16
May
08

On air: Who has the final say on a child’s medical treatment?

Lydia in Canada has suggested we talk about this, saying ‘it’s huge news story here’. This is it. An 11-year old in Hamilton has leukaemia and does not want to continue with chemotherapy. It’s a decision the child’s parents support. They want to look at alternative therapies, but the doctors treating the child say chemo is by far the best option. So who should decide?

The child is now in the custody of Children’s Aid Society in Canada, though they have agreed for the child to return home. And a judge has said that the parents do have the right to seek fresh opinions from other experts from the alternative and traditional fields of medicine. Beyond that it’s not clear what will happen.

So who should have the final say? The child, the parents or the doctors?


83 Responses to “On air: Who has the final say on a child’s medical treatment?”


  1. 1 Corey in Albany NY USA
    May 16, 2008 at 13:46

    Minors are not given the authority to make decisions about their own health. Doctors need permission of the parents to do a medical procedure on a minor, so if the parents refuse the treatment (acting on behalf of the child) I don’t think there’s much the hospital or the government can do.

    In New York State:
    “An individual who is legally a minor cannot give effective legal/informed consent to treatment and therefore, conversely, cannot legally refuse treatment.”
    Public Health § 2504:
    “4. Medical, dental, health and hospital services may be rendered to persons of any age without the consent of a parent or legal guardian when, in the physician’s judgment an emergency exists and the person is in immediate need of medical attention and an attempt to secure consent would result in delay of treatment which would increase the risk to the person’s life or health.”

  2. 2 steve
    May 16, 2008 at 13:49

    In all areas of family law, the “best interests of the child” trumps. 11 year olds also don’t like eating broccoli or going to school, yet we make them do those things. SO they shouldn’t have a say in their medical treatment because they aren’t emancipated adults.

  3. 3 Robert Evans
    May 16, 2008 at 13:49

    Personally I would allow the child who is the patient choose but with the doctors to advise them on the best course of action. So I feel it is appropiate for the patient to be allowed to decide

    Best of Luck

    Rob

  4. 4 Dee in Chicago
    May 16, 2008 at 14:06

    This is a tough one. I’ve just completed chemo myself, so I sympathize with this child. 11-year olds today are far smarter than in previous generations so his/her opinion is probably pretty well informed. I think in the end the child’s decision should trump the court’s.

  5. 5 Brett
    May 16, 2008 at 14:09

    I’d like to expand on Steve’s pointing out of “best interests of the child” being paramount. It is important the these “best interests” be the best medical interests of the child. Not the best religious interests, or best wishes, but the best medical interests of the child.
    When the child is old enough and dumb enough to refuse treatment for whatever reasons or ideals they hold near and dear to their heart then that is their decision; But only at that point in time.

    Of course an 11 year old doesn’t want to continue Chemo… its not fun! My friend is going through it right now. He doesn’t want to continue it, but realizes that he needs to for his own good. No one WANTS to undergo chemo.

  6. 6 Alex in Nairobi
    May 16, 2008 at 14:11

    I think the parents are just a bittoo sympathetic about their child and that’s quite natural. Only that their sympathy may now lead them to ‘destroy’ the very object of their symapthy. The parents should and must convince the child that the doctors means good for the child. The doctor is the expert here all others should stick with him.

    Else, that same or another child will tell his/her parents that s/he wants to commit suicide and the parents, being too ‘sympathetic’, will give the go-ahead.

  7. 7 Shirley
    May 16, 2008 at 14:11

    Has anyone here ever known a young person who had cancer? Has anyone here ever wandered the halls of a pediatric oncology unit? These children have an indominatable spirit – and a soul older than most adults who accompany them. Considering that human nature is pro-survival, especially in young people, if a child were to ask me to “make it stop, Mommy,” I would be hard-pressed to refuse his request. It is indeed a heart-breaking decision. I wish that no-one ever had to make it. But a child with such a huge burden to bear should be regarded on a case-by-case basis, not as part of a blanket consideration of children in general.

    This issue was dealt with in an episode of the U.S. TV series “House,” which airs on Fox TV. My family and I discussed it at some length. I also knew a young lady who fought cancer for several years before deciding on her own to stop treatment. Her passing was terribly hard on all of us in the community. However, I fully respect her decision as her own to be made.

  8. 8 Brett
    May 16, 2008 at 14:19

    With all due respect, you have kids drowning every year because they want to go swimming and jump in a pool when they can’t swim.

    What makes you think that a child is able to swim in the field of medical terminology, understanding and informed decision-making, because they jump in and make a decision?

    Of course if it was Doogie Houser….

  9. 9 John Smith - Jamaica
    May 16, 2008 at 14:23

    This is an unfortunate case. On one hand, the wishes of the patient (and since she is a minor, her parents) should be considered, esp since the effects of chemotherapy can be as bad as the cancer itself. On the other hand, the doctors are charged with providing the best care for a patient and if that is found to be chemotherapy, then they are going to insist upon that. When it comes to life and death issues, there is no right or wrong…unfortunately in the end the circle of life must continue. Not much use arguing this point, because there will be no winners, just a bunch of angry people who will try to use their own inherent moral views to justify their position.
    I believe this family should be left to sort itself out in this time of grieve without having judgemental people around the world casting aspersions on their decision.

  10. 10 Kwabena
    May 16, 2008 at 14:29

    The doctor has the capacity to recommend an appropriate medication but i believe the parents and the child has the right to accept or reject the doctors recommendation.

  11. 11 ZK
    May 16, 2008 at 14:32

    Definitely a tough one. In my opinion, the child’s wishes should be considered, at the very least — it is them on the receiving end, and not anyone else. As the child’s legal guardians, the parents will obviously have the final say.

    It just happens that, on this occasion, they’re willing to agree to their child’s request. It may be that they are prepared for whatever might happen, and so are ready and willing to do so. In which case, I believe that we should all respect that, and grant the request.

