A common question, rhetorical or otherwise, that skeptics are asked about alternative medicine is, "What's the harm?" It's seemingly an effective ploy for some modalities, so much so that years ago Tim Farley felt obligated to try to answer the question on a website (whatstheharm.net) that catalogues examples of the harm alternative medicine, supernatural and paranormal beliefs, and other pseudoscience do. After all, most homeopathy (at least anything diluted greater than around 12C, at least) is water, without any remaining remedy, effective or otherwise. On the other hand, some homeopathic remedies are adulterated, and some of the "less potent" (i.e., less dilute) remedies might actually have something in them. (homeopathic belladonna for teething babies, anyone?) Moreover, there can be grave harm when the use of ineffective alternative therapies keeps a person from using effective medical therapy. We have seen this over the years, for example, when parents following religions that do not believe in medicine and tell their adherents to rely solely on god for healing, which, sadly, does not work so well for diabetic ketoacidosis, pneumonia, or leukemia. Dead children, however, do not appear to deter belief in such quackery.

File this one as another example of "What's the harm?" Behold the sad, sad case of Ebed and Christine Delozier and their 18-month-old daughter Hope Elizabeth Delozier, who died in February:

According to a criminal affidavit from Magisterial District Judge Fred Wheaton’s Office, the couple was staying at a camper along Hiduk Road in Herrick Township, a property owned by the Hope Baptist Church. Ebed Delozier brought the toddler to the hospital, who was found to be in cardiac arrest. Despite efforts made by the medical staff to save her, the child was pronounced dead a short time later. No immediate cause of death was noted. Criminal investigators were told by a registered nurse on staff that the victim’s mother, Christine Delozier, and aunt, Rebecca Delozier, arrived at the hospital shortly after the victim. The nurse said that the victim’s parents made it clear they were against antibiotics and other chemicals associated with modern medicine. While emergency room staff worked on the toddler, who was not breathing, the nurse said she overheard Christine Delozier making statements such as, “You’re putting holes in her” and, “You’re putting chemicals in her.”

Yes, the doctors at the emergency room were doing exactly that—to try to save the toddler's life! In the case of a cardiac arrest, if there's any hope at all of reversing the situation and saving the victim's life, it involves some rather radical, invasive medicine. So how did Hope reach this state? It started with an ear infection:

The nurse said that while speaking with the family, they related the child had been sick for two weeks and was displaying symptoms consistent with an earache, headache and a fever. She told police the family indicated they had been treating the little girl with a homeopathic approach and were using herbal treatments to care for her.

Although most children recover from otitis media, which is what Hope appears to have had, and mild cases don't even require antibiotics, the key to treating children with mild otitis media is close followup, because antibiotics become necessary if the child doesn't get better quickly and especially if the child's symptoms worsen, as Hope's did. In cases of severe otitis media, antibiotics are still necessary, and sometimes tympanostomy tubes are even required. That's because, if left untreated, severe otitis media can result in a variety of complications, including but not limited to:

Chronic suppurative otitis media

Postauricular abscess

Facial nerve paresis (paralysis of the facial nerve)

Labyrinthitis

Mastoiditis

Temporal abscess

Intracranial abscess

Meningitis

Cerebrospinal fluid (CSF) leak

Unfortunately, of these Hope developed one of the most severe complications:

An autopsy performed on March 26 at Lourdes Hospital in Binghamton, NY, conducted by Dr. James Terzian, indicated that the 18-month-old toddler had died of “streptococcus pneumoniae meningitis”, which caused a cerebral abscess and terminal cerebral edema. The meningitis reportedly originated in a left ear infection, which had been left untreated by conventional antibiotic therapy. Dr. Terzian noted “a simple antibiotic would have saved the victim’s life.” Based upon these findings, Bradford County Coroner Thomas Carman ruled the death as a homicide.

Yes, this child died of something that could almost certainly have been prevented with a bit of that old evil "Western medicine" in the form of amoxicillin. Moreover, the child was sick for approximately three weeks before her death, and, given the severity of her condition, likely suffered horribly, first from pain in the ear and then from the symptoms of advancing meningitis that led to an intracranial abscess and swelling of the brain. Given that the child was being treated with only homeopathic remedies, her illness and death proceeded without treatment even to ease her symptoms. The mother reported that her child had had fevers ranging from 99° to 103° F during that time with occasional vomiting. Five days before her death, the child started draining fluid from her ear, most likely from an ear abscess having ruptured through the tympanic membrane. Finally:

Delozier kept treating the child with natural and herbal treatments to boost her immune system. On the day of the toddler’s death, Delozier laid the little girl down for a nap. Roughly one hour later, she observed her daughter’s breathing to be labored and shallow, taking one breath approximately every 10 seconds. The toddler eventually stopped breathing and went limp. “I watched her die,” Delozier told police. She performed CPR on the victim for approximately 30 minutes, at which time Ebed Delozier arrived home and took the child to the emergency room.

