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4 Reasons States Cite for Chemotherapy Treatment Mandate on Children

By    |   Friday, 10 Jul 2015 10:36 AM

Children who decline chemotherapy for religious or other personal reasons have found themselves in direct conflict with state officials, including child welfare agencies and even prosecutors attempting to mandate chemotherapy treatments for minors.

State officials, as well as many doctors and hospitals, give various reasons for pursuing this line of enforcement when it contradicts the wishes of young cancer patients and their families.

1. The state protects children, even from themselves.
In January 2015, Connecticut won a state Supreme Court ruling forcing a cancer-stricken 17-year-old, Cassandra Callender, to undergo chemotherapy against her wishes.

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In a statement after the ruling, the Connecticut Department of Children and Families, asserted a role for the state in safeguarding Callender's well-being, CBS News reported: "This is a curable illness, and we will continue to ensure that Cassandra receives the treatment she needs to become a healthy and happy adult."

2. Minors aren't mature.
Medical professionals question whether adolescents — people aged 12 to 18 — are qualified to make major health care decisions, given that they aren't fully developed, biologically and psychologically, in areas such as mental and emotional maturity, cognition and temperament.

"Just because we let them make decisions at 18 is not a sufficient enough reason to let them make them at 17," Douglas S. Diekema, a physician and clinical director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute, told U.S. News & World Report.

3. The law favors adults.
In 1979, the U.S. Supreme Court ruled 6-3 that a Georgia law enabling parents to force a minor child into psychiatric care is legal, and that absent a finding of parental neglect or abuse, the child's wishes are secondary.

"The law's concept of the family rests on a presumption that parents possess what a child lacks in maturity, experience, and capacity for judgment required for making life’s difficult decisions," the high court wrote in Parham v. J.R., the Georgia case.

The medical journal Pediatrics reported in 2013 that even with the advent of the mature minor doctrine giving people younger than age 18 an opportunity to withhold medical consent, the Parham case is still the last word on medical decision-making authority.

4. Refusing treatment is negligent.
The law's broad deference to parental authority isn't absolute: Child welfare agencies have gotten parents ruled negligent to force a sick minor to undergo chemotherapy, as happened in Connecticut in the aforementioned case of Cassandra Callender.

Callender's mother had agreed with her daughter's decision to withhold consent for treatment. In an editorial on "Cassandra's Catch-22," The Economist charged the state with "insidious" circular reasoning: The mere fact that Callender's mother backed her daughter's actions proved she was unfit.

"If we are entitled to choose on our own behalf — or on our children's behalf — only when we are deemed rational, and rationality is defined to mean a consensus with the authorities, then autonomy is a bad joke," The Economist said.

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In 2005, Texas child welfare authorities took custody of a 13-year-old cancer patient, Katie Wernecke, and placed her with a foster home while requiring her to undergo chemotherapy, The Associated Press reported. Wernecke and her mother had fled the state after a doctor told authorities the family objected to the treatment.

Prosecutors have also intervened: In 2011, Michigan charged the parents of a 10-year-old Michigan boy, Jacob Stieler, with medical abuse for taking their son off chemotherapy to treat a rare bone cancer because the boy found the treatment unendurable, MLive reported. A state judge, however, threw out the charge.

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Children who decline chemotherapy for religious or other personal reasons have found themselves in direct conflict with state officials, including child welfare agencies and even prosecutors attempting to mandate chemotherapy treatments for minors.
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2015-36-10
Friday, 10 Jul 2015 10:36 AM
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