## Facts

- Colin Newmark, age three, was diagnosed with Burkitt’s lymphoma, an aggressive and advanced pediatric cancer.
- Physicians recommended intensive chemotherapy that was invasive, painful, and associated with significant side effects.
- Medical estimates placed the chance of cure at less than 40%; without chemotherapy, Colin’s life expectancy was six to eight months.
- Colin’s parents, Christian Scientists, refused chemotherapy and chose spiritual treatment through prayer.
- The parents relied on Delaware statutes excluding from “abuse” or “neglect” those who treat a child “solely by spiritual means,” including 10 Del. C. § 901(11) and 16 Del. C. § 907.
- Delaware child protective authorities petitioned for temporary custody to authorize chemotherapy, asserting the refusal constituted neglect and that the State had a duty to protect Colin’s life and health.
- The parents argued that compelled treatment and removal of custody would violate their rights as parents and their free exercise of religion.

## Issues

1. Whether, under Delaware child-protection statutes that exempt spiritual treatment, parents’ refusal of chemotherapy constituted “neglect” justifying transfer of custody to the State to compel treatment.
2. What standard governs state intrusion into parental medical decision-making for a minor when proposed treatment is highly burdensome and only moderately likely to succeed.
3. How to weigh the State’s interest in preserving a child’s life against parental rights, religious exercise, and the child’s interests in avoiding suffering.

## Decision

- The Delaware Supreme Court reversed the Family Court’s order granting temporary custody to the State and returned custody to the parents.
- The court held the State did not establish statutory neglect in light of Delaware’s explicit exemption for parents treating a child solely by spiritual means.
- The court concluded the State failed to show sufficiently compelling grounds to override parental decision-making on these medical facts, given chemotherapy’s limited likelihood of success and substantial burden.
- The court resolved the matter primarily on statutory and best-interests balancing grounds, avoiding a broad constitutional ruling.

## Legal Principles

- When a child-protection statute expressly exempts parents who treat a child “solely by spiritual means,” the State must overcome that legislative exemption to characterize the parents’ conduct as neglect.
- Parental authority over a child’s medical care is the baseline; state interference requires the most compelling reasons and a substantial evidentiary showing that intervention is necessary for the child’s safety or health.
- In determining a child’s best interests in disputed medical treatment, courts should consider both the likely effectiveness of the proposed treatment and its probable impact on the child, including pain, risk, and the child’s remaining quality of life.
- The State’s interest in preserving life is not absolute; it must be weighed against constitutionally protected family interests and the child’s interest in avoiding futile or severely burdensome treatment.

## Conclusion

The court held that Delaware’s spiritual-treatment exemption and the State’s failure to justify overriding the parents’ decision, given the painful and low-probability chemotherapy regimen, required reversal of the custody order compelling treatment.


Newmark v. Williams, 588 A.2d 1108 (Del. 1991)