PHILADELPHIA (AP) — A Philadelphia couple who believe in faith healing over medicine and who were on probation in their son's pneumonia death were charged with murder Wednesday after a second young child died under what a prosecutor called "eerily similar" circumstances.

Herbert and Catherine Schaible ignored a court order to seek medical care if their children needed it, prosecutors said Wednesday. The requirement was a condition of the probation sentence they received after the death of their toddler son four years ago.

First Assistant District Attorney Ed McCann says the Schaibles are entitled to their religious beliefs — until it endangers their children.

"How many kids have to die before it becomes extreme indifference to human life?" McCann said in announcing the charges. "They killed one kid already."

The Schaibles are members and former teachers at the fundamentalist First Century Gospel Church in northeast Philadelphia. The church's website quotes Bible verses purportedly forbidding Christians from visiting doctors or taking medicine and suggests it's a sin to trust in medicine over faith.

Catherine Schaible declined to comment earlier Wednesday, before the arrest warrants were issued. Defense lawyers call the couple loving parents who did not intend for their sons to die.

A jury had convicted them of involuntary manslaughter and child endangerment after the 2009 death of 2-year-old Kent, who had been sick for about two weeks. Brandon Schaible died of pneumonia in April after suffering from diarrhea and breathing problems for at least a week, and refusing to eat.

"The circumstances are eerily similar," said Assistant District Attorney Joanne Pescatore, who handled the first trial and pushed for prison time because she feared the couple would not follow the court's order on medical care.

A conviction on the new case could bring seven to 14 years in prison or more, prosecutors said.

About a dozen children a year die in the U.S. when their parents choose prayer over medical care, according to Shawn Francis Peters, a University of Wisconsin lecturer who wrote "When Prayer Fails: Faith Healing, Children and the Law."

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In a handful of cases, the parents later watch a second child die.

"One of the building blocks of our legal system is the idea that people will be afraid of being punished," Peters said. But people who trust in faith healing fear "a different kind of punishment," he said. "It's not an earthly punishment meted out by the state of Pennsylvania. It's punishment going to be delivered by the Almighty on Judgment Day. It's difficult to find a legal regime that can change that."

The Schaibles, who quit school after ninth grade, have worked as teachers at their church. They are in their mid-40s, and their oldest child will soon turn 18. Their seven surviving children were placed in foster care after a parole violation hearing last month, when a judge rebuked them for failing to seek medical care for Brandon.

"I am sorry for your loss. Deeply sorry," Common Pleas Judge Benjamin Lerner told the couple. "But in all honesty, I am more sorry for the fact that this innocent little child will not be able to grow up to be what he wanted to be."

Catherine Schaible's public defender, Mythri Jayaraman, said Brandon had seen a doctor at least once in his life.

"When he was 10 days old, he had been taken to a doctor for a checkup, and to make sure everything was OK. We don't know beyond that," Jayaraman told The Associated Press.

Bobby Hoof, the lawyer who represented Herbert Schaible in the earlier case, described the couple as loving parents who grieved over Kent's death.

"He's a father just like the rest of us. He loves his children, wants to see them educated," said Hoof, who does not know if he will be appointed in the new case. "It's hard to indict someone for what they believe."