This isn’t about vaccines! Landmark SJC Holding Addresses the Reach of Parents’ Religious Rights in Care & Protection Proceedings
By Kylah Clay
If the Department of Children and Families (“DCF”) obtains temporary custody of a child, the legislature authorizes DCF to make decisions about that child’s housing, education, and medical care of a child in the temporary custody of DCF while the parents await a trial on the merits. G.L. c. 119, § 21 (defining DCF’s custodial authority). A parent’s objections to DCF’s custodial decisions are reviewed pursuant to the highly deferential abuse of discretion standard. Care & Protection of Walt, 478 Mass. 212, 230 (2017). But how should trial courts respond when a parent’s objection is rooted in their First Amendment right to decide and direct their child’s religious upbringing? Until earlier this year, Massachusetts trial courts did not have any clear guidance on the issue from Massachusetts appellate courts.
In a case of first impression, the Supreme Judicial Court (“SJC”) held that, when “the Commonwealth has assumed control over certain decision-making concerning the child, at least temporarily, that assumption of control does not extend to the religious upbringing of the child.” Care & Protection of Eve, 496 Mass. 42, 52 (2025). Rather, because “parents retain residual constitutional rights regarding the religious upbringing of their child,” a parent’s sincere religious objection must be honored unless DCF demonstrates that doing so would substantially hinder it from pursuing an unusually important governmental goal. Id. at 53-54. The SJC firmly established the parents’ religious rights concerning their children while they await a trial, but questions remain about the scope of these rights.
Background
DCF removed Eve (the child’s pseudonym) from her parents’ custody immediately after her birth due to concerns of intimate partner violence. During the temporary custody hearing, both parents testified about their religious beliefs as practicing Rastafarians. Id. at 45. Specifically, the parents explained that, in their view, they are “not supposed to put anything inside [their] body outside of what nature has already given [them] because it goes against God’s plan.” Id. Given their beliefs, the parents refused vaccinations and avoided Western medicine unless used as a “last resort[.]” Id.
After being granted temporary custody of Eve, DCF, along with Eve’s court-appointed attorney, asked the trial court for permission to vaccinate her pursuant to the standard immunization schedule recommended by the Center for Disease Control and Prevention (“CDC”). Id. at 46. In an affidavit signed by two of Eve’s treating physicians, DCF argued that the vaccinations were medically necessary, relying on the CDC’s general vaccine recommendations for all children. Id. at 46. The parents objected, citing their sincere religious beliefs against vaccination and a state statute granting parents a religious exemption to vaccine requirements on behalf of their school-aged children. Id.; G.L. c. 76, § 15. The trial court assumed that the parents’ religious beliefs were sincere but nonetheless decided that Eve’s best interests required her to be vaccinated over the parents’ beliefs. Id. The parents filed an interlocutory appeal which was taken by the SJC for direct appellate review. Id. at 46-47.
Notably, at the time of her removal and throughout the interlocutory appeal period, Eve’s three older siblings were also in DCF custody, but DCF never attempted to vaccinate Eve’s siblings. Id. at 58.
Opinion
In its decision reversing and remanding the trial court’s order, the SJC held that G.L. c. 119, § 21 does not grant DCF “any authority to direct the child’s religious upbringing or affiliation.” Id. at 48. Consequently, “parents retain residual constitutional rights” to direct their child’s religious upbringing even when their child is in DCF’s temporary custody. Id. at 53 (emphasis in original). The SJC reasoned, “[t]here is no question that the rights to freely practice one’s religion and to raise children ‘according to the dictates of [one’s] own conscience’ are among the most ‘sacred private interests,’ long recognized as such by this court and the United States Supreme Court.” Id. at 49.
With the parents’ religious rights clearly articulated, the SJC next decided the applicable standard of review when trial courts are faced with a parent’s religious objection to DCF’s custodial decisions. Reasoning that the parents’ right to the free exercise of religion is protected by the State Constitution, the SJC held that when a decision by DCF substantially burdens or conflicts with a parent’s sincerely held religious beliefs the State can only prevail by demonstrating that its custodial decision “pursues an unusually important governmental goal” and “an exemption would substantially hinder the fulfillment of the goal.” Id. at 54 (internal citations/quotations omitted).
Applying this framework, the SJC held that, although vaccinating children generally is an undoubtedly important governmental goal, DCF failed to show how an exemption would harm this goal where (a) the state legislature freely grants religious exemptions to compulsory vaccination of school-aged children, G.L. c. 76, § 15, and (b) DCF itself allowed Eve’s three older siblings to remain unvaccinated. Id. at 56-58. The Court concluded, “Given the exemptions already allowed by the Commonwealth and the inconsistent application of the vaccination requirement by the department here, we cannot conclude that allowing this child to remain unvaccinated would substantially hinder the department’s interests.” Id. at 57-58. The Court also disregarded DCF’s argument that children in foster care are at higher risk of exposure to vaccine-preventable illnesses, stating that such general claims “are insufficient alone to demonstrate that allowing this specific child to remain unvaccinated would unduly hinder [DCF]’s compelling interests.” Id. at 58 (internal citation/quotations omitted).
Remaining Questions and Broader Implications
Although the Court could have confined its holding to the narrow facts of this case, Care & Protection of Eve broadly establishes that “parents have not lost the right to direct their child’s religious upbringing when they have temporarily lost custody[.]” Id. at 55. This holding opens the doors to possible complex issues when considering the interplay between DCF’s custodial authority and parents’ religious rights. For example, can parents demand that DCF place their child with a foster family that shares their religious beliefs or that DCF enroll their child in a specific religious school? Can parents require DCF to ensure a child’s participation in a baptism, First Communion, B’nai mitzvah or other type of religious milestone ceremony?
Furthermore, the SJC does not address the further complications if a child does not agree with their parent’s religious beliefs. In Eve, the newborn child’s appointed counsel used substituted judgment to support DCF’s position. Id. at 53, n.6. However, the SJC found that, “Counsel did not, and could not, directly express the views of the child given the child’s age.” Id. Consequently, it is unclear how trial courts should proceed when a child’s expressed religious beliefs are contrary to their parents’ beliefs.
Finally, there is the practical question of how these disputes should be brought before the trial courts. Since decisions concerning religious upbringing fall beyond DCF’s custodial authority under § 21, id. at 48, if a parent tells DCF that they object to a custodial decision that substantially burdens or conflicts with their sincerely held religious beliefs, who bears the responsibility for bringing the matter before the trial court? Must DCF petition the court for permission to act? Or must the parent petition the court to restrain DCF from enacting that decision?
These questions may be answered by future appellate decisions. In the meantime, Care & Protection of Eve should be required reading for any practitioner before the trial court in care and protection matters.
Kylah Clay is a solo practitioner in Boston, Massachusetts. She graduated from Suffolk University Law School in 2022 and joined the CPCS Children and Family Law Appeals Panel as a bar advocate shortly after passing the bar exam. Attorney Clay represented the mother on appeal in Care & Protection of Eve.
