Washington Custody Battle Tests Roles

To her defenders, Tina Carlsen was a concerned mother exploring natural alternatives to surgery for her 9-month-old infant. To the state, she was a kidnapper who prompted an Amber Alert and an order restricting contact with her toddler until after her trial.

Carlsen was charged with second-degree domestic-violence kidnapping last month after she slipped baby Riley out of a hospital in a diaper bag to avoid surgery ordered by his doctors and a judge. The case has put her at the center of a battle testing the rights of parents and the roles of doctors and judges in disputes over children's medical treatment.

State judges can override a parent's wishes concerning such treatment, but the child's life typically must be in imminent danger.

"It's a difficult balancing act for states and courts," said Steve Calandrillo, a University of Washington law professor who specializes in debated areas of medicine. "Parents are generally given considerable latitude in their decisions before a state will interfere."

Riley was born with poorly functioning kidneys and will likely need a kidney transplant in the future. His doctor wanted to prepare him for dialysis by surgically implanting equipment to connect him to a dialysis machine. His mother, whose family has a history of kidney disease, questioned why the operation and the dialysis could not wait until the procedures were really needed.

Carlsen's doctor alerted Child Protective Services at least three times after Carlsen sought to treat her son with natural remedies instead of surgery. The child's parents asked to see another physician, but Dr. Nicole Becker stayed involved, according to Carlsen's attorney, Michael Shipley.

"I was told when he was three days old, 'You can start emergency dialysis now or take him home and let nature take its course,'" Carlsen told reporters Friday after a court hearing.

When Carlsen sneaked her child out of the hospital on June 22, doctors did not believe Riley's condition was life-threatening, but they feared it would worsen.

After the child disappeared, authorities issued an Amber Alert and spent two days searching for the pair. They were found about 50 miles south of Seattle.

Shipley said Carlsen was not given enough latitude to care for her son as she wished. He has represented families in two similar cases involving Riley's physician.

Shipley said he recognizes Becker was "not doing this out of maliciousness. I know she's doing it out of a care for her young patients."

But, he said, Becker has unfairly drawn a battle line against alternative therapies. A spokeswoman for Children's Hospital said Becker declined to be interviewed.

Carlsen, 34, returns to court Thursday to seek custody. "He's my baby. I'm going to fight until I die," she said.

Calandrillo said parents have a fundamental right to a relationship with their child "and the state must bear the burden of interfering with that right."

"Parents get quite a lot of latitude," he said.

Nancy Sutton, interim regional administrator for the state Department of Social and Health Services, said her agency's mandate is clear: to protect children.

Decisions about whether to get the courts involved do not happen without debate, she said.

"These aren't clear cut, and these aren't situations where one social worker works in isolation according to how she's feeling that day," Sutton said.

The president of a group that advocates for patients' rights said alternative treatments are "going to become a much bigger issue" as patients increasingly consult online medical information.

"We've talked with Tina extensively about the doctor being dismissive of her beliefs," said Kelly Meinig of Citizens for Safe Birth, a Seattle-based group that has advocated on Carlsen's behalf. "People now have power to access information, and they want to talk to their care providers about it."

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On the Web:

Advocates for Baby Riley: http://www.helpbabyriley.com