Difficult ethical questions.
Difficult ethical questions. How old do you have to be to decide for yourself that you're ok if you die? This is very difficult. We can absolutely keep people with Hodgkins alive, now. However, like many such things, they are not "normal" afterward, and there is a lot of potentially terrible suffering in the meanwhile. There's also a pretty good chance you will die a few decades later, earlier than otherwise, either from complications of treatment or from a second cancer (the two might overlap). When are you old enough to decide for yourself what you consider a quality life?
Where I've worked, there are, indeed, separate and additional consent sections for research studies that may involve children over a certain age, but under 18. That is not treatment, however. When you are 17, what's the practical difference versus being 18 and being able to make your own decision? There is a legitimate reason for laws protecting society's interest in protecting children, which we've generally defined as under 18. However, that is supposed to be when a parent or other legal guardian is not.
It's not going to be shared with the public whether lengthy consultations with bioethicists and mental health professionals and counselors who deal with children and cancer patients were held with the family. However, if the patient and her family were educated or informed or however you want to put it, then I think it is a decision that has to be respected. It isn't you, it isn't your kid, you don't have to live with it in the way they do. If it was a cancer with a high mortality rate, I doubt they'd be arguing.
I also have to say that I am appalled that they reportedly took the kid away from her family. That's the opposite of what you do if you're expecting someone to go through a horrible series of chemo and do well out of it. It certainly isn't anything a mental health professional should be endorsing. You're removing the kid from her primary support? No.
There's also reporting that they've continued the treatments while this is being disputed? I sincerely hope not. I don't care how old the kid is. That's abusive. If true, I am deeply distressed that there are medical professionals who would agree to be part of that. I don't care if you think you're saving the kid's life. What life, and for what? This is a person, not a statistic.
I do understand why the state CPS feels this is how they have to act. They are constrained by laws, Nevertheless, they should have some discretion, and this was not the way to go about this.
Cancer is a scary diagnosis. We can make you even sicker and possibly kill you by trying to cure you is not a reassuring statement under the circumstances (is it ever?). Meanwhile, an adult refusing treatment might be asked to meet with a support group, other patients, ancillary support professionals within the cancer treatment community, etc. both to address the fear of the disease and its treatment, and to try to provide information repeatedly and in pieces as the person is able to process what they are being told. Sometimes, you have to give people time and space to process. Sometimes, that means you have to wait for a treatment that may only have its best effect if you use it immediately. Sometimes, that means that some options will end up off the table because of needing to wait. Sometimes, you will start and stop treatment for many reasons, including the patient saying I can't do this right now.
But this girl is 17, not 18. I don't understand the doctors, though, not that we are hearing directly from them. What ever happened to autonomy and respect for persons? Unless they declare her legally incompetent, or there's some other documentable reason not to treat her like a full person, I think they are wrong here. I think they are very wrong. If she can demonstrate to a legal and ethical standard that she understands what is going on and what her decision means, they need to accept it and leave it be. How can you trust a system that calls CPS on you in a circumstance like this?
http://www.dailymail.co.uk/news/article-2898395/Connecticut-17-year-old-cancer-goes-court-against-state-agency-STOP-mandated-chemotherapy-treatments.html
http://www.dailymail.co.uk/news/article-2898395/Connecticut-17-year-old-cancer-goes-court-against-state-agency-STOP-mandated-chemotherapy-treatments.html
Where I've worked, there are, indeed, separate and additional consent sections for research studies that may involve children over a certain age, but under 18. That is not treatment, however. When you are 17, what's the practical difference versus being 18 and being able to make your own decision? There is a legitimate reason for laws protecting society's interest in protecting children, which we've generally defined as under 18. However, that is supposed to be when a parent or other legal guardian is not.
It's not going to be shared with the public whether lengthy consultations with bioethicists and mental health professionals and counselors who deal with children and cancer patients were held with the family. However, if the patient and her family were educated or informed or however you want to put it, then I think it is a decision that has to be respected. It isn't you, it isn't your kid, you don't have to live with it in the way they do. If it was a cancer with a high mortality rate, I doubt they'd be arguing.
I also have to say that I am appalled that they reportedly took the kid away from her family. That's the opposite of what you do if you're expecting someone to go through a horrible series of chemo and do well out of it. It certainly isn't anything a mental health professional should be endorsing. You're removing the kid from her primary support? No.
There's also reporting that they've continued the treatments while this is being disputed? I sincerely hope not. I don't care how old the kid is. That's abusive. If true, I am deeply distressed that there are medical professionals who would agree to be part of that. I don't care if you think you're saving the kid's life. What life, and for what? This is a person, not a statistic.
I do understand why the state CPS feels this is how they have to act. They are constrained by laws, Nevertheless, they should have some discretion, and this was not the way to go about this.
Cancer is a scary diagnosis. We can make you even sicker and possibly kill you by trying to cure you is not a reassuring statement under the circumstances (is it ever?). Meanwhile, an adult refusing treatment might be asked to meet with a support group, other patients, ancillary support professionals within the cancer treatment community, etc. both to address the fear of the disease and its treatment, and to try to provide information repeatedly and in pieces as the person is able to process what they are being told. Sometimes, you have to give people time and space to process. Sometimes, that means you have to wait for a treatment that may only have its best effect if you use it immediately. Sometimes, that means that some options will end up off the table because of needing to wait. Sometimes, you will start and stop treatment for many reasons, including the patient saying I can't do this right now.
But this girl is 17, not 18. I don't understand the doctors, though, not that we are hearing directly from them. What ever happened to autonomy and respect for persons? Unless they declare her legally incompetent, or there's some other documentable reason not to treat her like a full person, I think they are wrong here. I think they are very wrong. If she can demonstrate to a legal and ethical standard that she understands what is going on and what her decision means, they need to accept it and leave it be. How can you trust a system that calls CPS on you in a circumstance like this?
http://www.dailymail.co.uk/news/article-2898395/Connecticut-17-year-old-cancer-goes-court-against-state-agency-STOP-mandated-chemotherapy-treatments.html
http://www.dailymail.co.uk/news/article-2898395/Connecticut-17-year-old-cancer-goes-court-against-state-agency-STOP-mandated-chemotherapy-treatments.html
Well, that's happened before, so we're just fighting to keep it from happening again. And that's just here. There's some really nasty rumors about what goes on elsewhere in the world.
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