Science, religion and a dying baby

What drove Jan and Deborah Moorhead to refuse life-saving treatment for their baby son? HERALD REPORTERS investigate.

When Starship children's hospital paediatrician Dr Patrick Kelly saw Caleb Moorhead for the first time, he knew he didn't have long.

The 6-month-old baby was strikingly pale and neurologically abnormal, with developmental levels of a 6-week-old.

He was severely anaemic and had severe shrinkage of the brain.

Kelly, who specialises in dealing with child abuse cases, was so worried about Caleb's condition and the lack of understanding shown by his parents, Jan and Deborah Moorhead, that he contacted Child, Youth and Family Services (Cyfs) the next day to arrange a court order to remove Caleb from them if it became necessary.

Kelly explained the situation, including the court order, to the Moorheads, who asked for time to think about it.

Then they picked up Caleb and fled.

Charge nurse manager Julie Thompson saw them going and followed them outside. She asked if they realised their baby could die if they took him home. Deborah told her everything would be alright.

That night social workers went to the family's house in Dargaville but the Moorheads never came home.

Five days later, Kelly got a phone call from Catherine Curtis-Rangihau, a friend of the family and a social worker for Cyfs in Whangarei. She had persuaded the family to return to the Starship.

At the meeting, Kelly - who believed that Caleb's brain damage was irreversible - told the Moorheads their son would need an MRI (magnetic resonance imaging) scan, probably under a general anaesthetic.

The couple were worried about the anaesthetic. Eager not to lose their co-operation, Kelly talked through some possible compromises and the Moorheads agreed to call him back that night. They never did.

It was a busy week for Kelly. On Friday, he finally made it to the library, sat down with some books and "the penny dropped".

Because of her vegan diet, Deborah Moorhead lacked vitamin B12, which most people get from bacteria on animal products. The vitamin is vital for growing newborn babies' brains.

Most newborn babies are born with enough stores of B12 in their liver for three to six months, at which point they start eating meat solids.

But a blood test during pregnancy had confirmed Deborah Moorhead had low B12 levels. Caleb was running out of the essential vitamin and his mother's breast milk was not an adequate substitute.

Kelly now knew that an injection of B12, followed by daily supplements, could not only save Caleb's life, it could probably partially reverse his brain damage.

He rang Jan Moorhead three times that day, leaving messages on his mobile phone, which always went unanswered.

On Monday, Tuesday and Wednesday of the following week he rang again.

Jan called him back once and left a message but Kelly, who kept playing the game of telephone tag, doesn't think there was any last-minute change of heart. More likely, he thinks, Caleb's ever-polite but uncompromising father was just ringing to say "thanks, but we're fine".

Meanwhile, the police, led by Detective Sergeant Christopher Scahill, had made some progress in their search for the Moorheads.

For several days police had watched the couple's bank accounts and Eftpos cards without success and visited their home to check if they had returned.

But a trace on Jan Moorhead's mobile phone had tracked it to a repeater station covering part of Pukekohe and Bombay. That still left about 2000 homes to search.

Scahill says that by March 29 police were in the planning stages of a house-to-house search. "It would have been a couple of days before we could have marshalled the resources."

It was too late. In the early hours of that morning, Deborah and Jan Moorhead woke to hear Caleb breathing heavily as if he was having an asthma attack.

They tried one of their usual alternative remedies - cayenne pepper up his nostrils to stimulate breathing. An hour later, they noticed his lip quivering.

Deborah Moorhead later told the police: "We looked at each other trying to decide what to do and he took his last breath."

Kelly told the court Caleb's life could have been saved up until half an hour before his death if his parents had phoned for an ambulance.

Looking back on the case, he says he doesn't know what more he could have done - except perhaps arrange with the police to have Jan Moorhead followed when he returned to the Starship.

N OT so many years ago Jan Moorhead was a successful, hardworking man with a big house and a swimming pool in rural Dargaville.

Like many Kiwi blokes, the earthworking contractor lived on a diet at dinner time of meat and three vegetables.

Then he left his wife and two children and moved in with Deborah Murray. His ex-wife, Deborah Downey, says her husband of 15 years turned into a different man.

From a workaholic, bulldozing expert who liked to say "religion is for suckers", he became a deeply religious vegan.

He cut his hair short and ate only the fruit and vegetables the couple grew. Breakfast was porridge with nuts and mealtimes were at 9am and 3pm only.

For Downey, the most hurtful thing was the way Jan's new wife tried to turn her daughters - now 13 and 14 - against her, telling them that her mother was evil.

"Everything was to do with Satan," she says. "For the girls it was quite upsetting.

