Emma Joyce was 3 years old when she became sick at her family's farmhouse in rural Idaho. She vomited for days before she stopped breathing in her parents' arms in August 2009.
The next summer, her younger sister Ava Joan became sick too. The girl stopped eating, struggled to breathe and eventually began vomiting blood. She died at home from a complication of untreated diabetes.
Less than two years later, their toddler brother died from the same complication of untreated diabetes. Nine years after that, another brother died at age 4 following weeks of similar symptoms.
None of the four children had been taken to a doctor. Their parents told authorities that their religion forbade it.
They belonged to the Followers of Christ, a small Christian faith-healing movement with several congregations in Idaho. Members believe illness should be met with prayer and reliance on God rather than modern medicine. Idaho law gives parents who make that choice unusual protection from the child neglect laws that would normally apply when necessary medical care is withheld.
The four siblings are not isolated cases. In a new investigation, ProPublica obtained coroner and law enforcement records and had them reviewed by pediatricians and other medical professionals. The reviewers identified at least 15 children from Followers of Christ families in Idaho who died between 2015 and 2025 from conditions that appear to have been treatable. Antibiotics, insulin, oxygen and ordinary hospital care could have saved many of them.
The deaths leave Idaho facing a question that reaches far beyond one small church: Parents have broad freedom to raise children according to their faith. How far should that freedom extend when the religious decision could determine whether a child lives?
When Prayer Is the Treatment
The Followers of Christ emerged in Kansas in the late 1800s and today have congregations primarily in Idaho, with smaller communities in Oregon and Oklahoma.
Faith healing isn't their only distinctive practice. Followers traditionally use the King James Bible, practice adult baptism by immersion, engage in fasting and foot washing, and take literally the New Testament instruction to greet fellow believers with a "holy kiss." That last practice has earned members in some communities the sometimes-derisive nickname "Kissers."
Their rejection of most mainstream medicine is rooted in biblical passages instructing believers to trust God when illness comes. One of the clearest appears in the Book of James:
"Is any sick among you? Let him call for the elders of the church; and let them pray over him, anointing him with oil in the name of the Lord."
For many Christians, passages like this are an invitation to pray alongside medical treatment. For Followers of Christ, the implications are much more demanding.
Nathan Kangas, a patriarch in the church's Caldwell congregation, told investigators that children should be kept from doctors partly so they learn to rely on God when they become adults. Turning to medicine, in his mind, represents a failure of faith. Kangas knows the consequences personally: his wife and their final child died during childbirth, and three of his grandchildren have also died.
However, Kangas does not view these deaths as proof that the practice failed. Human beings cannot know God's reasons, he said. Earthly life itself is temporary preparation for what comes afterward.
"It isn't necessarily that we're supposed to have a joyous life here," he told ProPublica.
Spiritual healing itself is hardly unusual. Muslims may practice ruqyah, Hindu traditions include numerous spiritual approaches to healing, and Christians across denominations pray for the sick. Even Christian Science, famous for prayer-based healing, says members today are free to choose medical care. What sets the Followers apart is not believing God can heal, but expecting believers to refuse medical treatment when a life is endangered.
Growing Up With Death
Linda Martin grew up in the Followers of Christ in Boise. As a child, she remembers friends appearing at church one week and disappearing the next. When church elders gathered at a family's house, she came to associate it with another death.
Some of those deaths occurred in her own family. When recounting her story, Martin has described newborn cousins dying and a 2-year-old nephew dying from pneumonia without medical treatment. She left the church at 16 and has spent years since urging Idaho lawmakers to change the state's religious exemption laws.
"I represent myself and the children in my family," she told lawmakers in 2016.
Laren Eells left another Idaho Followers congregation much later in life.
As a boy, he watched his father survive what Eells believes was a ruptured appendix without medical care. That experience, he said, strengthened his belief that prayer was the answer.
Years later, his younger brother developed an ear infection, which subsequently spread into his bloodstream. Eells stayed beside him, "praying and wringing my hands," until his brother died.
Former members have described social consequences for seeking medical help, ranging from disapproval and exclusion from community gatherings to outright shunning. Kangas, in his comments to ProPublica, did dispute that shunning was common, although he acknowledged that a member who sees a doctor may be expected to repent and not do it again.
