If You Were the Judge, What Would Your Decision Be?
WE INVITE you to put yourself in the position of a judge in this court case from Austria:
A two-year-old girl is afflicted with leukemia. The physician handling the case orders administration of a blood transfusion. For religious reasons, the parents reject that treatment. From this point on, the physician refuses to give any further medical treatment to the child. The child is discharged from the hospital.
The parents then search for some other treatment that might help their little girl, but, a short time later, she dies. The local authorities charge the parents with manslaughter. The case comes before the court. The public prosecutor, in his accusation, demands that the parents be punished. If you were the judge, what would be your decision?
Please read this article and get familiar with the case before rendering your decision.
The Disease and the Child’s Death
In May 1970, Eduard and Veronika Walter of Steyr, Upper Austria, observed that their two-year-old daughter, Irene, was very pale. They immediately consulted a pediatrician. He believed that Irene’s ailment was simply a case of malnutrition. Since her condition did not improve, the parents consulted the doctor again in September. Irene’s blood was examined, but no blood disease was found.
A month later, toward the end of October, the child was sent to the General Public District Hospital in Steyr. Two days later, when the mother came to see the child in the hospital, she was told that Irene would have to be given a blood transfusion. Mrs. Walter explained that, as one of Jehovah’s Christian witnesses, she refused any blood transfusion for her child because of the Bible command to abstain from blood of any sort.—Acts 15:28, 29; Lev. 17:14.
Then the father was asked to come to the hospital, and he went. The parents maintained their stand respecting blood transfusions for their child. At that the doctor declared: “Then the case is closed, as far as I am concerned.”
Thus, from the very beginning the hospital showed intentions of discharging the child from its care if the parents would not agree to a certain type of treatment—a blood transfusion. That same evening, Mr. and Mrs. Walter were allowed to take their child home, without receiving any instructions whatsoever as to other methods of treatment.
Repeatedly, they asked whether there were methods of helping their child other than by blood transfusion. But the doctor said there were none. The parents took Irene to a clinical hospital in Upper Austria and thence to two nonmedical practitioners in Germany and Austria. No cure was found for the child. On November 5, 1970, she died at the home of her parents in Steyr.
Charges Brought Against the Parents
Are you under the impression that the parents actually wanted their child to die, or that they deliberately contributed to her death by their rejection of a blood transfusion? Dr. Alfred Andel seems to have felt that way, for when he made out the postmortem examination paper, he filled in Point 12 of the death certificate with the words: “Refusal of blood transfusion.” Point 12 bears the following heading: “In case of violent deaths (suicide, murder, manslaughter, accident) give details as to manner and cause of such violent death.”
The following day Dr. Andel reported the case to the Federal Police Station in Steyr. The parents were questioned immediately by the Federal Criminal Investigation Department, and they explained their religious viewpoint on blood transfusions. Moreover, they stated that the doctors had not been able to guarantee a cure, and, knowing that transfusion of blood can also have serious, even fatal results, this reason, too, had led them to refuse a transfusion.
The police passed the report on to the public prosecutor’s office, which, in turn, obtained an opinion from the Institute of Forensic Medicine of Paris Lodron University, Linz, regarding the death of Irene Walter. The final opinion of the Institute, written by Professor Norbert Woelkart and head physician Dr. Klaus Jarosch, said:
“Actually the life prognosis respecting this disease is infaust [not favorable] even with modern medication, i.e., basically a recovery was not possible, the fundamental ailment proving fatal sooner or later.”
However, this same opinion went on to say that refusal to consent to blood transfusions “shortened the child’s life-span not inconsiderably.” The summary was that the child died from anemia due to leukemia and “prevention of proper medical treatment.”
The public prosecutor’s office then filed accusation against Eduard and Veronika Walter at the Circuit Court, Steyr, on February 19, 1971. It was asserted that their refusal to consent to blood transfusion for their child was a violation of section 335 of the penal law with regard to security to life. This law says:
“Any action or default of which the acting person is able to perceive even by its natural consequences, obvious to anyone, or by virtue of specially publicized regulations or by way of his rank, office, profession, trade, occupation, or generally by way of his particular circumstances, that a danger to life, health or physical security of persons might be induced or likely to be enhanced, should, if severe injury was caused to a person, be counted as a violation of the law on the part of the guilty one and be punished with imprisonment up to six months or with a fine up to S 100,000.00 [about $4,350] and, should the death of a person result, with imprisonment up to one year.”
The accusation closes with the request that the second measure of punishment of this law be meted out.
Questions to Be Considered
What do you think about the case now? Do you agree with the public prosecutor’s charge, feeling that the guilt of the accused has been sufficiently established? Or did the parents conscientiously do all they could to save the child’s life? What likelihood was there for the child to survive or for her life to be lengthened by a blood transfusion? Was blood transfusion the only proper treatment and the best therapy in this case?
On the other hand, did the doctors do all they could do and ought to do in order to help the child? Let us turn to some opinions of experts.
What Is the Proper Therapy?
The summary in the aforementioned final opinion reads: “Death from anemia due to aleukemic lymphadenosis and prevention of proper medical treatment.” What if that which is considered “proper” treatment turned out to involve certain risks? As a fair judge you would have to take this into consideration in your opinion. Consider, then, the following:
During preliminary investigation, the parents submitted the Monatsschrift fuer Kinderheilkunde (Monthly Magazine for [the German Association of] Pediatrics), Vol. 118, No. 1, January 1970, to the court. This magazine published the discourses given at the 67th conference of the German Association for Pediatrics at Saarbruecken on September 24, 1969, on the subject “Newer Viewpoints on Leukemia of Children.”
