens after that. Actually, it’s obvious that you can’t. Your statement that Harvard routinely takes away children is completely false. Harvard can no more take a child away from his parents that you can. And, yes, children sometimes do need to be protected from their parents and you apparently agree that they do. Does the process always work the way it is supposed to? No. Could it be improved upon? Possibly. But your wholesale conspiracy-theory-laden rant against the process is ill-informed and will do nothing to improve it because you are not a credible source of information. Instead of staying within your echo-chamber, I suggest that you volunteer as a Guardian At Litem for a child (if you can pass the screening and training requirements), talk to the lawyers in your state who represent children and parents in these proceedings, talk to people who have served as medical guardians for children, and read up on the legal process involved. Talk to judges who handle these cases. I’ve actually represented a mother who was at risk of losing her child. Going through these proceedings with the state probably did more to benefit her and her daughter than any other intervention. It also got the dad out of the picture, as he should have been. I’ve also been involved as a lawyer in guardianship proceedings, which can be incredibly complex. You will find that the issues are not so black and white as you apparently believe once you actually take the time to learn more about them. But I doubt you will. You don’t sound like the type of person who wants to contemplate the possibility that he might be wrong. So stay in your echo chamber, where you can always be right.

    2. MTDoc says:

      Wish I’d known I could have “lined my wallet handing out dangerous drugs,etc.”, I might have been able to remain in private practice. I won’t waste time here explaining how medical practices work, at least in any of the jurisdictions where I have worked. But you might be interested to know that the present vaccines, inspite of covering more diseases, contain fewer antigens than the few we used years ago. The greatly increased cost of present day vaccines reflects the continued costs of improving and assuring safety. My office charge for a DPT used to be $2. Those were the days!

    3. WilliamLawrenceUtridge says:

      Well, we know that since this massive increase in immunization, we have limited some disease, but we also know and cannot explain the truly massive increases in asthma, allergies, autism, ADHD and other childhood problems.

      That’s minimizing things, isn’t it? We haven’t “limited some disease”, we have driven smallpox extinct, eliminated 99.9999999999999% of all cases of paralytic polio, prevented thousands of children of dying of pertussis, prevented thousands of cases of measles-based sterility, deafness and mental retardation, etc. etc. You know how if you have ten kids and all of them survive into adulthood and this fact is unremarkable? You know how you regard the death of a child as a tragedy instead of a fact of life? Well, those changes didn’t come about through magic, they cam about through vaccination.

      As for the connection between autoimmunity, autism and ADHD, there is some evidence for a connection between them and reduced immune challenge (though it’s not like the only immune challenges out there were the couple dozen diseases). Assuming these connections are true and not spurious, that does imply a difficult choice – do we subject our children to the risks of deadly vaccine-preventable diseases, or the generally quality-of-life issues of autoimmunity. Not to minimize the latter – autoimmune diseases can be awful, and can last an entire lifetime. Yes, medicine and biology continue to surprise, and we can certainly do better in terms of understanding autoimmunity, autism and ADHD.

      The United States has the highest number of mandated vaccines for children under 5 in the world (36, double the Western world average of 18), the highest autism rate in the world (1 in 150 children, 10 times or more the rate of some other Western countries), but only places 34th in the world for its children under 5 mortality rate. What’s going on?

      Well, the US might be better at diagnosing children, the resources made available for such children migth encourage self-identification by parents, the risk tolerance for vaccination might be different in different countries, and so forth. Regards under five mortality rates, for one thing there is the US’ egregious lack of a publicly-funded health care system, and there is also the fact that the way the US defines measures of childhood mortality is different from other countries. In particular, I believe what is considered a “stillbirth” is different – in the US it encompasses perinatal mortality while in other countries it doesn’t. So a baby that is born alive but dies shortly after is considered a stillbirth in one place (and hence doesn’t contribute to infant mortality) while in others it is considered a live birth.

      It’s complicated.

      So the all-wise government and Big Pharma enjoy and mock concerned parents who are looking at this obvious evidence and dare to question the massive profits vaccines offer.

      Except it’s not big profits, its’ something like 2-4% of most company’s bottom lines. Not insubstantial, but not blockbuster-status either.

      And what do these profits have to do with vaccine safety and effectiveness?

      When you complain about folks who are skeptical at this massive increase in vaccines, at the massive increase of drugs for ADHD (20 times the EU rate) and note that when Harvard took over the Childrens pediatric Mental health, they were able to find an eight times increase in BiPolar diagnoses among children under three.

      First, citations?

      Second, what do vaccines have to do with ADHD? The overdiagnosis of ADHD and excessive use of drugs would seem to be separate from the prevention of deadly diseases (and a set of problems that are recognized, studied and the subject of ongoing criticisms).

      For every instance of religious quack with a screwy way to treat their children, there are thousands of doctors lining their wallets and handing out dangerous and evil medications to a population of unsuspecting parents and children.

      So…we can’t prevent children from dying of medical neglect until there is no financial conflicts of interest in medicine? What an odd suggestion, the two would seem to be unrelated.

      yet you are silent on the problems of evil doctors and Big Pharma.

      Really? Silent? Are you sure?

    4. Gary Whittenberger says:

      This response by Willcox demonstrates a classical logical fallacy. A vague correlation obtained from a small sample is interpreted as a causal relationship, i.e. vaccinations cause autism. This logical fallacy is then made worse by people who then use it to justify avoidance of vaccination, which then leads to harm to children.

      There is an abundance of sound evidence that vaccinations do not cause autism.

      The other logical fallacy exposed in the Willcox rant is “We don’t know the causes of autism, so it must be vaccinations.” This is the classical argument from ignorance.

      The main thrust of Bellamy’s article was against religious exemptions, but Willcox says almost nothing about that.

  7. Keating Willcox says:

    Why does the U.S. recommend 36 vaccines vs 11 for countries like
    Norway and Israel? Why is the U.S. autism rate 1/150 and Norway’s
    1/2200?

    I guess its all the religious and anti-science freaks in the USA? Right, Dr.?

    1. Chris says:

      Because we don’t like to see kids get sick, disabled and even die. At least for us that are scientifically literate, and then there are religious institutions like the Catholic Church that support science and medical care (including preferring children get the vaccinated for rubella as part of the MMR instead of having babies die from Congenital Rubella Syndrome*).