  12. 12 bobinqld
    May 16, 2008 at 14:34

    As a parent and grandparent (with children ranging from 25 down to 3 years old…don’t ask!) I don’t think an eleven year old is ready to take this decision. By all means it should be discussed with them and they should have all the options explained to them but, in the end, this is a decision for adults.

    Normally I’d say the parents should be the responsible adults but, in cases where their views are too extreme then that horrible phrase “the best interests of the child” has to come into play. I believe that, in the case of childhood leukaemia, the prognosis is pretty good for children given conventional medical treatment…but almost certainly fatal in the case of “alternative therapies”. That, to me, is a compelling argument.

  13. 13 Muthee
    May 16, 2008 at 15:13

    HelLo WHYS,
    I just can not tell what the world is coming to.If the future is gonna be dictated by rights and constitutionality and all that, then surely heaven help us.
    How can such a story even make headlines, the parents of that child have got to do what they have to do which i believe is the best for that child. Where did the kid learn about treatment of such serious diseases and their treatments?
    Any other way, then this Swahili saying that can be translated as ‘if a child insists on being given a razor, go ahead and give them’ should come in handy.
    Nairobi

  14. 14 nicholas kariuki muthaara
    May 16, 2008 at 15:14

    doctors should have the final say on treatment of patients.they have experience on that field.

  15. 15 Lubna
    May 16, 2008 at 15:18

    Hello Precious Ros… I’m a fourth year medical student who intends to become a pediatrician after graduation Inshallah…. Ever since I entered the medical school four years ago I keep asking myself and my senior doctors this question : What exactly are my main duties as a future doctor ?! And this is the answer that I often get from many of my senior doctors : Your main duty isn’t only to cure or treat your patients, but to also to improve the quality of their lives even when having a chronic or debilitating illness…. To me as a future doctor the most scared value that’s worthy of all my time and efforts (both mental and physical) is the preservation of the human life… Regarding this kid’s case, in my opinion a child can never be trusted to make a choice when it comes to deciding what to do with the most scared gift that has ever been given to him i.e. HIS LIFE ! With my love. Yours forever, Lubna.

  16. 16 Amy
    May 16, 2008 at 15:20

    Everyone here has made good points, but I agree with that the decisions should be made on a case by case basis. This boy has already gone through chemo so he knows what to expect. With childhood leukemia, if it returns after going into remission, the odds of survival, even with treatment, goes way down. I had a close friend who went through this ordeal with her oldest child. The child had chemo, went into remission and then the leukemia returned. While everyone wanted her to survive, her parents knew that putting her through the chemo again would take what little vitality she had left. They let the girl make the decision on whether or not she wanted to go through it all again. She said no. She was a little over 3 at the time. Do not underestimate what these kids know and understand. Whenever cancer enters your world, no matter the age of the patient, your understanding increases. My friend did what she thought was best for her child and I think the parents of the boy in Canada should be allowed to do what they feel is best in this situation. Doctors don’t like “bad” outcomes and will do everything they can to try and avoid them. If the boy doesn’t have the will to fight, he won’t and all the chemo in the world won’t defeat the leukemia.

    Amy in Beaverton, Oregon

  17. 17 steve
    May 16, 2008 at 15:22

    When we let kids dictate to us what they want to do, you have spoiled brats running around, causing havoc. You don’t let kids make adult decisions, period. If they want to be fools when they are adults, they are free to, but they have to be an adult before they can do that. You wouldn’t trust that kid to drive, you wouldn’t trust that kid to make dinner (it would consist of mac and cheese and chocolate bars), so we trust a kid to make life and death decisions? This is the same problem we have with “feral” kids that cause problems on the street, because their parents gave them too much freedom to make stupid decisions, as kids.

  18. 18 John in Salem
    May 16, 2008 at 15:24

    An 11 year-old simply does not have the capacity or maturity to make life and death decisions about his future.
    His doctors say he will not live more than 6 months without futher treatment and that with it he has a 50-50 chance of beating it. While an adult might see the prospect of 6 months of chemo as a small price to pay for another 50 years of life, a child sees 6 months as an eternity.
    Having to make tough choices for your child is one of the responsibilities you accept when you decide to have children, and along with that is the reality that we keep and raise our children because the state allows us to.
    If you can’t handle that then don’t have children.

  19. 19 Timothea
    May 16, 2008 at 15:25

    Best case scenario – I think those decisions should ultimately be made by the parents. Those parents should know their child (there is a huge range in maturity and understanding in different 11 year olds) and take their feelings and choices into account, giving it the weight it merits. Those parents should be listening to the medical community and be guided in their treatment choices. This assumes the parents are not withholding reasonable treatment to their child because of extreme religious beliefs. This assumes the doctors are open to patients having valid concerns. It has to be a balance between the 3, to ensure the best possible outcome.

    Having watched a friend’s 4 year old go through multiple aggressive chemo treatments I am in awe of her attitude facing it all. Children facing these illnesses possess a wisdom beyond their years.

  20. 20 savane
    May 16, 2008 at 15:31

    I’ve held my daughters down, endured very powerful strategically placed kicks, (thank you God for making me female! Sorry Papa and Dr. G that you were born male!), and chased after them as toddlers when they ran out of their doctor’s clinic, just so they wouldn’t get their childhood immunisations! Yesterday evening, I had to tackle my Tween (11 years’ old) to get a tetanus shot after a nasty fall (don’t ride your bicycle barefooted!)

    Speaking as a mother who panics when my kids sick, I will do everything in my power to ensure my girls get the best medical treatment available, and right now, Western medicine is what we use. I make it a point to educate my girls on preventative (which is mainly natural) and curative healthcare.

    I’m their mama! It’s my job to take care of them. Know chemo’s horrid – so is eating pumpkin and liver! But they are good for you!

