On Easter Sunday of 2008, 11-year-old Kara Neumann of Weston, Wisconsin, suffered waves of nausea as she lay motionless on her deathbed, too weak to walk or speak. Kara's parents both followers of the Unleavened Bread Ministries, an online church that shuns medical intervention knelt in prayer beside their dying daughter. They did not call a doctor for help. A few hours later, Kara died of diabetes, a relatively common and treatable condition.

Within weeks, a Wisconsin state attorney brought charges of reckless endangerment against Kara's parents, Dale and Leilani Neumann. The couple protested on grounds of religious freedom, but Judge Vincent Howard of Marathon County Circuit Court ordered Mr. and Mrs. Neumann to stand trial this spring. If convicted, each faces up to 25 years in prison. Unleavened Bread Ministries immediately released a statement saying the couple is being unfairly punished for the "crime of praying." (Read the top 10 religion stories of 2008.)

The Neumanns' highly anticipated trial has sparked new debate in a long-running battle over faith healing in the United States. Under current Wisconsin law, a parent cannot be convicted of child abuse or negligent homicide if they can prove they genuinely believed that calling God, instead of a doctor, was the best option available for their child. The law is part of the legacy of the 1996 Child Abuse Prevention and Treatment Act, which included a landmark exemption for parents who do not seek medical care for their children for religious purposes. While all states give social service authorities the right to intervene in cases of child neglect, criminal codes in 29 other states also provide additional protection for parents who forgo mainstream medical treatment. (Read TIME's cover story on God vs. Science.)

In light of Kara's high-profile case, faith-healing communities around the country are worried about losing their right to treat their children according to their religious beliefs. "The way the law is worded right now is confusing and makes it seem like we have a shield to recklessly endanger children," says Joe Farkas, legislative affairs representative for the Church of Christ, Scientist, in Wisconsin. The Church has teamed up with Wisconsin Democratic Sen. Lena Taylor to write new legislation that could repeal a provision in the state's child abuse and neglect statute that exempts parents from prosecution in some faith-healing cases, while creating a new "affirmative defense" for parents who made a "reasonable attempt" to provide medical care for their child. "We want to have an affirmative defense where parents relying on Christian Science treatment are given a fair opportunity to explain why they believed their action was in the best interest of their child," says Farkas. "Our church loves children and we want to protect children."

Religious objections to medical treatment have historical roots that can be traced back to the late 1800s in England, when a sect called the Peculiar People ended up on trial for allowing generations of children to die as a result of their decision to reject doctors and medicine. Today, many religious groups routinely reject some or all mainstream health care on theological grounds, including Christian Scientists, Jehovah's Witnesses, Amish and Scientologists. "Fundamentalists tell us their lives are in the hands of God and we, as physicians, are not God," says Dr. Lorry Frankel, a professor at the Stanford School of Medicine and author of Ethical Dilemmas in Pediatrics. "We respect people's religious beliefs and try to compromise, but we won't deny treatment that will save lives." Frankel says he's taken Jehovah's Witnesses to court in the past when they've refused blood transfusion for their children in life-threatening cases. "The judge invariably rules in our favor and I've never had a child denied care," says Frankel.

Nobody knows exactly how many children's health problems are exacerbated by a parent's religious beliefs because "the system can only kick in if people become aware that a sick child is not getting care," says Dr. Sara Sinal who co-authored a July 2008 article on religion-based medical neglect in Southern Medical Journal. "It is suspected that many deaths go unreported and unrecognized, particularly in closed communities." Former Christian Scientist Rita Swan, executive director of the nonprofit Children's Health Care Is A Legal Duty, estimates that since the 1980s 300 children have died of "religion-based medical neglect" in the United States. Shawn F. Peters, author of the 2007 book When Prayer Fails: Faith Healing, Children, and the Law calls the situation an unfolding tragedy. "Americans treasure religious liberty and it's one of our bedrock freedoms," says Peters. "Most of us realize that there have to be some limits to such freedoms."

Deciding just what those limits are has increasingly become a matter for the state courts, with most judges coming down on the side of doctors like Frankel when young lives are at stake. In December, an upstate New York judge ordered two Amish parents to allow an operation needed to repair their infant's life-threatening heart condition despite their religious objections to the procedure. Earlier in January, a judge refused to drop criminal charges against a couple in Oregon charged with second-degree manslaughter and criminal mistreatment in the death of their 15-month-old daughter who would have survived had she received antibiotics, rejecting their argument that prosecution would violate their religious freedom and parental rights. Last year, another Oregon couple were charged with criminally negligent homicide in the death of their 16-year-old son, who died from complications of a severely painful but easily treatable urinary tract infection.

Christian Scientists maintain that seeking medical attention is a personal decision and that the First Amendment protects their right to believe that "God's infinite goodness, realized in prayer and action, heals," as noted on the website of the The Church of Christ, Scientist. But a long list of major U.S. organizations have already called for repealing of existing religious exemptions, including the American Academy of Pediatrics and the American Medical Association. "Too often, deference to religion in contemporary American society has resulted in us subordinating all other values," says Dr. Richard Sloan, professor of psychiatry at Columbia Presbyterian Hospital. "The law must recognize that the right of children to live supersedes the rights of their parents to free expression of religion."