Chemo May Be Forced on 17-Year-Old Cancer Patient

Discussion in 'Up to the Minute' started by Softail, Jan 9, 2015.

  1. Softail

    Softail New Member

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    Conn. Supreme Court Rules 17-Year-Old Cancer Patient Must Have Chemo

    The top court in Connecticut ruled today that a 17-year-old girl can be forced to undergo chemotherapy after she refused treatment for her cancer.

    The case went to the Connecticut Supreme court to determine whether the teen, identified in court papers as Cassandra, has "the fundamental right to have a say about what goes on with your [her] body," attorney Michael Taylor, who represents the teen's mother, told ABC News earlier this week. Taylor was appointed by the public defender's office, and Cassandra has her own court-appointed lawyer, but they've filed joint appeals.

    http://abcnews.go.com/Health/conn-supreme-court-rules-17-year-cancer-patient/story?id=28093594
     
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  3. Lulu14

    Lulu14 New Member

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    The court was right.
     
  4. Morag

    Morag Active Member

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    Indeed. What I don't understand is why her mother supports this girl's decision. This is a very curable form of cancer.
     
  5. FlyerFan28

    FlyerFan28 Member

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    Okay, I don't care if it the chemo will cure it or not. Chemo sucks. I went thru it twice. It is her body and the courts should not be the ones forcing her to take the poison cocktail if she doesn't want to. Why are they spending all this money to break her will?

    Chemo sucks. It sucks it sucks it sucks.
     
  6. Lulu14

    Lulu14 New Member

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    Because to me, her decision sounds suicidal. And we don't just let people commit suicide, do we?
     
  7. Lulu14

    Lulu14 New Member

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    Double post.
     
  8. Softail

    Softail New Member

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    :dunno: I'm torn on this one. I've seen many people that I've cared about die from the treatment, and not the cancer.
     
  9. MsFacetious

    MsFacetious What a Kerfuffle...

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    So in most states she can get prenatal care without her parents being informed.
    She can have an abortion without her parents being informed.

    Yet she can't decline cancer treatment that could leave her with lifelong issues?
    (Including an inability to conceive children actually.)
    She is 17, when is her 18th birthday?
    They can't force her after her 18th birthday right?

    I likely would not support my daughter denying cancer treatment.
    However, if both the parents and child agree... I think the court should stay out of it. :twocents:
     
  10. K_Z

    K_Z Verified Anesthetist

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    Been following this case with interest. As a health care provider, admittedly I have a different perspective on these teen cases than perhaps some do. At the beginning of my career, I worked with pediatric cancer and bone marrow transplant patients in an acute care hospital, so am familiar with these issues in the newly diagnosed, as well as those in chronic and ineffective treatments, and adolescent patients at the end of life in treatment.

    I think the court did the right thing here. This is not a teen who has been undergoing painful and miserable treatments that are ultimately futile, and wants to stop. This is a very naïve and uneducated teen, newly diagnosed, and scared of the diagnosis, and the treatment.

    At the risk of offending some, I will also respectfully suggest that the teen's mother, IMO, does not demonstrate from her comments that she is knowledgeable enough to allow her daughter to make a fatal decision to avoid treatment for this highly treatable cancer. The girl is under 18, so I am glad an assertive approach has been taken to save her life.

    We as a society need to err on the side of keeping this teen alive, so that when she is an adult, she is free to make her own decisions. This is not an uncertain diagnosis, nor a particularly rare cancer. We know a lot about these cancers, and how they respond to treatments. She is not being forced to take an experimental treatment, but a treatment regimen that his an extremely high rate of cure. That, IMO, is what makes this "forcing" by the courts a very moral and ethical decision, IMO. For me, that makes all the difference-- the teen is newly diagnosed, not in the end stages of illness.

    Would the teen feel the same way if it was her mother with a new diagnosis of cancer, who wanted to refuse curative treatment? Perhaps so, perhaps not. Again, lots and lots of education and discussion are needed, with providers that can establish a rapport with both mom and teen.

    Had the mom been the cancer patient and wanted to avoid treatment, I'd still be sorely disappointed and very disturbed at her choice, coming at the time of diagnosis, not the middle of a futile regimen, or at the end stages. I would would hope that all of the providers and the mom fully explore why she would want to refuse life saving treatments. This would include making sure she understands that complementary and alternative medicines and therapies often can be incorporated, and address her fears. If she still wanted to refuse after a lot of ongoing discussion, I'd honor that, making sure she understood she could change her mind any time, and make sure she had a mainstream medical provider to see her regularly as an outpatient so symptoms could be treated as they occur.

    When I worked pedes years ago, I saw a handful of situations like these. We had leukemia and cancer patients whose families were Jehovah's Witness, and wanted to refuse blood products. The hospital went to court to get permission to treat, and easily received it (back in the 80's and 90's). In Minnesota not too long ago, a family of a 13 year old autistic boy wanted to avoid this same kind of curative treatment, and instead use herbs and complementary medicine. At one point, the teen and mother fled, just like this teen did. The court ordered the chemo, and the teen is alive today.

    http://www.nbcnews.com/id/31372774/...therapy-helping-boy-friend-says/#.VLAiiektH9k

    http://www.cnn.com/2009/US/05/19/minnesota.forced.chemo/index.html?_s=PM:US

    http://www.lymphomainfo.net/blog/ge...-boy-with-hodgkins-finished-with-chemotherapy

    Anyway, These are thorny decisions for all involved. I do think that teens and parents should be able to refuse chemo and life prolonging therapies, in the proper context of ongoing futile treatment. I don't think this is apporpriate at the beginning of a diagnosis where the treatment has such a high curative rate, and refusal is certain death. Those are the appropriate cases for the courts to step in, IMO, and err on the side of making decisions to attempt to treat the teen, and keep them alive so they can later make their own decisions as adults.

