John Travolta's son died. Apparently he had a seizure disorder and was killed by a seizure – that is what the death certificate says, at least.  The parents must be devastated.  My heart goes out to them.

It seems that some people are raising questions about Travolta's religion – Scientology – and whether he and his wife followed the best course of treatment for their son.  I will not criticize them one way or another.  No one really knows precisely what the son's condition was nor how he had been treated over time. 

But I do want to engage with a more general question that is raised by this sad episode: how should parents medically care for their children?  

In the US this is a rights question.  Do parents have the right to deny their children medical care that is generally viewed as effective and safe?  There is one Supreme Court case (there may be others) that suggests that the religious beliefs of parents are not sufficient justification to endanger the health or life of their children.  The decision contains a memorable line:

"…Parents may be free to become martyrs themselves.  But it
does not follow they are free, in identical circumstances, to make
martyrs of their children." 

But the law appears unsettled.  Apparently, there are laws in many states that allow parents a certain leeway in keeping their children from receiving medical treatment.   Christian Scientists are famous for their aversion to medical care, and they have worked to shield their children from modern medicine. 

My interest in all this is, as usual, to link it to ancient Chinese thought.  What would Confucianism and Taoism make of the question of a parent's obligation to seek medical care for his or her child?

Taoism would, I believe, understand the positions of Christian Scientists and Scientology, at least on the narrow issue of medical treatment.  If a person, any person, even a child, has a condition that is bringing on death, a philosophical Taoist would be open to the possibility of simply accepting the situation as is (religious Taoism would like take the opposite position and strive to prolong life).  There would be no hard and fast Taoist rule, but if a parent were to argue that it was "natural" to allow a disease or medical condition to run its course without modern scientific intervention, a Taoist would, at the very least, understand and possibly accept that argument. 

This might be especially the case with seizure conditions.  The treatment of seizures is famously uncertain.  I once had a pediatric intensive care specialist tell me that he felt the hit-or-miss, trial-and-error quality of seizure medications was something like alchemy (rather like religious Taoism!).  Don't get me wrong: for some people, certain medications can be very effective.  But it is very hard to know how any particular individual is going to react to any one seizure med.  What works for one person may not work for another, even when they have the same diagnosis.

There are reports that Travolta's son had taken an anti-seizure drug, Depakote, but that it had lost its effectiveness and they stopped using it.  What should be kept in mind is that when one seizure medication fails to work, the probability of any other seizure med working is reduced significantly.  We tried over a dozen anti-seizure meds with Aidan.  Some worked for a time, but none ultimately stopped the seizures completely.  It is a very frustrating situation.  Under such circumstances, if such were what the Travoltas faced, why not step back from medical intervention and just let the child live the life he has before him?  It may not be the life that you or I or his parents want for him, but it is the life that he has.  That, to my mind, would be a Taoist-like approach.

A Confucian would have a rather different position.  Although not framed in terms of universal rights, as in American legal-philosophical discourse, a Confucian perspective would encourage the parents to seek medical care.

Parents have an obligation to care for their children.  And while there is room here for the exercise of judgment regarding any particular course of treatment, if an intervention was relatively easy and safe, even if of questionable effectiveness, a Confucian might pursue it.  If Depakote did not work, why not try another med, if the side effects were not too problematic?  There are two Confucian grounds for this more interventionist stance.

First, as is most clearly stated by Mencius, parents have a strong primary duty to care for their children:

Honor you elders as befits elders, and extend this honor to all elders.  Honor you own children as befits children, and extend this honor to all children. (1.7)

What does it mean to honor children "as befits children"?  On the face of it, this suggests that children should be treated differently than adults: they must be disciplined and taught and nurtured so that they come to understand Duty and Ritual and Humanity.  But I think there is a presumption here also of physical care and safety of children.  If a child is in poor health, a Confucian parent must do what is necessary to improve the situation in order to enable the child to continue to learn and enact Duty and Ritual and Humanity.

Second, if a child faces a life-threatening problem, the parent should take action.  There may be limits on how far a parent should go, especially in light of the effects of any such action on other family members, but reasonable and safe medical intervention would seem to be called for.  I say this because of the general Confucian aversion to causing death.  To do nothing and have an innocent person die would generally be seen as a bad thing, as Mencius suggest here:

Prince T'ien asked: "What is the task of a worthy official?"

"To cultivate the highest of purposes," replied Mencius.

"What do you mean by the highest of purposes?"

"It's
simple: Humanity and Duty.  You defy Humanity if you cause the death of
a single innocent person, and you defy Duty if you take what is not
yours.  What is our dwelling place if not Humanity?  And what is our
road if not Duty?  To dwell in Humanity and follow Duty – that is the
perfection of a great person's task." (13.33)

Death by commission or omission both could count here. In order to preserve Humanity, we must try not to cause the death of others, either by commission or omission.

Thus, from what we know, what little we know, of the Travolta tragedy, a Taoist would agree with those who say that parents can rightly withhold medical treatment from their children, while Confucians would take a more interventionist stance.