      Now, for at least the third time, Mr. Willcox, if you have any real evidence other than some copy pasta please present it. Provide us the PubMed indexed study by a qualified reputable researcher that any vaccine on the American pediatric schedule is more dangerous than the disease.

      For example, in the USA before 1963 measles killed over four hundred children and disabled thousand. Also in the early 1960s a rubella epidemic caused tens of thousands of babies to be born disabled, plus thousands of stillbirths. Does the MMR vaccine cause the same level of damage?

      * One actually known cause of autism is rubella, the actual virus.

    2. Calli Arcale says:

      The US recommends different vaccines than Norway does because it is a different country. Different population, different endemic diseases, different public health priorities. But it isn’t true that we require 36 vaccines and Norway requires only 11. You are counting them differently, which is a bit disingenuous. You are counting *injections* in the US, while counting the diseases vaccinated against in Norway. Norway actually vaccinates against about the same number of diseases as we do. The list is not identical; they do not require chickenpox vaccine, but they do require tuberculosis vaccine, which we do not. Otherwise, the schedule is very similar to ours.

    1. Chris says:

      Some reading for your, Mr. Willcox:
      http://www.sciencebasedmedicine.org/?s=age+of+autism

      You might try learning to think for yourself, and actually do real research using real science.

    2. Chris says:

      A wee bit of advice: a five year old article by an MBA is not science. It is more of a joke. Read these:
      http://www.sciencebasedmedicine.org/?s=blaxill

    3. Carl says:

      FYI, everyone reading here is laughing at what a fool you are for citing AoA.

      Just thought you should know.

    4. Wow, what flavor Kool-Aid are you drinking? You do know AoA site promotes unscientific discredited nonsense?

    5. windriven says:

      The moment you cited Age of Autism I turned off to anything else you had to say. If you are unable to see AoA for what it is then I feel free to draw the inference that you’re either a crank or a dope.

      Let me also mention that autism is now autism spectrum disorder and there is considerable latitude in making that diagnosis. That diagnosis may or may not be made using similar criteria in, say, Norway. It is irrelevant as a statistic unless you can demonstrate consistency across the samples and the methods.

    6. Andrey Pavlov says:

      Citing AoA = losing the argument in every conceivable way. You’re almost better off citing the bible to argue with me about evolution.

  8. tw says:

    If a prospective parent can chose to end the life of their fetus, or choose to endanger it through high risk activities…..with the states’ (courts or constitution based on your point of view) approval in the former case, does this not in a way engender the predicament you describe?

    I other words, if a prospective parent can make life and death decisions based on “ownership” as a prospective parent, should this be considered different than denying certain types medical treatment based on religious grounds as a parent?

    From the other side: to be against abortion on religious grounds on one hand and then to be against effective medical treatment on the other would seem equally inconsistent. One is pro life the other is not.

    This is a philosophical question not a statement. I am curious about your thoughts from a legal perspective.

    tw

    1. Iorek says:

      Don’t women who choose to abort foetuses do it on the basis not that they own the foetus but that, as the only person in the picture-the foetus not yet having the capacity to live independently-they are entitled to decide what happens with their own body?

      Here in Oz one of our governments-we have oh so too many-is considering legislation to prevent pregnant women from drinking, or doing anything else to harm the unborn baby, on the basis of the cost to the community of caring for the damaged baby once it is born. I have the feeling bodily integrity for women of childbearing age in NT is about to go the way of the dodo.
      http://www.abc.net.au/news/2014-03-14/nt-government-considering-rights-of-unborn-child/5320016?section=nt

    2. windriven says:

      A fetus and a child are quite different entities. We can all quibble all day long about the moment at which agency attaches – and we’d all be wrong – because there is no ‘right’ answer, just the one we’ve generally adopted.

    3. WilliamLawrenceUtridge says:

      tw, there are limits on the age at which a pregnant woman can request an abortion. The decision of when someone is “pregnant” versus “a parent” mostly lies within the mind of the person making the decision. While any cut-off is always inherently arbitrary to some degree, the efforts by medical personnel are to push abortion dates as early as possible, for practical, health and compassionate reasons. The legal, political and logistical efforts to delay and discourage abortions unfortunately work against this. Most egregious are the anti-abortion agencies that masquerade as abortion providers whose efforts are solely directed at mendaciously delaying abortions until they are legal.

    4. Jann Bellamy says:

      As some have already pointed out, in the U.S. the courts make a distinction between a fetus and a living child. Because there are two involved in the pregnancy, the mom and the fetus, the courts take both into consideration. Fetal age is the main determinant in deciding whether and under what circumstances a woman can legally obtain an abortion — the older the fetus, the more negative impact on a woman’s health the pregnancy has to have in order for her to obtain an abortion. That’s a simplification but that is the general idea. I do see this situation as different from a living child, because of the impact the pregnancy has on the mother’s health disappears when the child is born. On the other hand, I agree that it is logically inconsistent to be anti-abortion and pro-denial of medical care for a child. If you are arguing that the fetus shouldn’t be harmed by an abortion, how could you possibly argue that it’s permissible to harm a living child by denial of medical care.

    5. Gary Whittenberger says:

      I think the problem with your argument here is that you assume that a zygote, embryo, and fetus are equivalent to a child or adult or that these early stage living human organisms (ESLHOs) have been assigned a right to life. They haven’t, and they shouldn’t be! The courts have assigned a right to life only to the fetus in the third trimester, and even then this right is not absolute, since if the pregnant woman’s life or health is endangered, then fetus may be aborted.

      So, Bellamy’s concern about the well being of children is not contradicted by the practice of abortion during the first two trimesters.

      The life of a human organism is not the same as the life of a human person. They are different ontologically, ethically, and legally.

      1. Andrey Pavlov says:

        Very correct. There is no bright line between zygote and person and no possible definition – scientific or otherwise – can truly capture and delineate any proposed line. At some point it will break down and either make an adult non-human or a cancerous tumor fully human.

        This is precisely why a zygote and a human are not equivalent and anything that purports to make any sort of hard delineation – including that any stage of a conceptus is unequivocally fully human – is simply incorrect.

        As with the very nature of development itself, any judgment on the matter must also flow continuously with some judgments necessarily much easier than others.

      2. WilliamLawrenceUtridge says:

        Treating them as people could lead to involuntary manslaughter, couldn’t it? That’d be interesting. Of child-bearing age but don’t know you are pregnant and your baby suffers for it? Welcome to jail!

