State v. Hickman
| Citation | 358 Or 1 |
| Decision Date | 08 October 2015 |
| Docket Number | CA A150127,CC CR1001094,SC S061896 (Control),CA A150126,CC CR1001093,No. 37,SC S061902,37 |
| Parties | STATE OF OREGON, Respondent on Review, v. SHANNON MAE HICKMAN, Petitioner on Review. STATE OF OREGON, Respondent on Review, v. DALE RYAN HICKMAN, Petitioner on Review. |
| Court | Supreme Court of Oregon |
En Banc
On review of an order of the Court of Appeals.*
Bronson D. James, Portland, argued the cause for petitioners on review and filed the briefs for petitioner on review Shannon Mae Hickman.
Ryan E. Scott, Scott & Huggins Law Offices, Portland, filed the brief on behalf of the petitioner on review Dale Ryan Hickman.
Cecil Reniche-Smith, Senior Assistant Attorney General, Salem, argued the cause and filed the brief for respondent on review. With her on the brief were Anna M. Joyce, Solicitor General, and Ellen F. Rosenblum, Attorney General.
Timothy R. Volpert, Davis Wright Tremaine LLP, Portland, filed a brief on behalf of amicus curiae The American Civil Liberties Union of Oregon. With him on the brief were Kimberly L. McCullough and Kevin Diaz.
The decision of the Court of Appeals and the judgment of the circuit court are affirmed.
Defendants Dale and Shannon Hickman were convicted of second-degree manslaughter (ORS 163.125) after they declined to seek medical treatment for their son David, who died about nine hours after he was born prematurely. Defendants are members of the Followers of Christ Church. That church encourages its members to rely on God to heal sickness and injury, and considers resorting to conventional medicine as a failure in faith. At trial, defendants argued that, because they withheld medical treatment from David based on their religious beliefs, the Oregon Constitution requires the state to prove that they acted "knowingly"—that is, they knew that David would die if they relied on prayer alone and, despite that knowledge, failed to seek medical treatment for him. The trial court disagreed and allowed the state to proceed on a theory of "criminal negligence," consistently with the statute defining second-degree manslaughter by neglect or maltreatment. The Court of Appeals summarily affirmed. We granted review to consider whether the state must prove that a criminal defendant acted with "knowledge" that an unlawful result would follow when that defendant's conduct was motivated by a sincerely held religious belief. For the reasons explained below, we conclude that it does not.
Defendants Dale and Shannon Hickman have been lifelong members of the Followers of Christ Church. That church—drawing from the Christian Bible's descriptions that Jesus and his disciples, rather than doctors, healed the sick and disabled—instructs its members to rely on "faith healing" and to eschew conventional medicine. For the Followers of Christ, faith healing entails prayer, anointing the sick with olive oil, or the laying on of hands. Those practices derive most directly from a passage in the New Testament, which provides:
James 5: 13-16 (The New English Bible (1970 ed)). Accordingly, other than visiting a dentist and an optometrist, at the time of trial defendants had never seen a doctor for the purpose of receiving medical treatment or advice.1 But defendants did not reserve the faith healing practice for themselves—they also used it to address their children's medical ailments. That decision—to pray for their children's health and well-being instead of taking them to the doctor—is what gave rise to the circumstances that led to this case.
Shannon was between 30 and 32 weeks pregnant when she began experiencing labor pains.2 As was custom in the Followers of Christ community, Shannon went to her parents' home to deliver the child. Three women in the Followers of Christ community attended to the birth. Dale, along with several other family members, was also present in the birthing room. According to Shannon, the delivery was quick but was similar to that of her daughter, who had been born at full-term and without complication. After David was born, several women from the church—including David's grandmothers and great-aunts—cared for him. To keep David warm, they took him into the bathroom, where they had the heater turned on high, and wrapped him in towels and blankets that they had warmed in the dryer. They "downsized" diapers and a beanie hat to fit him and fed him using an infant spoon to pour breast milk into his mouth.
