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Jessica Crank had a swollen shoulder. Not just swollen: In May 2002, when theteenager’s mother, Jacqueline, finally took her to a walk-in clinic in Lenoir City,

When ‘Religious Freedom’ Leaves Children DeadMany states don’t consider it “abuse” to rely on faith healings when kids get sick.

Why isn’t this a bigger issue?

Jessica Crank with her mother, Jacqueline

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Tennessee, the nurse practitioner found signs of bone disintegration and “otherindications of a serious medical condition” on the x-ray. She called theUniversity of Tennessee emergency room and had them prepare for Jessica’sarrival and urgent treatment.

But Jessica never made it to the E.R., just as she and her mother didn’t show up atthe hospital when a chiropractor had urged them to seek medical care earlier inFebruary. Instead, as Jaqueline Crank later testified in court, she chose to turn to“Jesus Christ, my Lord and my Savior, my Healer, Defender, for [Jessica’s]healing.”

Crank “knew there was a problem” with the “grapefruit-sized tumor” on herdaughter’s shoulder. But she believed Jesus “was the only Healer,” she said,“and through that belief we took it in our hands to pray for her, to heal her withprayer.”

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Religious Freedom Doesn't Protect Child Abuse

It did not work. After the walk-in-clinic nurse called the police and Jessica wastaken to the hospital, she was diagnosed with Ewing’s Sarcoma, a rare form ofcancer. Getting medical care sooner likely wouldn’t have saved her, but it wouldhave helped manage her symptoms and “positively impacted the quality of herlife,” her pediatric oncologist testified. Jessica died in state custody at the age of15.

Crank was found guilty of misdemeanor child neglect, along with the man shewas living with, Ariel Ben Sherman, who had founded a small prayer groupcalled the Universal Life Church a year earlier in Lenoir City. Their defense, theyargued, was right in the Tennessee Code Annotated: Under state law, it wasn’t

considered abuse or neglect for parents to seek “treatment by spiritual meansthrough prayer alone” in lieu of medical care for their kids.

The case made it all the way up to the Tennessee Supreme Court. Sherman diedwhile the case was on appeal, but Crank’s conviction was upheld: Because shewasn’t part of a “recognized church or religious denomination,” the Court held,she wasn’t entitled to the faith-healing defense. Her sentence was affirmed:Eleven months and 29 days, to be served on unsupervised probation.

The Court didn’t strike down the law, but one year later, the Tennesseelegislature acted. This spring, it quietly repealed the faith-healing exemption inits child-neglect law, becoming one of just a handful of states that don’t provideany religious exemptions to civil or criminal charges of child neglect or abuse.

Religious-freedom fights often focus on issues of speech and prayer, of worshipspaces and safe observance. Exemptions to charges of child abuse, however,rarely get that kind of attention. The laws are just there, sitting on the books,waiting for a kid to die before they get repealed.

* * *

Of all the people governments act to protect, children are perhaps the mostvulnerable. Despite federal laws that seek to protect kids under 18 from neglectand abuse, there is no one definition across states of what “abuse” actuallymeans, especially when it comes to families who rely on prayer and faith healingsin place of medical care. In some places, if a child is injured, or dies, parents canuse their state’s religious exemption as a defense against criminal charges.

The federal government started pushing states to pass these laws starting in1974 under Richard Nixon’s administration. Largely because of lobbying effortsby Christian Scientists, the Department of Health, Education, and Welfare,which later became the Department of Health and Human Services, determined

that parents who don’t seek traditional medical care for their kids for religiousreasons should not be held negligent. The agency threatened to withhold federalfunding from states that didn’t allow similar accommodations. One by one,states codified religious defenses into their child abuse, endangerment, andneglect laws. Even as federal law has changed over the years, most of these lawshave stayed on the books, equally distributed across states red and blue.

A few legislatures have changed their laws; like Tennessee, most states only takeaction after hearing harrowing reports. A few months after the TennesseeSupreme Court ruled in the Crank case, a lobbyist named Chris Ford, who hadbeen hired by the American Academy of Pediatrics and an advocacy group calledChildren’s Healthcare Is a Legal Duty, or CHILD, approached Senator RichardBriggs about the possibility of sponsoring a repeal bill. The Knoxville surgeonand legislator said yes, although he was wary of potential attacks from religious-freedom advocates and those who oppose “big government.”

In this deeply conservative state—which, in its last legislative session, very nearlydeclared the Bible its official book, and passed a controversial religious-conscience exemption for counselors who don’t want to treat LGBT patients—this bill could have triggered an intense fight. “People were asking me, ‘Why doyou want to take this on?’” Briggs said.

It’s possible Tennessee conservatives thought the child-neglect issue was a political loser.

Some of the state’s conservative groups came to see him with potential concerns,including Bobbie Patray, the head of the Tennessee Eagle Forum—the latePhyllis Schlafly’s organization—and David Fowler, whose group, the FamilyAction Council of Tennessee, routinely pushes legislation on conservative socialissues in the state. (Patray and Fowler both declined to comment on their

involvement in the repeal process.)