        What really gets my goat is the number of unadopted children. Seriously, if you’re going to bitch and moan about abortion and how terrible it is, if you’re going to advocate and demonstrate – put your money where your fucking mouth is and adopt.

  9. Elizabeth says:

    Hi,
    I wanted to respond to this argument as a very religious mother of 3. I am Catholic. I do not NOT believe in homeopathic remedies, “natural” remedies, “diets” or anything of that nature to cure my kids over my kids’ doctors advice.
    I have friends who are also Catholic and homeschooling. Nothing is more frightening to me, as a Catholic mother of 3 going on 4 to read these women’s posts about their medical methods. Nothing is more frightening than to hear them talk so hoity toity about how they dont’ vax.
    For a Catholic, it is very frightening. Because I love God I love my religion. I love my priest. I love my parish and I am highly faithful. But it freaks me out how paranoid other Catholics are.
    Some women posted on my Facebook wall the other day that all these kids died from vaccines. I didn’t buy it.
    I talked to my OB who said she’s glad I vaccinated myself and my kids because of resurgences of diseases cropping back up because people refuse vaccines for every kind of reason you can think of.

    For a religious it is MORE scary for us than for a non religious to watch our fellow religious deny their kids real health care because of witch doctoring. I don’t know how to explain it to secular minded people WHY I think I am more terrified. I guess its not rational. I think its because I am supposed to connect with these people and they want me to change how my kids eat, sleep, drink, what they play with and when they get vaccines. And the worst part is they actually have no moral reason to deny their kids these kinds of health care! No vaccine is morally objectionable as they claim. My PRIEST told me that he does not object to any medication or vaccine you can find on the market today.
    They have no real backing they just interpret the bible or the church doctrines any kinda crazy way they want to scare their fellow Catholics into not getting proper care for t heir kids.
    They say “Try this homeopath” “Try this diet”
    “Don’t trust your doctor.”
    “Don’t believe your doctor” “Here is an essential oil”
    Its frightening to me because WHAT THE HELL? Have Christians on a whole gone back…gone mad? This is witch doctory. This is a joke! These people don’t even know our history.

    I can be religious, and go to mass every sunday, and observe Lent and Easter, and pray til my knees hurt. I can love God and still not hate science.

    These people have forgotten our history as human beings. And its not just Christians. I’ve seen this mad sciencey witch doctoring from secularists and atheists too! Seriously…look into it!! I can find just as many secularists as self proclaimed religious doing this crap! Its insane! Completely irrational. And most of the people who do it aren’t even crack moms. Crack moms just don’t give a hell. These people ACTUALLY neglect their kids health because they THINK for whatever kooked out reason…that they are doing what’s best. THAT is scary my friends.

    Our history shows that with the evolution of medicine we’ve gotten better, we can live longer…… infant mortality, maternal mortality child mortality all that has plummeted and diseases have started to disappear but if people don’t do the right stuff for their bodies….we’re all messed up. if people rely on garlic and apple cider vinegar to cure all their woes…..they are going to be hurt in the long run. who wants to bet we see shorter lifespans in the coming years if this trend continues? Funny thing the same people who tout false medicine…..claim they are healthier than me….will live longer than me etc.
    And have more allergies than i do. (I have none)
    And have more breathing problems than i do (i have none)
    And go to their “doc” more than i do ( i go for OB that’s it because prenatal care)
    but want to tell me how healthy they are? WOW

    BTW I love this blog. I read it all the time. Its my only place for sanity away from the health claims that keep coming my way from quack jobs….of every kind.

    Thanks so much for making this. I have been freaking out about how many people especially people of my own kind….freaking using homeopaths for their kids…I want my kids to hang out with other Catholic kids…but not if they end up with polio or some crap.

    1. Sean Duggan says:

      In general, I haven’t found Catholics to often succumb to this. Benefit of over a thousand years of experience, I suppose. That said, there are extremists in every area, and we often share the same universal tendency to believe the most ridiculous things when it’s our friends telling us, I know my wife has often commented on the amazing new development someone’s posted on Facebook with breathless excitement. Sometimes, it’s a legit scientific advancement. Sometimes, it’s sensationalistic reporting. Far too often, it’s nonsense like “oil pulling” or cinnamon/vinegar/bleach curing all diseases.

      1. Elizabeth says:

        As a Catholic my friends list is full of Catholics because I hope for some like minded people to connect with. I have my family, non Catholic but medically sane, that I connect with. Then Catholics and then a few pagans and some secularists. One pagan she seems to have all her screws in, another she likes the essential oil therapy. There are like 4 Catholics (could be more) AT LEAST that do not vax their kids. There are no Church doctrines or laws opposed to vaccinations. These people are simply FEAR mongering. One woman has even made up a moral reason to be anti-vax. There is no moral ground but she pulled it out of thin air and some ingredients in the vax. I brought the ingredients to my well researched priest….who also was homeschooled and is very traditional. He said that the list of ingredients would not put my soul or anyone else’s at danger for utilizing it. That this is a matter of over scrupulousness.

        I want to jump through my screen and choke slam every Catholic on my page whom I’d otherwise get along with….when they talk oil pulling, essential oils, rubbing grapes on your face (Idk if this is real i am making it up) chiropractors, oh and the feingold diet.

        While their kids are sickly. I am sorry if your kid is allergic to every kind of food there is and has exzema and has asthma….that means what you are doing is wrong.

        or at the very least…they are sickly.

        My kids have none of those issues. Other than the fact that they struggle to put weight on even with a pretty good diet the pediatrician recommended….not a feingold just a high carb/high calorie…
        they have no other issues. their protein, iron levels and other levels are great. they have no allergies or skin disorders.

        But these women (its mostly women) keep bringing up the fact that their kid (sickly) will out live my kid (healthy) because my kid once in awhile has a mcnugget or has some bacon for breakfast or eats bread from the grocery store or we don’t shop at the farmer’s market.

        It is SCARIER to see a person who is of sound mind (overall) who is supposed to care about heir kids ignore their kids in favor of thousand year old and older remedies. Their remedies are laughable. The fact that anyone with an iota of reasoning ability can tell you a smelly oil can’t solve your stomach issues and a back massage can’t get rid of morning sickness should be alarming that these people take these methods into account.

