The judge’s four-page decision, which was provided to the Globe, was remarkable for its detail and forcefulness. Johnston faulted Connecticut’s child protection agency for its failure to get involved in a case involving a child from its state, and faulted Pelletier’s parents for their verbally abusive manner and haphazard decision-making that he says has sabotaged plans to move their daughter closer to home.

The ruling by Judge Joseph Johnston means the 15-year-old will probably stay in state custody until her 18th birthday unless her parents can prove they are fit to care for their child.

A long-running child custody case took a dramatic turn Tuesday, when a Massachusetts juvenile court judge awarded permanent custody of teenager Justina Pelletier to the state Department of Children and Families.


Johnston wrote that the parents called Boston Children’s Hospital personnel Nazis “and claimed the hospital was punishing and killing Justina. Efforts by hospital clinicians to work with the parents were futile and never went anywhere.”

More recently, he wrote, “there has not been any progress by the parents. Rather, the parents . . . continue to engage in very concerning conduct that does not give this court any confidence they will comply with conditions of custody.” He noted that because of allegations that Justina’s father, Lou Pelletier, threatened a state social worker assigned to the case, the worker had to be reassigned.

Linda and Lou Pelletier with Justina in September. Family photo

In his ruling, Johnston, for the first time publicly, stated his belief that Pelletier suffers from “a persistent and severe Somatic Symptom Disorder,” a psychiatric diagnosis that doctors at Children’s reached in early 2013 when the girl was brought there because she had difficulty walking and eating. The parents objected to that diagnosis, leading to accusations of medical child abuse and setting off a monthslong battle over her care.

The Rev. Patrick Mahoney, of the Washington, D.C.-based Christian Defense Coalition, who has become the parents’ spokesman, said Tuesday that Lou and Linda Pelletier are “outraged” by the decision.


“There is no reason Justina should not be returned immediately back to the parents,” he said. Mahoney said the parents, who live in West Hartford, Conn., believe that their daughter is being “treated as a pawn and piece of property.”

The parents’ lawyer, Philip Moran, wrote in an e-mail to the Globe that the parents are too emotional to describe what their next steps will be, but may have more to say Wednesday.

“The decision is obviously devastating to the parents and according to them to Justina herself,” Moran wrote.

While the Department of Children and Families has had temporary custody of Justina since February 2013, the judge’s decision to award permanent custody gives the agency more confidence to make placement decisions with less fear of a quick change in custody. Though offering no timetable, agency spokeswoman Mary-Leah Assad issued a statement saying its goal continues to be “finding a solution that would allow her to return to Connecticut.” Pelletier is living at a residential facility in Framingham, Wayside Youth and Family Support Network.

“The department is exploring all options that will allow Justina to return to her home state where she has the support of her friends, family, school and community,” Assad wrote.

The judge’s ruling reinforces his earlier decision that the state child protection agency met its burden, during closed-door juvenile court hearings late last year, of proving the Pelletiers were unfit to handle their child’s complex needs and should not be restored custody of their child.


The legal burden now largely shifts to the parents to prove, with new evidence, that they are fit caregivers and deserve a new chance to regain custody. The parents are allowed to submit new information to the judge at most once every six months.

The judge made his custody order retroactive to Dec. 20, so a review could occur as soon as early summer.

Johnston also denied a request by lawyer Mathew Staver of Liberty Counsel in Florida to help represent the parents. Staver said he plans to take part in a plan to appeal Tuesday’s ruling on legal grounds, a process that he hopes might reverse the custody decision earlier than the summer.

In tone, Johnston’s ruling made it appear he had lost patience after trying for months to carefully orchestrate a resolution to a case that has drawn nationwide media attention.

Lou Pelletier has taken part in numerous national media interviews to condemn the Department of Children and Families and the judge and call for the return of his daughter. Since the start of the year, several conservative Christian organizations have gotten involved in defending the parents, seeing the case as an example of government interference in the sanctity of parental rights, and have instigated massive phone and letter-writing campaigns to the judge and other state officials.

Johnston wrote that the parents had repeatedly “impeded progress” in resolving the case. “Instead of engaging in quality visits with Justina, the parents use profanity directed at MA DCF personnel in Justina’s presence,” he said. “There is absolutely no meaningful dialogue by the parents to work towards reunification.”


Back in December, the judge suspended a decision over permanent custody while hoping to broker a compromise. He appointed a court investigator to advise him and come up with possible solutions.

At a hearing in February, the judge wrote, the parents agreed to a deal where Justina would be moved to a Connecticut program under the temporary custody of that state’s child-protection agency. But a month later, through Staver, they informed another lawyer in the case that they would accept no state oversight and would agree only to their daughter’s returning home.

Previous efforts to find a residential treatment center for Justina in Connecticut have failed, largely due to the reluctance of many providers to get involved in a high-profile controversy. One facility in Connecticut that had tentatively agreed to accept Justina last year balked after her father threatened to sue it.

Tuesday’s decision came in response to a motion, presented by the girl’s court-appointed lawyer and the lawyers for her parents, which called for the parents to be awarded “conditional custody” of their daughter.

The Department of Children and Families took emergency custody of the teen on Valentine’s Day 2013 after a diagnostic dispute arose between some doctors at Tufts Medical Center and Boston Children’s Hospital over the causes of her medical problems, including difficulty eating and walking.


Tufts doctors had been treating Pelletier for mitochondrial disease, a group of rare genetic disorders affecting cellular energy production, but physicians at Children’s concluded that her symptoms were largely psychiatric in origin. Her parents rejected the new diagnosis, and when they tried to move the girl back to Tufts, the Children’s team notified the state that it suspected the parents of medical child abuse.

Pelletier remained at Children’s for almost a year, most of the time in a locked psychiatric ward. Johnston wrote that the girl was ready to leave the hospital in June 2013 but could not be discharged because Massachusetts child-protection officials’ efforts to find a suitable placement “were significantly hampered by the parents.”

It was not until late January that she was moved to the Framingham facility.

Mahoney, the parents’ spokesman, said they are troubled that their daughter has yet to be seen by physicians at Tufts. Department of Children and Families officials said Pelletier’s visits at Tufts will take place soon, now that the parents “reached an agreement” with Tufts over a number of issues.

Neil Swidey of the Globe staff contributed to this report. Patricia Wen can be reached at patricia.wen@globe.com. Follow her on Twitter @GlobePatty.