    Savane
    Nairobi Kenya

    p/s: I dare you to catch me when I need to be given a shot!!! And I stopped eating pumpkin when I turned 17 and went to university far away from home!! But when I visit my parents and my Mama’s made pumpkin, I EAT IT!

  21. 21 steve
    May 16, 2008 at 15:31

    I’m shocked people are defending a life or death decision by a 11 year old let alone a 3 year old. Do we let kids decide if they don’t want to be vaccinated either? You have no choice, you get vaccinated, because you are forced to go to school, which kids don’t like either.

  22. 22 Rochelle
    May 16, 2008 at 15:33

    The parents are responsible for the child until he is an adult. It the child is making an informed decision, and the parents agree, then that should be the final say. Granted Doctors have plenty of knowledge in the medical field, but they don’t have the only definitve knowledge in the medical field.
    Facts are humans hae the ability of free choice in many countries, this is a free choice that I fully support!

  23. 23 Brett B
    May 16, 2008 at 15:42

    Certainly not the doctors, and certainly not the State. It should be up to the individual and the family.

    Kids may just know a little more about life or death than we do!

  24. 24 Rufaa
    May 16, 2008 at 15:53

    Hi Ros!
    I agree with Lubna(above)on the fundamental point she makes about preservation of human life. Life is precious and doctors are better trained to find the best treatment for a patient. The most appropriate, if not, the panacea we crave for.Neverthless, when doctors trust is lost for personal interests or on a strict superstitious grounds, the stage can be left for the concerned. They should, however provide an alternative diagnosis as in the case of Hamilton. The situation is different when the child’s life is at risk and the only option is fate and fine surgical hands…I guess, the doc is free and prayers for the Almighty to help is the only idea. We watch and wait.

  25. 25 Shirley
    May 16, 2008 at 16:13

    nicholas kariuki muthaara
    May 16, 2008 at 3:14 pm
    “doctors should have the final say on treatment of patients”

    I firmly reject the notion that doctors whould have so much power over their patients. If a doctor told me to kill my unborn child because of some vague risk to my life, I would want the power to refuse. If a doctor dictated to me a cesaerian, I would want the power to refuse. If a doctor refused me the chance to use garlic and ginger medicinally when I catch the cold, I would want to power to go my way. Entering a doctor’s office should not be akin to immigration to occupied Myanmar.

  26. 26 Venessa in Portland, OR
    May 16, 2008 at 16:20

    Unfortunately I won’t be able to listen to today’s programme but I would like to contribute this discussion:

    Please ask yourself these questions: In our society aren’t parents responsible for their minor children? They are allowed to decide if a child is circumcised or not – does that cause damage or impact your personal property (your body)? Have you ever dealt with someone with a terminal illness?

    I have lived with and taken care of someone who was terminally ill and I can’t imagine the pain my step-father was in. I drove him to dialysis 3 days a week and spent plenty of time getting to know the inside walls of the ICU unit on nearly a weekly basis. I watched him live with this for nearly 10 years. At the very end with a collapsed lung, cancer on his spine and no kidneys who am I to decide if he should live or die even if the medical capabilities are there to keep him alive?

    I said this on the blog last night and if you break it down I find it quite paradoxical that I have the right to mutilate my body for purposes of vanity that can result in permanent disfiguration or death and I can tattoo every inch of my skin, but when it comes to the choice of when I want to die or whether or not I want to bear children everyone else wants to have a say. It’s your body and personal property why should anyone give up the right to do as they wish with it?

    Isn’t this discussion really perpetuated by our own inherent fear of death and not based on our right to our own personal property? My body is the one thing I solely own and I don’t appreciate someone telling me how to treat it.

  27. 27 Shirley
    May 16, 2008 at 16:25

    John in Salem: An 11 year-old simply does not have the capacity or maturity to make life and death decisions about his future. (May 16, 2008 at 3:24 pm)

    steve: They shouldn’t have a say in their medical treatment because they aren’t emancipated adults. (May 16, 2008 at 1:49 pm) and You don’t let kids make adult decisions, period. (May 16, 2008 at 3:22 pm)

    I raise my old question: How many of you have actually known a child who was faced with this kind of decision?

    I believe that acting like dictators towards children teaches the children to become dictators when they grow older. I have seen it happen myself.

    I do believe that children need limits. We, the adults who care for them, should indeed establish certain routines consisting of a general daily schedule, dietary norms, healthful sleep patterns, expected behaviours, rewards for fulfilment of those behaviours, and consequences for refusal to comply with expected norms. However, when we take the role of beneficial guardian to such an extreme that we dictate every element of a child’s young life, the psychological consequences can be devastating.

    I have seen children raised in such an environment become bullies or interact with others in a sly double-faced way so as to get their way with everything. Such children are mean and unpleasant to be with; and it is not even their fault while they are yet at such a young and impressionable age.

    For the most part, children will comply with medical requirements for their health. Yes, infants spit and sputter; and we wear more cough syrup than they ingest. However, as the child ages and approaches the age of reason, they can and will listen to explanations about why they need to the medical treatment to feel better and be healthy again.

    I know another young person who has been in and out of hospitals with various congenital conditions since his birth – before his birth, even. He knows the torture of long-term medical treatments. He has endured physical conditions that are excruciatingly painful. He knows how painful IVs and other equipment can be. Yet he complies with his medical treatment. He has the spirit to continue the fight for life; and you can see it in his eyes and the way that he acts. In fact, he generally acts quite normally.

    I saw my friend who died from cancer turn from a youthful, vibrant, vivacious person with hope to an exhausted, hopeless individual whose youth had been stolen from her. She had fought and won; but when the cancer returned and mainstream and alternative treatments ceased to be effective, she lost the will to live. I saw her lose ability after ability to the tumour. It killed her family to see the process. A part of me died, as well. But the fact remains that she made her own informed decision to discontinue medical treatment for her cancer. She left this world of her own accord, relatively pain free, and respectably – no tubes, no machines, no noisy chaos.

