Children's Healthcare is a Legal Duty

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Children's Healthcare Is a Legal Duty (CHILD)
CHILD logo
Abbreviation CHILD
Formation 1983
Type 501(c)3
Focus Child neglect
  • Lexington, Kentucky, USA
Key people
Rita Swan, president; Ken Stringer, board chairman

Children's Healthcare Is a Legal Duty (CHILD) is an American non-profit membership organization that works to stop child abuse and neglect based on religious beliefs, cultural traditions, and quackery. CHILD opposes religious exemptions from child health and safety laws. These exemptions have been used as a defense in criminal cases when parents have withheld lifesaving medical care on religious grounds. These exemptions also have discouraged reporting and investigation of religion-based medical neglect of children and spawned many outbreaks of vaccine-preventable disease.[1][2] CHILD publicizes the ideological abuse and neglect of children, lobbies for equal protection laws for children, and files lawsuits and amicus curiae briefs in related cases.

CHILD was founded in 1983 by Rita and Douglas Swan after the death of their son, Matthew. The Swans were persuaded not to seek medical treatment for him by Christian Science practitioners, who claimed they were healing him. When the practitioner said Matthew might have a broken bone and that Christian Scientists were allowed to go to a doctor for setting broken bones, the Swans took their baby to a hospital, but it was too late to save him.[3]

According to the National Association of Counsel for Children, which gave an award to Rita Swan for her efforts, "Due in large part to CHILD's efforts, Colorado, Massachusetts, Maryland, South Dakota, Hawaii, and Oregon have removed laws which provided exemptions from prosecution to parents who fail to provide medical care for their sick children based on religion."[4][5][6]


The mission of Children's Healthcare Is a Legal Duty is to end child abuse or neglect related to religion, cultural practices, or quackery through public education, research, and a limited amount of lobbying.[7]

CHILD supports


Rita and Douglas Swan founded CHILD as a legacy to their son, Matthew.[8] In 1977 he became ill with bacterial meningitis. The Swans, Christian Scientists at the time, were persuaded by Christian Scientist practitioners – the religion's name for its spiritual healers – not to seek medical treatment for their son. The Swans did take Matthew to the hospital after he had been ill for 12 days, but his illness had progressed too far, and he died.[9] Motivated by this tragedy, CHILD works to eliminate religious exemptions in child health and safety laws. Parents belonging to various religions, in particular Christian Science, have used these exemptions as legal defenses in criminal cases for failing to provide medical care for children who then died.[10]

The Swans left the Christian Science Church,[3] and CHILD and Rita Swan have worked "relentlessly" to publicize cases of religion-related child abuse and neglect.[11] In 1998, Seth Asser and Rita Swan published a benchmark study in Pediatrics analyzing 140 child deaths in which medical treatment was withheld. This study showed that 90% of these children would have survived with routine medical care.[12][13]

In 1996 Congress added to the Child Abuse Prevention and Treatment Act a provision that nothing in the act can "be construed as establishing a Federal requirement that a parent or legal guardian provide any medical service or treatment that is against the religious beliefs of the parent or legal guardian."[14] CHILD has opposed this provision on several fronts. CHILD's work has led to the repeal of some or all religious exemptions to child neglect laws in Colorado, Massachusetts, Maryland, South Dakota, Hawaii, Oregon, Minnesota, Ohio, and Rhode Island.[5][15] In 2009 CHILD lobbied successfully to remove provisions from the federal Affordable Care Act that would have provided government funding and mandated insurance company payment for faith healing that includes no medical care.[16][17]


  • American Academy of Pediatrics (AAP): 2012 President's Certificate for Outstanding Service awarded to Rita Swan, MA, PhD for efforts in children's rights to medical care and decades of work with the AAP on these issues.[18]
  • Iowa Chapter of the Methodist Federation for Social Action: 6 June 2010 Outstanding Social Justice Work Award.[19]
  • Omicron Delta Kappa chapter at Morningside College: 27 April 2003 Honoris Causa Award.
  • National Association of Counsel for Children (NACC): 2001 Outstanding Legal Advocacy Award received by Rita Swan, MA, PhD for working to protect children from religious-based medical neglect through policy advocacy and amicus curiae work.[5]
  • Oregon Pediatric Society: 17 June 2000 Child Advocacy Service Award.
  • Oregon Peace Officers Association Child Abuse and Sex Crimes Investigators: 2 November 1999 Award for Child Advocacy.
  • The Giraffe Heroes Project: 12 January 1993 Award for Risk-Taking and Service.[20]
  • Sioux City Human Rights Commission: 2 May 1991 Human Rights Service Award.
  • South Dakota Chapter of the American Academy of Pediatrics: 14 September 1990 Child Advocacy Service Award.[21]


