Carl and Raylene Worthington told investigators they first noticed the bump on their daughter's neck when Ava was 3 months old. A doctor later said it was a benign cyst battling an infection in the child's blood; it continued to grow as she grew older. By the time little Ava reached 15 months, the bump measured three by four inches—the size of Clackamas County Deputy District Attorney Greg Horner's wallet, he told a jury in the Portland, Ore., suburb of Oregon City last week. By Feb. 29, 2008, Horner said, this "cystic hygroma," a congenital lymphatic lesion, was pressing up against the girl's windpipe, according to a ruling from the county's medical examiner. She was slowly choking to death.
Carl and Raylene called in the devoted parishioners of their Oregon City place of worship, the Followers of Christ, to seek God's help. They anointed Ava with oil. They fed her diluted wine. They extracted phlegm from her throat with the kind of suction bulb used to baste a Thanksgiving turkey. They laid their hands upon the toddler and prayed she would get better. What the Worthingtons did not do is call an ambulance.
The first physician ever to examine Ava was the Clackamas County coroner, who performed her autopsy. "Almost up until the end, if they had gotten her adequate medical treatment, they would have been able to help her," Horner said during his opening statement. Ava died last March of bronchopneumonia and sepsis, associated with the cyst that compressed her airway and deprived her organs of the oxygen they needed to function properly, according to the county medical examiner. Seven women and nine men will soon decide whether Ava's parents should be convicted of manslaughter and criminal neglect for choosing not to seek medical attention for their child.
Circuit Court Judge Stephen L. Maurer rejected the couple's motion to dismiss the case on the grounds that they were being persecuted for their religion, which teaches that the use of doctors is a sign of weak faith. The case against the Worthingtons represents the first time prosecutors have employed a 1999 law passed by the Oregon Legislature after several children who belonged to the Worthingtons' church died during the previous decade.
Ava's 16-year-old uncle, Neil Beagley, died just four months after she did. Beagley succumbed to complications from a blocked urinary tract, a condition that, like his niece's, required a fairly simple medical remedy: antibiotics. Beagley's parents, also members of the Followers of Christ, are scheduled to face charges of criminally negligent homicide in January. Jeff Beagley entered a plea of not guilty last year; his wife, Marci, has yet to enter a plea.
Despite a recent rash of high-profile cases, those who rely completely on prayer to heal the sick appear to be dwindling in number, say experts in religious studies and medicine (none could offer specific statistics). And deaths attributed to a rejection of secular medicine are steadily in decline, says Seth Asser, a Boston pediatrician who studies the practices of faith-healing groups. That's largely because of the diminishing influence of sects such as the Church of Christ, Scientist (Christian Science), Asser explains, whose membership has dropped from more than 1 million before World War II to as few as 100,000 today, by some estimates (the church does not publish official numbers.)
Still, Ralph Hood, a University of Chattanooga professor of religion and psychology, is 66 years old and has never been to the doctor. "You can make the argument that medicine produces at least as much illness as it cures," Hood says. "I can think of conditions where—I cut wood, if I took a chainsaw and cut my leg half off, I might go for emergency treatment. Or I might wrap it up myself, and see what I can do."
Stephen Post, a professor of psychiatry and religion at the Center for Medical Humanities at Stony Brook University, says the impersonal nature of modern medicine causes some patients to be attracted to faith healing. People have come to feel like commodities in the health-care system, the "kidney in room three, the infection in room five," Post says. "It's all gotten quite dehumanized." Others worry about medical errors and dangerous infections.
Faith healing has a longevity that predates modern medicine, and recorded history for that matter. In Ecuador, shamans treat the sick with a guinea pig, or cuy, passing it over a patient's upper body to absorb negative energies, even smacking the subject with the rodent. The cuy is then cut open and its insides "read" to diagnose the human patient before prescribing an appropriate remedy. Jehovah's Witnesses believe it better for a child to die than to accept a blood transfusion, and in Christianity, faith healing has been infused into teachings for more than 2,000 years, based largely on descriptions of Jesus healing the sick with touch, prayer and anointing oil. One of the Worthingtons' briefs purports that chiropractic care was founded as a practice based on "received religion wisdom," and notes widespread use of acupuncture in Asian cultures that seeks to channel mystic energy, along with homeopathic medicine in Oregon and elsewhere. "Mr. and Mrs. Worthington's choice of prayer, anointing oil, and laying on of hands, all methods of healing employed by the Great Physician (Jesus), for their family all fall within the gamut of medical treatment options that are legitimately selected and practiced in Oregon," wrote the Worthingtons' attorneys, Mark Cogan and John Neidig, in their brief.
Christian Science is one of the more widely known religions to preach that prayer is a better option than modern medicine, but the church's director of legislative and media affairs, Phil Davis, insists that individual members are free to go to doctors if they wish. The church teaches that trust in God is "challenged" when "material reasoning" gets in the way, says Davis, who has not been to a doctor since military service in the 1970s required it. Doctors and modern medicine interfere with "the beauty of being able to put complete faith in God," according to church doctrine. The idea is to heal so effectively through prayer that there's no need for a conventional approach, Davis says.
When it comes to children, Davis says the church's standard is a little different, however. "When you're thinking of another life, not your own, it's a higher responsibility," he explains. "The healing needs to take place quickly, and results matter. The life of a child is paramount."
The police asked Carl Worthington if he thought that Ava could die. Yes, the father answered. And when Worthington considered that horrible possibility, what did he do? "We kept praying," he said. In the state of Oregon, prosecutors say that wasn't enough.