    As a Shia Muslim, I shudder to think that the last moments of my life will by fiqhi (1) necessity be spent in the noisy and painful chaos of various attempts to resuscitate me. Lubna, do you know whether really old people really do have to go through all that nonsense even when they are at the end of their lives? Or is it only wajib (2) to incessantly attempt to revive the person when some unforeseen accident befalls them?

    (1) jurisprudential
    (2) obligatory

  28. 28 gary
    May 16, 2008 at 16:26

    Human beings are individually defined by the ways in which they exercise free will. As adults, we teach children proper use of this most prodigious gift by defining their “spheres of mischief.” Thus, we strive to limit our children to survivable, and instructive, bumps and scrapes. Childhood ends, and when it does, freewill allows the emergent adult to make life-threatening decisions. The only people, who know about the adulthood of Hamilton, are Hamilton himself and his family. Having stated this, only one other comment (to Hamilton) is necessary: Wise adults use all available resurces to make the best possible decisions.
    g

  29. May 16, 2008 at 16:36

    The health of any person is the responsibility of society as long as there are services to cater for that. Medical treatment shouldn’t be stopped if this becomes life-threatening.

    In the case of children, they’re too young to take decisions on such matters. They should get all the support to bear with the treatment however painful it can be if it can save their lives.
    Yielding to a child’s refusal to get medical treatment is a tacit form of euthanasia, as his /her death becomes a permanent cure.

    Doctors and psychiatrists should work out ways to convince the child that it is in his/her interest to be courageous enough to get the best cure to enjoy a healthy life through which they can fulfil their ambitions.

    It must be a painful experience for the parents to have a critically ill child refusing crucial treatment. But their support and care will be the cure needed for the child to voluntarily accept medical treatments. Sometimes the psychological support plays wonder when the physical side is run down. It’s the mental preparations for a morale lifting that can defeat the physical pain.

    After all, doctors know better. If they are sure of their treatment, they should have the final say. Parents can be just the moral support of their child to go through a life saving experience. For parents, it’s better to feel that they have done all they can than to feel that they have let their child down by being soft out of compassion instead of being firm about a matter of life and death.

  30. May 16, 2008 at 16:42

    The child`s parents usually have the right to make decissions with their chid’s welfare, in this child’s case it may be for religious reasons that they prefer an alternate treatment aginst the doctor’s advice. In such cases it should be left to a Judge in a court of law to decide on the child’s welfare.

  31. 31 Abdi,in Mandera Kenya
    May 16, 2008 at 16:43

    I think the parents are the right people to make the final decision. Because chances are that they won’t make the wrond decisions this is because it hurts them more than any other person be it the doctor,the child or the Court.Our religion -Islam teaches us to obey and accept any conculotions that our parents reach with or without our parents.The Prophet (PBUH) said ‘paradise is under the feet of your parents”so this hadith clearly tell’s us to respect our parents and their decisions.
    (To all listners: if you haven’t seen Sony A ward Giving Ceremony Pictures then you’r not A loyal listner to WHYS like -I have’t missed listening to WHYS through out since 2oth Jan to date.go find it from Ros.They are amazing,fantatic scenes from London no one in the world will want to Miss it.)

  32. 32 thelegendali
    May 16, 2008 at 17:03

    Surely the doctors know whats happening and they are the rightful epople to make final decision on the child’s medication.

  33. 33 DOLAPO AINA
    May 16, 2008 at 17:07

    Kids are not allowed to vote till they are 16, 18 in different countries that tells us something. Let the doctors make the examinations and the parents can decide but they should have the child in mind and not for personal interests but the overriding factor should be the welfare of the child.
    It is tricky and dicey but the best potions have to be carefully made.

    Dolapo Aina,
    Lagos, Nigeria.

  34. May 16, 2008 at 17:16

    Who gave birth to the child? Who fed and clothed the child for 11 years? Who was there to comfort the child when he or she had nightmares, problems at school or just wanted a hug? I’m sorry, the answer is obvious – the question is ridiculous.

  35. 35 selena
    May 16, 2008 at 17:20

    Doctors don’t always know/do best! As my mother lay dying, with no hope of survival, a doctor was using every means at his disposal to keep her alive for that extra second. She asked to be left alone and was ignored.

    He knew that she was virtually dead but he probably felt that he had to cover himself for insurance purposes and in one sense, with litigation never far away, that can be understood.

    On the other hand, it make my mother’s dying moments a nightmare for the family. It was a special nightmare for me because the family felt that, being a former insider, I could/should have stopped it.

    The reality is sometimes procedures are carried out for no other reason than to document that everything possible was done.

    There are no right or wrong answers in those situations. Each case stands on its merits. In the case of children probably parents should decide if at all possible, unless they are religious fanatics.

    I don’t know what to say about the 11 year old boy making such a decision. Looking back, I think I could have made a choice. At that age, I was pretty proficient at looking after myself.

  36. 36 Venessa in Portland, OR
    May 16, 2008 at 17:42

    Requiring someone to live who is terminally ill is just a selfish act on the part of the person advocating that they must live. Isn’t preservation of life a concept that satisfies an individual’s own moral or religious beliefs?

    There was a time when we did not have the medical capabilities we do now and such a person would simply die. Why should I be forced to engage in such medical treatment? Is my body not my own personal property? I keep returning the same answer: the inherent fear of death people have keeps perpetuating the argument that we MUST preserve life at the cost of limiting their decisions regarding the use or disposal of their personal property.

    Parents are responsible for their minor children; if they allow a child to not eat broccoli because they don’t like it is that not the right of the parent to allow such behavior? It doesn’t hurt you in any manner does it? If a parent allows a child not get the required immunizations that are required attend school – is that their right? No, the child needs the immunizations due to the threat it poses to other individual’s bodies.

