Let him have his way...

[Gob]

A 17 year-old Jehovah's Witness who was fighting a court order to have a life-saving blood transfusion has lost an appeal just four months shy of his 18th birthday.

The religious teenager, who is being treated for Hodgkin's Lymphoma at The Sydney Children's Hospital, had threatened to rip the IV needle from his arm and said it would be akin to rape if he was given a blood transfusion while under anaesthetic.

A Supreme Court judge ruled in April that the boy, known as X for legal reasons, had to have the transfusion but his family appealed it, arguing that he was "highly intelligent" and his maturity and competency should be enough to override the court's power.

Justice John Basten rejected the appeal on Friday morning but said the order would be removed when X turned 18 in January, allowing him to make the potentially life-or-death decision for himself.

His doctor, Professor Glenn Marshall, told the court earlier this year that X had an 80 per cent chance of dying from anaemia if he didn't have the transfusion.

"The interest of the state is in keeping him alive until that time, after which he will be free to make his own decisions as to medical treatment," Justice Basten said in his judgement.

"The interest of the state in preserving life is at its highest with respect to children and young persons who are inherently vulnerable, in varying degrees."

X has had three unsuccessful rounds of chemotherapy at a lower dose than Professor Marshall advised.

After some initial success, the cancer in his lymph nodes spread to his lungs and spleen in November last year.

X was advised to have more intense chemotherapy but, because that treatment was likely to lead to a blood transfusion, he and his parents refused.

On a whiteboard in his hospital room, X's father wrote a scripture reference to abstaining from blood.

Barrister David Bennett, QC, argued during the appeal that a child was entitled to a degree of decision making "reflective of their evolving maturity".

He referred to several overseas cases of younger Jehovah's Witnesses being allowed to refuse blood.

In most cases, the young person died like 15-year-old Joshua McAuley, who refused a blood transfusion following a car crash in England's West Midlands in 2010.

The Children's Hospital said the boy had a "cocooned upbringing" and his family had "little exposure to challenges of their beliefs from outsiders" so what they may have thought was best was not necessarily correct.

It was no clear to the appeal judges whether X might die before his 18th birthday but Justice Basten's judgement said that the state's interest was not satisfied "merely by keeping the applicant alive until his 18th birthday if the appropriate treatment to allow the continuation of his life thereafter should be given now".

The boy and his family were not in court for the decision.



Read more: http://www.smh.com.au/nsw/jehovahs-witn ... z2g3bDa1bb

[dgs49]

With apologies for my cynicism, this kid is going to die in the easily foreseeable future, one way or another.

Leave him (the fuck) alone.

[Big RR]

Not only that, it's a few months short of his 18th birthday--it's not like he's a 6 or 8 year old.

[Scooter]

The problem is that they acceded to the parents' wishes for too long, and subjected the kid to suboptimal chemo that hasn't worked, and now it probably is too late. They should have gone to court right away and provided him with the treatment he needed and which probably would have cured him.

Oh, and if the kid dies, the parents need to be charged with murder. Being a parent isn't a license to endanger your children's lives in furtherance of humouring your antediluvian superstitions.

[Joe Guy]

Oh, and if the kid dies, the parents need to be charged with murder. Being a parent isn't a license to endanger your children's lives in furtherance of humouring your antediluvian superstitions.

I wonder how a trial would go?

Would the state need to prove that the child would have lived if he had received more intense chemotherapy?

[Lord Jim]

I completely agree with this:

The problem is that they acceded to the parents' wishes for too long, and subjected the kid to suboptimal chemo that hasn't worked, and now it probably is too late. They should have gone to court right away and provided him with the treatment he needed and which probably would have cured him.

But I don't see how this works:

Oh, and if the kid dies, the parents need to be charged with murder.

Given the fact that the government and the legal system went along with what the parents were doing...

This isn't like the case that was in the news not too long ago where the parents ran off with the kid to prevent him from getting the medical treatment he needed, that a court had ordered that he receive...

[Big RR]

Jim---I'm not sure--I don't see that the treatment was suboptimal (indeed, if it was I would presume the doctor would have committed malpractice); maybe it was the SOP and this last high dose treatment is a go for broke gamble. But, in any event, absent a mental defect, I think this kid is now way too old to have the government force him to accept a treatment he does not want.

I agree with you on the murder charge as well.

[Scooter]

But I don't see how this works:

Oh, and if the kid dies, the parents need to be charged with murder.

Given the fact that the government and the legal system went along with what the parents were doing

If the parents had systematically starved the kid to death, their culpability would not decrease because authorities sat back and did nothing (that would be reason for charging those authorities in addition to the parents, but not for letting the parents get away with murder).