    I hope this young lady responds to the treatments, and I also hope she is able to make come connections with docs and nurses there so that she can feel more secure that they have her best interests in staying alive in mind. I hope she can continue to learn about her body, her cancer, and the treatments for both the cancer and the side effects. I hope she and her mom will come to the realization that mainstream medical care and providers are not "the enemy." Mainstream medicine and complementary and alternative therapies are increasingly being used together to treat patients, and often family's CAM choices can be incorporated alongside mainstream therapies. (They do it in every single Chinese hospital, for example, due to centuries of reverence for traditional Chinese medicine.)

    No one wants a beautiful 17 year old girl to die from an impulsive and uneducated decision. Refusal of this kind of care IMO means we need to have a lot more conversations with this family.
     
  11. K_Z

    K_Z Verified Anesthetist

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    Articles say she was diagnosed in September 2014-- and her 18th birthday is next September. So she had just turned 17 right around the time of diagnosis. She needs about 6 months of chemo, so should be "done" hopefully by her 18th BD.
     
  12. Morag

    Morag Active Member

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    Lifelong issues? How long will her life be if she doesn't go through chemo?

    Inability to conceive children? If she conceived today, she wouldn't live to deliver the baby.

    Her 18th birthday? She won't live to see it if she doesn't receive treatment.

    About 30 years ago, my friend received this diagnosis. She didn't want to do chemo, she was just prepared to die (at the age of 25 or so). But she decided to have treatment. She fought the cancer with everything she could for about 10 years. But she died. In those ten years, however, she married, adopted children, traveled the world for business and pleasure, and moved forward vigorously in her career. She thought undergoing the treatment was worth it for those ten years. So did her husband. So did her mother and sister. So did her children. So did I.

    What if this girl was 7 instead of seventeen? Should her mother just allow her to die? That's why the court is involved. It's not up to the mother to make that decision for her, and the girl is not mature enough to decide for herself.
     
  13. K_Z

    K_Z Verified Anesthetist

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    Let me pose a "thought experiment."

    Let's say a 17 yo girl arrived by ambulance to a trauma ER, conscious, but bleeding to death from a car accident or some kind of trauma that is typically "fixable" with urgent ER care, and perhaps a trip to the OR. Imagine the ER staff is trying to stabilize her. The teen is saying -- "No, stop, let me die!" The mother arrives in the ER, and says, "Well, she's making her wishes known, it's ok-- stop, let her die. I support her right to make decisions about her body. Don't take her to the OR, no blood products, no IV's, leave her alone."

    In this example, should the ER staff simply strip off their gloves and walk out of the room, letting her bleed out and die from a fixable injury? Or should they continue to stabilize her and send her to the OR for emergency surgery to save her life?

    What would the repercussions be for the docs and nurses, whether the staff stopped, or continued to resuscitate? The hospital?

    What would the repercussions be for the teen? The mother?
     
  14. Softail

    Softail New Member

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    Correct. Not sure when she turns 18, but she can refuse the treatment at that time, as I understand it.

    I tend to agree that the court should stay out of it. :twocents:
     
  15. Softail

    Softail New Member

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    K_Z As always, thanks for your valuable input! :) Always the voice of reason, and appreciate your experiences.
     
  16. Zuri

    Zuri New Member

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    Great "thought experiment" example. IIRC, we had one of those similar instances some years ago. We just kept treating the patient, and let the hospital admins deal with the other. For some reason, I think a judge was involved and the patient was made a ward of the state or something. The teen patient survived.

    Does this scenario sound feasible? It was a long time ago.
     
  17. K_Z

    K_Z Verified Anesthetist

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    I'm curious. For those that feel the courts "should stay out of it", is this your opinion because she is 17 and close to legal adulthood? Or are there other reasons why, beyond her age?

    Would you agree the courts should "stay out of it" if the minor is 15? 13? 10? 8? 4?

    If age based, what age would you legally emancipate the minor to make her own health decisions? (That would be emancipation thru the courts.)

    Should a parent always have a right to make, or allow a child, or teen to make, a decision to withhold lifesaving care, for their minor children? In all circumstances, or only in some? Which ones?

    Jodi Picoult wrote a novel encompassing a lot of these issues, called "My Sister's Keeper", about a child intentionally conceived/ designed thru assistive reproduction to be an ongoing blood and tissue donor for her older sister's cancer treatment. The story is about the issues surrounding each of the sisters rights to refuse medical care-- in the case of the younger-- to refuse to be forced to be a donor. (The movie version significantly changed the ending from the book-- book was better, IMO.)

    http://www.amazon.com/My-Sisters-Ke...=1420833833&sr=1-1&keywords=my+sisters+keeper
     
  18. MsFacetious

    MsFacetious What a Kerfuffle...

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    That DOES happen... with Jehovah's witnesses. :twocents:
     
  19. K_Z

    K_Z Verified Anesthetist

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    Lol-- some of my grad students hate my "thought experiments!" I ask them to write opinion papers on such topics, justifying their opinions with evidence from the literature, and then presenting them in class. I love it as an educational tool to teach them to think critically about differing options and opinions. I'm evil that way, lol!
     
  20. K_Z

    K_Z Verified Anesthetist

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    Not with pediatric Jehovah's Witnesses. Adults, yes.
     
  21. MyBelle

    MyBelle Active Member

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    Yes, chemo sucks. Nobody has said chemo is a picnic.

    She's a minor. No different than if she needed a blood transfusion and her mother was against it.
    She's got one of the most curable forms of cancer and I'm surprised her mother supports her decision.
     

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