    The point of such laws is to prevent the harm or impact that you have on someone else. My choice not to participate in a particular medical treatment in no way impacts your body or your right to live; just as my choice to eat broccoli does not have an impact on your body.

  37. 37 John in Salem
    May 16, 2008 at 17:46

    Shirley~
    When the choice my child is making involves a chance for life or certain death I have no qualms about being a “dictator”. That’s my job as a parent.
    If you allow your child to make that choice and throw away their life rather than face an unpleasant 6 months of chemo you have failed as a parent.
    The fact is you can’t see the future – we have to rely on doctors to give us their best guess – and every cancer patient I have known would consider 50-50 odds as a damn good fighting chance.
    Allowing your child to quit and die shows more sympathy for the disease than for your child.

  38. 38 Thea Winter - Indianapolis
    May 16, 2008 at 18:07

    Hi all,
    All of you have stated your point well.

    Parents should always have the last say. I am not sure in this case if the parents have all the information on the treatments for their son. However, I think parents can get too close to their child’s suffering and only see that and want it to stop. That is why most Doctors to not treat their family members, they are too emotionally involved to make correct decisions. I hope this is not the case here.

  39. May 16, 2008 at 18:10

    Andrew in Australia

    Ultimate decision should be given to the courts. Doctors have vested interests in treating illness and not many would advocate discontinuing treatment, and for a child there is the emotional aspect of giving up a conventional and potentially life saving cure. Parents can have a similar bias if they choose to have their child discontinue treatment for dubious reasons as has been shown in specific media cases. As for the child itself, how could a child of young age make an informed decision? The point of parents is to make decisions for their children they are the guardians. In the end it is a decision for all parties to be involved with, but a child should not have the ultimate say, how could they really take on such a critical decision. On the one hand society sees to want to treat children as adults with the wisdom of the world, but in reality they are not there yet and must have others look out for them.

  40. May 16, 2008 at 18:11

    Zak in the US

    Both my sister and brother died from a brain tumor; my brother in ’85 when the options were mainly based on chemo-therapy. My sister passed away 2 years ago undergoing the same chemo treatment. That to me clearly shows there’s no evidence that therapy works. Moreover it made the end of their lives interminably long and painful years.

  41. May 16, 2008 at 18:14

    Adam in Portland

    The family should have the say not the government.

  42. 42 Shirley
    May 16, 2008 at 18:22

    Some clarifications.

    1. Being good to one’s parents is obligatory in Islam as per the Qur’anic verse 17:23, where Muslims believe that God commanded, “Thy Lord has decreed you…to be good to parents.” Further details in this verse entail that one speak respectfully to one’s parents and treat them respectfully, and that one care for their needs. Sunni Islam interprets this as a command to obey one’s parents except when it entails sin ( http://qa.sunnipath.com/issue_view.asp?HD=3&ID=4496&CATE=452 ). Shia Islam holds that obeying one’s parents is not obligatory. However, the standards of respectful and dignified treeatment of one’s parents stands. Islam considers it sinful to say nasty thigs to one’s parents or to do mean or hurtful things to them.

    2. The saying from Prophet Muhammad is “Paradies lies at the feet of your mother.” It is recorded in the compilations of Ahmad, Nisa’i, and Bayhaqi, as well as in Shia compilations of Prophetic sayings.

  43. May 16, 2008 at 18:27

    In this type of law suit judges invariably agree with the physicians, as though they or the state own our bodies and our lives. This has nothing to do with a reverence for life, and everything to do with a misplaced reverence for medicine and physicians.

    Mira de Vries, Chairperson for the association for Medical and Therapeutic Self-Determination in The Netherlands

  44. 44 steve
    May 16, 2008 at 18:27

    It’s so sad to listen to John go on, tainted by false hope. These natural approaches don’t work. Nobody gets “cured” of cancer by natural means. There are natural approachs to trying to prevent cancer, but cure? His son will surely die if natural methods are used. Don’t give the kid false hope by making him think some plant can cure him. Let him know it’s chemo or certain death. His views are tainted by the “natural” option which is a scam.

  45. 45 Shirley
    May 16, 2008 at 18:27

    John in Salem:
    Did you read the article? How long has the child in question been struggling with this cancer? How long has the child been undergoing chemotherapy? Have you even met any children who have been in this situation? You are writing as if you have not been paying attention to the situation being discussed.

  46. May 16, 2008 at 18:28

    AJay
    Chester, Connecticut USA

    My daughter survived cancer, now a decade ago. Chemotherapy is no longer the “heroic means” many people have rightly refused; it is an accepted therapy. The eleven-year-old is unlikely to understand matters of life and the finality of death, only that it hurts, and he wants the pain to stop–to use his words–“to be a normal eleven-year-old boy.” It is a heart-rending call, but where there is life, there is hope. I side with hope, as painful as it may be to watch.

  47. 47 Ian from Arizona
    May 16, 2008 at 18:28

    Ros & WHYS:

    I believe in preserving life. But, there is more to Life than just Living. I agree that an 11 year old, legally, does not have the right to make decisions. It is up to the parents to make the decision. The parents and the doctors should be making the best decision for the patient which is their quality of life.

    Quality of life is more than just a body that is breathing, walking around, etc. Quality of life includes the Spirit (or soul), the mind, interacting with people. Where is the concern for this boy’s quality of life. Where is the boy’s choice to live his life in dignity?

    It seems to me that the parents of this boy have made the best decision for their child. It also seems to me that the government has taken away the rights of the parents.

    It should never be left to government (courts) to make the decision. We would we as citizens give up our rights to make the decisions that is best for us and our families? I believe the Canadian Government oversteps its bounds in taking away the rights of the parents to make the best decision for their child.

    Have we forgotten Terry Schiavo so quickly?