        I give more credit to the crack mom who ignores her kids health. At least she has crack to blame…a substance abuse problem. At least with rehab she can change.

        Do you think that Christians, Christian scientists, or -shudder- these off the wall Catholics will change because the state tells them? No all that will happen (I know because I hang out with these people) is they will get a persecution complex and go underground to continue their witch doctoring. Even if it kills their kids. And Catholics should know better because we don’t believe kids go to heaven as a guarantee. We believe baptized infants and children under the age of reason go to Heaven no questions asked .We don’t believe that about kids over the age of 7. So for a Catholic to practice unsound medical advice on a sick child is scary…..or should be because unlike all other religion where they think their kids make it to Heaven without a blink…we have no promises of such. So they can’t use the “my kid is better off in Heaven” line for why they self help heal their kids.
        Even if one would assert thaat all children go to Heaven no questions asked that’s still not a good reason to throw essential oils, grapefruit seeds, guava juice etc on cancer. That’s not a legit reason to medically neglect one’s kids. Don’t they ever think: Will I have to hold an account to God for allowing my child to needlessly die? I am of the firm belief God put us here with minds and brains and abilities to achieve g reat things and medicine is part of that plan. Unless a doctor used some unethical or immoral treatment method that would go completely contrary to faith (which i’ve yet to see) then yes you will be held accountable. *I* think so. If you (general) allow your kids to die because you don’t trust doctors but have no just cause not to trust doctors no real reason then you will be held accountable. AND SHOULD be held accountable by the courts. JMO

        I understand these questions don’t matter to secularists. But they should to people proclaiming Christ and Heaven.

        ________________

        On another topic I also have friends who are crunchy moms (atheist to boot) who posted an article from ABC or some other mainstream media source where the parents had smothered their baby by cosleeping. She claimed that you can’t do that you can’t smother a child co-sleeping and that this is a sickness that doctors are trying to scare parents and guilt people into thinking they can’t go ‘all natural’ with their kids.
        Are there any articles on SBM here that would debunk the necessity to cosleep or would prove that cosleeping is harmful and that would back the findings of American Academy of Pediatrics? I’d love to read it. AAP says cosleeping is dangerous, wake up by sleeping face up all that. but crunchy natural mommies tell everyone that cosleeping is safer than crib sleeping and tell them that the incidents where the baby died in the parents bed was just SIDS or some other cause but not cosleeping. This has to be wrong but I can’t prove it. I’d love an article from SBM and other science bloggers because these people are fear mongering other parents and telling them they don’t love their kids enough if they make them sleep in a crib etc and telling them AAP are basically lying.

    2. Jann Bellamy says:

      Thanks for hanging in there with science! Many readers comment about how hard it is to push back against the “CAM”-loving crowd. It is indeed horrifying that parents could fall for the anti-vaccination propaganda that has so often been proven wrong or treat their children’s illnesses with water (homeopathy). The U.S. Conference of Catholic Bishops actually spoke out against reiki a few years ago because it is essentially a supernatural practice. Perhaps you could talk to people in the Catholic hierarchy about your concerns and get them to speak out against these practices as inconsistent with Catholic doctrine.

      1. Elizabeth says:

        I see these new age medicines as just that new age so it is totally anti-Catholic to practice these things and should be seen as such by Catholics but folks are blind to it.

        I believe that religion can cooperate with ethical science. And will not back down from treating my kids in good conscience. I am not against homeschooling if the parents follow protocols of care. Its when these parents are using homeschooling as a cop out. To skirt the laws and such. That’s what’s scary about homeschoolers. Many are using it to skirt the laws about vaccines when they can’t find a legit reason not to vaccinate. Some schools require that if you have a religious exemption you get a priest (or whatever) to write something or prove it…
        Well tahts what i heard. So most priests wont sign their name to anything saying its against our religion because its not.

        Its not just vaccines. Its countless other “Remedies” that freak me out.

        1. Kathy says:

          Like Jann says, hang in there Elizabeth. Never mind the Supermother crowd.

          Like you I’m Christian (though not RC) and I know that sinking-heart feeling when you see people linking some form of magical nonsense to their faith, when it’s got zilch to do with it. Oh no, no, no, no, NO! Use the brains God gave you, use the brains he gave other people, like doctors and researchers. Please … get a life you wusses!

    3. Gary Whittenberger says:

      Thanks for standing up for the health and well being of your own children and those of others.

      If God did exist, he would want all of us to pursue and accept science-based medicine with our children!

  10. Sean Duggan says:

    I somewhat wonder if the objections have less to do with religion than fear of government interference. No one likes to be told that they’re doing something wrong, parenting in particular, and I know that I virtually go into cold sweats the moment the government steps in and says that they know exactly what’s right for a child. In the last case, it’s often well-meaning, but poorly executed, c.f. far too many educational standards written by government officials divorced from academia for decades. The religious are likely to object in part because they already have an infrastructure for guiding their best practices, but I wouldn’t be surprised if the rates are just as high among survivalists, etc who simply don’t trust the government to do right by them whether due to perceived malice or perceive incompetence (funnily enough, I often see people opposed to religious hierarchies for the same reason, accusing the Church of being actively evil, incompetent, or merely far too slow to react).

    I will admit that, as someone who grew up reading dystopian fiction involving government imposing unnecessary medical procedures upon their citizens in an attempt to manipulate them, my sense of plot significance is definitely triggered whenever I see a story of the government stepping in and mandating such and such medical procedure, but fortunately, it’s generally pretty common sense stuff such as vaccines and preventing flagrant cases of abuse masked as treatment (with some odd exceptions for areas such as treatment of autism via bleach, of course). I can only hope that when they proceed to mandatory sterilization (a historical reality in the United States although not currently done as best I know) or nerve stapling, that I’ll know that it’s time to put my foot down.

    1. David Lear says:

      I suggest you avoid dystopian fiction. Not a good way at all to arrive at any opinions. It’s fiction, you know.

      1. mousethatroared says:

        Yeah, 1984 – how silly.

        1. windriven says:

          Mouse! Nicely done. I was winding myself up to take Mr. Lear through a review of dystopian literature starting with 1984 and ending with Oryx and Crake, then pointing out the resonances with recent history. You trumped all that with four words. I stand in awe.

