Ezekiel Stephan’s father attacks the Canadian Medical Association

I’ve been writing about the case of Ezekiel Stephan since 2016. The reason, of course, is that Ezekiel Stephan was a healthy toddler living in Alberta who died unnecessarily because his parents, David and Collett Stephan, chose to treat him with “holistic” treatments, including olive leaf extract, whey protein, and supplements made by David Stephan’s company Truehope, as over a couple of weeks Ezekiel got sicker and sicker and sicker from what turned out to be bacterial meningitis. By the time the conventional medical system was involved, which didn’t occur until the Stephans called emergency services because Ezekiel had had a respiratory arrest. EMS managed to get Ezekiel to the hospital, but it was too late. He did not survive long, dying in the hospital of massive sepsis from his infection. The autopsy results showed that the cause of death was meningitis and pneumonia, complete with pus on the brain and pus in the pleural cavity (empyema). The autopsy results were also suggestive that this overwhelming infection was due to a vaccine-preventable disease, Hemophilus influenza type b. Unsurprisingly, along with their belief in “holistic medicine” and Truehope supplements, the Stephans are rabidly antivaccine.

In 2016, the first time I encountered the case, Crown prosecuted the Stephans for failing to provide the necessities of life. The Stephans were convicted in a jury trial, but because the verdict was not unanimous it was automatically appealed to the Supreme Court of Canada. Unfortunately, the Canadian Supreme Court reversed the conviction on a technicality and granted the Stephans a new trial in 2018. The results of that trial were not good. In a massive miscarriage of justice, Justice Terry Clackson acquitted the Stephans in a ruling that used such insulting language about a key expert witness for the Crown that a formal complaint of racism was made against him and based the acquittal on such brain dead reasoning and an egregious misinterpretation of the facts and belief of a dubious expert witness for the defense that the Crown decided to appeal. So at odds with reality was the ruling that, personally, I strongly suspect that the fix was in.

Three weeks since the last time I wrote about this, David Stephan awaits the Crown’s appeal, and I was made aware of an brief news report by Marie-Claude Grégoire published a couple of weeks ago in CMAJ News, the news section of the official journal of the Canadian Medical Association, Doctors urge courts to protect children from parental negligence:

Many Canadian physicians expressed anger, frustration and incredulity following the recent nonguilty verdict in the retrial of David and Collet Stephan, whose son Ezekiel died in 2012 from a treatable illness. One of these physicians is Dr. Linda Leblanc, a radiation oncologist in New Brunswick. She initiated a petition demanding action against the ruling, which gathered more than 2600 signatures.

“As a profession, we need to call this out,” says Leblanc. She worries the decision could create a dangerous precedent in Canadian legislation, leaving children without legal protection in situations of parental negligence.

It’s good to see Canadian doctors angry and mobilized now. Often it takes a high profile case to shake people out of their apathy, because there’s nothing new about the Stephan case. Parents choose to treat serious diseases in their children with quackery rather than real medicine all the time, thus endangering them, and doctors don’t speak out about it nearly enough. Not knowing the Canadian legal system well enough to know if the Stephan acquittal, if allowed to stand, would result in any sort of real precedent given the idiosyncratic facts of the case and the bumbling of the Crown in prosecuting it from the very beginning, but certainly one worries about children’s rights in the event of parental negligence. However, I note that this is just one doctor with one petition. She does not represent the CMA.

The problem, as I’ve repeated many times over the last 15 years, is that there is an inherent bias in people’s belief systems and, sometimes depending on the jurisdiction, the law, that values “parental rights” over the rights of a child and treats the child, in essence, as the property or an extension of the parents, giving parents near absolute power to make medical decisions for the child, no matter how injurious those decisions are. I know I’ve quoted him time and time again, but Senator Rand Paul’s quote from nearly five years ago springs to mind: “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” Unfortunately, this attitude, that parents in effect own their the children and have near-absolute power over them, is prevalent among parents and politicians not just in the US, but all over the world. It’s why there is frequently such opposition to even relatively modest efforts to protect children, such actually promising to follow the precepts of the Convention on the Rights of the Child. It’s why it’s basically open season on children in states like Idaho, which have broadly written statutes protecting “religious liberty” that in practice make it very difficult to prosecute parents for the medical neglect of children if parents based their treatment choices on religion. It’s why parents like parents Herbert and Catherine Schaible in Pennsylvania can choose prayer instead of antibiotics to treat bacterial pneumonia in their toddler, resulting in death, not just once but twice.