    Ian from Arizona

  48. May 16, 2008 at 18:28

    Steve in the US

    I don’t get why adults would like young children make life or death decisions. Children have no say when it comes to vaccinations too, and that’s the way it should be. I hated going to the allergist and getting 50-100 shots in my arm to figure out what I’m allergic to. I hated getting a weekly allergy shot. I hated having braces. I had no say because I was a child. So if I had cancer I should be able to determine whether I get chemotherapy/radiation treatment? You need to be parents, not do what your child wants or doesn’t want. It’s very unfortunate you’re in this situation, but you are. Life isn’t all fun and games, there are very bad aspects to life. You shouldn’t quit because your kid wants to quit. When that child turns 18, then their opinion matters, and they can make the decision or not. Following a “natural” approach to fighting cancer, your child will not live to be 18.

  49. May 16, 2008 at 18:29

    GB
    Oyster Bay, NY

    Well I guess if the Docs and do gooders actually went and had a session of chemo like I did and your guests loved ones did they might come to a different conclusion. I had 9 months of it and I was reduced to a mess. I can’t even imagine what a child would make of it. This is best left to the family and your guests seem like decent loving people.

  50. May 16, 2008 at 18:34

    Brad in the US

    I believe the point is the disreguard of the informed human decision made by the person and his legal guardian. Survival by the horror of chemotherapy destroy quality of life and that’s all that matters.

  51. May 16, 2008 at 18:40

    Prince in Lagos, Nigeria

    The question shows, beyond particularisation, that the caucasian race has destroyed meaning and morality as a way of life. That is why caucasians have something as ordinary as the meaning and morality of parenthood as an issue. do you understand what i mean? what is parenthood? what rights belong to parents as parents concerning their children? what duties are morally obligatory to parents? is any other person, a government, organisation (e.g unicef) or court the “owner” of the children that were given life to by a man and a woman?

  52. 52 savane
    May 16, 2008 at 18:41

    About a month ago, we blogged about whether mothers (parents) should be held responsible for their delinquent children’s behaviour. This week we blogged about our ‘fear’ of teenagers?

    Hello? What’s happening to parenting? When did the children become in-charge? This is not a human rights issue! Are parents today focusing on being their children’s friends? Or are they trying not to be like their parents because they didn’t like their control?

    My parents were very clear about who was in charge! Them! Not me or my siblings. They were benevolent dictators! So am I! We were encouraged to express our opinions, and our parents were under no obligation to change their decisions.

    Parents, please! Step up and do your job! Make decisions for your children based on facts, not emotions.

  53. 53 steve
    May 16, 2008 at 18:41

    @ Brad

    It’s an 11 year old, not an adult making that decision. Remember, an 11 year old cannot even get a bandaid from an emergency room without an adult’s consent. Yet we will let an 11 year old make a life or death decision?

    Survival by chemotherapy destroys quality of life and that’s all that matters? So does cancer! Being 6 feet under isn’t that great of a quality of life either! It’s chemo or certain death. Is recovery certain? No, but some chance is better than no chance. It’s an 11 year old, we allow 11 year olds to make no other adult decisions, this shouldn’t be an exception.

  54. 54 steve
    May 16, 2008 at 18:45

    @ Savane

    Good point, Rabbi Shmuley brings it up on his show all the time, that parents really have abdicated their parenting, and just give in to whatever the kids want.I realize medical treatment is different than caving in to Connor or Dakota whining about how they want the latest trend toy, but kids have no say in their medical treatment. The best interest of the child is to live.

  55. 55 Pat in the US
    May 16, 2008 at 18:45

    Everyone has missed a very salient point in this discussion. Due to the extremely LITIGIOUS society in Canada and the US (and perhaps elsewhere), medical practitioners are under extreme strictures. If the treatments have been found to be the most successful overall, they must proceed with them. Even in the face of disagreement, particularly on the part of a minor child. The medical community (including the institutions in which they practice) are routinely held liable for failing to provide the treatment. True, the consent of an adult is required, but when it comes to minor children, the legal ramifications are huge. There would be people stepping up to bring suit against them (doctors and others) because they DID not provide the treatment. These are people that would not normally have any business in the situation.

  56. 56 Zak
    May 16, 2008 at 18:48

    People who speak based on generalities need to spend some time in a hospital with a loved one unable to even speak. If any person has undergone years of chemo-therapy then they ARE ADULTS no matter what age. You don’t question a child makes the decision to leave an abusive home for a relatives and that is considered a “rational adult” decision by child psychologists; so how do you suppose to tell that child they haven’t learned the horror of an abusive treatment. How do you claim the right to pronounce the government holier than thou in that situation.

    Does anyone ever consider that the child once did say yes to the treatment, and has specific knowledge of what it can and can’t do. How weak minded it is to think that a child cannot learn the depths of life when they have seen it; pathetic excuses are all that exist for forcing a child to continue undergoing treatment once it’s failed.

  57. May 16, 2008 at 18:48

    Chris in Namibia

    Forcing a child, who knows what’s happening, to have medical treatment it has decided it doesn’t want, is no better than rape.

  58. 58 archibald in oregon
    May 16, 2008 at 18:56

    I think it is the patients choice, provided that they are properly informed about what is happening…….A child knows what is happening to them though they may not be capable of communicating it. It is too easy to treat this as a black and white issue. Every situation is unique. Closed minds and limited thinking only mire us deeper in hopelessness, there are myriad alternatives to chemotherapy and radiation, it is only western medicine which encourages otherwise……..

  59. 59 steve
    May 16, 2008 at 19:02

    “Chris in Namibia

    Forcing a child, who knows what’s happening, to have medical treatment it has decided it doesn’t want, is no better than rape.”

    So no kid would get vaccines or visit the dentist. Did you you can die from a toothache? That the bacteria from your mouth can go to your heart and infect it? Also your brain too. http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html

    This is EXACTLY why we don’t allow children to make medical decisions, because they’re children!