And if the parents had brainwashed this young man for his entire life into believing that food was not necessary, and he became an anorexic as a result, we would not be debating whether at 17-2/3 years or whatever, if he is old enough to know his own mind. We would be recognizing his delusion for the mental illness that it is and we would shove a feeding tube down his throat and strap him down so he couldn't pull it out, while providing whatever psychiatric help was necessary to assist him in conquering his delusion.

I don't see any difference between that, and the delusion that tells him that his god would rather see him die than use blood products, just because society gives the latter a veneer of respectability by cloaking it with the protection accorded to religious beliefs.

[Scooter]

Jim---I'm not sure--I don't see that the treatment was suboptimal

From the OP:

X has had three unsuccessful rounds of chemotherapy at a lower dose than Professor Marshall advised.

They had to use the lower dose because the recommended dose would have caused anemia, which would have required blood transfusions, which the parents would not allow. So in deference to the wacko beliefs of these parents who were out to murder their son, these medical professionals did not put forth their best effort for this boy. For which they probably should be charged with malpractice, but who is going to do that when the victim has been brainwashed by living among demented nutbars his entire life?

And this:

On a whiteboard in his hospital room, X's father wrote a scripture reference to abstaining from blood.

looks very much like an attempt by the parents to bully their son into refusing transfusions.

[Jarlaxle]

He needs to skip the country until he's 18.

[Big RR]

Scooter--I saw this.

X has had three unsuccessful rounds of chemotherapy at a lower dose than Professor Marshall advised.

Advised when? At the time the lower level treatment was run, or now? If he really thought that the lower amounts would not be successful, then I would think it malpractice to go ahead and treat that way. Many times a doctor will start with a more conservative treatment, and then proceed to an aggressive, go for broke one.

And FWIW, I see the difference between withholding/discouraging food and aggressive medical treatment a huge one. If you don't eat, you will die--if you eat, you won't starve to death. But if you have an aggressive cancer and take a treatment that debilitates you, there is no guarantee you will live, and in many cases you will likely die. I have seen it again and again where the physician prescribes aggressive treatment in all-but-hopeless cases; I support the right of people to decide how they choose to live out the last months of their lives and whether they will go gently into that good night or dies puking up the best the pharmaceutical industry can offer. Yes not all decisions made are the same ones I would make, or even logical, but that's part of freedom.

[Jarlaxle]

After seeing someone go through aggressive chemo (and regret every minute of it to the day he died), I decided I would never even consider it. If I let my cats suffer the way he did, I would go to jail!

[rubato]

Scooter--I saw this.

X has had three unsuccessful rounds of chemotherapy at a lower dose than Professor Marshall advised.

Advised when? At the time the lower level treatment was run, or now? If he really thought that the lower amounts would not be successful, then I would think it malpractice to go ahead and treat that way. Many times a doctor will start with a more conservative treatment, and then proceed to an aggressive, go for broke one.
.....

It was suggested that the family refused the higher-dose treatments because of the probability they would lead to a transfusion. Had it been solely the decision of the physician he may have used the higher-level treatments. But it was not his decision.

IIR this case has been ongoing for years. The patient was much younger at the beginning and less likely to be considered an adult. At this point it may be moot anyway.

yrs,
rubato

[Big RR]

rubato--

It was suggested that the family refused the higher-dose treatments because of the probability they would lead to a transfusion. Had it been solely the decision of the physician he may have used the higher-level treatments. But it was not his decision.

Yes, some have suggested just that; but we really don't know what happened or why treatment was at the lower level, do we?

Jarl--I had a friend who went through combined chemo and radiation and survived, but still says he would not do it again if he had to make the same decision, even knowing he would live (and he's now a bit debilitated, but alive for over 5 years). The day it hit home how bad it was is when he was on his 14th weekly course (out of 15) and said he wanted to stop; the doctor told him he would have to start all over again and have 15 more courses and he said he didn't care (he subsequently chose to finish it but said it was the hardest thing he ever had to do). Honestly, I don't think I can even begin to comprehend how bad something is that I would even consider having 15 more treatments just to skip the current one, or after finishing it and surviving, saying i would never do it again (and this man is happy to be alive and enjoys his life now); I can't imagine how much worse it would be if your chances for survival were not all that good.

[Grim Reaper]

The religious teenager, who is being treated for Hodgkin's Lymphoma at The Sydney Children's Hospital, had threatened to rip the IV needle from his arm and said it would be akin to rape if he was given a blood transfusion while under anaesthetic.

I'd start by having a group of rape victims come talk to him and give him some basis of understanding as to why having a blood transfusion isn't close to being in the same building as rape.

[Big RR]

It's a stretch, but it is forcible penetration of his body against his will. I can understand his analogy.

Indeed, it reminds me of the end of a play I saw a long time ago, Dark of the Moon, where the congregation of a church sanctioned to rape of a young girl "for her own good" (to keep her away from the Witch Boy, who could have nothing to do with her if she was not a virgin). Here the court is sanctioning the forced medication because they believe it is in his interest. There was no real malice in either case--the best interest of the minors were being looked out for by those sincerely wanting to protect them. But they are being violated to protect them. The same as rape? no? But I think in the "same building".

