A BOSTON jury convicted David and Ginger Twitchell of manslaughter this week in a troubling case involving the death of their 2 1/2-year-old son Robyn. The Twitchells are Christian Scientists who believe that prayerful intervention is preferable to medical care. Although their church does not prohibit members from seeking the assistance of doctors, such a step is generally considered a last resort. When Robyn became ill, the parents called on a Christian Science practitioner, who prayed with the family for the baby's recovery. After five days the child died. An autopsy revealed he had a bowel obstruction, a condition that doctors say could have been cured by surgery. The Twitchells, who protested that they did not comprehend the seriousness of Robyn's condition, were then indicted for manslaughter, a charge that requires a finding that they acted "with reckless and wanton disregard for human life".

American courts have repeatedly held that a child's welfare cannot be held hostage to his parents' religious convictions. Sects cannot justify on religious grounds the severe beating of children or their exposure to life-threatening snakes or poisons. Nor can they withhold food, blood transfusions or other medical care when life is at stake. But can they choose one kind of action (prayer) over another (surgery) without running the risk of criminal prosecution?

Perhaps the Twitchells thought they could. Both state and federal law provide a number of exceptions for Christian Scientists that could lead parents to believe their conduct had official sanction. Massachusetts and more than 40 other states, for example, specifically exempt parents from criminal liability if their children are harmed because they chose religious healing over medical care. Federal child abuse laws contain the same exemption. Many state Medicaid programs and most large insurers reimburse Christian Science practitioners as they do doctors. Private payments to practitioners are deductible as medical expenses under state and federal income tax, and Medicare makes payments to Christian Science "sanitoriums" as if they were hospitals.

The Twitchell case will surely be appealed, but these statutes and regulations need review as well. While adults have every right to make medical choices based on religious beliefs for themselves, the state has an interest in protecting the lives and welfare of children at risk. State and federal laws should not be allowed to muddy this paramount obligation.