When it comes to things like abortion, end of life, and medical care, decisions seem to get complicated.
Suddenly no options are all that attractive, and for better or worse others feel they have the right to opine or even dictate some of these decisions.
An example is the case of Cassandra C. Cassandra is a 17-year-old who was diagnosed with Hodgkins lymphoma. According to reports, she did not want to undergo chemotherapy and her mother supported her decision.
In fact, some say that her mother encouraged that decision and was actually the decision maker. Cassandra ran away to avoid being forced to undergo chemotherapy treatment and the case ultimately went to court.
The state called upon experts who told the judges that with the chemotherapy Cassandra had an 80 percent chance of survival, and without it she would die.
After two factual hearings, the court found that Cassandra did not have the competence to decide whether chemotherapy was right for her, and the state took over her care and forced her to undergo the treatment. On Thursday, the Connecticut Supreme Court upheld that ruling, and Cassandra continues to receive the chemotherapy she wanted to forgo.
Many have decried this decision and opined that it is Cassandra’s body and she should be able to make her own decisions about what goes into it. She will be 18 years old in September, and all agree that when she turns 18 her medical decisions will be up to her.
However, she is not yet 18, and therefore under the law she is a minor. The law is not clear as to what decisions minors can make when it comes to their medical care, and the issues are far more complicated than they seem on first glance.
As of 2013, there were 17 states that recognized the mature minor doctrine. In those states, there are differing standards on when that doctrine applies and what choices a minor can make for himself. For example, in Illinois, a mature minor does have the right to reject treatment.
However, the other states do not address that issue. These statutes seem meant to address medical decisions involving things like STDs, substance abuse issues and abortions. They seem to have been developed in order to allow teens to make their own decisions with regards to their bodies, even if that decision is contrary to what their parents may want.
The majority of the statutes do not address, or even contemplate, whether a mature minor can make decisions involving life prolonging medical treatment. The laws allow teens to choose to terminate a pregnancy, but not to choose to terminate their own medical treatment.
One state has passed a law to address this issue. In Virginia, a similar case resulted in a law referred to as Abraham’s Law, as it involved a young teen named Abraham who did not want to undergo chemotherapy.
While that case was not litigated because the state and the family were able to reach a compromise, the subsequent law says that minors 14 years and older can refuse life prolonging treatment with the agreement of their parents.
This law puts the decision in the hands of the teen and the parents, under the assumption that they will do what is right for the teen and the family. When it comes to the use of chemotherapy to fight cancer, many agree that this is a good compromise.
However, there are situations where it may not be so simple. What if a teen and his parents believe that a less toxic drug was nonetheless dangerous? Herbert and Catherine Schaible are a Pennsylvania couple who are currently serving three to 7 1/2 years in jail for refusing to give their 8-month-old child penicillin for pneumonia.
He died, and they were charged with third-degree murder. Those who feel that a minor like Cassandra should have the right to make her own decisions with her own body may think twice about whether a minor and her parents should be able to withhold life saving antibiotics, even when it is for religious reasons.
There are so many shades of gray. What age is the right age for a minor to make his own medical decisions? What medicines are so well established or so risk free that they can be forced upon a minor against her will? If Cassandra were 13 and did not want to take an antibiotic for an ear infection, it would be unlikely to make the national news and most would likely agree if the state stepped in to ensure she got the medicine she needed.
What age is the right age for minors to make these decisions? What decisions must be made in conjunction with their parents and what decisions can they make on their own? How poisonous must a treatment be in order for us to support the decision to reject it?
To me it is clear that this is not an area for legislation or executive action. These are issues that are meant to be resolved within the judicial system, by judge who hear the evidence, including the medical evidence, and make decisions based on what is right for the minor, the family and society as a whole.
There are some choices that are relatively easy. For the rest, we often have to rely on the Courts. Here, the Supreme Court of Connecticut has made the right one. Yes, Cassandra is the one who has to live with that decision—and someday she may thank the court for giving her the chance to do so.
Heather Hansen is a trial attorney and a partner at O'Brien and Ryan LLP. She is a legal analyst for Newsmax and can be seen on MidPoint every Monday afternoon. Hansen is a trained mediator and a volunteer for the Support Center for Child Advocates. She also serves as a legal analyst for CNN, Fox News Channel, CBS Sports, and Fox29. For more of her reports, Go Here Now.
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