August 12, 2016

Most states allow religious exemptions from child abuse and neglect laws

All states have laws prohibiting child abuse and neglect. But in 34 states (as well as the District of Columbia, Guam and Puerto Rico), there are exemptions in the civil child abuse statutes when medical treatment for a child conflicts with the religious beliefs of parents, according to data collected by the U.S. Department of Health and Human Services.

Additionally, some states have religious exemptions to criminal child abuse and neglect statutes, including at least six that have exemptions to manslaughter laws.

These exemptions recently drew renewed attention in Idaho when, in May, a state task force released a report stating that five children there had died unnecessarily in 2013 because their parents, for religious reasons, had refused medical treatment for them. The report has prompted some of Idaho’s legislators to begin pushing for a repeal of state laws that protected the parents of these children from civil and criminal liability when they refuse to seek medical treatment for religious reasons. 

Such legal exemptions in Idaho and other states mean, for example, that if a parent withholds medical treatments for an ailing child and instead opts for spiritual treatment through prayer, the child will not to be considered “neglected” under the law, even if he or she dies. These exemptions are meant to accommodate the teachings of some religious groups, such as Christian Scientists and the Idaho-based Followers of Christ. Some of these groups urge and, in the case of Followers of Christ, sometimes mandate the use of faith-based healing practices in lieu of medical science.

In most cases, adults are free to make their own decisions as to how or even if they want to treat an illness. But when the patient is a minor and still legally under the care of parents or guardians, the issue can quickly become fraught with competing claims, from child welfare and medical necessity to parental rights and religious liberty.

Currently, 19 states and territories have no religious exemptions to civil child abuse and neglect statutes. In addition, Nevada and American Samoa have exemptions that do not specifically mention religion, but could apply to religion. For instance, American Samoa’s statute says, “those investigating child abuse must take into account accepted child-rearing practices of the culture in which the child participates.”

The exemptions came into being as a result of federal requirements that no longer exist; they grew out of the federal Child Abuse Prevention and Treatment Act (CAPTA), which was signed into law by President Richard Nixon in 1974. While that statute did not mention religious exemptions specifically, the requirements issued by what was then the Department of Health, Education and Welfare for states to receive federal funding specified that a religious exemption must be added to the state’s child protection laws. In 1983, this requirement was removed. A religious exemption was added to the text of the law in 1996 but that, too, was removed in 2003. The most recent reauthorization does not include a religious exemption.

In many states religious exemptions are not absolute. Sixteen states and territories that have such exemptions mention that if treatment is given through spiritual means alone it must be in accordance with the practices of a “recognized” religious denomination. (These include Pennsylvania, which specifies that the parent’s beliefs must be consistent with a “bona fide religion.”) Three additional states – Arizona, Connecticut and Washington – have exemptions that specify that children receiving Christian Science treatment from an accredited Christian Science practitioner are not considered neglected.

In addition, 17 of the states and territories that have exemptions specify in their statutes that, in some cases, a court can order treatment for children, regardless of the parent’s religious wishes. Colorado’s law states: “The religious rights of the parent shall not limit the access of a child to medical care in a life-threatening situation.” Florida, similarly, states: “This exception does not preclude a court from ordering medical services or other treatment to be provided when the health of the child so requires.”

Correction: This post has been updated and some wording has been changed. The update includes a correction concerning the state of the law in Tennessee.

Topics: Health Care, Parenthood, Religion and Government, Religion and Society

  1. is a copy editor focusing on religion at Pew Research Center.


  1. Anonymous2 months ago

    California exempts NO ONE from vaccination… not even on the basis of religion… EXCEPT
    if the person involved receives a Medical Doctor’s approval for the exemption… for

    1. David Kent2 months ago

      Thanks for your interest. This link to CA Code 300(b)(1) might offer some clarification, though it does not specifically address vaccination:…

  2. Anonymous2 months ago

    Please explain (or edit to make less ambiguous) your comment that “most states allow exemptions from child abuse…”

    1. David Kent2 months ago

      Thanks for your comment. State child abuse and neglect laws often cover a wide range of issues, including whether a child is provided adequate medical care.

