Religious exemptions to child neglect laws still being passed despite convictions of parents

Article Abstract:

A Boston jury recently found David and Ginger Twitchell guilty of negligent homicide in the death of their young son, Robyn. The Twitchells, practicing Christian Scientists, were convicted because of their failure to provide conventional medical aid when Robyn suffered a fatal bowel obstruction. In testimony, the prosecution showed that the child had been in excruciating pain during the five days before his death. The only treatment that the child received during this time was prayer under the supervision of a Christian Science nurse and practitioner. The church theology allows pain medication in certain situations (e.g., obstetrical pain), and allows for dental procedures, but does not allow the treatment of critically-ill children. The gruesome death of this child has enraged child-protection advocates and prompted calls for the repeal of religious exemption from child neglect laws. These groups point to the ''religious sacrifice'' of the children as a test of the parents' religious faith. The Twitchells were sentenced to 10 years of probation for their role in the death of their son, and they join four other Christian Science couples who have been convicted in the wrongful deaths of their children during the last 15 months. The Christian Science church is Boston-based and vigorously worked to get an acquittal in this case, which was located on their home turf. The church claims that it is fighting for the right to pray, but child-protection advocates say that there is no intention to restrict religious freedom, only to provide life-saving medical care for severely ill children. Issues concerning religious freedom, the right to provide alternative health care for children, and the obligation of a society to protect its children are more fully developed. Despite concern over the protection of children from neglect, in June 1989 Colorado passed a law that re-establishes Christian Science healing as a valid alternative to standard medical practice. Similar statues are in place in Louisiana and Texas. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Laws, regulations and rules, Child abuse, Medical ethics, Catechisms, Theology, Spiritual healing, Christian Science

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Educators say MD-PhD degree programs make sense, but prove it

Article Abstract:

Highlights of the first national symposium concerning the education of physician-scholars are presented. Held in November 1989, the meeting addressed issues such as the greater value of programs in which students work simultaneously for both the MD and PhD degrees, compared with those where the degrees are earned sequentially. One viewpoint is that concurrent programs are the most cost-effective and efficient for turning out successful researchers; however, all participants agreed that ''hard'' data that support one approach over the other are lacking. In response to this need, Ruth Kirschstein, director of the National Institute of General Medical Sciences, announced a study of graduates of its Medical Scientist Training Program. The Institute provides funds to train 700 students at 29 institutions that offer combined degrees, with the proviso that students perform research or teaching to pay back their support. Reports from several institutions indicate that as many as 90 percent of the graduates funded by the Training Program engage in research, and Kirschstein also maintained that the graduates had a better-than-average rate of success at getting federal research grants. This was disputed, however, in another study. A new study by the Association of American Medical Colleges will compare graduates of the Medical Scientist Training Program with people who participate in the scholars' program of the Howard Hughes Medical Institute. Of particular concern will be faculty appointments and grants awarded. Several other programs that train physician-researchers are described; overall, there is a great need for such people. The need is fueled by financial pressure, which often turns people away from research, toward clinical endeavors. However, public support of funding for MD-PhD programs seems unlikely, since medical education is thought to cater to ''fat cats.'' Better data that show the cost-effectiveness of such programs are now needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Conferences, meetings and seminars, Education, Curricula, Medical education, Graduate medical education, Medical scientists, Postgraduate medical education

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Health and safety standards being developed for child-care programs

Article Abstract:

State licensing requirements for child care in out-of-home settings were surveyed by the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA). Each state is responsible for its own day care health and safety regulations, and licensing rules were found to vary considerably from state to state. All states had requirements for centers that serve 13 or more children, but many states had no regulations for settings where fewer children are enrolled. Basic, important standards for protecting children were lacking in 25 to 50 percent of states; examples of standards omitted include evaluation of staff health, training of staff, and staff-to-infant ratio. Larger facilities had better regulations, but far more children are placed in smaller group and family day care arrangements. Even in states with adequate regulations, inspections and enforcement tend to be sporadic. The AAP and APHA are currently preparing guidelines to serve as a model for states which are drafting regulations. The AAP and APHA are also calling for state and federal government subsidies for child care to assure that all children receive high quality day care. Most experts describe day care in the United States as woefully inadequate.

Care and treatment, Standards, Child care, Children, Licensing agreements, Day care centers, Family day care

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