Cathy Ren: Refusing Medicine for Children
Medicine can be bad for us. Many drugs or treatments that are FDA-approved bring about a multitude of side effects, some potentially fatal, and it is within the rights of patients to refuse any treatment that they do not wish to endure. However, when the competency of the patient is questionable, the right to make medical decisions can be controversial. For minors, a parent or guardian must make such decisions on behalf of the patient. Problems arise when a lack of treatment threatens the lives of the children: the parents’ refusal of treatment conflicts with the hospital’s responsibility to preserve the child’s life. Past lawsuits have not set a clear precedent for how to approach these concerns, so legal decisions regarding treatment have been made on a case-by-case basis.
Refusing Chemotherapy
A few years ago, the Huffington Post published an article about an Amish girl, Sarah Hershberger, who underwent chemotherapy at Akron Children’s Hospital for a month before stopping treatment because her parents decided that “the effects on their daughter were horrible and that they were now relying on natural medicine, such as herbs and vitamins.” Andy Hershberger, Sarah’s father, told ABC News, “Our belief is the natural stuff will do just as much as that stuff if it’s God’s will.” Sarah herself also “told a probate and juvenile judge that she didn’t want chemotherapy because it made [her] feel ill, can damage her organs, and make her infertile.”
The hospital claimed that “the girl will die without chemotherapy and is morally and legally obligated to make sure she receives proper care” because she has an 85 percent chance of survival with treatment. When the case went to court, the first judge decided that there was “not a scintilla of evidence showing the parents are unfit.” The hospital appealed, and an October 1st ruling overturned the first decision, giving limited custody to a nurse at the hospital to make medical decisions on behalf of Sarah. The Amish believe in modern medicine, so the conflict was not based on religion, but rather on parents’ desire to prevent Sarah’s pain. In the case of Sarah Hershberger, the hospitals’ interests in preserving life prevailed over the parents’ interests in raising their child in a certain way.
Refusing Vaccines
In 1998, a British doctor named Andrew Wakefield published an article that suggested the MMR (mumps, measles, rubella) vaccine was a cause for autism. Some parents became hesitant to allow doctors to administer the MMR vaccine on their children, and celebrity Jenny McCarthy, who has a son diagnosed with autism, quickly became a spokesperson for the movement.
McCarthy has appeared on television and even written a book about the dangers of vaccines. This media coverage has convinced many parents to refuse vaccinations on behalf of their children, leading to recent increases in outbreaks of measles and other diseases. Doctors and hospitals question the decisions of these parents, but usually have no power to force vaccinations upon children whose parents decide against them. The Center for Disease Control (CDC) recommends administering the first dose of the MMR vaccine at 12-15 months of age. Coincidentally, signs of autism begin to appear around this time, which may be the reason that some attribute autism to vaccination. After the period in which signs of autism usually appear, some parents will allow their children to be vaccinated, but there is a period of time in which their children are susceptible to infections of easily preventable diseases. If a community of parents refuses vaccinations, this can cause large outbreaks.
While Wakefield’s study proved to be flawed in the end, without laws that require mandatory vaccinations for children, doctors still have trouble convincing some stubborn parents to allow the MMR vaccine to be administered.
Refusing Life Support
Both chemotherapy and vaccines are treatments that are intended to improve the health of patients or prevent diseases. In contrast, life support simply keeps people alive and does not treat a condition. Withdrawing life support has been compared to euthanasia or physician-assisted suicide, due to the result of death. The distinction is that life support means removing something that keeps someone alive, while the euthanasia and physician-assisted suicide mean administering a treatment that kills a person. Parents’ personal decision to withdraw life support from their children can be extremely complicated. For example, at the age of 21, Karen Quinlan fell into a persistent vegetative state after consuming and overdosing on drugs and alcohol and was put on a ventilator. Her father asked the hospital to remove life support, but the hospital refused. The case went to court, and the New Jersey Supreme Court ruled in favor of Karen’s father. In 1976, Karen Quinlan’s ventilator was removed.
The case of Karen Quinlan has set a precedent for similar incidents. In 2003, in a case involving a Brooklyn girl, a New York court ruled in favor of a mother who had sued for the right to have her daughter’s respirator removed. Although the hospital opposed this action, the court’s decision supported the right of parents to decide on a child’s life support.
The Trend
There is no law that says parents can always make medical decisions on behalf of their children. In addition, these cases fall under state, not federal jurisdiction, so it is possible that a ruling in one state can be the opposite of a similar case in a different state. However, the above cases illustrate a pattern in this murky field. In general, parents, who are believed to have best interests of their children in mind, are allowed to make any and all medical decisions on behalf of their children. The courts will only step in when the child’s life is in danger and the suggested treatments are likely to be effective.
Cathy Ren is in Berkeley College. This story has been re-uploaded from our 2015 issue.