For parents inside the church, those expectations have often been there since childhood. By the time their own child becomes seriously ill, calling a doctor can mean defying both their religious beliefs and the community that shaped their lives.
Why Does Idaho Treat Prayer Differently?
Idaho law ordinarily requires parents to provide necessary medical care, but its child protection and criminal statutes contain religious exceptions. Parents who choose "treatment by prayers through spiritual means alone in lieu of medical treatment" cannot, for that reason alone, be considered neglectful or to have breached their legal duty to a child.
An Idaho court can authorize emergency medical treatment when a physician says a child's life is greatly endangered and the parents refuse treatment, but even then, the statute directs the court to consider spiritual treatment being provided by members of a bona fide religious denomination.
It Wasn't Always Like This
In 1915, state authorities investigated Followers of Christ member Lewis Annis after his 13-year-old daughter, Pearl, became gravely ill. A doctor and police officer found her near death at the family's home. Her father was arrested for refusing to allow his daughter to receive medical attention, and Pearl was taken to a hospital, where she died.
For decades, Idaho authorities could continue to intervene in cases like Pearl's, when parents chose prayer instead of medical care.
Then, in 1974, Congress passed the Child Abuse Prevention and Treatment Act (CAPTA). The intent of the law was to compel states to improve the reporting and investigation of child abuse, but the intervention of one group would change everything.
For decades, the Christian Scientists had advocated on Capitol Hill for legal recognition of prayer-based healing. While they weren't successful in actually getting a religious exemption written into CAPTA, they were able to convince the Department of Health, Education, and Welfare (the agency in charge of implementing the law) that Congress had intended for that protection to be included. Remarkably, the Department would adopt a policy that if a state did not include an exemption within its own laws barring parents from being charged with neglect for relying on prayer-based healing, that state would be ineligible to receive any of the federal grant money set aside to help combat child abuse.
With big bucks at stake, a wave of legislation was quickly passed in state capitols across the country establishing these protections.
Less than a decade later, the federal government reversed course. New regulations adopted in 1983 stopped requiring the exemptions, noting that Congress had never included one in the statute itself. Some states later narrowed or repealed their protections, while others retained them in varying forms.
Idaho chose to keep its exemption on the books.
That history matters because the current law is not simply the inevitable result of the First Amendment. The U.S. Supreme Court has long recognized both parental rights and religious liberty, but it has also recognized limits when children are involved. In Prince v. Massachusetts, a 1944 case involving a Jehovah's Witness child, the Court wrote that parents may choose martyrdom for themselves, but do not necessarily have the same freedom to make that choice for their children.
Across the Border, a Different Experiment
If Idaho lawmakers were curious how different the picture would look if they did change their law, they wouldn't have to look far.
Followers of Christ also live in neighboring Oregon. After a series of child deaths and prosecutions, Oregon began removing its religious exemptions in 1999. In 2011, lawmakers eliminated reliance on spiritual treatment as a defense to several crimes involving victims under 18.
The religion did not disappear. Families remained free to pray, anoint the sick and believe that healing ultimately comes from God. However, they would now face legal consequences if they did not seek mainstream medical care for their children when it was needed.
Oregon prosecutors and investigators told reporters that after the change, more Followers began taking seriously ill children to doctors. The possibility of legal intervention also gave authorities more ability to protect surviving siblings after one child became dangerously ill or died.
That leaves two neighboring states with communities practicing the same faith. One changed the rules; the other didn't.
Children continue to die from treatable illnesses on the Idaho side.
Whose Faith Is Being Protected?
An adult member of the Followers of Christ can understand the church's teachings, reject a doctor's advice, and accept whatever follows. Religious liberty protects choices that outsiders may consider misguided precisely because freedom of conscience means little if it covers only popular beliefs.
A newborn cannot meaningfully make that choice. Neither can a 3-year-old with diabetes.
And while the Followers may hold real and sincere beliefs in this area, there are also real consequences.
At Peaceful Valley Cemetery near Caldwell, children from Followers families lie in graves beside siblings, cousins and other members of the church. In some families, investigators found two, three or four children who died after medical care was withheld.
For the adults involved, those deaths may represent submission to God's will.
For Idaho, they present a question the state has postponed for decades:
Where should the law draw the line between a parent's sincere religious duty and a child's independent interest in lifesaving medical care?
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