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A fundamentalist couple who prayed over their sick toddler rather than get medical help before his pneumonia death have been ordered to stand trial on manslaughter charges.

Prosecutors believe 2-year-old Kent Schaible succumbed because his parents chose prayer over modern medicine.

But defense lawyers — perhaps mindful of Pennsylvania's strict parental-duty laws — deny the case hinges on religious freedom. They say Herbert and Catherine Schaible did not know their son was dying.

"We're talking about symptoms that mirrored the flu and the common cold," said public defender Francis Carmen, who represents the mother. "The Commonwealth is dragging this (issue) into the courtroom, to persecute them for their minority religious beliefs."

About a dozen U.S. children die each year in such cases, often from diabetes, pneumonia and other treatable illnesses, according to Shawn Francis Peters, a University of Wisconsin lecturer who wrote "When Prayer Fails: Faith Healing, Children and the Law."

Their parents often claim they failed to recognize the severity of the illness, he said.

Some states carve out exceptions to criminal neglect statutes for parents who rely on faith or spiritual healing. But even in states that don't, juries or judges often sympathize with them, especially given their lack of intent.

In a recent Oregon trial with parallels to the Schaible case, a jury acquitted the defendants of manslaughter in their 15-month-old's pneumonia death. The father, Carl Worthington, was instead convicted of a misdemeanor, criminal mistreatment.

"It's very rare for a parent to even get more than a year in prison after they're found guilty," Peters said. "No matter how gruesome the circumstances, it's really a different kind of case, both legally and culturally."

The Schaibles, who quit school after ninth grade, work as teachers at their church, First Century Gospel Church in northeast Philadelphia.

The Philadelphia judge who upheld involuntary manslaughter, child endangerment and conspiracy charges Wednesday against the Schaibles called them "loving" but "misguided."

Kent Schaible died Jan. 24, about 10 days after he fell ill. His symptoms included coughing, congestion, crankiness and a loss of appetite, and he was warm to the touch, the parents told police in their Jan. 26 statements.

"They took time off from work, they fed him, they nourished him, they comforted him," Carmen said.

A day or two before he died, they thought he was improving, as he slept better and ate and drank some. But when his condition worsened, they called their pastor and then a funeral home.

Police later asked why they didn't call a doctor.

"They both pretty much said, 'We believe in God for healing. We don't take it ourselves, either,"' Assistant District Attorney Joanne Pescatore said Thursday. She believes the child suffered.

"They can refuse medical treatment. They can be martyrs if they want," Pescatore said. "They can do that because they're adults, not a child."

But defense lawyers say they never told police they would not have gotten medical care at some point. Police never asked, they said.

The Schaibles were arrested in January, but court dates were delayed in part because of the birth of their most recent child.

They have no known prior contacts with police or social workers, and their other children remain in their care. They are free on $150,000 bail.

Defense lawyers declined to discuss their church's teachings, and messages left at the church Thursday for Herbert Schaible and their pastor were not returned.

Catherine Schaible, reached at home Thursday, declined to comment.

"Thank you for your concern," she said politely, above the playful sound of a child's voice.