IN THE INTEREST OF: A.W., JR., S.W., J.W., AND M.W., : MINOR CHILDREN APPEAL OF: A.W., SR., FATHER, AND T.A., MOTHER
from the Order Entered December 14, 2016 In the Court of
Common Pleas of Philadelphia County Family Court at No(s):
CP-51-DP-0001514-2016, CP-51-DP-0001515-2016, FID#
BEFORE: BOWES, J., OLSON, J., and NICHOLS, J.
Sr. ("Father") and T.A. ("Mother")
(collectively, "Parents") appeal from the order
entered on December 14, 2016, wherein the juvenile court
directed the Philadelphia Department of Human Services
("DHS") to fully vaccinate and immunize
Parents' four minor sons: S.W., A.W., Jr., J.W., and M.W.
juvenile court summarized the relevant factual history of
this case as follows.
On July 9, 2016[, ] DHS received a Child Protective Services
(CPS) report alleging that A.W.[, Jr., born August 2010, ]
was hospitalized at the Children's Hospital of
Philadelphia (CHOP) and was diagnosed with a rare form of
epilepsy named, "Refractory Epilepsy." The family
was visiting an unidentified person in Lehigh County when
A.W.[, Jr.] had a seizure and was transported to a hospital
in Lehigh County and [then] transferred to CHOP. Mother
refused medical treatment for A.W.[, Jr.] because she
believed the anti-seizure medication prescribed to A.W.[,
Jr.] was increasing his seizures. Mother attempted to remove
A.W.[, Jr.] from CHOP. CHOP staff would not allow Mother to
remove A.W.[, Jr.] as it would have endangered A.W.[,
Jr.]'s life not to receive the prescribed medication. The
report stated A.W.[, Jr.] resided in the state of Delaware.
The report stated the family had an open case in Lehigh
County Children and Youth Services (CYS).
On July 10, 2016, D[H]S received a supplemental report
alleging that A.W.[, Jr.] was having increased seizure
activity. CYS previously had physical custody of A.W.[, Jr.]
and returned physical custody to Mother on July 5, 2016[, ]
to make medical decisions for A.W.[, Jr.]. Mother continued
to refuse treatment on the evening of July 9, 2016[, ] as
A.W.[, Jr.] suffered increased seizures. The report further
stated that if Mother continued to refuse medical care for
A.W.[, Jr.], he would suffer either neurological damages or
sudden death. The report stated between the evening of July
9, 2016[, ] and the morning of July 10, 2016, A.W.[, Jr.]
experienced at least 42 seizures. As a result of the 42
seizures, A.W.[, Jr.]'s medical status had deteriorated.
A.W.[, Jr.] was moved to the Pediatric Intensive Care Unit
(PIC) and was intubated.
Juvenile Court Opinion, 11/1/17, at 1-2.
10, 2016, DHS obtained an Order of Protective Custody
("OPC") for A.W., Jr. Approximately one week later,
DHS filed a dependency petition, and a hearing was held on
July 19, 2016. At the hearing, the court discovered that
A.W., Jr., had three other siblings who were in need of
medical treatment. Specifically, it was noted that A.W.,
Jr.'s, siblings had extensive dental issues. At the
conclusion of the hearing, the juvenile court adjudicated
A.W., Jr., dependent pursuant to 42 Pa.C.S. § 6302(1)
and ordered that DHS investigate the condition of A.W.,
immediately obtained protective custody of S.W., J.W., and
M.W., who were born October 2007, December 2010, and January
2013 respectively. DHS filed a dependency petition on July
29, 2016, and following a hearing, the juvenile court
adjudicated S.W., J.W., and M.W. dependent.
December 14, 2016, the juvenile court held a permanency
review hearing, wherein it ordered S.W., A.W., Jr., J.W., and
M.W. to be fully vaccinated and immunized to ensure their
day-to-day medical needs. Parents objected to the
vaccinations, noting that they preferred their children to be
treated through natural modalities, such as marijuana. That
same day, the juvenile court held a hearing on the matter to
allow Parents to state their opposition to the vaccinations
on the record. At the hearing, DHS presented the testimony of
Peaches Mulba, the caseworker assigned to the family, and
Laura Simon, M.D., A.W., Jr.'s, attending physician and
an expert in pediatrics. Parents did not present any
testimony; however, counsel summarized their opposition on
the record: "[My] clients believe that the interference
with the immune system is unnatural and it's not well
understood and not tested for long term safety. And
that's a moral and philosophical reason not to have an
immunization." N.T., 12/14/16, at 10.
Mulba testified regarding her conversations with Mother about
vaccinating the children, and specifically, A.W., Jr. She
stated, "Mom said that she wasn't going to get -
they wasn't going to get vaccination to [A.W., Jr.]
because that is one of the reasons that keeps him in the
hospital and this [way] they can be with him." N.T.,
12/14/16, at 18. On cross-examination, Ms. Mulba elaborated,
"Mom said that the vaccination wasn't good for the
children. It's just not good for the immune system[, and]
because of that they wasn't prone to sign for
vaccinations for any of [the children]." Id. at
Simon testified to her opinion that immunizations are
generally accepted as safe and effective, with minimal risk.
N.T., 12/14/16, at 34. Likewise, Dr. Simon noted that she
recommends immunizations to all of her patients. Id.
Dr. Simon expressed concern that there are a large number of
vaccine-preventable diseases that can cause chronic illness,
disability or death. Id. As it relates to A.W., Jr.,
Dr. Simon explained that because of A.W., Jr.'s increased
risk of disability due to his seizures, she recommended that
A.W., Jr., be fully immunized. Id. at 38, 41. Dr.
Simon testified that as A.W., Jr., approaches school-age, his
risk of contracting a vaccine-preventable disease increases
as he attends daycare or school. Id. at 41.
Dr. Simon also recommended that S.W., J.W., and M.W. be fully
vaccinated. Like with A.W., Jr., Dr. Simon explained that the
other children, if left unvaccinated, would be at a higher
risk of contracting vaccine-preventable diseases and could
suffer from more severe reactions or illnesses if they were
to contract a disease. Id. at 42. Further, Dr. Simon
cautioned the court that if any of A.W., Jr.'s, siblings
were to ...