    We force mentally ill people to take medications if they are a threat to themselves or others. Is that no better than rape? They have no choice.

  60. 60 Zak
    May 16, 2008 at 19:12

    A white man stands on ground occupied by a Native American culture for a more than 30,000 years free of all disease and proclaims that disease should be as accepted as the treatment. He says there’s no such thing as alternative medicine; ignorant of people living for a century growing and smoking tobacco shown to have anti-cancer properties in the green leaves. He is a vision of corporate America that was death and disease itself to that culture…He will never learn.

  61. 61 adam in portland
    May 16, 2008 at 19:13

    @ Selena
    Bravo

    @ Lubna
    as a future pediatrician, Inshallah, your perspective is of great value, I do not agree with it to the letter but it is good to hear. Thank you for sharing.

    @ everyone with much respect to you and your perspectives
    consider when you post your comments on this, looking into the eyes of any of the three gentlemen who were on the air when you type in your responses here as this thread continues here on the blog. Please consider their feelings as I suspect they will be reading this.

  62. 62 savane
    May 16, 2008 at 19:20

    For the last 15 years, I’ve watched my sister-in-law bounce between Western medicine, traditional medicine and faith (religion) in unsuccessful attempts to ‘cure’ her epilepsy which began when she was 10 years’ old. She’s not cured. After every withdrawal from Western medicine, her seizures return stronger.

    The stigma of epilepsy is very strong and epileptics are often seen to be possessed by evil/demons. Before she turned 18, her parents, made her health decisions. They are not medical professionals, haven’t researched her condition, and lost confidence in Western medicine when she kept having seizures while on her meds, and the 2-year seizure-free period became elusive.

    Today, she’s a 33-year old, with the mind of a 10-year old, and is married with a 7-year old daughter. She’s never held down a job, and she, her husband and child are fully dependant on her mother, who’s getting older, has burnt out and still makes her daughter’s decisions. She wants my husband to take over from her.

    She’s the poster child for decisions made out of ignorance and heavily fuelled by emotions.

  63. 63 Sulayman Dauda
    May 16, 2008 at 19:27

    it may sound an attack to the personal freedom of the family to mention the Doctors decission as the final say. yet the state must have the final say base on medical advise to save the life of the young shall grow.

  64. May 16, 2008 at 19:28

    Nywakar

    Children who are old enough to reason should be given a chance to decide. Parents can just recommend but leave an informed child to decide. Take note of the many court cases the children of Jehovah Witnesses – who’ve won when doctors want to force BLOOD TRANSFUSION on them!

  65. May 16, 2008 at 19:28

    Anguzu

    The child reserves the to object to the treatment if the benefits are not properly explained to him. An 11 year old child can make a very good decision.

  66. May 16, 2008 at 19:30

    This is an unfortunate case, but the child is a minor – and not even close to adulthood. The child appears to have maturity for his young age, and that must be reciprocated with honest talking from parents and doctors; but it has to be the doctors who make the final decision on treatment as they are the professionals, with the best knowledge and experience of these matters.

  67. May 16, 2008 at 19:31

    I just don’t feel that an 11-year-old has the ability to understand the finality of death.

    Why do teenagers engage in unprotected sex, or drinking and driving or any number of dangerous things? Because they truly believe “it won’t happen to me.”

    So how can an 11-year-old really appreciate the fact that death is almost certain without treatment?

    Obviously, if the doctors feel that chemo would just prolong the inevitable for a very short time, then it might not be worth it. Personally, I’d rather spend my time with family and friends, maybe even taking a trip, instead of in a hospital.

    But if there were decent odds that I might survive for a few more years, I would have to take that chance, no matter how agonizing the chemo might be.

    What 11-year-old would really say “yes” to chemo? Probably none. But for many patients, chemo is a life-saving tool.

    Let’s just hope that in five years from now, that boy will be getting his driver’s license and dating girls …thankful that the court intervened and made the decision it did.

  68. 68 Dennis
    May 16, 2008 at 19:34

    I think that the parent has a final say on a child medical treatment….

    Unless a State social services agency can prove to a court of law….

    Dennis~Madrid, United States of America

  69. May 16, 2008 at 19:44

    Ater in Kampala

    In other parts of the world where large number of people have easy access to the Internet it is possible but in Africa case we are still dragging behind as usual! If there are any real Democracies in Africa!!!

  70. 70 steve
    May 16, 2008 at 19:57

    Kids sometimes die when parents have an inability to say no to a child.

    http://www.sfgate.com/cgi-bin/article.cgi?f=/chronicle/archive/1996/04/12/ED19845.DTL

    Remember this, the 7 year old girl who was flying airplanes? She’d be alive today if her parents actually had said no to her. A 7 year old shouldn’t be flying planes, just like they shouldn’t drive cars. You are the parents, not the kid. Act like it.

  71. 71 selena
    May 16, 2008 at 20:11

    @ Steve,

    Are you so sure that the girl died because the parents couldn’t say no? Wasn’t it more a case of the parents WANTED the child to fly airplanes?

  72. 72 John in Salem
    May 16, 2008 at 20:16

    Shirley~
    I read the article before the program began. I am aware of how long the child had been undergoing therapies and what the courts, the doctors and the parents all had to say. I sympathize with the boy’s father but also note that he said little about the discussion with his son before agreeing to support the decision to end treatment.
    I have known 3 children who have fought cancer. All had extensive chemo – two lived, one died. Had all three convinced their parents that death without treatment was preferable all three would now be dead.
    You obviously have a faith that gives you some comfort that those who die will be in a “better place”. I, on the other hand, am an atheist, and I don’t buy it. This life, this world is for me all there is and I like it that way, and me and mine do not go gently into that good night.

