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Failing To Treat Child’s Cancer Medical Neglect

Failing To Treat Child’s Cancer Medical Neglect

At what point is a refusal to treat your child’s cancer with traditional chemotherapy medical neglect?  Just how far does a family’s personal religious freedoms extend?  

Minnesota Judge John Rodenberg grappled with these exact issues, ruling Friday that a family’s refusal to treat their son’s Hodgkin’s lymphoma with chemotherapy amounted to medical neglect.  The Judge ordered the 13 year-old to be evaluated by a doctor to determine if the boy would benefit from chemotherapy treatments, over the objections of the boy’s parents.  The family has until Tuesday to seek additional evaluations.  If the tests show that the cancer has advanced to the point where chemotherapy and radiation would be futile, then the Court would not order treatment.  However, if the tests show that chemotherapy and radiation would help the boy, and if the parents continued to refuse treatment, the boy would be placed under the care of child protective services, although it is not at all clear how Court-ordered medical treatment would proceed.

The Minnesota case illustrates just how difficult these kinds of religious exercise cases can be.  We witnessed the absurd politicization of Terri Schiavo’s last days, with politicians who were not treating physicians but happened to be medical doctors making pronouncements on her care.  Shiavo’s case became a cause celebre for the right-to-life movement, yet that same advocacy group has so far been unusually quiet regarding the Minnesota case.  

Why is that?  If pro-life groups consider it murder to remove the life support of a woman who spent seven years in a persistent vegetative state, what about these parents who refuse a medical treatment that the treating physicians believe have about a 90 percent chance of curing their son’s cancer because it conflicts with their personal religious beliefs?  

The reality is both families made essentially the same argument, that is, that they, and not the government, should have the right to make personal, critical, and important medical decisions for themselves and their family members.  Though they cite two separate sources for that right, in the Schiavo case it was the right to privacy, and in the Minnesota case, the right to exercise their religious beliefs as they saw fit, both families wanted the privacy and dignity to make a painful decision without the interference of the government.  Both families should have that right, regardless if it is a privacy right or a religious exercise right, and the pro-life movement should recognize that right, regardless of source.  Of course to do so would to cede ground on the intellectual and Constitutional underpinnings of Roe v. Wade.  

The Minnesota case is a real tragedy.  A family struggles with making life and death decisions concerning their child and have essentially had the ability of to make those decisions abdicated by the Court.  Judge Rodenberg deserves a lot of credit for trying to come to a practical, compassionate, and just ruling.  However the case remains a lesson in just how hard it is to balance individual freedoms when the result inevitably ends in death.
 

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photo courtesy of TheNickster via Flickr

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204 comments

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2:03PM PDT on May 23, 2009

I think this is an extreme and extraordinary case. I think there are things that we do not know about the details.
It was reported today in the Minneapolis Star Tribune that Dr. Bostrom indicated "It was the first time in 25 years I've ever had to do that," Bostrom said Friday. "I've had parents who disagreed, but until now, we've always been able to work it out, find a way to get appropriate treatment."
A court-ordered X-ray that showed the tumor, which had shrunk after the first of six planned treatments, had grown back. (While they were doing nutritional interventions at home)
There is no evidence, from the X-ray, that the cancer has spread,'' Bostrom added. "We're just back where we started."
Yes, I agree this is an extraordinary case.
Another portion of the series in the Star Tribune indicates that the mother became a member of the Nememhah Tribe after the cancer was diagnosed.
http://www.startribune.com/local/45848357.html?elr=KArksi8D3PE7_8yc+D3aiUo8D3PE7_eyc+D3aiUeyc+D3aULPQL7PQLanchO7DiUr

12:26PM PDT on May 23, 2009

This is a very gray area of medicine, law, family rights, etc. However, one issue that has been mentioned is that Daniel is unable to read, and didn't quite seem to comprehend what his religion is about, what his illness is about, or understand the choice in treatments and possible outcomes. In other words, this was not a mature, well educated 13 year old who had a full understanding of the issues at hand.

The whole story just seems to hazy to me. Having worked in healthcare, I have seen first hand how families and professionals clash over treatment issues for children. This is not a one size fits all situation, but in this case, I wonder how much Daniel really understood about anything? Or his parents for that matter?

FYI, I am a big proponent of alternative therapies, but I do believe in combining the best of alternative and standard to achieve the best outcomes for the patient.

11:08AM PDT on May 23, 2009

This is her child and she feels she is protecting him from harm so nobody has a right to make her do anything that she feels will hurt him unless or until they prove to me that those people brought him into this world they are stepping over the line and that is a fact.