    2. mousethatroared says:

      @Sean Duggan – I think that one problem is that often only the cases that have stirred the most controversy are reported on. The vast majority of CPS interventions for abuse and neglect are ignored. My friends SIL is the adoptive parent of two great kids, through the state/foster care system. Her older daughter was removed from the custody of her birth mother because she failed to follow up on care for the infant’s life threatening GI condition and the home visit indicated pretty extreme neglect. There was more to the process, but that is the just of it.

      The fact is some people abuse and/or neglect their children and the children need some entity to step in to protect them. Who are you going to give that power to? An entity that is constrained by a constitution where decisions are made through a democratic process or ???. If you don’t trust the state to handle it well (and yes there have been issues with how states have handled these issues, the process is not perfect) then best to do something to fix that specific problem, because there is no other reasonable option that I can see.

      I’m pretty sure that one could write a dystopian novel on a society that considers the right of parents to be supreme and how that affects the children.

      1. Sean Duggan says:

        {nods} Essentially, I think it’s a case of keeping one’s eyes open either way. Blind obedience, whether to the state, to the latest reports of scientific advancement, or to scriptures or religious leaders is a good way to get yourself in trouble. If something sounds off, it often is. Unfortunately, when something sounds too good to be true, it often is too… In short, you always have to take things with a grain of salt, but to also consider that you might not be on the right track yourself, or at the least not on the best track.

        There is also a bit of the law of unintended consequences too. As people pointed out when the Patriot Act was being passed, it was fairly reasonable for the time, but it left the path open for horrible abuses, as we’re learning. Similarly, I have my qualms of giving the government too much power to countermand family decisions. So long as it works within the system, trials and the like, and the system works (not always a guarantee, unfortunately. Legal fees are high and public defenders are often overworked even if you do get one of the competent ones), there are checks and balances. Making things more difficult, it can be very easy to support giving more power to regulation when you’re on the side of said regulation. I know that I’ve shut down more than one argument that the U.S. ought to have a state-run religion by pointing out how oppressed they’d feel if that state-run religion wasn’t theirs.

    3. Gary Whittenberger says:

      The dictates of the church and the state should be rejected if they contradict the findings of science! If the government requires vaccinations, don’t reject this just because it comes from the government. Look to the science! Is the requirement supported by peer-reviewed well-designed scientific studies?

  11. Elizabeth says:

    Off topic but I would really like to see an entry about the importance of safe sleep for infants or an article that talks about the controversial issue of crunchy parenting because SOME crunchy parents take a leaf from this all natural stuff. And a thing that scares me with crunchy parents and their science denial is: cosleeping which they keep insisting doesn’t cause suffocation related deaths even with infants dying from cosleeping.

    They also are heavily involved with “all natural” remedies and “Eastern “meds and are anti vax etc. I think the lack of vaccines and the lack of vitamin k shots are also what is causing some infants to die. I reaad at least one case where the child died within a few months of going home because the parents denied the baby the newborn vitamin k shot. How many crunchy parents encourage this and then dont blame the lack of vaccinations, proper treatment etc for children and infant deaths??

    1. WilliamLawrenceUtridge says:

      I often wonder about at which line(s) of longitude that vaccinations cease to be effective, and bear bile starts to be effective. And, if you were vaccinated West of that line, is it always effective, or does it stop when you cross it? What happens if you get sick to the East of that line, and are prodromal until you cross it again? Or what if you’re showing symptoms? Could you take antibiotics, and when the side effects are bad, hop across that line for a bit to take a break?

      Since, you know, apparently medicine cares about geography.

  12. David says:

    @ Elizabeth:

    You say: “And a thing that scares me with crunchy parents and their science denial is: cosleeping which they keep insisting doesn’t cause suffocation related deaths even with infants dying from cosleeping.”

    The cosleeping parents I know would call that a strawman because they readily acknowledge that infants die from cosleeping, but point out that most of those deaths occur when the parent(s) is drinking, doing drugs, or smoking cigarettes. If they are correct, then it is not cosleeping per se that is the problem. In fact, arguably cosleeping (sans drugs/alcohol/cigarettes) is safer than having your infant in a separate room where you cannot as easily hear/see signs of distress.

    In any case, it is an interesting topic and I’ll add my voice to those who think it’d be great if an SBM doc wrote about it.

    1. Sean Duggan says:

      On a side note, I was recently rereading the Snopes.com article about how Deborah Skinner’s enclosed (and heated) crib was mistaken for a Skinner box, and it makes me wonder if that idea will ever come back. It seems to make sense, at least if you’re a believer in cribs in general. Although, based on the description of it, where Skinner talked about how babies naturally thermoregulate by adding and removing blankets, I wonder whether this would remove said agency, and if that would then add an onus of responsibility to the parents to adjust the temperature based on the age of the baby, responsibility which does not mix well with commercial baby products.

    2. WilliamLawrenceUtridge says:

      Basinettes (sp?) would seem to have the advantage of keeping the child in the room without the risk of rolling over onto them. The AAP recommends against cosleeping (the term they use is “bedsharing”) in favour of room-sharing (i.e. a basinette, sp again, I should just look it up).

      http://pediatrics.aappublications.org/content/128/5/e1341.full

      Even without smoking, drinking and drugs, it’s still a potential danger; as the paper points out – you can not smoke, you can not drink, you can not do drugs, but it’s pretty hard to avoid being tired (particularly with a noisy baby in your bed waking you up every two hours).

      1. David says:

        @ WilliamLawrenceUtridge:

        “…it’s pretty hard to avoid being tired…”

        Fair enough (believe me, I have a 6-year old who had major sleep issues until he was about 2). I was tired. But really, how many times has being tired caused you, for example, to roll out of your bed? Ever? If your body/brain keeps you in your bed, despite the fact that you’re asleep, what are the odds you are going to roll over onto your infant?

        I’m genuinely curious to know how often a sober, sleeping adult rolls over onto an infant in a way that harms or kills the infant. There must be data out there. To the google!

        1. WilliamLawrenceUtridge says:

          How many times has being warm and tired caused you to throw off a comforter?

          How long would it take for an infant to sustain permanent brain damage due to being underneath that comforter.

          Even the thought gives me a grue down my spine. The risks may be low, but if I ever had a kid they would never, ever sleep in the same bed with me, unless I was awake and moved them elsewhere.

          Perhaps I’m more risk-averse than some.

