End-of-Life, Healthcare

At What Age is One Old Enough to Make Healthcare Decisions?

The article in the The Atlantic is what I came across both yesterday and today on LinkedIn. A 17-year-old girl is being forced to accept treatment that she does not want. Cassandra C. was diagnosed with a type of cancer called Hodgkin’s lymphoma in September 2014. The disease infiltrates essential components of the body’s immune system, specifically weakening the lymphatic tissue, which helps fight infection. Though fatal, patients often have a high survival rate with early treatment. Yet, Cassandra was adamantly against treatment from the beginning, according to the Hartford Courant. Her mother (Fortin) supported her decision.

Connecticut’s Department of Children and Families (DCF), accused Fortin of neglect. The DCF removed Cassandra from her mother’s stewardship and put her into temporary state custody. According to court documents, the state forced Cassandra to undergo two chemotherapy sessions in November, after which she ran away. When she returned a week later, Cassandra was placed in Connecticut Children’s Medical Center in Hartford, where she currently continues to receive unwanted treatment.

I am trying to be objective about this, but I am looking at this from a few ‘sides.’ One as a social worker-obviously any professional should be looking out for Cassandra and helping her to make needed and necessary choices/decisions to the best of their abilities. As a mother, tough call. Cassandara is 17 and is old enough to know what she does and does not want. On the other hand, would I be ready to let my child die without trying a treatment that has a good chance of saving her life?

In the U.S., adults have the right to bodily integrity, meaning they can refuse life-saving medical treatment. Cassandra will only be 18 this September. Only a few states allow the “mature minor doctrine” which lets 16 and 17-year-olds argue in court whether they are mature enough to make medical decisions.

Cassandra’s mom, Fortin, continues to stand with her daughter, telling NBC, “My daughter and I have a close connection, and I have always said—since she was a baby—no matter what you do in life, I will be here for you and I will be by your side.” This is parenting at its best. This is humanity at its best. Letting an individual make the choice that works for them even if we as a parent or professional do not agree with it.

What are your thoughts? Take a look at this link for further information.

January 12, 2014-an update from Cassandra: 

Cassandra said her chemotherapy side effects are “mild to none so far.”

“My oncologist believes I am responding well,” she wrote. “That doesn’t mean as the chemo continues things won’t get worse, but I’m more concerned about the long-term side effects, and also the fact that I don’t want these drugs in my body, but they are and it disgusts me.”

“Everyone including myself should have the given right to say what you do or don’t want to be done to their body.”

“I hope that one day if a minor is put in my position, they will not have to go through what I’m going through,” she wrote.

 

Victoria Brewster, MSW (Vikki)