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A 17-year old is being forced to receive chemotherapy that is guaranteed to cause her premature death. Will you stand up to save her?
Background: The Connecticut Supreme Court ruled on Jan. 8th that a teenger diagnosed with Hodgkin's lymphoma who declined treatment with chemotherapy will be made to undergo treatment anyway. The 17-year old female, who cited chemotherapy's adverse health effects as her primary reason for refusing, is now in protective custody at Connecticut hospital where she will be forced to undergo treatment against her will, and the will of her mother, her legal guardian, who supported her decision.
The latest case of forced chemotherapy by the State of Connecticut has raised a number of highly concerning legal issues simultaneously, primarily: the "mature minor doctrine", parental rights, and the right to make medical decisions.
According to USlegal.com the mature minor doctrine "provides for minors to give consent to medical procedures if they can show that they are mature enough to make a decision on their own." The court order ruled that the 17-year old, referred to as Casandra S in the court document, was not fit to make medical decisions for herself, making it a moot point.
While it is within the court's legal right to deny her decision-making capability, nowhere is the issue of parental rights addressed in this case. Instead, the court deferred to what are known as 'legislative findings of medical fact,' i.e. they assumed that the government's views on chemotherapy as 'life saving' is true, evidence-based and sufficent reason for refusing the young woman and her mother the right to decline chemotherapy for Hodgkin's lymphoma.
Deference to legislative findings of medical fact is a highly contentious concept within constitutional law, and has been reviewed in depth in a legal document titled, "The Constitutional Right to Make Medical Treatment Decisions: A Tale of Two Doctrines," wherein it was concluded:
"This Article concludes that a constitutional right to protect one's health should be consistently recognized; that the recognition of this right should not be artificially limited by excessive deference to legislative findings of medical fact; and that this right will have to be carefully balanced against the state's real and legitimate interest in regulating the practice of medicine to protect the public."
The document also reveals that the Constitution protects individuals from State enforced medical intervention:
"In 1958, in a mostly forgotten case, the Fifth Circuit sweepingly pronounced that, under the Fourteenth Amendment, "the State cannot deny to any individual the right to exercise a reasonable choice in the method of treatment of his ills."
The uncertainty emerges from doctrinal contradictions and court decisions that appear to affirm diametrically opposed interpretations of the 14th Amendment's safeguards. As stated in "The Constitutional Right to Make Medical Treatment Decisions: A Tale of Two Doctrines":
"The court's unqualified language [supporting medical freedom] may have been overly optimistic, however: nearly fifty years later, it is hardly certain whether, and to what extent, the government can interfere with individuals' medical treatment choices."
Regardless of academic debate on the subject, the salient question here boils down to this:
Is chemotherapy for childhood Hodgkin's lymphoma really as life-saving as is claimed?
This is the linchpin question. Unless the answer is a resounding, unequivocal YES, the justification for forcing the treatment on Cassandra or any other child disappears into thin air. In the court order itself the question is never explored. The court's stance on pediatric Hodgkins lymphoma is unequivocally stated as follows:
"[pediatric Hodgkin's lymphoma is] ...a cancer that has a high rate of cure if treated and that will certainly kill Cassandra if not treated."
Is this really so?
Most people reading the court's justification would assume that "a high rate of cure" means that once treated with chemotherapy, if successful, the young woman's condition would go away permanently. Isn't that implied by the term "cure"? Nothing could be further from the truth. The actual definition of "cure" within modern Med-speak is known as the 5-year survivor rate. If after diagnosis and treatment the patient survives 5 years, without remission or experiencing treatment-associated secondary cancers, they can claim to have "cured" them. Not only is this a highly disingenuous semantic trick, manipulating terms like cure to mean something quite different if not entirely opposite to the public's colloquial understanding of it, but when chemotherapy treatment inevitability increases morbidity and mortality in a patient after they survive through the 5 year 'cure' period, it can more easily be written off as unrelated to the original treatment. In other words, it is easier for them to cover up the fact that no real cure was ever produced.
Ironically, the young woman in question (referred to as Cassandra S. in the court documents) is far more aware of the real dangers associated with chemotherapy than the court, a Washington post article revealed:
"The teen's mother has said that her daughter "knows the long-term effects of having chemo" and doesn't want to put "poison" in her body.
"She may not be able to have children after this, because it affects everything in your body," her mother, Jackie Fortin, said in a video posted on the Hartford Courant's Web site. "It not only kills cancer, it kills everything in your body. She knows this.
"This is her human rights — her human constitutional rights — to not put poison in her body. Her rights have been taken away. She has been forced to put chemo in her body right now, as we speak. These are her rights that have been taken away. She does not want to [put] poison in her body."
What is perhaps most surprising is how clearly the National Cancer Institute's data portal on long-term (i.e. "late effects") adverse health effects of childhood cancers confirms the young woman is 100% correct about the life-threatening dangers of chemotherapy, which also makes the Connecticut Supreme Court justification for their decision appear abysmally incompetent. The NCI states:
"Late effects are commonly experienced by adults who have survived childhood cancer and demonstrate an increasing prevalence associated with longer time elapsed from cancer diagnosis. The Childhood Cancer Survivor Study (CCSS) investigators demonstrated that the elevated risk of morbidity and mortality among aging survivors in the cohort increases beyond the fourth decade of life. By age 50 years, the cumulative incidence of a severe, disabling, life-threatening, or fatal health condition was 53.6% among survivors, compared with 19.8% among a sibling control group. Among survivors who reached age 35 years without a previous severe, disabling, life-threatening, or fatal health condition, 25.9% experienced a new grade 3 to grade 5 condition within 10 years, compared with 6.0% of healthy siblings."