  13. Steven says:

    I enjoyed reading your article, but I feel that I must clarify a common misconception. The article stated that Christian Scientists and Jehovah’s Witnesses are two groups “supporting rejection of medical care”. I cannot speak for Christian Scientists, but I am one of Jehovah’s Witnesses, and I can assure you that we do not, as a group, reject ‘medical care.’
    The only treatment we refuse is the transfusion of whole blood ,or any of its four primary components: red cells, white cells, platelets or plasma.
    As far as minor blood fractions (such as those used in some preparations of erythropoietin) are concerned, this is a personal conscientious decision for each Witness to make.
    We want the best non-blood medical management that modern medicine has to offer, and in recent years, we have been getting it, from skilled physicians throughout the world. Much has been learned in the last 25 years, with many doctors viewing non-blood medical management as a “gold standard.” “Bloodless” surgery centers, performing EVERY type of surgery without the use of blood transfusions, testify to this; patients heal faster, go home sooner, with less complications, better outcomes, with reduced costs to hospitals and patients.
    Even though there are benefits (not contracting HIV, hepatitis, cytomegalovirus, etc.) this stand is purely a religious one.
    I have seen many patients refuse blood, even though they were not even Jehovah’s Witnesses.

    1. Andrey Pavlov says:

      Rejection of blood products is rejection of medical care. Jann did not say that Jehovah’s reject all medical care, but simply that they are a commonly recognized group that consistently rejects medical care (in the form of blood products). The further point is that it is a completely irrational rejection of medical care, since it is not based in any empirical reality.

    2. WilliamLawrenceUtridge says:

      Refusing blood is stupid, irrespective your reason. Doing so for religious reasons adds a layer of irrationality that I can’t even pretend to respect. Adding a gloss of superficial “you might get diseases” rationalization on top of that irrationality and pretending it has anything to do with your decision drops you into negatives.

      3,000-years-dead sheepfarmers have nothing intelligent to tell us about health care.

      1. Steven says:

        [The following is an excerpt from my reply below]
        As far as the statement ’3000-years-dead sheep farmers [sic] have nothing intelligent to tell us about health care’ goes: yes, they do. Actually, make that 3,500 years; the Mosaic Law contained very specific regulations about, among a myriad of other things, cleanliness, how to handle dead bodies, how to dispose of human and animal waste, quarantining the sick, etc. This was is stark contrast to the nations surrounding Israel, who would eat and slather human excrement on their bodies as ‘medicine’. This law code, part of the bible, showed a knowledge of germs, long before anyone knew what a germ was.
        Fast forward to the 19th century: we perform autopsies, then are called to deliver a baby. The mother dies soon after. In fact, the mother often dies. And then one day a Mr. Pasteur tells us to wash our hands between cases – “How absurd! Who does he think he is?! We are physicians, this is the 19th century! How could washing our hands after touching a dead body possibly benefit anyone?”
        I seem to remember a “sheepfarmer” who said . . .

        1. WilliamLawrenceUtridge says:

          They didn’t term it as “germs”, it was a form of ritual purity that had nothing to do with pathogens. At best one could say that by accident they adopted behaviours with health consequences. Note that these same consequences could have been avoided by washing their hands. And are you really claiming they deserve credit for knowing their sick should be isolated? If the Bible were to impress me, it would need to show a way of isolating the sick in the prodromal phase. Isolating people with symptoms isn’t showing a remarkable insight into the nature of disease. And accompanying these islands of sometimes-useful behaviours are a host, a layering of even further irrationalities – kosher dietary restrictions, ritual purity baths that present risks, the irrational isolation of menstruating women, and more. These practices are based on the idea of an invisible, unmeasureable, unverifiable spiritual purity to appease a hypothetical being whose opinions on the matter cannot be verified or questioned (because he doesn’t exist). Don’t pretend their primary purposes was preserving physical health, that’s handwaving.

          It’s just as absurd as claiming Native Americans have some special insight into nutrition because they drank boiled pine needles during the winter to avoid scurvy.

          I have far more respect for religious people who acknowledge the irrationality of their beliefs and adhere to them anyway than I do for the people who try to pretend their religious beliefs are somehow based on an empirical reason related to how the world actually works. It’s faith. Acknolwedge it’s irrational and embrace it. Don’t preted that the queasiness with breaking kosher or halal laws has anything to do with physiology.

    3. Jann Bellamy says:

      My apologies; I mistakenly posted this as a separate comment (see below) instead of a reply to Steven, so here it is again:

      It is indeed fortunate that fewer people will die for lack of blood transfusions with bloodless surgery. That doesn’t negate the fact that people who don’t have access to these methods or came along before they were available have died unnecessarily because religious belief dictates that a life-saving transfusion be refused. Nor will it help those for whom bloodless methods are not medically indicated, such as those who suffer massive blood loss through trauma. They will continue to die, although they would have lived with a transfusion. It is ironic that Jehovah’s Witnesses have benefitted tremendously from advances in science like bloodless surgery, yet continue to allow unnecessary deaths by rejection of science when science-based medicine dictates a transfusion is required. What you are really saying is: “Look how science has helped us, but we’re still going to ignore science when we don’t like it.” You can’t have it both ways.

      1. Steven says:

        Well, I certainly didn’t mean to drop some Mentos into the Diet Coke, causing a flame war.
        No ‘gloss’ of ‘you might get diseases’ is needed; it is only a fringe benefit. Like I said, the Witnesses stand on blood transfusions is PURELY religious, period.
        As far as calling it ‘stupid’, I beg to differ.
        We need to respect patients rights, especially when they are made conscientiously and rationally. There is no woo, or crunchy homeopathic, chiropractic craziness going on here, just a personal religious decision that is firmly based on scripture. Whether you believe in that ‘scripture’ is your choice.
        No one is asking to have anything ‘both ways’, and indeed, many physicians have expressed gratitude to the Witnesses because it was they who were the only willing ‘guinea pigs’ that allowed us to come up with many of the bloodless advances that we have today.
        As far as massive blood loss caused by trauma; can we really always be certain that someone will surely die if they do not accept blood, or that they will live if they are transfused?
        I don’t want to die; I want to live. I am not interested in being a martyr, but, if face to face with death – that’s not the smartest time to disobey my creator. You do not have to agree. Many people that are hailed as heroes have given up their lives for much stupider aspirations or causes.
        As far as the statement ’3000-years-dead sheep farmers [sic] have nothing intelligent to tell us about health care’ goes: yes, they do. Actually, make that 3,500 years; the Mosaic Law contained very specific regulations about, among a myriad of other things, cleanliness, how to handle dead bodies, how to dispose of human and animal waste, quarantining the sick, etc. This was is stark contrast to the nations surrounding Israel, who would eat and slather human excrement on their bodies as ‘medicine’. This law code, part of the bible, showed a knowledge of germs, long before anyone knew what a germ was.
        Fast forward to the 19th century: we perform autopsies, then are called to deliver a baby. The mother dies soon after. In fact, the mother often dies. And then one day a Mr. Pasteur tells us to wash our hands between cases – “How absurd! Who does he think he is?! We are physicians, this is the 19th century! How could washing our hands after touching a dead body possibly benefit anyone?”
        I seem to remember a “sheepfarmer” who said . . .

