Parents vs. Hospitals

Written by: Leah Jeunnette, Ph.D.(c)

17 year-old Hodgkin’s lymphoma patient Cassandra is being forced to undergo chemotherapy in Connecticut against her and her mother’s wishes. They wanted to seek alternative therapies, calling chemo drugs “poison.” Because they refused to comply with the recommended course of care, the hospital reported mother Jackie Fortin to DCF for medical neglect (remember Justina Pelletier?), who placed Cassandra into protective custody.

Ethicists are taught that parents consent on behalf of children, because children do not have the right/ability to consent, although minor assent is still sought. Parents are to use the best interests standard in medical decision making.  Best interests of the child according to what? According to their own value system or the medical institution’s and state’s? I am deeply troubled that a hospital could pull the medical neglect card, so the state would “protect” Cassandra from herself and her mother.

Now the court seems focused on the patient’s maturity – seemingly circular reasoning: if she were mature, she would do what the medical experts want – if she won’t, it proves that she is immature?!

Regardless of how the tactical focus shifts, the issue of whether hospitals/states can trump parental rights when they disagree over treatment cannot be ignored. And if this is about whether or not ends justify the means or a matter of the lesser of two evils, then let’s dip into that ethical discussion, as well . . . .

Is this paternalistic usurping of parental rights and failure to honor obtaining a minor’s assent to treatment or well-intentioned and necessarily enforceable protection of the incompetent?