## Facts

- Child Protective Services took temporary custody of Cheyenne, a nine-month-old child, and placed her in foster care after concerns of developmental delay attributed to inadequate nutrition, along with concerns involving domestic violence and alcohol abuse in the home.
- The Arizona Department of Economic Security (ADES) filed an amended dependency petition; the mother, Diana H., did not contest dependency, and the juvenile court adjudicated Cheyenne dependent.
- After temporary custody began, Diana asserted a religious objection to immunization and submitted a written request seeking a religious exemption from immunization requirements applicable to child-care settings.
- ADES moved for court authorization to immunize Cheyenne over Diana’s objection, asserting immunizations were medically necessary and in the child’s best interests, and that the child’s child-care placement required immunization.
- Diana proffered evidence that most local child-care facilities would accept an unimmunized child, contesting the claim that vaccination was needed to maintain placement.
- Following an evidentiary hearing, the juvenile court authorized ADES to consent to vaccinations, reasoning that ADES’s duty to provide medical care controlled once the state had custody.
- Diana sought extraordinary relief in the Court of Appeals, arguing her residual parental right to direct her child’s religious upbringing included the right to refuse immunizations on religious grounds.

## Issues

1. Whether a parent of a dependent child retains residual parental rights to direct the child’s religious upbringing, including a religiously based objection to immunization.
2. Whether ADES’s statutory duty, as legal custodian, to provide medical care authorizes immunization over a parent’s religious objection after a dependency adjudication.
3. Whether the state showed a compelling interest sufficient to override the parent’s religious objection to immunization in the circumstances presented.

## Decision

- The Court of Appeals accepted special-action jurisdiction because no adequate remedy by appeal existed and the dispute presented a statewide, first-impression legal question.
- The court held that dependency and the grant of legal custody to ADES did not extinguish Diana’s residual parental rights.
- The court held that residual parental rights included the right to direct the child’s religious upbringing and to object to immunizations on religious grounds.
- Applying a compelling-interest analysis, the court concluded the state did not show a sufficiently compelling, case-specific justification to override Diana’s religious objection.
- The court found the juvenile court abused its discretion by authorizing immunization without proper regard to residual parental rights and without the required showing, and it vacated the immunization authorization.

## Legal Principles

- When the state holds legal custody of a dependent child, its statutory authority to provide “medical care” is limited by, and must be exercised subject to, the parent’s residual parental rights.
- Residual parental rights in dependency proceedings include the parent’s right to direct the child’s religious upbringing.
- When state action burdens a parent’s religiously grounded direction of a child’s upbringing, the state must demonstrate a compelling interest in the specific circumstances to override the parent’s objection.
- Statutory religious-exemption provisions for immunization in school and child-care contexts may be considered in evaluating whether the state’s asserted public-health interest is compelling in the particular case.

## Conclusion

The court ruled that a dependency adjudication and state legal custody do not eliminate a parent’s residual right to make religious decisions for a child, and that the state, on this record, failed to establish a compelling interest to immunize the dependent child over the parent’s religious objection.


Diana H. v. Rubin, 171 P.3d 200 (Ariz. Ct. App. 2007)