These exemptions also have discouraged reporting and investigation of religion-based medical neglect of children and spawned many outbreaks of vaccine-preventable diseases and deaths.

[3] According to the National Association of Counsel for Children, which gave an award to Rita Swan for her efforts, "Due in large part to CHILD's efforts, Colorado, Massachusetts, Maryland, South Dakota, Hawaii, and Oregon have removed laws which provided exemptions from prosecution to parents who fail to provide medical care for their sick children based on religion".

Parents belonging to various religions, in particular Christian Science, have used these exemptions as legal defenses in criminal cases for failing to provide medical care for children who then died.

[10] In 1998, Rita Swan and Seth Asser published a benchmark study in Pediatrics that analyzed 140 child deaths in which medical treatment was withheld.

[18][19] The Swans filed a wrongful death suit against the Christian Science Church in 1980, but it was dismissed on First Amendment grounds, and the U.S. Supreme Court declined to hear their case on appeal.

[8][20] In 2000, CHILD sued the director of the Centers for Medicare and Medicaid Services and the Secretary of the U.S. Department of Health and Human Services (Children's Healthcare Is a Legal Duty, Inc. v. Min De Parle), over federal healthcare monies being directed to Christian Science facilities and others that provide no medical treatment.