Legal actions[edit]

The Swans filed a wrongful death suit against the Christian Science Church in 1980, but it was dismissed on First Amendment grounds, and the U.S. Supreme Court declined to hear their case on appeal.[9][23] In 2000, CHILD sued the Director of the Health Care Financing Administration and the Secretary of the U.S. Department of Health and Human Services (Children's Healthcare Is a Legal Duty, Inc. v. Min De Parle), over federal healthcare monies being directed to Christian Science facilities and others that provide no medical treatment. The suit, alleging a violation of the establishment clause, was dismissed with summary judgment; on appeal, the judgment was upheld, and the Supreme Court declined to hear an appeal.[24][25] Other legal cases include CHILD Inc. and Brown v. Deters challenging Ohio's religious defense to child endangerment and manslaughter (ORC 2919.22a) and CHILD Inc. v. Vladeck against the federal government's use of Medicare and Medicaid funds for Christian Science nursing.[26][27]

Testimony before legislatures[edit]

  • Oregon Senate Judiciary Committee, 26 April 2011[28]
  • Oregon House Judiciary Committee, 21 February 2011[29]
  • Wisconsin Assembly Committee on Children and Families, 17 March 2010
  • Nebraska State Legislature, Health and Human Services Committee, 25 January 2007[30]
  • Iowa House Education Subcommittee, January 2006
  • Maine Joint Standing Committee on Health and Human Services, May 2005
  • Nebraska State Legislature, Education Committee, February 2005
  • Rhode Island House Health, Education, and Welfare Committee, February 2004
  • Missouri House Judiciary Committee, April 2003
  • Colorado Senate Health, Environment, Children, and Families Committee, April 2001
  • Maryland House Judiciary Committee, March 2001
  • Colorado House Criminal Justice Committee, February 2001
  • Oregon House Criminal Law Committee, March 1999
  • South Dakota House and Senate Health and Human Services Committees, February 1998[31][32]
  • Michigan House Judiciary Committee, February 1997
  • U. S. Senate Labor and Human Resources staff briefing, June 1995
  • Minnesota House Judiciary Committee, March 1994
  • Minnesota House Judiciary Committee, December 1991
  • Minnesota Senate Judiciary Committee, March 1991
  • South Dakota House State Affairs Committee, January 1990
  • California Assembly Committee on Public Safety, October 1989
  • Ohio House Children and Youth Committee, March 1989
  • Ohio House Children and Youth Subcommittee, March 1985
  • North Dakota House of Representatives, January 1979[21]