Page two states that weeks before hospitalization, symptoms of the disease are perceptible. Pages four to twelve deal with the variety of today’s most effective chemotherapeutic methods of treatment and their success. This scientific discussion on twenty-six pages of the publication for pediatrics was submitted to the Forensic Institute of Forensic Medicine of Paris Lodron University, Linz, in order to obtain a supplementary opinion.
Thereupon, the Institute summarized the discussion in about thirty-five lines and stated that “the more recent methods of treatment of acute leukemia have led to a considerable prolongation of survival.” They added: “The time of survival has been increased by modern methods of treatment to an average of 13 months.” “One even expects five times the normal period of survival.”
The parents’ counsel for defense also obtained expert opinions: Professor H. Weicker, head of the Institute of Human Genetics at Bonn University and coeditor of a handbook for pediatrics, treated more than 200 children suffering from acute leukemia during twenty years of pediatric practice. Professor Weicker writes:
“The average life expectancy of a child with acute undifferentiated leukemia is approximately three months, if the child is not treated from the first occurrence of clear symptoms of leukemia. Irene Walter showed these symptoms in May or June (unusual paleness) and in July (enlargement of the spleen), regardless of whether they were diagnosed as such or not. The average life expectancy—without treatment—would have been September or October 1970; this could have varied, of course, individually. The life expectancy of children with leukemia has not or has only insignificantly changed since blood transfusions have been introduced. . . .
“Only by the introduction of cortisone into leukemia therapy has the life expectancy increased to six to nine months on the average. This is why the combined cortisone-cytostatica therapy is completely in the foreground in leukemia treatment. . . . Judging the course of disease in this manner and taking into account our knowledge about the chances of survival of leukemic children, the inference of a violent death due to refusal of a blood transfusion must be rejected in the case involved. . . . There is no doubt that the chances of prolonging her life were increased considerably since the combined cortisone-cytostatica therapy was introduced, however, alone by means of this therapy and not by means of blood transfusions, customary since the forties.”
Risks of Blood Transfusions
Another expert asked for his opinion was Dr. F. W. Guenther, head of the city hospital of Wuppertal-Barmen, Germany. He said that he ‘entirely agreed’ with the above-mentioned opinion of Professor Weicker and then added his own opinion:
“Being director of Wuppertal-Barmen’s clinical hospital for children, which admits four to five thousand patients annually, the disease features of leukemia during childhood are familiar to me. I have never seen a child survive that was suffering from leukemia. . . . The physicians treating Irene are to be agreed with inasmuch as a blood transfusion was recommended to the parents. In this connection, however, it should be mentioned that I have observed myself that blood transfusions can cause serious, even fatal complications in leukemic patients.”
By order of the court the records of the case were sent to the head physician of the pediatric department of the Moedling Hospital, to university lecturer Dr. Ruziczka, to obtain an additional pediatric expert opinion.
In this opinion, Dr. Ruziczka said that a blood transfusion would have been appropriate in the case of Irene Walter as treatment for the anemia associated with the leukemia affliction. But he also pointed out the disadvantages and even life endangerment that a blood transfusion may bring about.
Mr. and Mrs. Walter were well aware of the risks involved in giving blood transfusions. They had read the booklet published by the Watch Tower Bible and Tract Society entitled “Blood, Medicine and the Law of God.” This treatise, which gives documented evidence as to the various dangers involved in administering blood transfusions, was added to the court’s records.
The Trial
On October 27, 1971, the trial was held at Steyr. A physician of the Steyr hospital, Dr. Johann Fritz, was heard as a witness. He testified that the proposed blood transfusion would have been intended to improve the general condition of the child, namely, her striking paleness, not as the actual treatment of her disease. After the examinations that were made in cooperation with the Innsbruck University clinical hospital, the child would have been transferred to the next bigger treatment center in Vienna. (The child died, however, about two and a half weeks after the initial reception into the hospital!) The actual treatment would then have been administered in Vienna.
Then the public prosecutor read the bill of indictment, charging the parents as being guilty of or, rather, accessory to criminal offense against security of life. He demanded their punishment.
The counsel for the defense, Dr. Heimo Puschner and Dr. Hans Frieders, Vienna, argued that the parents had done more to save their child than they had been required to do by law.
If you were the judge, what would you decide? Please review the pertinent facts of the case by answering the following questions from what you have read:
What was said in section 335 of the penal law, which the parents were accused of breaking? What did the medical opinions from both sides state? What did the parents do to prolong the life of their child?
Do not let your reasoning be swayed by the thought that the child would have died anyway. According to the law, even a shortening of life is punishable. On the other hand, would the child’s life definitely have been prolonged by a blood transfusion?
Have you reached a decision? If so, you can compare it now with the judge’s actual decision in the Walter case:
The Decision
Mr. and Mrs. Walter were acquitted on the basis of the following:
(1) The accused had informed themselves sufficiently about the effectiveness of a blood transfusion and knew that there were other efficacious methods of treatment. Therefore, they were not able to see, in the sense of the law, that refusal of a blood transfusion should be an offense against the security of the life of their child.
(2) Actually, the hospital would have been obliged to call upon the court of guardianship to receive further instructions as to the child’s treatment. In view of the risk involved, the court of guardianship might well have renounced a forced blood transfusion and might have respected the religious convictions of the parents.
(3) The experts called upon by the court pointed to the disadvantages of a blood transfusion. Thus, the parents’ refusal was not unfounded.
NOTE: About ten well-known Austrian specialists, including university lecturers, chief surgeons of pediatric clinical hospitals and directors of pediatric hospitals of universities in Austria declared, when questioned in connection with this case, that they personally were willing to respect the religious stand of Jehovah’s witnesses in the blood issue and that they would administer all other conceivable medical treatment, so as to help these patients. Such physicians are to be commended, for they are endeavoring to help their fellowman, and, at the same time, they show respect for the Bible-based dictates of Christian conscience.