Q&A: The Spirit Seizes You and You Fall Down
The Spirit Seizes You and You Fall Down
Question
I’m in the middle of reading the book The Spirit Catches You and You Fall Down by Anne Fadiman. The book deals with a family from the Hmong tribe who immigrated to the United States and are coping with raising an epileptic daughter.
The book discusses the gap between the tribe’s traditional pagan view of treating illness (idolatrous remedies, sacrifices to spirits) and the American doctors, who are convinced of the exclusive effectiveness of conventional medicine. The tribe members barely understand English, do not trust the doctors, and therefore do not follow their instructions.
The book deals with many episodes surrounding this issue, and the main characters are, as stated, the family with the daughter who suffers from a very severe epileptic illness. The authorities intervene and place the daughter in foster care.
And here the moral question arises: do the authorities have the moral right to intervene in such extreme cases and ensure the child’s life is saved?
Do doctors have the moral right to refrain from certain treatments that seem very unacceptable to the tribe, in order to gain its trust in the hope that over time it will agree to all forms of treatment?
Answer
What would you say about parents who want to murder their child? Should they be allowed to do that too?
The line between giving parents autonomy over their child and society’s intervention is a fine one, and I don’t know how to give clear criteria for it. Where it is clear to us that the parents are mistaken, there is room for intervention. Where we have an opinion but it is possible that they are right, I would not intervene (as in today’s controversy over childhood vaccinations). Where the dispute is about values and not facts, there is less room for intervention (as, for example, in Haredi education, where they understand that they are not giving children economic training, but that is their value system. One can and should, of course, refrain from funding them and instead let them bear the consequences of their decisions).
As for the decision whether not to intervene in order to gain their trust—that really is a difficult question. On the face of it, one life is not set aside for another. On the other hand, society does make such decisions; for example, it sends soldiers into battle to die in order to save others, or it invests money in various goals and does not provide a response for some patients even when there is mortal danger. Especially since I am not killing the children but only not saving them, there is more legitimacy to such decisions.
Discussion on Answer
This is not a question of authority but of the child’s best interest. The authorities are acting here on his behalf (as his guardian). In more minor matters, the authorities are not supposed to intervene even though they think differently. So there is no comparison here between their authority and the parents’ authority.
I understand that in a case where the treatment definitely saves lives, in your opinion one should intervene?
The question is also what the supreme value is for a moral person. Is saving lives the supreme value, or is it causing the greatest happiness for as many people as possible?
In the present case, we have before us a group of tens of thousands of people who know our arguments, and nevertheless do not accept them. They tell us: we do not want your life-saving treatments—not when our children are in distress, and not when we ourselves are in distress. Your treatment only causes us sorrow, tears apart the tribal hierarchy, and rouses the demonic forces that will endanger us even more.
If the patient were an adult and he refused treatment that would definitely save his life, would you force it on him? I assume not. So does the fact that he is only a child mean that the authorities have greater standing toward the child than the parents do?