  • "Persistence Counts." American Academy of Pediatrics Chapter Advocacy Summit, Schaumberg, IL, 16 March 2012
  • "Oregon Reforms the Child Abuse Shield Law." Center for Inquiry / Council for Secular Humanism Conference, Orlando, FL, 2 March 2012
  • Northwest Freethought Conference, Portland, OR, 26 March 2011
  • Salem Humanists, Salem, OR, 22 February 2011
  • Oregon State University Hundere Lecture in Religion and Culture, Corvallis, OR, 28 January 2010
  • Iowa Society for Consumer Healthcare Advocacy, Iowa City, IA, 20 October 2006
  • "When Religion Endangers Children." Morningside College Academic and Cultural Arts Series lecture, Sioux City, IA, 26 February 2003
  • Florida's First Coast Conference on Child Maltreatment Jacksonville, FL, 19 April 2001
  • Northern New England Conference on Child Maltreatment, Portland, ME, 18 September 2000
  • National Association of Counsel for Children, Portland, OR, 10 October 1999
  • American Family Foundation, Chicago, 14 November 1998
  • American Atheists, Washington, DC, 13 June 1998
  • "Religion-based Medical Neglect: Update on the Status of Children We Abandon."(general session lecture), San Diego Conference on Responding to Child Maltreatment, San Diego, CA, 28 January 1998
  • Minnesota Civil Liberties Union, Minneapolis, MN, 19 August 1997
  • Council on Child Abuse for Southern Ohio, Cincinnati, OH, 10 June 1997
  • Mayo Clinic Family Practice Residents Seminar, Rochester, MN, 6 June 1997
  • Training conducted for Iowa child abuse investigators in Iowa City, Des Moines, and Newton, IA, March 1995 through May 1996
  • "The Religious Exemption Issue in the 1995 CAPTA Hearings." National Child Abuse Coalition, Washington, DC, 13 December 1994
  • "Medical Neglect of Children on Religious Grounds." Freedom from Religion Foundation conference, Madison, WI, 1 October 1994[33]
  • Third Central Midwest Conference on Child Abuse, Moline, IL, 1 April 1993
  • "Medical Neglect of Children on Religious Grounds." St. Luke's Child Protection Center conference, Cedar Rapids, IA, 1 October 1992
  • "Religiously-based Medical Neglect: Legal Child Abuse?" (plenary lecture) and "Cultural Barriers to Medical Care of Children" (workshop), National Association of Counsel for Children Conference, Philadelphia, PA, 19 October 1992
  • "Cultural Barriers to Medical Care of Children." (pediatric inservice), St. Luke's Regional Medical Center, Sioux City, IA, 22 September 1992
  • "Cultural Barriers to Medical Care of Children." Marian Health Center and Siouxland Council on Child Abuse and Neglect conference, Sioux City, IA, 29 April 1992
  • "Equal Rights for Children under the Law." Iowa School Nurses Organization spring conference, Des Moines, IA, 11 April 1992
  • "Medical Neglect in the Context of Religious Beliefs." Iowa Chapter of National Committee for Prevention of Child Abuse spring conference, Des Moines, IA, 10 April 1992
  • "Public Policy on Religiously-based Medical Neglect." U.S. Advisory Board on Child Abuse and Neglect hearings, Los Angeles, CA, 3 April 1992
  • "Medical Neglect and Religious Exemptions." (pediatric grand rounds), University of California, San Diego Medical Center, San Diego, CA, 21 January 1992
  • "Medical Neglect in the Context of Religious Beliefs." (general session lecture), San Diego Conference on Responding to Child Maltreatment, San Diego, CA, 24 January 1992
  • "The Christian Science Parent in a Health Care Crisis." 27th Annual Postgraduate Symposium on Medicine and Religion, University of Kansas Medical Center, Kansas City, KS, 16 October 1991
  • Presentation on deaths of Christian Science children, Interagency Council on Child Abuse and Neglect, Los Angeles, CA, 11 July 1991
  • "Ethical Issues: Withholding Medical Care on Religious Grounds" (grand rounds), Minneapolis Children's Medical Center, MN, 25 June 1991
  • "Medical Neglect: Public Policy and Public Scrutiny." Regional Conference on Medical Neglect of Children, Council Bluffs, IA, 30 November 1990
  • "Child Abuse and Medical Neglect." Cult Awareness Network Conference, Teaneck, NJ, 27 October 1989
  • "Children's Rights to Medical Care." Symposium in Pediatric Medical Ethics, Arnold Palmer Hospital for Children, Orlando, FL, 8 November 1988
  • "Public Policy on Sectarian Medical Neglect." Cult Awareness Network Conference, Washington, DC, 19 March 1988
  • "Religious Exemptions from Parental Duties of Care." Seventh National Conference on Child Abuse and Neglect, Chicago, IL, November 1985
  • "Paranormal Health Cures." Committee for the Scientific Investigation of Claims of the Paranormal, Buffalo, NY, 28 October 1983
  • "Faith Healing Sects and Children's Rights to Medical Care." Fifth National Conference on Child Abuse and Neglect, Milwaukee, WI, April 1981[15][21][34]

Television appearances[edit]