“Parental freedom” is an effective message for believers in quackery, though. It’s no wonder that David Stephan is leaning heavily into it now. For example, over on his blog, Stephan is, as he has done since the beginning, painting his wife and him as the persecuted victims. Who’s doing the persecuting? The medical establishment, and all of it, of course! He begins with a long rant, a key excerpt I quote here:

With the Judge’s recent decision and the precedent that was established over the past few months of court proceedings, things have backfired on a catastrophic level. Not only was Alberta Health Services exposed for causing the death of our son, Ezekiel… but the charges of “failing to provide the necessaries of life” were further clarified in that the crown now has to prove that allopathic medical attention would actually make a difference, before parents can be convicted for not seeking it out as their first line of treatment. This is an incredible victory for all parents in Canada! Conversely, this is an incredible loss for, and will greatly hurt the bottomline profits of, both the medical establishment and the pharmaceutical industry alike, as they are intrinsically connected at the hip.

The ruling might have backfired, but not in the way that Stephan thinks. Justice Clackson’s ruling was so poorly argued, so clearly steeped in racism against the Crown’s expert witness, that it finally shocked doctors to respond. Moreover, the ruling did not “expose” Alberta Health Services for anything except for trying its best but failing to save a child who was too far gone from a deadly infection to be saved. Stephan does, unfortunately, more or less correctly characterize the standard Justice Clackson used in his acquittal, namely that the Crown had to prove that medical attention would have actually made a difference in the outcome. The problem is that he applied that standard only when the Stephans had finally called EMS for help, by which time Ezekiel was too far gone to be saved, neglecting to consider that if the parents had taken Ezekiel to the doctor two weeks earlier his death could almost certainly have been averted. It’s like blaming the trauma surgeon for the death of a victim of a gunshot wound to the heart because the victim was on the verge of cardiac arrest due to shock when he presented to the emergency room and the damage from the bullet to the heart was too extensive to fix, rather than on the person who pulled the trigger. Indeed, Justice Clackson ruled that Ezekiel’s cause of death was lack of oxygen to the brain. Yes, but every single one of us will die one day due to “lack of oxygen to the brain.” That’s the final common mechanism of every death. What led to Ezekiel’s lack of oxygen to the brain? His untreated bacterial meningitis! Justice Clackson’s conclusion was, as I said at the time, akin to concluding that that gunshot wound to the heart didn’t kill the shooting victim, but rather the lack of oxygen to the brain did.

Stephan spends a lot of time bemoaning the criticism (to him “attacks”) of the judiciary and of the ruling before pivoting to Dr. Leblanc:

Just when we thought that the attacks were as dirty as they could get… we discovered that Dr. Linda LeBlanc, who resides clear on the other side of Canada, started a petition that would be submitted to both the Alberta Crown as well as the Canadian Judicial Council, pressuring for an appeal to be made as well as a conviction against Collet and I. She obtained just over 2600 signatures before she claimed victory as the Crown declared that they were going to appeal our acquittal and seek to have it made into a conviction at the Alberta Appeals Court. How did she obtain these 2600 signatures? Through the blatant misrepresentation of the facts to a degree that we have never seen before, and in some instances, by even adding some fictional events of her own creation. Two clear examples of her fabricating evidence directly associated with convincing others to sign her petition, is when she stated that, “The child had been ill for a month…”, when in reality he was off and on sick over the time period of 2 weeks, 1 day and a few hours. Another instance is when she stated, “The judge ascertained that the child died because of lack of oxygen in the ambulance on the way to the hospital.” In contradiction, she would go on to state that, “The child in fact died of overwhelming sepsis secondary to meningitis…”. Nowhere in any medical evidence or in any testimony given over nearly 7 years of court proceedings did anyone state that there was any evidence of sepsis, let alone “overwhelming sepsis”. In fact to the contrary, 24 hours after Ezekiel had arrived at hospital, the doctors were looking for an alternative cause of death as the CT scan had ruled out meningitis (however the radiologist did identify brain damage due to hypoxic injury (oxygen deprivation within the ambulance)) and further to this, there was no objective evidence of an infection (sepsis). Not only is she entirely wrong, but it will be interesting to find out what kind of legal liability there will be in relation to the intentional creation and misrepresentation of facts for the sole purpose of generating public pressure to influence court proceedings? Mark my words, this is definitely not the last time that we will hear about Dr. Linda LeBlanc out of Moncton, New Brunswick.

OK, so Dr. Leblanc got the period of illness wrong. It was two weeks. I’ll admit that that was careless of Dr. Leblanc. I know from long experience that when you write an article like that you can’t afford to make a mistake as basic as that, even if the mistake doesn’t change the overall message of what you’re arguing. That doesn’t exonerate David Stephan. It’s also incorrect that evidence of sepsis was not presented, and the autopsy results contradict Stephan’s claim. The Crown’s medical examiner reported two sites of major infection, the lung and the brain.