Despite knowing that David was around two months premature, neither defendant—according to their testimony—thought that David was or would soon be in physical distress. Aside from David's tiny size—he weighed three pounds and seven ounces—defendants believed that he was healthy: They testified that he had a strong cry, his whole body was pink, and he was able to pump his arms vigorously. But David was not healthy and was not thriving. He died a mere nine hours after he was born.
Although the medical examiner initially suspected that David had died from sepsis caused by Group B streptococcus, the laboratory results did not support that conclusion. Instead, the Oregon State Medical Examiner's office determined that the cause of David's death was staphylococcus pneumonia, with other significant conditions being pulmonary immaturity and chorioamnionitis. The medical examiner found no evidence of sepsis, congenital anomalies, or asphyxiation. Drawing from different aspects of the medical examiner's report, the parties presented two different theories for the cause of David's death.
According to defendants, David was lively, pink, and vigorous until moments before he died. In those final moments, David's great-aunts were caring for him while defendants were asleep. One of the aunts awoke Dale after they noticed that David was "fading," both in color and in the muscle tone of his face. As one of them described it, David had "[j]ust a different look in his face," which led them to believe that he was "going very quickly." Dale ran into the room where one of his aunts was holding David and anointed David's head with olive oil and began to pray. He noticed that David was taking short breaths, was minimally responsive, and was lighter in color, so he took David into the bedroom where Shannon still lay. At that point, it was "in the back of [Dale's] mind" that David would not survive. He sat in a chair by the bed, held David in his arms, and prayed. According to Shannon, when she sat up and looked at David, he "didn't look like the baby [she] had seen a couple of hours before." He was pale and, from the time he entered the room until he died, she believed she heard him breathe only once or twice. Over the next few minutes, David turned blue, then gray. Dale believed that it was about five to tenminutes from the time his aunts woke him until David died; Shannon believed it was about five minutes.
In defendants' view, David's symptoms were consistent with early-onset sepsis, an infection in the bloodstream that is often fatal. Although defendants recognized that the medical examiner's laboratory results did not support that conclusion, they argued that both Shannon and David had physical symptoms that supported a finding of early-onset sepsis. First, they pointed to the medical examiner's conclusion that chorioamnionitis was an "other significant condition" contributing to David's death. Chorioamnionitis is a condition that affects the mother and can cause preterm labor. Specifically, it is an infection of the two layers of the amniotic sac—the chorion and the amnion—that can spread and infect the unborn child. If the infection spreads to the child, it can lead to early-onset sepsis. Second, defendants relied on another doctor's testimony that infants who have early-onset sepsis can appear to a lay person to be in perfect health, but then suddenly "drop off the cliff" and die shortly thereafter, as defendants contend happened with David.
According to the state, defendants' theory that David was perfectly healthy and then suddenly developed symptoms within 15 minutes of his death made "no biological sense." Instead, the state urged that David struggled to stay alive from the moment he was born, due to complications that resulted from his prematurity. The state's expert witnesses testified that an infant born at 30- to 32-weeks gestational age has a greater than 90 percent chance of survival if he receives medical treatment; however, without medical treatment, he has "zero" chance of surviving. That is so because preterm infants have underdeveloped organs. Specifically, an infant born at 30- to 32-weeks gestational age, like David, is likely to have pulmonary immaturity, i.e., underdeveloped lungs, compounded by a lack of body fat to regulate the infant's temperature. Infants born at that gestational age also might not have developed the ability to suck and swallow, causing them to have trouble eating on their own.
Doctors who testified for the state were able to watch a video of David that family members recorded aboutone hour after he was born. The doctors noticed that, in that video, David's chest was retracting, a sign that he was having to rely heavily on his chest muscles to breathe; they also noticed that he was grunting, indicating that he was continually trying to open his airways. Both retractions and grunting are classic signs of respiratory distress. The doctors observed that David had a strong cry, but that did not alter their assessment that he was in...
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