  1. ^ "Some Outbreaks of Vaccine-preventable Disease in Groups with Religious or Philosophical Exemptions to Vaccination", CHILD website (CHILD), retrieved 30 Apr 2013. 
  2. ^ Tilkin, Dan (KATU News); Murad, Mike (KBOI News, Idaho) (20 May 2011). "Man speaks out about child deaths in NW faith-healing church" (TV news broadcast). Portland, OR: Fisher Communications, Inc. KATU. Retrieved 30 April 2013. 
  3. ^ a b Bell, Bonnie (31 Mar 1980), "Their baby's death provokes Doug and Rita Swan to a holy war on Christian Science", People, ISSN 0093-7673 
  4. ^ Castle, Marie Alena, "No legal protection for kids in faith-healing families: Why most states sanction religion-based child sacrifice", Atheists for Human Rights, retrieved 30 Jan 2013 
  5. ^ a b c "Children's Law News" (PDF). The Guardian (National Association of Counsel for Children) 23 (3): 15. 2001. Retrieved 4 Apr 2013. 
  6. ^ Munns, Roger (2 Jun 1996). "Mom fights prayer that excludes medicine". Los Angeles Times. Retrieved 22 Apr 2013. 
  7. ^ a b c "CHILD About", CHILD website (CHILD), retrieved 4 Apr 2013 
  8. ^ Fraser, Caroline (1999), God's Perfect Child: Living and Dying in the Christian Science Church, New York: Henry Holt and Company, pp. 295–298, ISBN 0805044302, OCLC 473250863 
  9. ^ a b Fraser, 1999, pp. 278–291.
  10. ^ Larabee, Mark (30 Nov 1998), "Parents turn grief into a mission: Change the laws", The Oregonian (Advance Publications), ISSN 8750-1317 
  11. ^ Fraser, Caroline (Apr 1995), "Suffering children and the Christian Science Church", The Atlantic, ISSN 1072-7825, retrieved 18 Apr 2013 
  12. ^ Asser, S.M.; Swan, R. (Apr 1998). "Child fatalities from religion-motivated medical neglect". Pediatrics (American Academy of Pediatrics) 101 (4 Pt 1): 625–9. doi:10.1542/peds.101.4.625. ISSN 0031-4005. PMID 9521945. 
  13. ^ Gallegos, Alicia (19 Sep 2011). "Miracle vs. medicine: When faith puts care at risk". American Medical News (American Medical Association). ISSN 0098-7484. Retrieved 17 Apr 2013. 
  14. ^ Title 42-The Public Health And Welfare, Chapter 67-Child Abuse Prevention And Treatment And Adoption Reform, Subchapter I-General Program, Sec. 5106i-Rule Of Construction 42 U.S.C. § 5106i
  15. ^ The Patient Protection and Affordable Care Act, Pub.L. 111–148
  16. ^ "Victory! Christian Science provision not in merged health care reform bill." (News Release), Freedom From Religion Foundation, 20 Nov 2009, Faith-healing mandate nixed from Senate health care reform bill 
  17. ^ "AAP President recognizes Dr. Swan for work on children's equal rights to health care", AAP News (American Academy of Pediatrics) 33 (5), May 2012 
  18. ^ "2010 Social action award recipients" (PDF). Social Questions Bulletin. Iowa Chapter Methodist Federation for Social Action. Jun 2010. p. 3. Retrieved 17 Apr 2013. 
  19. ^ "The Giraffe Heroes Database: Swan, Rita". The Giraffe Heroes Project. Retrieved 17 Apr 2013. 
  20. ^ a b c "Rita Swan, PhD Fellow Board of Directors", Institute for Science in Medicine website (Institute for Science in Medicine), retrieved 23 April 2013 
  21. ^ "CHILD newsletter archive", CHILD website (CHILD), retrieved 6 May 2013 
  22. ^ Brown v. Laitner, 435 N.W.2d 1, 432 Mich. 861 (1989).
  23. ^ CHILD Inc. v. Min De Parle 212 F.3d 1084 (8th Cir. 2000); No. 98-3521 U. S. Court Of Appeals for the 8th Circuit Submitted: 18 Oct 1999. Filed: 1 May 2000. Retrieved from Public.Resource.Org 17 Apr 2013.
  24. ^ Harris, B. (2010). "Veiled in textual neutrality: Is that enough? A candid reexamination of the constitutionality of section 4454 of the Balanced Budget Act of 1997" (PDF). Alabama Law Review 61 (2): 401–402. Retrieved 4 Apr 2013. 
  25. ^ CHILD Inc. and Brown v. Deters 92 F.3d 1412. No. 95-3850. U. S. Court Of Appeals, 6th Circuit. Argued 4 Mar 1996. Decided 5 Aug 1996. Rehearing And Suggestion For Rehearing En Banc Denied 20 Sep 1996. Retrieved from Public.Resource.Org 17 Apr 2013.
  26. ^ CHILD Inc. v. Vladeck 938 F.Supp. 1466 (1996) No. 3-96-63. U. S. Dist. Court, D. MN, 3rd Div. 7 Aug 1996. Retrieved from Google Scholar 17 Apr 2013.
  27. ^ Oregon Senate Committee on the Judiciary Minutes 26 Apr 2011. 2. Retrieved 18 Apr 2013
  28. ^ Oregon House Committee on the Judiciary Minutes 21 Feb 2011. 2. Retrieved 18 Apr 2013
  29. ^ Nebraska State Legislature, Health and Human Services Committee 25 Jan 2007 transcript. 11-13. Retrieved 18 Apr 2013
  30. ^ Legislative Research Council, South Dakota Legislature. "Minutes 13 February 1998, Senate Health and Human Services Committee".  Retrieved 22 Apr 2013
  31. ^ Legislative Research Council, South Dakota Legislature. "Minutes 6 February 1998, House Health and Human Services Committee".  Retrieved 22 Apr 2013
  32. ^ Swan, Rita (Nov 1994). "Medical neglect of children on religious grounds". Freethought Today (Freedom From Religion Foundation) 11 (9). ISSN 0882-8512. Retrieved 23 Apr 2013. 
  33. ^ Swan, R.; Houy, M.; Carnes, R.M. (1981), "Healing sects and children's rights to medical care.", Proceedings of the Fifth National Conference on Child Abuse and Neglect, Milwaukee, WI: Wisconsin University, pp. 174–180  Missing or empty |title= (help)

Further reading[edit]

External links[edit]