"They weren't allowed to play and had to have Bible lessons. They had to eat the food and they hated it."

Downey says that when she and Jan were together the Moorhead name was well respected in town.

She is supported by the Snooks family, who lived across the road for 36 years running the business Snooks Custom Killing, and describe Jan at the time as a very loving and hard-working father.

Jan's father, Trevor Moorhead, who used to live next door to his son and his first wife, says he liked his son's former wife.

"I used to get on good with her. I wished he stayed with her."

Downey says that after a trip for about three months to America with members of the Seventh-Day Adventist Church the couple's beliefs became more intense.

Trevor Moorhead says he noticed a number of changes. The biggest was that Jan became withdrawn and hard to talk to.

Then the couple moved, because Deborah Moorhead did not want to live in such a large, elaborate house.

They found a small cottage at the end of the muddy Awakino Rd.

On September 3, 2000, Jan and Deborah had a son together and the family's problems turned to tragedy.

When Caleb was born he was described as a "thriving, bonny, healthy boy".

But from 3 to 6 months he developed a bad rash, a terrible cough and looked pale.

Deborah Moorhead wrote notes about his condition: "Worried, worried, could die". Her mother, Mary, urged her to take Caleb to a doctor but the couple refused.

Eventually, in March last year, they took him to a GP, who referred them to the Starship on March 14.

The Moorheads went reluctantly but over the next few weeks their faith overwhelmed any belief in the doctors.

A leading medical ethics specialist says the case shows the growing difficulties doctors face in taking legal action against parents who refuse to take adequate care of their children.

Professor Don Evans, director of the bioethics centre at Otago University, says doctors regard court orders against parents as an absolute last resort. "There's a huge price to be paid for that last step. It pretty well destroys any collaboration for the future between parents and health carers."

As a result, Evans says, doctors will bend over backwards to co-operate with parents' reservations. They will also tend to back down more if the disease is not life-threatening.

But recent life-or-death cases - notably Liam Williams-Holloway, the Laufau family and now the Moorheads - threaten this approach and the legal assumption that parents will always act in the best interests of their children.

Over the past few years health authorities have changed their minds about when they should step in. Otago health officials obtained a court order to treat Liam Williams-Holloway's cancer with chemotherapy, which caused a national uproar.

Starship doctors backed off these tactics in the Laufau case two years ago, partly because they were afraid the public would react as they did in the Williams-Holloway case.

In the same year they tried to get guardianship for a 6-year-old boy with cancer, but his parents reacted by taking him to the Cook Islands.

Despite these setbacks, Starship doctors, social workers and police combined to try to seize Caleb - but were too late.

RECENT TUG-OF-WAR CASES

Liam Williams-Holloway: Three-year-old Liam's parents refused chemotherapy treatment for their son's cancer and said they would pursue alternative treatments. In 1999 health officials forced him to have chemotherapy through a court order which gave the courts guardianship over Liam. His parents went into hiding for four months, setting off a national debate about conventional versus alternative treatments and the rights of doctors or parents to decide what is best for a child. The Otago family eventually went to Mexico, where Liam died, aged 5, at an alternative healing clinic in October 2000.

Tovia Laufau: The 13-year-old Mangere boy died from a cancerous tumour on his leg which weighed 15kg and had spread to his lungs. Despite warnings that the cancer would kill him, his parents, Peni and Faafetai Laufau, refused medical help. They said Tovia was too scared to return to hospital and was old enough to make his own decision. A High Court jury disagreed. In August 2000 it found the parents not guilty of manslaughter but guilty of failing to provide the necessaries of life. They later received a 15-month suspended prison sentence. Starship Hospital admitted in court that it did not try to get a court order to take Tovia from his parents. Doctors said they did not want to alienate the family and were worried after the public fallout from the Liam Williams-Holloway case.

Unnamed Cook Islands boy: It emerged during the Laufau case that the hospital had tried to win legal guardianship over a 6-year-old boy, whose parents then fled to the Cook Islands. Surgeons removed a brain tumour but his parents objected to the follow-up radiotherapy on religious grounds and because their son feared he would die if he was put back into the CT scanner machine. Five months later his tumour grew back. His mother rushed him back to hospital but he died in July 2000.

Laura Boomsma: Two months ago, Australia had its own version of the Liam Williams-Holloway case. Five-year-old Laura, from New South Wales, was diagnosed last November with a rare tumour in her right kidney, which was removed in January. When her parents objected to post-operative chemotherapy, Brisbane's Royal Children's Hospital took them to the Queensland Supreme Court. The case lapsed when the family went to London for alternative treatment.

Reporting team: Bridget Carter, Tony Stickley, Scott Inglis, Andrew Laxon

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