        1. WilliamLawrenceUtridge says:

          See my comments here regarding attempting to defend ritual purity through reference to disease.

          No ‘gloss’ of ‘you might get diseases’ is needed; it is only a fringe benefit. Like I said, the Witnesses stand on blood transfusions is PURELY religious, period.

          If it’s a fringe benefit, then don’t talk to nonbelievers as if it were part of the decision-making process. No JW rejects blood transfusions due to fear of disease, it’s due to fear of ostracism.

          As far as calling it ‘stupid’, I beg to differ.

          Bring it ;)

          We need to respect patients rights, especially when they are made conscientiously and rationally. There is no woo, or crunchy homeopathic, chiropractic craziness going on here, just a personal religious decision that is firmly based on scripture. Whether you believe in that ‘scripture’ is your choice.

          Patient rights – yes, adult, mentally-competent patients should have their choices respected, including things like abortion and euthenasia.

          Pretending that religious- or woo-based decisions about health care are different in their irrationality is wrong. There is no rational reason to believe in anything but the meat sacks we walk around in. Every single specific religious belief about a higher power is maintained through cultural inertia and little else. Just like woo, when used to inform health decisions the resulting decisions are at best improved through accident, and realistically result in more dead people.

          Yes, I will accept that competent adults should be allowed to make stupid health decisions for stupid reasons. No, I will not respect it. Particularly because I’m not a doctor and don’t have to deal with patients.

          No one is asking to have anything ‘both ways’, and indeed, many physicians have expressed gratitude to the Witnesses because it was they who were the only willing ‘guinea pigs’ that allowed us to come up with many of the bloodless advances that we have today.

          Again, this is an accidental benefit; those discoveries could have, and would have been made anyway without the JW, it might have taken longer (and at the expense of money being drawn away from other areas of research; there is an opportunity cost). And for every JW or non-JW who is alive today because of bloodless surgery, one must also think of the cost of the people who died while these techniques were being developed because supplementary blood was not available as a rescue measure.

          As far as massive blood loss caused by trauma; can we really always be certain that someone will surely die if they do not accept blood, or that they will live if they are transfused?

          In individual cases, of course not. In aggregate, of course we can. You take someone whose sole problem is blood loss through a wound to an artery or vein. You close the artery or vein, you put blood back in. They will get better. Do you not see the intellectual contortions you are going through to justify beliefs that are inherently not based on any form of reality?

          I don’t want to die; I want to live. I am not interested in being a martyr, but, if face to face with death – that’s not the smartest time to disobey my creator. You do not have to agree. Many people that are hailed as heroes have given up their lives for much stupider aspirations or causes.

          Obviously I don’t agree.

          I don’t want to die. I want to live in perfect health for centuries. That’s not going to happen, and I have to accept that instead of creating and believing in a cute story about how everyone gets to go to heaven. The price is perhaps some small loss of comfort (though not really – it doesn’t matter where you are, consciously experiencing eternity could only be described as torture).

          Your creators were your mother and father, and it happened through processes that involved no conscious thought, merely the blind, drunk staggering of genes through the bloodied fields of billions of deaths. The fact that this is not comforting doesn’t make it any less true. The fact that your belief in a deity brings you comfort doesn’t make that true. I’ll respect any religious person who admits their beliefs are believed in the absence of rationality far more than someone who pretends and claims to have proof for their beliefs.

          As for the people who have died for causes other than religion – I can respect what they do (particularly if they had some sort of meaningful positive outcome). But people aren’t that simple. Mother Theresa was a miserable bitch who spiritually raped Hindus by baptising them, against their knowledge and wishes, before their deaths, and hoarded millions of dollars that could have been used to prevent their deaths. I’ll give her props for not absconding with the money and living in wealth in Monaco, and that’s about it. And that whole “spiritual rape” thing? I’m outraged and furious about that despite not believing in baptism, the soul or higher powers. So yeah, I do believe in people’s rights to practice their irrationalities. I totally respect Ghandi’s nonviolent resistance to separate India from the UK. But in his personal life he was apparently a miserable, manipulative dick who believed in religious nonsense and his economic policies were terrible.

        2. MadisonMD says:

          As far as massive blood loss caused by trauma; can we really always be certain that someone will surely die if they do not accept blood, or that they will live if they are transfused?</blockquote.

          You can do what you like based on your personal beliefs. But please don't justify with the nirvana fallacy. Blood transfusions need not save the lives of each person who receives them in order to be effective and life saving. Neither do seatbelts, airbags, cancer treatment, or vaccines save every life. But they save many.

          I realize that this nirvana fallacy may decrease your cognitive dissonance, helping you reaffirm your decision about no transfusions, which you have made for other reasons. But it is still a fallacy.

  14. Jann Bellamy says:

    It is indeed fortunate that fewer people will die for lack of blood transfusions with bloodless surgery. That doesn’t negate the fact that people who don’t have access to these methods or came along before they were available have died unnecessarily because religious belief dictates that a life-saving transfusion be refused. Nor will it help those for whom bloodless methods are not medically indicated, such as those who suffer massive blood loss through trauma. They will continue to die, although they would have lived with a transfusion. It is ironic that Jehovah’s Witnesses have benefitted tremendously from advances in science like bloodless surgery, yet continue to allow unnecessary deaths by rejection of science when science-based medicine dictates a transfusion is required. What you are really saying is: “Look how science has helped us, but we’re still going to ignore science when we don’t like it.” You can’t have it both ways.

