Children don’t often die like this in the United States.
But on Sunday in the Town of Weston, near Wausau, 11-year-old Madeline Kara Neumann died of diabetic ketoacidosis, a treatable though serious condition of type 1 diabetes in which acid builds up in the blood.
Neumann’s parents said they didn’t know she had diabetes. They didn’t take her to a doctor. They prayed for healing.
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The common course of medical treatment for the disease involves injections of insulin and intravenous fluids, said Omar Ali, assistant professor of pediatric endocrinology at the Medical College of Wisconsin in Wauwatosa.
“A fatal outcome would be unusual these days in the United States,” Ali said.
The death of the girl has shocked the community and raised profound moral and legal questions over when medicine should trump faith, especially when the life of a child is at stake.
There is no indication authorities knew of the girl’s dire medical condition before her death. Local police are investigating the case and have said they could forward their results to the Marathon County district attorney’s office. The Marathon County Department of Social Services has also launched an investigation.
Authorities said Wednesday that the Neumanns’ three other children – ages 13, 14 and 17 – were being interviewed by Social Services and law enforcement and were being checked by a physician.
“The reaction is sadness, and I think a little bit (of) amazement,” said Dean Zuleger, administrator for the Village of Weston. “I haven’t seen a lot of what I would see to be knee-jerk judgment. There is a general sense of grief and sadness. Because I know the family a bit there is a great deal of concern for their well-being.”
Zuleger said the girl’s parents, Dale and Leilani Neumann, are well-known in the community. They moved there from California two years ago and run a popular coffee shop.
“I probably had seen the little girl sometime during the winter,” Zuleger said. “She appeared to be a vibrant little 11-year-old. I know some folks who were at some of the birthday parties said she appeared to be fine. I don’t know how the onset of this diabetes affects kids. By all indications based on our knowledge of the family they aren’t weird or peculiar or fanatic or anything like that. Everything appeared to be normal.”
Reached by telephone at her home, Leilani Neumann said the family did not know 11-year-old Kara had the disease before her death.
“It was something that came on suddenly,” she said. “She went to birthday parties recently, she went sledding for two hours, she was perfectly fine until the last few days. We ask if people can pray for us and give us our privacy as we grieve our daughter.”
Leilani Neumann told The Associated Press that the family does not belong to any organized religion or faith but believes in the Bible and said that healing comes from God.
There were also two postings under her name on the Web site AmericasLastDays.com, which is operated by Unleavened Bread Ministries, an evangelical ministry that focuses on the apocalypse.
‘They aren’t crazy people’
It was Sunday at 2:33 p.m. when Everest Metro Police said they first learned of the girl’s condition. A call came into the dispatch center from a family relative who lived in California, said Police Chief Dan Vergin.
Vergin said the relative notified authorities “that the child was ill, and due to religious reasons the family would not take the child to the hospital.”
Officers were dispatched to the home, and a second call – this time from the family’s residence – was placed to 911, Vergin said. The caller said the girl was not breathing and did not have a pulse, Vergin said.
Officers and emergency service personnel went into the house and found the girl in a family-room area lying on a futon mattress on the floor, Vergin said.
“The mother and father were praying over her at that time,” Vergin said.
The girl was pronounced dead at St. Clare’s Hospital and through an autopsy it was determined she had diabetic ketoacidosis, Vergin said.
“The doctor who did the autopsy and others have said she would have been showing signs for about six months, and she would have been symptomatic, very thirsty, lots of urination, dry skin for the last week,” he said. “They felt she would have been quite ill.”
Vergin said that during an interview with detectives the parents said “they believed even though they knew she was ill, they had enough faith and prayer that God would heal her.”
“They said it was the course of action they would take again,” Vergin said. “They firmly believe even if they had taken her to a doctor, if this was the time God had chosen for her to die, she would die regardless of medical interference.”
“This is not their defense, they aren’t crazy people,” Vergin added.
Vergin said the death of the girl brings up difficult issues.
“At what point do religious beliefs take over for medical help? And the flip of the coin is at what point are the parents responsible for the health and welfare of their children,” he said. “These people truly believed their prayer and faith would heal their daughter. They have no question about that.”
Police and courts have grappled with such issues for decades.
Norman Fost, professor of bioethics and pediatrics at the University of Wisconsin School of Medicine and Public Health in Madison, said the First Amendment to the Constitution gives citizens the right to practice religion.
“A Jehovah’s Witness can refuse life-saving blood transfusion based on their religious belief,” he said. “They’re protected. But they can’t refuse it for their child . . . the First Amendment extends to their own behavior but not their children’s.”
Under Wisconsin statutes, parents can’t be accused of abuse or neglect if the sole reason for the injury is that they relied on prayer, Fost said. But Robyn S. Shapiro, an attorney who is professor of bioethics and director of the Bioethics Center at the Medical College of Wisconsin, said abuse or neglect can include “failure to appropriately respond or supply medical care to your kid.”
“What else did they do, what else did they know about, what did they see, why didn’t they figure it out?” Shapiro said.