## Facts

- David and Ginger Twitchell were Christian Scientists and the parents of a two-and-a-half-year-old child, Robyn.
- Robyn became ill over five days and died on April 8, 1986, from peritonitis caused by a perforated bowel associated with Meckel’s diverticulum.
- Evidence indicated the condition was medically treatable, including by surgery with a high success rate.
- During the illness, the parents obtained spiritual treatment through a Christian Science practitioner and nurse and consulted a church official about legal rights.
- After that consultation, David Twitchell read church literature quoting language from G.L. c. 273, § 1 suggesting that “remedial treatment by spiritual means alone” could satisfy parental obligations under Massachusetts law; the literature was based on an Attorney General opinion.

## Issues

1. Whether parents have a common-law duty to obtain necessary medical care for a child, such that failure to do so can constitute wanton or reckless conduct supporting involuntary manslaughter.
2. Whether the “spiritual treatment” language in G.L. c. 273, § 1 bars involuntary manslaughter liability for parents who rely solely on spiritual treatment.
3. Whether due process permits a mistake-of-law defense when defendants reasonably rely on an official but mistaken or misleading interpretation of law issued by the government official charged with enforcing the law.
4. Whether excluding the reliance-based defense theory from evidence and jury instructions created a substantial risk of a miscarriage of justice.

## Decision

- The Supreme Judicial Court reversed the involuntary manslaughter convictions and remanded for a new trial.
- The court held that parents have a common-law duty to seek medical care for a child in circumstances like Robyn’s, and breach of that duty may constitute wanton or reckless conduct supporting involuntary manslaughter.
- The court held that G.L. c. 273, § 1’s spiritual-treatment provision does not immunize parents from involuntary manslaughter liability.
- The court held that a mistake-of-law defense may be available where defendants reasonably relied on a mistaken or misleading interpretation of law from the government official charged with enforcing the law.
- The court concluded the trial judge’s refusal to allow the jury to consider the reliance-based defense theory created a substantial risk of a miscarriage of justice.

## Legal Principles

- Parents have a common-law duty to obtain necessary medical treatment for their children; failure to act can satisfy the wanton-or-reckless element of involuntary manslaughter when the risk of death or serious harm is or should be apparent.
- Statutory language excusing “spiritual treatment” for purposes of a child-neglect statute does not bar prosecution for involuntary manslaughter based on wanton or reckless conduct causing death.
- Although mistake of law is generally not a defense, due process may require a limited exception when a defendant reasonably relies on an official, erroneous interpretation of law from the public authority responsible for enforcing or administering that law.
- When a properly supported reliance-based defense is kept from the jury by exclusion of evidence or by refusal to instruct, a new trial may be required if the omission creates a substantial risk of a miscarriage of justice.

## Conclusion

The court reaffirmed that religiously motivated refusal to seek medical care can support involuntary manslaughter when the refusal is wanton or reckless, but it ordered a new trial because the jury was not permitted to consider whether the defendants reasonably relied on an Attorney General–issued interpretation suggesting their conduct was lawful.


Commonwealth v. Twitchell, 416 Mass. 114 (1993)