I don’t want to re-argue the facts of the case against the distortions, misinformation, and dubious arguments about the case being promoted by Stephan, his supporters, and the various quacks who have taken up the Stephans’ cause. I’m more interested in showing how Stephan is portraying himself, and, unsurprisingly, it’s as a victim. For example, a week ago on Facebook:

He starts out by complaining that the Canadian Medical Association has alerted its 75,000 members about his case and how they should feel and act about it, claiming, as he did in his blog post, that the CMA is engaged in an effort to influence the court to rule against him and his wife. Let’s just say that this is an…exaggeration. The article in CMAJ, the official journal of the CMA, was a news report about an effort by Dr. Leblanc, not an endorsement of that effort by the Canadian Medical Association. Now here’s the thing. This was a petition posted to Avaaz.org by a single physician. According to the CMAJ article, it had accumulated 2,600 signatures by October 23, the publication date of the article, noting:

Leblanc’s petition against this decision has been acknowledged by the Canadian Judiciary Council and the Province of Alberta. On Oct. 15, the Crown filed an appeal of the acquittal. The group lead by Leblanc is hoping for retrial and conviction.

So the Court acknowledged the petition? So what? If a petition is filed to the court, I’m guessing that it has to acknowledge it. Whether it will have any effect, who knows? My guess is that it probably won’t. I also note that the petition is no longer on the Avaaz.org website. The link in the CMAJ article just goes to the front page of the website, and a search using the almighty Wayback Machine on archive.org failed to come up with a copy. I was, however, able to find a Google cache of the petition; so I’ll quote the whole thing before it disappears completely into the digital ether:

We are a group of physicians and patient advocates from across Canada demanding action be taken against the recent ruling in the Ezekiel Stephan case. The judge ascertained that the child died because of lack of oxygen in the ambulance on the way to the hospital. He was convinced by the defense pathologist who made this claim based on hearing the 911 recording of the child’s breathing pattern and reviewing the autopsy report of which she had no part. The child in fact died of overwhelming sepsis secondary to meningitis (likely bacterial) as was explained by the pathologist who completed the autopsy who denied there were signs of anoxia in the brain.

Ezekiel had been ill for 3 weeks and the parents chose to treat him with ‘natural’ remedies, including a supplement widely advertised and sold by the Stephan family. When the child’s condition deteriorated a nurse who was a family friend as well as the parents’ Naturopath told the parents to seek medical attention as they suspected meningitis. In fact in order to bring the child to the Naturopath visit they needed to lay him on a mattress in the car as he was too stiff to sit in a car seat, an obvious sign of meningismus.

Later that day the parents called an ambulance when Ezekiel stopped breathing and then cancelled the ambulance when he resumed breathing. Ambulance was called a second time as the child stopped breathing yet again. The judge unbelievably concluded that Ezekiel’s death was due to lack of adequate oxygen in the 9 minute ambulance ride, not the 3 weeks of gross negligence from the parents that led to the child’s critical condition, including the 2 episodes of respiratory arrest prior to the ambulance arriving on scene.

The judgement creates an unbelievably dangerous precedent—as a parent you can neglect your child and deny him or her life saving treatment. If the outcome is poor you will be absolved of all responsibility. It also legitimizes ‘natural’ remedies as treatment of life threatening conditions as was explained by the child’s father upon his acquittal: He stated his case “helps protect parental rights so that parents won’t be held criminally liable if they choose alternative treatments for their sick children”.

He does not mention sadness for the death of his child but rather relief at not being held accountable. His livelihood is that of selling ‘alternative treatments’ therefore his statement pushes for their continued use ensuring he can continue to profit from its sales. One could argue the delay in seeking medical attention was driven by the parent’s need to legitimize the efficacy of their business’ product. Need we add this couple have other young children.

Children are not our property, they have a right to be protected from harm irrespective of the adult responsible for the harm inflicted. It is in the name of all children that we demand a review of what led to this travesty of justice.

This petition contains a more or less an accurate representation of what happened. One can quibble with how a couple of the details are represented, but the petition does boil the pertinent facts of the case down to a digestible summary. Dr. Leblanc is also very much correct when she points out that Stephan profits from the use of the supplements that he used to treat Ezekiel. He’s the scion of the founder of Truehope, which has long peddled dubious supplements. In all of Stephan’s rants on his blog and in his video I can’t help but think that his accusations that the medical profession is persecuting him and his wife in order to protect their profits is what I like to refer to as projection. In the video, he repeats claims that he’s made that the reason the death of his son was due to a vaccine-preventable disease (which, examining the evidence, I think it probably—but not certainly—was) is because of big pharma and big medicine wanting to maintain their monopoly. At one point, he even says that parents, out of fear of being held criminally liable, will take their children to doctors unnecessarily and in some instances “subject them to vaccines,” as if that were a horrible thing. He also misrepresents Dr. Leblanc’s petition as though it were the official position of the CMA and that the CMA was itself urging the court to convict him. That is simply not true; all the CMA did was to report on Dr. Leblanc’s petition after the fact, and indeed the petition appears to have been taken down since it was presented to the court.

The case of Ezekiel Stephan made me sad to learn about it, but as the legal proceedings have dragged on and on for years, it’s made me more angry than anything else. That an antivaccine supplement grifter and his wife, who so obviously medically neglected their child resulting in his death, can escape justice for so long infuriates me. It should infuriate you too.