[Sue U]

Except that in this case there is more than sufficient provision for due process, and it involves a comparatively painless medical procedure.

So if you've got a building that fits both a court-ordered transfusion and rape, that would be one ginormous building.

[Sue U]

After seeing someone go through aggressive chemo (and regret every minute of it to the day he died), I decided I would never even consider it.

Jarl--I had a friend who went through combined chemo and radiation and survived, but still says he would not do it again if he had to make the same decision, even knowing he would live (and he's now a bit debilitated, but alive for over 5 years).

It's not necessarily an unreasonable decision, but I would first find out exactly what kind of cancer, what kind of chemo/radiation treatment, and what specifically is the prognosis. There is a wide variation in side effects and likely outcomes depending on the individual case.

[Scooter]

X has had three unsuccessful rounds of chemotherapy at a lower dose than Professor Marshall advised.

Advised when? At the time the lower level treatment was run, or now?

An article written about the original hearingshould clarify the timeline:

X was admitted to the hospital in January last year, and he and his parents consented to chemotherapy which continued for seven months. The treatment resulted in remission, but in November Professor Marshall found cancer in the patient's lungs, spleen and lymph nodes. He recommended X receive more intense chemotherapy but, because that treatment was likely to lead to a blood transfusion, X and his parents refused.

Instead X had two cycles of chemotherapy at the lower dose, but scans in February showed only a 25 per cent to 50 per cent reduction in his tumours.

''Professor Marshall was disappointed with these results,'' Justice Gzell's said in his judgment.

''Based on his experience treating patients of similar age with similar disease type, he would normally expect no tumour to be present after treatment with higher doses of different cytotoxic chemotherapy agents.''

So chemo was started at a lower dose intentionally, appeared to have been successful, but then the cancer came back and the doctor recommended a new course at a higher dose. The parents refused because it would necessitate a blood transfusion, and so the doctor tried sticking with the lower dose, but it wasn't as effective as he hoped, and nowhere near as effective as would be expected from a higher dose.

By March, X developed severe anaemia and chemotherapy had to be stopped. Professor Marshall feared that once it was restarted X would again become severely anaemic. He told X and his parents if he suffered severe bleeding or his blood pressure dropped to dangerous levels, blood would immediately be brought to the ward and administered. In response, X said he would ''rip the IV out''.

So the kid ends up severely anemic even at the lower dose, forcing the doctor to stop the treatments, and telling the parents they can't start again without being allowed to transfuse. Note well - it was not the parents deciding to forego the chemo; their objection was to the transfusions.

If he really thought that the lower amounts would not be successful, then I would think it malpractice to go ahead and treat that way. Many times a doctor will start with a more conservative treatment, and then proceed to an aggressive, go for broke one.

That appears to be what was done at first. But the time came when more aggressive treatment was the preferred option. And the choice he had was between a high dose chemo that almost certain to cure the cancer but just as certain to kill the kid without transfusions, and a lower dose that was probably less effective but without (so it was believed) the life threatening side effect.

]And FWIW, I see the difference between withholding/discouraging food and aggressive medical treatment a huge one. If you don't eat, you will die--if you eat, you won't starve to death. But if you have an aggressive cancer and take a treatment that debilitates you, there is no guarantee you will live, and in many cases you will likely die.

Let's not cloud the issue by making this about the expected success of cancer treatment. If the parents' argument against the transfusions was that the higher dose chemo would not cure their son's cancer, so the transfusions wouldn't serve any purpose, then consenting to continue chemo at the lower dose makes no sense; if they didn't expect the higher dose to work, then they couldn't have believed that the lower dose would cure him, and there would have been no point in any further treatments.

If the parents had said, "we don't have any guarantee that chemo will work, and absent that, we don't believe that violating a major tenet of our religion is justifiable, so our son won't be doing any more chemo if it means transfusions," then I would have found their position to be more justifiable. They would be weighing a doubt against what they consider a certainty, and deciding according. But that isn't what happened here. The near certainty here is that continuing the chemo without transfusions will kill the kid. The parents didn't go to court asking that the chemo be stopper, so by refusing consent to transfusions they are dramatically increasing the risk of death for no benefit.

]I have seen it again and again where the physician prescribes aggressive treatment in all-but-hopeless cases; I support the right of people to decide how they choose to live out the last months of their lives and whether they will go gently into that good night or dies puking up the best the pharmaceutical industry can offer.

Hodgkin's is one of the most treatable of all cancers, especially in the young, and this does not appear to have been all-but-hopeless case (at least until 4000 year old superstitions were used to thwart scientific judgment).[/quote]

[Crackpot]

Uhh try less than 150 years.