credit: Associated Press
Yesterday, a 17-year-old girl received a court order to undergo chemotherapy treatments to treat Hodgkins lymphoma. Both the girl and her mother disagree with the ruling. The girl will remain in the hospital to ensure she receives proper treatment.
Physicians mostly side with authorities, agreeing the girl, known as Cassandra C., should receive chemo. Survival and cure rates are quite high; currently 83 percent of women with Hodgkins lymphoma have a 10-year survival rate.
As one oncologist inside SERMO stated, “I would treat her and let her complain to me until she is an old lady.”
A hematologist added, “Agree with those that point out Hodgkin Disease is curable, not palliable, in many if not most cases. The chemo is no treat, but not prohibitive. Mom has demonstrated her complete unfitness to provide rational care for her daughter.”
The Ethics of Forced Medical Care
Many in the media have pointed out the patient is only months away from refusing treatment when she turns 18 and question when the right to make medical decisions comes into play. A chapter published in the book, Pediatric Critical Care Medicine, looks at when to let parents and patients decide and when the medical community should take over. They cite specifically when emergency services are needed, and a parent is not available to give consent and when the family is unable to make an informed decision.
The teen told reporters and the state that chemotherapy will do more harm to her body than the cancer will. Her mother also said if she gets the chemo there could be long term health affects including the inability to have children. The Washington Post reported, “This court agrees with the trial court that, even assuming that the mature minor doctrine applies in this state, the respondents have failed to meet their burden of proving under any standard that Cassandra was a mature minor and capable of acting independently concerning her life-threatening medical condition,” Full court order here.
The ethics of forced medical care comes up fairly regularly, often for religious reasons. One surgeon wrote, “The courts have typically sided with physicians in the case of minor children. This most commonly occurs with parents refusing surgery, or, especially with Jehovah’s Witnesses, refusing transfusions.”
What do you think, does a medical team’s knowledge trump an uninformed patient? When is it OK for the courts to step in and mandate care? What about forms of patient care that are so clear cut, such as parents refusing vaccinations?
There is an active discussion about this inside SERMO. If you’re an M.D. or D.O. we invite you to join the conversation; membership is free.
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