  15. DW says:

    Regarding the Justina Pelletier case, I’ve long wished one of the writers on this blog would take up the matter of somatoform disorders. There’s a very potent and interesting connection to quack medicine there. People suffering from somatoform disorders are very vulnerable to snake oil salesmen. There’s often a similar sort of ignorance and paranoia regarding the medical profession in general that infects these people – a whole “Don’t trust doctors” mentality that lets people with psychosomatic illnesses be readily susceptible to claims of far-fetched cures.

    Of course Justina Pelletier wasn’t being preyed on by quacks -the Tufts docs were clearly not quacks. I just think the connection between somatoform disorders and the general topics of this blog is interesting and would like to see the sciencedbasedmedicine docs explore it.

    1. n brownlee says:

      So would I. I’ve one sister who’s spent a tidy fortune (which she did not have) over these five decades, on treatment for every possible bogus “diagnosis” and non-existent disease running rampant through the nebulous thought processes of American “sufferers”. Another sister, a completely whacked-out narcissistic loon, suffers from intermittent bouts of delusional parasitosis. They are so obviously in real distress- and yet are so obviously enjoying the attention their maladies draw- there seems to be no rational response.

      1. simba says:

        People w ho have ‘real’ illness often obviously enjoy the attention. I’ve seen really sick people who others thought were ‘faking it’ for that reason.

        Attention and real distress, as you say, can go hand in hand. But it’s hard to know how far that’s… I want to say acceptable. It can be irritating when it’s a family member.

        1. n brownlee says:

          I believe my sisters ARE sick. But I also believe that some of their illnesses are psychogenic. And oddly, their very obvious and genuine physiological ailments (serious, advanced osteoporosis, and attendant complications) are not the ailments upon which they choose to dwell, to search for “holistic” treatments, and to talk about insistently and incessantly. They have only the most cursory interest in others, including their children and grandchildren, and one can see them impatiently waiting for a break in conversation about the concerns of others in which to insert their latest “diagnosis”. It is, I believe, a manifestation of rampant and out-of-control narcissism- though giving it a putative name doesn’t help much.

          Nor does knowing that the behavior has been recognized for hundreds of years, maybe longer. The very early (1850s) mystery novel by Wilkie Collins, “The Woman in White” includes a bang-on-the-money description of such an “invalid”, and it’s not the earliest such description, by a long shot.

          1. DW says:

            Thanks brownlee. What you’re describing is so similar to my mother, it is fascinating, in a sad way – the narcissism and lack of interest in others, waiting to insert herself and her problems into every conversation, and yes, her suffering is absolutely real, and indeed there is no rational way to respond to it.

            And yes, it is definitely a rule – whenever she has an actual diagnosed medical problem, she has no interest in it, and will actually usually refuse treatment for it, often angrily. Her imaginary ailments are much more compelling.

          2. DW says:

            I’ll have to check out The Woman in White, thanks.

            1. n brownlee says:

              There’s a good movie version, as well- if you don’t mind old black-and-white dramas.

          3. mouse says:

            @n brownlee – Your description is kinda fascinating to me. I’m not sure I’ve experienced that personality before.

            I think my brother is a narcissist, Whenever he is around, the world revolves around him. There are other indications that I won’t go into. But he is a very charismatic person and into being fit, healthy and attractive. Years ago he got a severe MRSA skin infection. He had to be hospitalized with IV antibiotics for a week or more. The weird thing is – he must have been in pain, a great deal of pain, but he tells the story of the infection and treatment with such a combination of gruesome glee and umbrage (that HE could be affected by such a thing) that it’s very easy to lose sight of that fact. I thought that’s what you were going to say with your family, but it sounds very different.

            Speaking as someone with kinda “mystery”* symptoms for a couple of years. It’s hard to know when or how much it’s socially appropriate to talk about such things, Maybe you have experienced that. I want to talk about it because, well it’s part of my life. Sometimes talking a problem through with someone can help bring some sort of resolution or insight that is useful in coping. I think there is also some looking for – validation, I guess. Although to be honest, I’m not sure validation of what, because I don’t know what’s going on.

            Anyway, when I bring up my health to my sisters, it’s always – not such a big deal, they’ve had far worse, let’s do something interesting like argue about politics.

            On the other hand people don’t complain about their health in the family that much. When they do, it’s concrete, broken bones, joint replacements, rashes and disc degeneration, mostly. So the upside is, I don’t have to listen to a bunch of alternative claptrap.

            *My new doctor has been testing some things and I’m hoping that most of my symptom may be actually rather mundane and easily treatable – h-pylori and anemia. But I’m trying not to get my hopes up (maybe that sounds twisted).

            1. n brownlee says:

              Oh, Mouse, I do hope you get some relief! I had symptomatic Carcinoid for almost a decade before diagnosis. It’s not even hard to diagnose, but somebody first has to think of it as a possibility. A rare disease- which apparently translates to “non-existent” in the minds of many clinicians.

              The “narcissistic cluster” of personality disorders is pretty well covered in Wiki, with good references. The diagnostic criteria and the nomenclature change somewhat, but the behaviors are very clearly defined. The charm, and the “performing” behaviors are inherent, though I think it’s often unrecognized and unremarked that the behaviors are displayed in varying degree- much more extreme in some people than in others.

              1. mouse says:

                Thanks – n brownlee.

                It makes a lot of sense that different people would exhibit narcissism very differently and to greater, lesser degrees. I hope I didn’t sound like I thought only folks like my brother are narcissist. But I will admit that I did find myself relieved that my brother is not the fixate on alternative medical diagnoses type. I should check out the wiki page.

  16. charles says:

    Just because you can have kids does not mean you are in any way fit to raise them.

    America should do what Germany does.
    1) No home school
    2) No unnecessary surgery (circumcision)
    3) Mandatory vaccines
    4) Government provided maternal and paternal leave from work
    And so much more stuff

    What makes you qualified to raise a child? What makes you qualified to educate your child? What makes you qualified to make medical decisions for your child?

    Most parents would say “parents know what’s best for their children”. However they do not. Just because you had a child and spend time with them does not mean you know whats best for them on subjects you are completely ignorant about (no reading the Wikipedia article or doing “research” does not make you any less ignorant).

    Leave things like education and medical care to the professionals that have spent their whole life learning the BEST way to do things.

    Parents have way too many rights and kids are missing out because of that.

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