By which time it was far, far too late to save Hope. After 30 minutes of CPR and a trip to the emergency room, she had almost certainly sustained, at minimum, severe neurological damage and was most likely dead by the time she reached the emergency room. Another thought comes to mind: WTF was Delozier thinking as her daughter's breathing slowed to 6 breaths/minute. Didn't she figure out that something was very, very wrong at that point? Her story implies that, at some level, she must have realized that something was very wrong. It's not clear how long she watched her daughter's breathing, but it sounds like the Cushing reflex, which occurs in response to increased intracranial pressure and involves increased blood pressure, lowered pulse, and slower, irregular breathing. Although I don't like citing Wikipedia for medical matters, the Wikipedia entry on the Cushing reflex has about as apt a statement of the significance of this finding as I've ever heard: "Whenever a Cushing reflex occurs, there is a high probability that death will occur in the near future (seconds to minutes). As a result, when a Cushing reflex is detected, immediate care is needed."

Of course, Delozier is not trained in medicine; so it's unreasonable to expect her to recognize the Cushing reflex or realize how serious it is when someone breaths like this, but even lay people know that breathing once every ten seconds is too little, particularly if it keeps slowing down. Certainly Delozier recognized that there was something badly wrong with Hope's breathing. If Hope had been taken to the hospital while still breathing, she might still have had a chance, although probably relatively small. Instead, Delozier did exactly as she stated, and we have no reason to doubt this part of her story. She sat there and watched her daughter die without intervening to try to stop the process.

Not surprisingly, Delozier distrusted "Western medicine," which meant she was also antivaccine:

Interviews conducted with Christine Delozier on March 24 and March 30 found that her child had been born at home without the use of a midwife and from there on, had never seen a medical doctor, nor did she receive any vaccinations. She said her views against modern medicine stem from her childhood as she was raised without taking pills or receiving shots. She told police she has done her own research on vaccinations and found they can be related to death, SIDS, autistic disorders, immune disorders and shaken baby syndrome. While her views are not religiously motivated, she said she does feel God is the ultimate healer.

So once again we see the toxic combination of fundamentalist religion and belief in alternative medicine resulting in the preventable suffering and death of a child who could have been saved with the fairly straightforward use of an antibiotic. True, in this case, religion appears to have played a supporting role rather than the primary role, but it's clear it was important. Be that as it may, unfortunately such is the power of beliefs like this that even now, three and a half months after Hope's death, Christine Delozier has learned nothing and knows nothing new:

Newswatch16 spoke with Christine Delozier at length at her home on Hiduk Road near Wyalusing. She declined to go on camera, but did explain her religious convictions, how she still mourns the loss of her daughter, and about her lack of trust in the American medical community. “If doctors expect people to trust them, they need to become trustworthy,” Delozier said. “People are a lot healthier in countries where doctors aren’t paid by patients.” With tears streaming down her face, she went on to say, “I believe the medical community is at least the third, maybe the first, leading killer in the United States.”

Wait a minute. What does she mean when she says people are a lot healthier in countries where patients aren't paid by patients? Does she mean countries like Canada or the U.K., which have single payer systems in which the government pays its citizens' medical expenses? It's a pretty safe bet that, had Hope been seen by a physician in Canada or England, for example, she would have been prescribed antibiotics and treated pretty much the same way that local pediatricians in Bradford County would have treated her. The treatment of otitis media is fairly standard. As for the trope that medicine is the leading killer in the US, to me it sounds as though Ms. Delozier has been reading too much Mike Adams.

The fact is that the Deloziers' extreme medical neglect killed their daughter. Period. Sadly, cases like this, though thankfully uncommon, aren't nearly as unusual as they should be in the US, where a warped view of religious freedom produces an extreme deference to religious beliefs as a justification for the medical neglect children.

In fact, when I first posted this on various social media, at least a couple of people responded by pointing out to me that cases like this aren't rare but that rather what is rare is that the parents are actually being charged with involuntary manslaughter and endangering the welfare of children. For example, in 2009 Catherine and Herbert Schaible let one of their children die at age 2 months of a treatable pneumonia, which had developed after a cold. Even though the child got sicker and sicker, they refused to take him to a doctor because of their religious beliefs. The courts, bending over backwards not to take the rest of their children away, put the Schaibles on probation and granted them custody if they would promise to take their children to the doctor when they are ill. In 2013, another of the Schaibles' children died in almost exactly the same manner, of pneumonia that developed after a cold. He was 7 months old.

Indeed, one can't help but wonder whether, if the Deloziers had asserted that it was their religious belief not to use doctors or medicine (as the Schaibles, who belonged to a church that explicitly forbade its members from using conventional medicine, did) rather than saying that she just didn't trust doctors and medicine, they would be facing the serious charges they're facing. As it is, I highly doubt the Deloziers will ultimately serve significant jail time even if convicted. Parents who kill their children through medical neglect like this rarely do. Whatever the case, the Deloziers' next court date is today.