Should a teenager be able to refuse chemo

Really interesting case in Connecticut where a court is mandating that a 17-year old teen with non-Hodgin’s lymphoma (a highly curable cancer with chemotherapy) receive treatment despite the fact that she and her mother insist she will be cured without subjecting herself to “poison.”  Here’s the NPR story.

Update at 3:05 ET: The Connecticut Supreme Court ruled unanimously Thursday afternoon that the state can require Cassandra to continue treatment.

Her mother, Jackie Fortin, said she’s disappointed by the decision. “She knows I love her and I’m going to keep fighting for her because this is her decision,” Fortin said. “I know more than anyone, more than DCF, that my daughter is old enough, mature enough to make a decision. If she wasn’t, I’d be making that decision.”

Here’s our original story, reported Thursday morning:

A 17-year-old Connecticut girl recently diagnosed with cancer has been removed from her home after refusing to undergo chemotherapy.

The girl, named Cassandra, is now in the custody of child welfare authorities and is being forced to undergo cancer treatment. The state Supreme Court is taking up her case Thursday to weigh whether she’s mature enough to make her own medical decisions.

Cassandra is Jackie Fortin’s only child. Fortin has been a single mother for Cassandra’s entire life. Until last month, they lived together in Windsor Locks, Conn. Fortin says this is the first time they’ve been separated.

“Nobody, whether it’s her age or an adult, should ever have to go through this by herself,” she says.

For the past month, her daughter has been held at a local hospital, undergoing chemotherapy treatment against her wishes. A court gave the state Department of Children and Families temporary custody of Cassandra, as well as the authority to make medical decisions for the teen, after doctors reported Fortin for neglect. Court papers document missed appointments and arguments with doctors over her daughter’s diagnosis.

But Fortin says it’s her daughter’s right to refuse chemotherapy, saying she doesn’t want to poison her body.

“This is not about death,” Fortin says. “My daughter is not going to die. This is about, ‘This is my body, my choice, and let me decide.’ ”

But Cassandra’s doctors say that without treatment, she will die. They testified in previous hearings that Hodgkin lymphoma, a cancer of the lymph system, is lethal without the recommended treatment. With treatment, she has an 85 percent chance of survival.

We’ve got to have a line when it comes to adulthood, and for better or worse, we’ve generally (though, admittedly imprecisely) settled on 18.  If Cassandra was 18, she could let herself die with her “natural”treatments and it would be an unfortunate, but unnoticed story.  But Cassandra is a minor and therefore the state does have a legitimate role to seeing to her well-being if her own mother will not.  And sure, chemo is not exactly fun, but we are talking about a life here.  I might be inclined to grant the minor her wishes if they were not demonstrably against science.  She will, in fact, very likely die without chemotherapy.

So, I’m with the state for two science-based reasons.  One: the daughter and her mother are basically anti-science, and when that comes to a life-saving medical treatment for a minor, that’s a real problem.  But also, because regardless of legal status, it is now well-established that a 17-year old brain is still years away from being fully mature in decision-making capabilities.  And by almost any objective calculation, this is simply horrible decision-making.  I’m pretty comfortable with the state erring on the side of keeping a minor alive.  Safe to say, I’d feel differently if it were the opposite.  Anyway, very interesting case.

About Steve Greene
Professor of Political Science at NC State

3 Responses to Should a teenager be able to refuse chemo

  1. Mike says:

    A similar incident happened in Canada. I’m not sure if I mentioned this before or not. A native child and parents want to treat leukemia with “traditional” native medicines because they don’t trust the “Western paradigm of medicine” and declared chemo to be poison. I don’t even know what traditional treatment means, herbs, dancing and a shaman? Doctors say the child, 11 years old, will without a doubt die without real treatment.

    Canadian Justice Gethin Edward “concluded that the family’s aboriginal rights trumped the hospital’s attempts to compel child-welfare authorities to intervene”.
    In my opinion, it’s nothing short of premeditated murder. The weapon is ignorance.
    It makes me furious to contemplate a very young girl will die because of woo and a distrust of science. I see lots of idiots like this, yes, they are idiots. They wear glasses, drive cars, use cell phones, and take advantage of every other modern technology and convenience, but cringe at “modern medicine”, vaccines, cancer treatment.

    Freakin’ idiots.

    I don’t care about the mother or father. If they want to die, let them. But the girl could live to 100, 120, maybe even 150 or 200 years old, by that time. She’s far too young to make this choice and her parents shouldn’t be allowed to let her die.
    I can’t say how disappointed I am in the justice that made this ruling.

  2. Mike says:

    Latest news, the girl is dead. The parents say they did the right thing, and blame the Chemo. They took her to some quack in Florida that does alternative treatments in a “massage establishment”.
    In an interview with CBC News, [J.J.’s] mother said, “This was not a frivolous decision I made. Before I took her off chemo, I made sure that I had a comprehensive health-care plan that I was very confident that was going to achieve ridding cancer of her body before I left the hospital. This is not something I think may work, this is something I know will work.”

    The girl’s mother said her daughter received cold laser therapy, Vitamin C injections and a strict raw food diet, among other therapies at Hippocrates Institute (who’s website says they “internalize and actualize an existence free from premature aging, disease and needless pain.”)
    I don’t know how a Florida clinic can be dispensing “traditional” native medicine for people from Ontario, Canada.

    The doctors from say the girl had a relapse and her Leukemia killed her. A disease which these days has excellent chance of recovery, but only if the entire treatment is taken.

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