by Shawn Francis Peters. New York: Oxford University Press, 2007. 272pp. Hardback. $29.95/£17.99. ISBN: 9780195306354.

Reviewed by Christine L. Nemacheck, Department of Government, The College of William & Mary. Email: clnema [at] wm.edu.


In WHEN PRAYER FAILS, Shawn Francis Peters provides a comprehensive overview of faith-based medical neglect of children throughout the United States and earlier incidents dealt with in the British courts. Peters’ account is especially well done in that, although its focus is on the processing of parents and religious healers in the courts, he consistently provides a holistic account of actions by legislators, prosecutors, judges, juries and the public at large. Through this broad focus, Peters tells a compelling story of how each of the parties have historically felt conflicted regarding the guilt of individuals who have lost their children due to failed faith-based treatments, and even more so have been troubled by imposing harsh sentences on these individuals. Child neglect or endangerment laws in the United States have long contained exemptions for parents who do not provide their children with medical treatment due to their own religious beliefs. In addition, Peters’ approach nicely includes analysis of the religious groups, such as Christian Scientists, who have actively pursued such exemptions through successful grassroots lobbying at the state and federal level. In short, Peters provides an excellent overview of the history of faith-based medical treatment of children in the United States.

One of Peters’ main themes is the tension between competing rights that are triggered in cases involving faith-based medical treatments. First, there are clear tensions between First Amendment religious liberty concerns and the state’s responsibility to protect children’s welfare. Interestingly though, in many of the earlier cases Peters discusses, the debate about the First Amendment is secondary to an argument over whether medical science could have been any more beneficial to the ailing child than was prayer. As medicine advanced and became accepted as a science, the religious liberties claim became more prominent. When discussing these changes, Peters also incorporates the changing view among the public that the state has a responsibility to protect children and that the courts are an appropriate venue for resolving such disputes. This confluence of events meant that the courts became the stage on which these tensions were resolved, or on which they have remained unresolved.

Peters begins his book with a discussion of several cases in which children were not given medical treatment because of their parents’ religious beliefs. In addition to telling the stories of several children who would likely have lived had their parents pursued a medical course of treatment, Peters also introduces advocacy groups, such as [*273] Children’s Healthcare Is a Legal Duty (CHILD), who have lobbied against religious exemptions in state manslaughter and child-neglect statutes. On the other side of the debate, Peters discusses the Christian Science Church’s success in lobbying, first to get many of these exemptions, and then to retain them in the face of opposition groups’ efforts.

After providing an excellent introduction to faith-based healing and the legal question of neglect, Peters examines the Biblical basis for spiritual healing and discusses the efforts of science to determine whether prayer can have beneficial effects on healing. The chapter focuses primarily on studies of whether people who benefited from the prayers of their friends and relatives, or even strangers, had better health than those who did not receive such prayers. The evidence Peters presents tends to show that prayer did not have such effects. Peters also cites studies indicating that examining the effects of prayer on health is inherently problematic due to the difficulty of controlling whether someone is the subject of concerted prayer. Peters’ focus on studies examining prayers for others versus the effects of prayer or meditation on one’s own health is reasonable, given that the cases examined in the book largely concern children for whom adults direct their prayers. But the discussion also seems to illustrate a bias in the author’s depiction of faith-based healing that appears as an undercurrent throughout the book.

It seems clear from the author’s discussion, indeed even the title of the book, that he sees cases of failed faith-based healing as conduct that should not be protected by the First Amendment’s religious liberty guarantees. Most of us might well agree with him on that point. But in a book analyzing the unresolved legal treatment of such faith-based practices, Peters ought to state his position up front. Contrary to Peters’ views, the religious practitioners of such faith healing do not believe, when a child dies, that their prayer has failed or that they have committed a crime. Instead, they fervently believe that the death was God’s will. Peters goes on to discuss the belief-action distinction prominent in common law concerning conduct based on religious beliefs, but dealing first with this central assumption would lay a stronger foundation for the analysis that follows.

In chapters three and four, Peters takes the reader on a tour of early religious-based medical-neglect cases in the British courts and in the United States. Many of the cases in the British courts dealt with a religious sect known as the Peculiar People who relied on the Epistle of James’ instruction that illness be treated with elders’ prayers and the anointment of oil. These early British cases in which parents were prosecuted for their children’s death after shunning medical treatment in favor of prayer foreshadowed the debates that would confront American courts: Could medicine have saved the child? Did present statutory law cover such scenarios? Were the parents’ beliefs sincere? The outcomes in the British courts were also similar to those at which judges and juries in the United States were to arrive years later. Typically parents were found guilty of neglect but were not punished or received sentences of parole with [*274] guarantees that they would provide medical treatment to their other children as needed in the future.

Peters devotes chapters five and six to a discussion of the Christian Science Church and follows up in chapter seven with a shorter, but similar discussion of the Faith Tabernacle, a group largely based in Pennsylvania. Peters’ account of Christian Scientists’ beliefs and practice of faith-based healing is again excellent. What is particularly interesting is his attention not only to the cases they fought in the courts, but also their successful grassroots lobbying efforts with respect to religious exemptions in state manslaughter and child-neglect statutes. This comprehensive perspective provides insight into the fact that battles concerning rights and liberties are rarely isolated to one branch or level of government. To understand properly the law in these areas, we must take a more macro-level perspective on its development, and Peters does just that.

After an interesting discussion of spiritual healing and reproductive rights in chapter eight, Peters moves on to discuss, in chapters nine and ten, several cases where spiritual healing resulted in children’s deaths in Oregon and the ensuing legislative battle to repeal the religious exemption in Oregon’s murder statute. That exemption allowed parents to claim as a defense to murder that they had pursued religious healing practices rather than medical treatment. Peters again examines the intense lobbying efforts by Christian Scientists, but this time those efforts failed, and the exemption to Oregon’s murder statute was repealed.

Peters’ discussion of whether such repeals will have a deterrent effect on parents is an especially interesting one in cases where sincerity of beliefs (and thus one would think that changes in the law would not be a deterrent) is one of the standards by which our courts gauge defenses based on religious principles. Some initial studies have indicated that there have been fewer reports of children’s deaths in groups adhering to spiritual healing. However, given that the exemption no longer exists, one wonders whether underreporting and/or efforts to hide such incidents have also increased.

Peters wraps up his discussion of religious-based child-neglect by examining changes in state laws across the United States in comparison to those places where, despite children’s deaths due to a lack of medical treatment, religious exemptions in manslaughter and child-neglect statutes have been maintained.

Peters’ book is, in short, an excellent resource on faith-based healing, or lack thereof, and the law. It is expertly written and will be of interest both to First Amendment scholars as well as to non-academic readers with an interest in religious liberties, the care of children and the law. It will also be useful to graduate and undergraduate students in civil liberties, religious liberties or more broadly defined law and politics courses. In addition to learning about the law in this area, students will also be drawn into Peters’ excellent writing and story-telling throughout his account. I highly recommend the book.

© Copyright 2009 by the author, Christine L. Nemacheck.