  73. 73 Zak
    May 16, 2008 at 20:22

    It’s so ironic how not one single post here expressing a lack of right for the child has any children who have suffered the failure of chemo. Speaking from the armchair of idiocy it’s easy to proclaim that a child should have to suffer more treatment which has at best a half chance of working. It’s just as easy to claim that a person in that situation hasn’t suffered enough to know what the end of life brings and you could not be more wrong, or cruel.

    If you want to sound less a hypocrite tell me you’ve been water boarded and would do it again in the interest of science – that you’ve stared at death through the barrel of a gun for years like any cancer patient at any age has.

  74. 74 steve
    May 16, 2008 at 20:40

    @ Zak

    50% chance is better than 0% chance. The kid is dead if there is no chemo done for sure. It’s not the place for an 11 year old to decide what is “enough”. We don’t 11 year old make any other decisions. They cannot even pick what courses they take in school, yet life or death decisions? This is the price of being a child, you don’t get to do what you want, you do what you are told to do. That changes when you’re 18.

  75. May 16, 2008 at 21:09

    Certainly the child’s welfare is paramount. But one has to make sure that he or she has had the best advice to make the decision. After all, the whole treatment is for the patient’s welfare is it not, not anyone’s.

  76. 76 Neal H
    May 17, 2008 at 01:51

    I’d say the final say would be with the parents, if they want to take into account the child’s wishes in their decision making that would be their choice, but in the end, it’s the parent’s decision to make, being responsible for their dependant child.

    There’s a lot of swirling nonsense in the US about people refusing medical treatment for their children for religious reasons, and I am not really clear at what point or if it’s even possible for authorities to step in on the grounds of reckless endangerment. There was in the news recently about a woman that had left a hospital with her baby, and how panicked people were trying to find this woman because her baby needed medical treatments.

    Murky at best.

  77. 77 Pangolin
    May 17, 2008 at 11:11

    Don’t they have medical ethics boards in Canada? Somewhere in this mess there is a path where the child is allowed an improved quality of life and the treatment continues. There should also be a path where it is recognizable that the child’s treatment is not effective and should be halted in order to provide some comfort before death.

    Having watched a family member undergo years of futile chemotherapy for a cancer that had a 90% prognosis of fatality upon diagnosis I think the doctors may take things a little too far.

  78. May 17, 2008 at 13:30

    I don’t believe a generalised answer can be found for this qeustion, but that each case should be considered on its own facts.
    In this case, I feel this way:
    The child is 11 and cannot take adult decisions – he knows that Chemotherapy is awful and just doesn’t want it but cannot reason his way through the consequences.
    The Parents are desperate to help their child not suffer any more – for they are the ones who have to go and see him suffer – a killer for all parents, BUT if the doctors – who of all people, KNOW the awfulness of chemo – are wanting to treat the child this way, I;d say that they are doing their best to save his life; and thank goodness they are standing firm. If they didn’t believe he could be helped by chemotherapy, they would doubtless not suggest it!! There are loads of cases where chemotherapy doesn’t work, and a great many where it does; but an eleven-year-old and his parents are in no position to argue with the medical people..

  79. 79 George Wills Bangirana
    May 17, 2008 at 15:16

    This is an interesting discussion. I guess there is something going terribly wrong with the parents of the child.
    Granted they love their daughter so much and cant afford to see her “suffer” with the chemotherapy.
    My question is, do they have another option to heal the poor girl?
    Which is better? Letting the girl they “Love” so much die as there is no alternative to chemotherapy or supporting her to take the drugs so as to lie at least just a bit longer?
    Here in Uganda, such things can’t even be a matter of discussion.
    You either take the medicine willingly or you are forced to take it even with some spanking to accompany it.
    I think the parents are giving too much freedom to the young lady to the extent that they are willing to let her commit “suicide”
    The world is going nuts

  80. 80 Tita Lenz
    May 17, 2008 at 16:09

    I suggest any of the three person who best understand the illness better,if all know about the illness effect then the child should decide,but if not then the doctors should educate them and then both then decide.
    Thanks
    Cameroon (Bamenda)

  81. 81 Mark
    May 18, 2008 at 06:15

    In the United States the courts have ruled again and again that the ultimate authority rests with the state. Neither an individual nor his family can make the decision to die, especially where a minor is concerned. Followers of the Christian Science faith who believe it is god’s will if their child will live or die and would deny doctors the chance to perform life saving operations or administer transfusions of blood have been overruled. People wanting help committing suicide risk the consequence of criminal prosecution of those who assist them and are deemed not capable of making rational decisions for themselves by a court if they refuse potentially life saving medical treatment. This of course only happens when it comes to the attention of authorities but increasingly medical professionals are being held liable if they know of such cases and don’t report it.

  82. 82 David
    May 19, 2008 at 19:09

    Brett
    May 16, 2008 at 2:19 pm said

    “With all due respect, you have kids drowning every year because they want to go swimming and jump in a pool when they can’t swim.

    What makes you think that a child is able to swim in the field of medical terminology, understanding and informed decision-making, because they jump in and make a decision?

    Of course if it was Doogie Houser….

    Kwabena said

    May 16, 2008 at 2:29 pm

    “The doctor has the capacity to recommend an appropriate medication but i believe the parents and the child has the right to accept or reject the doctors recommendation”. You are right Kwabena.

    Who knows the child better, the parent or the doctor? Think hard about this. I would love to hear from any doctor on this blog.

  83. 83 Mrs.Josephine Hyde-Hartley
    May 21, 2008 at 00:02

    I understand the main point of medical or nursing practice is that it should do no harm. With regard to this childs situation all those concerned would have to decide whether it would be harmful to force the child to undergo treatment against his will and the will of his parents. “Consent” is paramount. It must be fully informed which should include all potential side effects, risks and the intended and likely outcome of the treatment on offer. Here in the UK consent is provided voluntarily and not under pressure of eg threats of court scenes later.However, it’s very difficult for medical and nursing practitioners to provide information about alternative treatments because they’re not employed to do this.


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