  3. Anonymous2 months ago

    If we prevent families from following ALL precepts of their religion, then we have to admit we do not, as a country, support total religious freedom. That’s ok with me…I just think we have to be very honest about abridging the rights of families.

    1. Mike HughJass2 months ago

      That was pretty much laid out by the Supreme Court in Reynolds v United States, 1878

    2. Anonymous2 months ago

      The Christian bible mandates death for gathering sticks on the sabbath, that is not allowed in the US, so why should causing the death of a child by withholding medical care be accepted?

    3. Paul Doogood2 months ago

      I guess that involves balancing the religious freedom of the parents with the fundamental rights of the child, none of whom are free to choose their own parents.

  4. Anonymous2 months ago

    I do not believe that any religion or religious belief should be allowed to prevent children from receiving essential health care. If adults prefer to use prayer or other religious forms of health care, they are free to do so. Children, however, have neither the power nor the authority to access life saving health care w/o the intervention of an adult. Usually that adult is a parent. However, when parents refuse to provide or allow essential treatment for their children, the state has a duty to do whatever is necessary to get those children treated. Children are not property, they are people.

    1. Mike HughJass2 months ago

      Retroactive: “You child has cancer and rubbing olive oil and praying are not legitimate forms of treatment, but you may certainly do that in addition.”

      Proactive: “Your child needs a whooping cough vaccine. We don’t care what you say your God thinks about it. You are not only endangering your child’s health but the health of many others.”

      Left lingering: “You taught your child that objective science is wicked and that the world is flat. You have convinced them that a long list of fairy tales and falsehoods are true. You have distorted the mind of an innocent child making them less rational, less educated, and misinformed on how the world functions.”

  5. Bruce Dale3 months ago

    Thanks for bringing attention to this important issue. It’s an issue that should be resolved at the federal level. There is a strong argument to be made that states’ religious exemption laws affecting children’s access to medical care are in conflict with the 14th amendment to the Constitution.

  6. Anonymous3 months ago

    I admire Florida’s process. What I take away from this article is that Medical treatment is often RESERVED for emergency situations that cost a lot to treat. I will not argue why people choose to use “Religious practices” though it is indeed very sad to see it fail, much like anything else. Preventative care is often overlooked, unrepresented and perhaps outright nonexistent in some areas here in the USA, because regulating it leaves less grey areas of overpriced treatment that nobody thinks twice about questioning. Even though it does save lives. Interesting read and all, but I believe there are other topics of more importance. All topics get people thinking though… not a bad thing.

    1. Anonymous3 months ago

      You don’t think children dying because of superstition is important?

    2. Lara Carter3 months ago

      Unfortunately, no. Many religious groups believe and disallow any intervention other than faith healing. The Christian Scientists grew from the work of a brilliant thinker of the mid-late 1860s who recognized the connections between mind, body and spirit and that balancing these and focusing prayer alone or in community could ease symptoms. I often feel that if she knew this practice continued after penicillin, polio surgeries and every discover since her death she would me mortified. But that is just my perspective after some study. Other groups, of course, may ascribe it to a religios prohibition when in fact it is to avoid as much contact outside their communities. And some refuse specific treatments. Jehovah’s Witnesses accept other, perhaps all medical care but believe the scripture prohibits blood transfusions. Interestingly, Amish and Mennonite communities (to a large degree) are very open to modern medicine, particularly to protect against the potential for genetic abnormalities within closed, isolated and often very small communities. It is all fascinating to me, as well as frustrating.

      1. Anonymous2 months ago

        No many religious groups. A very, very few religious people refuse treatments for their children. Focusing on these few taints the vast majority of religions and religious people who use medicine to help their children.