## Facts

- Joseph Hofbauer, age seven, was diagnosed with Hodgkin’s disease, a life-threatening condition if untreated.
- Joseph’s attending physician recommended consultation with an oncologist or hematologist and conventional treatment, including radiation and possibly chemotherapy.
- Joseph’s parents declined the recommended course and instead pursued “nutritional or metabolic therapy,” including laetrile injections, first outside New York.
- After returning to New York, the parents placed Joseph under the ongoing care of a duly licensed New York physician who continued the alternative regimen and monitored Joseph’s condition.
- The treating physician testified he believed the regimen was helping and that he would recommend conventional therapy if the disease progressed.
- The child-protective agency filed a neglect petition under New York Family Court Act § 1012, alleging the parents failed to provide adequate medical care by refusing mainstream treatment.
- The Family Court dismissed the petition, finding the parents loving and attentive and concluding the child was receiving adequate medical care; the Appellate Division affirmed.

## Issues

1. Whether parents commit medical neglect under Family Court Act § 1012 by declining recommended radiation/chemotherapy for a child with Hodgkin’s disease and instead using alternative metabolic therapy, including laetrile, supervised by a licensed physician.
2. Whether choosing a treatment not widely accepted by the medical community, without more, shows a failure to exercise the “minimum degree of care” required to provide “adequate medical care.”

## Decision

- The New York Court of Appeals affirmed the dismissal of the neglect petition.
- The court held the parents had not neglected their child within the meaning of Family Court Act § 1012.
- The court concluded the record supported findings that the parents did not abandon medical care and instead relied on ongoing, physician-supervised treatment.
- The court declined to treat departure from mainstream medical recommendations as per se neglect and gave weight to lower courts’ fact findings.

## Legal Principles

- Medical neglect under Family Court Act § 1012 turns on whether parents failed to exercise a “minimum degree of care” in providing “adequate medical care,” not whether they selected the best or most widely approved treatment.
- Parents do not necessarily neglect a child by selecting unorthodox medical treatment when the child remains under active care of a duly licensed physician and the chosen course is not shown to be plainly futile or grossly inadequate on the record.
- A neglect proceeding focuses on parental conduct and present adequacy of care; it is not a vehicle to adjudicate the legality or professional correctness of a physician’s treatment choice as a malpractice matter.
- Appellate review respects trial-level credibility determinations and case-specific medical evidence in assessing adequacy of care.

## Conclusion

The court held that parents who reject recommended conventional cancer therapy are not automatically neglectful when they secure ongoing, supervised treatment from a licensed physician and the evidence supports a finding that the child is receiving adequate care meeting the statute’s minimum standard.


In re Hofbauer, 47 N.Y.2d 648, 393 N.E.2d 1009 (N.Y. 1979)