6:07AM PDT on May 23, 2009

There is a National Center for Complementary and Alternative Medicine; Advocate for increased funding.
http://nccam.nih.gov/health/decisions/consideringcam.htm

Participate in clinical trials for complementary medicine:
http://nccam.nih.gov/research/clinicaltrials/
It is through these means that someday there may be proven alternatives to chemotherapy. We are no there yet, but it is a possibility in the future.

5:55AM PDT on May 23, 2009

Certainly if natural works then natural is the way. But when it doesn't work one goes to what does. This isn't about big pharma, it is about a young 13 year old, intellectually challenged boy and how he can live into adulthood. It is about how he can receive treatment for a type of cancer that is almost completely curable. Once the cancer is gone, he can continue to do all of the preventative natural measures one would do to prevent cancer. He can do them now to complement chemotherapy and decrease the harsh effects of a very harsh treatment regimen.
I hope one day they will find a natural alternative to chemo that actually works, but we are not there yet.
We can support and fund valid research on these natural, alternative methods so that someday there may be a kinder cure for cancer.

5:21AM PDT on May 23, 2009

And for those who keep insisting that a child has the absolute right to control his own medical care, even if it means he may die:

If a 13-year-old boy has a gangrenous leg that needs to be amputated to save his life and he refuses because he thinks going through life with only one leg is the end of the world - should his parents allow him to make the choice?

If a 16-year-old girl needs steroids to treat a life-threatening condition but refuses to take them because they make her puff up and appear overweight and she hates not looking beautiful - should her parents allow her to make her own choices?

If a ten-year-old child has an appendix that is about to burst, killing him, but doesn't want the surgery because he's scared of doctors and surgery and shots - should his parents allow him to choose to not have surgery?

Children often don't think things through. A boy who is heavily into football may well balk at having a leg amputated, even if it will save his life. He may not have the maturity to realize that lots of people go through life with only one leg - and have wonderful lives.

A teenaged girl may not have the maturity to realize that looks aren't everything - and that being puffy from medication is better than being buried in the grave.

A child may not have the maturity to realize that there is more to fear from a burst appendix than there is from the surgery.

It's about parents showing maturity and protecting children from immature choices.

5:07AM PDT on May 23, 2009

Penicillin is a poison. It kills a living organism, namely bacteria. And can also kill a small portion of those people who take it who are allergic to the medication. And it saves far, far more lives than it takes, and is therefore a beneficial medication in appropriate circumstances.

Chemotherapy is also poison. Its purpose is to destroy cancer. And it can sometimes kill a patient as well. But, like penicillin, it saves or helps more patients than it kills, and is therefore a beneficial medication in appropriate circumstances.

9:45PM PDT on May 22, 2009

Chemo is Poison. So, Poison put into the body to kill a disease is the right way? And something created by nature is put aside because the FDA says so. Start thinking for yourself. I know someone that was on his death bed, that without doing the other besides strickly Chemo, he would be dead.

9:40PM PDT on May 22, 2009

Gee! People sure are full of opinions and quick to Judgement. However, we are not in her or her sons shoes. She is scared and I am sure he is as well, her son. Maybe even more so. He should have the right to choose the treatment he wants. He is a person. Young, yes, but still the one that has this disease. Unfortunatley, drug companies have made loads of money off of illness. Do you really think they are as forth coming as you think?
Amazes me how we will believe that the only way is conventional medicine, but Nature is way out. come on!

3:47PM PDT on May 22, 2009

Most seem to think that the mother and son duo are headed for Mexico for alternative treatment. But even some of those who practice alternative treatments feel that it has no real effect on cancer:

"Lise Alschuler recommends pulling from both medical approaches. Alschuler is the president of the Association of Naturopathic Practioners. She's also a naturopathic oncologist who practices in Arizona. She frequently recommends her cancer patients undergo conventional treatment along with the integrative medicine she prescribes. But she said some of her patients have decided to go to Mexico for treatment, and they do return feeling better, according to Alschuler.

"They are typically converting people to a really healthful, nutrient dense diet," Alschuler said. "But it's possible to feel well and have a cancer growing rapidly at the same time."

That's what happens with some of her patients, but not all.

"I've also had patients who have come back and have had some reduction with their tumors, even had a couple of patients who had significant reduction with their tumors," she said.

In all of her patients who visited clinics in Mexico, the tumors eventually returned, Alschuler said."
http://minnesota.publicradio.org/display/web/2009/05/21/alt_medicine_mexico_debate/

So all of her patients who received that alternative treatment in Mexico had tumors that eventually returned.

I hope they find the boy in time.

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