Effort Seeks to Force Child Medical Care Regardless of Beliefs : Health: Christian Scientists and others face increasing pressure on the issue of eschewing treatment other than prayer for the afflicted. State laws that provide religious exemptions are under attack.

Douglass Lundman saw his parents die early for their beliefs, and he accepted their choice as Christian Scientists to reject medical science in favor of prayer. But for Lundman, the absolutes of religious freedom faded when he learned his son was dead.

Eleven-year-old Ian Lundman’s diabetes went untreated because of his mother’s belief in Christian Science. After Ian died in 1989, Douglass Lundman sued the church and his ex-wife, winning $14.2 million.

“I still believe adults should be able to make such decisions for themselves,” he said. “But I don’t see that the issue of health care for children brings into question anyone’s religious freedom. Children’s lives need to be protected.”

A growing knot of children’s advocates, prosecutors, legislators and physicians agree with Lundman. Driven by a number of high-profile cases, they are working to eliminate state laws that allow denial of medical care to children for religious reasons.

This month, Massachusetts lawmakers voted to join Hawaii and South Dakota in removing such religious exemptions from its laws; there have been similar attempts in Iowa, Minnesota, Missouri, Maryland, Delaware and Kentucky.

“There’s a growing awareness about the whole issue,” said Patricia Toth, director of the National Center for Prosecution of Child Abuse, a wing of the National District Attorney’s Assn. “People see more and more of these cases where, for children, these exemptions become a life-and-death issue.”

But officials with the First Church of Christ, Scientist say a basic tenet of their religion is under attack. Without exemptions, they say, they will be no longer be able to choose a way of caring for their children that is central to their beliefs.

“It’s a question of who makes the decision,” said Victor Westberg, a church spokesman. “Does the state know better than the parents about their children? Parents make choices every day for their children, and parents should be allowed to make these decisions for their children.”

The issue of spiritual healing came to the forefront this summer when a Minneapolis jury found for Lundman in his wrongful death suit.

The Christian Science church was ordered to pay $9 million in punitive damages; Lundman’s ex-wife, her new husband and the church were also assessed $5.2 million in compensatory damages. The verdict is being appealed.

It was the first successful civil verdict against the church, which believes “scientific prayer” is the sole way to treat illness.

There are scores of smaller sects that choose prayer over medical treatment; Jehovah’s Witnesses eschew blood transfusion. But Christian Scientists are the largest and most persuasive lobby.

About 40 private insurers cover treatment by Christian Science practitioners and nurses; last year, Medicare paid about $7.4 million to Christian Science nursing homes, though that money paid for general care, not for healing.

Christian Science describes God as the source of all real being, so that nothing except what he has created--not death, disease or sin--can ultimately be real. Believers cite Scripture as evidence that a true understanding of God heals sickness as well as sin.

“Scientific prayer is diametrically opposed to medical treatment,” said Westberg. “That’s the reason we seek exemptions from state law, so we can freely practice our religion.”

But the deaths of at least seven children in the past decade, and resulting charges against their parents, have brought that practice under scrutiny.

In 1990, Ginger and David Twitchell were convicted of involuntary manslaughter in the case of their 2-year-old son, Robyn, who died in 1986 of a surgically treatable bowel obstruction. The trial in Boston, home of the Christian Science Mother Church, attracted national attention.

The conviction was overturned this summer when the state Supreme Court said the Twitchells were not allowed to argue that they thought they were within their rights to choose spiritual treatment.

Prosecutors say the complex issues of religious freedom versus child neglect makes such cases hard to win.

“The prosecutor has to prove the parent had knowledge of grave injury or death facing the child,” said Ryan Rainey, a former assistant district attorney with Los Angeles County. “Obviously, it would make the prosecutor’s job easier if we didn’t have these exemptions. Most feel they make children second-class citizens.”

Forty-seven states now have clauses in civil or criminal child welfare statutes that exempt parents who choose prayer over medical care for their children.

Christian Science advocates who pushed for such exemptions were aided by a vaguely worded 1974 federal child abuse statute that many states thought required such clauses.

Those on the front lines of child abuse oppose the exemptions, including the American Medical Assn., the American Academy of Pediatricians, the district attorney’s association and various child advocacy groups.

They argue that if everyone were subject to child welfare laws, parents would not be torn between their faith and their children’s lives.

“I honestly feel we are acting in the best interest of these parents,” said Rita Swan, a former Christian Scientist who has lobbied against the exemptions since the 1977 death of her son. “If the laws were straightforward and simply said you have to get medical care for a child, I think that would be a tremendous relief to them.”

Publicity from the more sensational spiritual healing cases has helped Swan’s crusade. The Twitchell conviction, and subsequent appeal, led to the legislative action in Massachusetts. South Dakota changed its law after five infants died in the Sioux Falls area. Their parents belonged to a faith-healing sect.

Hawaii removed its exemption after federal officials requested a review of state law to clarify the 1974 regulation.

Although federal statute allows parents to choose spiritual healing, it also gives state officials the right to intercede on behalf of the child.

David W. Lloyd, director of the federal National Center on Child Abuse and Neglect, said several states, including Indiana, Maryland and California, misinterpreted the law and eliminated any state authority over a child’s health care.

“The fact that a parent has bona fide religious beliefs and does not want to provide medical care does not mean the denial of care should be excluded from the definition of child neglect,” Lloyd said.

Christian Science officials argue the issue is one of choice.

“An integral part of our religion is choice,” Westberg said. “If an individual thinks healing isn’t coming through prayer, the church doesn’t excommunicate them if they turn to medical treatment.”

Some former church members disagree. When Suzanne Shepard’s daughter went into a coma from a ruptured appendix, the onetime Christian Science practitioner rushed her to a St. Louis hospital.

There she was confronted by church members who urged Shepard to take her daughter home. She was told there would be no prayers for the 6-year-old child.

“The Christian Science practitioner said it would be better if she died because she had not relied totally on God,” said Shepard, whose daughter survived. “This had been my whole life and I felt like I was being exiled to hell.”