Neither group ended up taking on the issue; Briggs said he persuaded them bycomparing the exemption to supporting abortion—because life matters beforeand after birth—and allowing “fundamental Muslims [to practice] sharia law.”(All observant Muslims would likely say they’re following sharia law; Briggs wasspecifically referring to some non-American Muslims’ practice of stoningwomen, he said.) It’s also possible that, following a sad and controversial courtcase over a teenage girl’s death, Tennessee conservatives simply thought thechild-neglect issue was a political loser.

Others who expressed concerns were Christian Scientists. When Tennesseeadded a religious exemption to its child-welfare laws in 1994, according to courtdocuments of the hearing records, a member of the Senate Judiciary Committeenoted that it “was offered by the Christian Scientists, and it ensures that they areprotected.”

Over the past four decades, Christian Scientists have often been involved inefforts to add religious-exemption language into child-welfare laws. Thedenomination, founded in 1879 by Mary Baker Eddy, emphasizes theimportance of spiritual healing, which can include the physical body. Whenfaced with medical challenges, including an on-going health issue or emergency,individual Christian Scientists can choose to seek traditional medical help, orthey can rely on prayer and guidance from Christian Science practitioners whoare trained in the art of faith healing.

The group has lobbyists in each state to watch for legislation affecting their faith,said Debbie Chow, the Christian Science contact in Tennessee. The “Churchreally doesn’t get into the legislative process,” including drafting or pushing forspecific bills, she claimed. But “if there’s something that really is going to affectChristian Scientists, we might jump in there and ask for an accommodation.”Ultimately, the Christian Scientists decided not to take a position on the

Tennessee repeal bill. The law was “never [intended] to shield reckless parents orto leave children unprotected,” Chow said.

When Tennessee’s repeal bill came to a vote at the very end of the term, it passednearly unanimously, with no floor debate. What could have been a majorlegislative fight went through with little note. Other states haven’t had suchsmooth experiences: In Idaho, children who are part of a group called theFollowers of Christ have reportedly been dying of treatable and preventableillnesses at rates much higher than the national average. In next-door Oregon,outcry over the practices of the same group eventually led legislators to repealthe state’s child-welfare exemptions for faith healing and prayer. So far, theIdaho legislature has refused to change its child-welfare laws along those lines.

Meanwhile, religious defenses against child-abuse charges have recently been inthe news. This summer, an Indiana woman used the state’s newly passedReligious Freedom Restoration Act, or RFRA, as an argument against felonychild-abuse charges. Prosecutors allege she beat her son with a coat hanger,leaving 36 bruises; she justified her actions via scripture, arguing that “[sparing]the rod spoils the child.”

By the time these laws do get used in court, the worst hasoften already happened.

Cases like this can seem like liberal catastrophizing come to life: Someopponents of RFRAs have claimed such laws give religious parents cover forabusing and neglecting their children. In reality, legal experts say, it’s unlikelythat the Indiana statute will actually shield the mother from charges. “Literallynobody believes that general religious-liberty provisions like RFRA create adefense for injuring a child, or injuring an adult, for that matter,” said DouglasLaycock, a law professor at the University of Virginia.

Specific, state-level exemptions, like the former law in Tennessee, focus on faithhealing, prayer, and parents’ obligation to seek formal medical care. Differentlaws protect parents against charges ranging from misdemeanor neglect tocapital murder, which is the case in Arkansas. One reason why many stateshaven’t revisited their religious exemptions to child-welfare laws is that they’renot used that often in criminal cases, according to the heads of a half dozenchapters of the American Civil Liberties Union in the states that have the mostpermissive laws. But when the relatively rare cases of faith healings do come up,“there [those statutes] are, and they protect conduct that probably should nothave been protected,” Laycock said.

The case of the coat-hanger beating in Indiana, along with Jessica Crank’s deathin Tennessee, offer an interesting study in contrasts. News of gruesome childdeaths or injuries that are justified by religious freedom seems to get selectivecoverage, depending on the laws at hand. In a place like Indiana, where the lawin question is already politically charged and associated with fights over LGBTrights, an alleged child-abuse case might get a lot of attention. In Tennessee,however, repeal of the law’s faith-healing exemption brought barely a whisper ofconversation.

Thanks to uneven state laws, charges might not even be brought in similar casesin other places: Before Oregon’s child-welfare laws were revised, for example,prosecutors declined to bring cases against Followers of Christ whose childrendied from treatable or preventable ailments—technically, their behavior wasn’tillegal. In most states, these provisions remain tucked in the depths ofcodebooks, dusty and forgotten. By the time they do get used in court, the worsthas often already happened—it can take an intervention by child services orreports of a severe injury for these kinds of parental choices to become public.

It may take a case like Jessica Crank’s to get legislators to act. It’s change, at theprice of a child’s life.

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EMMA GREEN is a staff writer at The Atlantic, where she covers politics, policy, andreligion.

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