When 11-year-old Weston resident Madeline Kara Neumann died from diabetic ketoacidosis on March 23, the pundits began shouting for prosecution. The law, many say, allows for individuals to reject their own medical care; but withholding care for your child is tantamount to neglect.
For me, the issue seemed cloudier than that. We all make choices for our children, I reasoned, from how and where we give birth to childhood vaccinations to dietary choices to treating illness.
I’ve certainly made unpopular choices — I gave birth at home, breastfed longer than many peers, and chose natural remedies over conventional medicine. If something had gone wrong, could I be prosecuted for my parenting choices?
Because the Neumann depended on prayer rather than medical care also raises specifically religious questions. What happens when secular law conflicts with religious practice?
Do we really want the state telling us what religious practice is acceptable? Do we really want the state not protecting minors from their parents’ errors in judgment?
I called Milwaukee native Rabbi Edward I. Reichman, M.D., to help me look at this case through a Jewish lens. He is an associate professor of emergency medicine at Montefiore Medical Center and associate professor of philosophy and history of medicine at the Albert Einstein College of Medicine of Yeshiva University in New York City, where he teaches Jewish medical ethics.
Reichman did not speak about whether to prosecute the parents but focused on the question of non-treatment.
“The current in Jewish teaching is to use all available options to [preserve life]. There has never been any tradition in mainstream Judaism [telling Jews] not to avail themselves of medical care,” Reichman said.
Moreover, “the majority of the [commandments] can be violated for the preservation of life.”
As should the modern respect for honoring personal space, it seems. Based on the biblical injunction, “Lo taamod al dam re’ekha” (“You shall not stand idly by the shedding of human blood” — Leviticus 19:16), Jews are commanded to save lives however and whenever possible.
“You have the obligation to enforce that, even against the person’s will,” Reichman said. “It’s not necessarily their life to lose…. They and we have an obligation to preserve their life.”
Though it clashes with the law of the land, Jewish law permits coercive treatment, Reichman said.
“In this particular case, if it had been known in a theocratic Jewish society that a young diabetic was refusing treatment, the community could intervene, take the child to the hospital and treat them,” he said.
For me, that clarity is comforting and daunting. I remember the year in college when I shared a small Jerusalem apartment with my friend, who suffers from juvenile (Type 1) diabetes.
Over time, I learned the basics about the disease — how to identify when she needed insulin and when it was time to eat. I practiced giving her insulin shots and once panicked when we discovered that she had been “burning ketones,” a dangerous condition leading to diabetic ketoacidosis.
My friend certainly knew why she was educating me: I was to save her life, if necessary. I was charged with the duty to tie her down, if needed, and feed her when she was defiant from hypoglycemia. She might need me and I had to be ready.
The choice of how to act — as a bystander, a neighbor or a parent — is more obvious when the risk is death but fuzzier when faced with a variety of other behaviors. Part of knowing how to respond is assessing risk, Reichman said.
One thing seems clear: If Dale and Leilani Neumann were Jewish, their daughter would likely still be alive. Not because Jews are better parents, but because they would likely see God not only in prayer but also in the medical treatment that would have saved her.
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