Chemo May Be Forced on 17-Year-Old Cancer Patient

[Morag]

Jodi Picoult wrote a novel encompassing a lot of these issues, called "My Sister's Keeper", about a child intentionally conceived/ designed thru assistive reproduction to be an ongoing blood and tissue donor for her older sister's cancer treatment. The story is about the issues surrounding each of the sisters rights to refuse medical care-- in the case of the younger-- to refuse to be forced to be a donor. (The movie version significantly changed the ending from the book-- book was better, IMO.)

http://www.amazon.com/My-Sisters-Ke...=1420833833&sr=1-1&keywords=my+sisters+keeper

I haven't read this book (yet)' but here's a link to an actual story which may have inspired the book. And it's a wonderful story with a happy ending.


http://www.dailymail.co.uk/news/art...cancer-stricken-sister--said-looked-back.html

 

[EmmaliLucia]

Okay, I don't care if it the chemo will cure it or not. Chemo sucks. I went thru it twice. It is her body and the courts should not be the ones forcing her to take the poison cocktail if she doesn't want to. Why are they spending all this money to break her will?

Chemo sucks. It sucks it sucks it sucks.

Because one of the only reasons if not the only reason she doesn't want Chemo is because she's afraid of infertility. That in itself is kind of proof that she is not thinking this through like a rational adult. treating the cancer with chemo gives her a 85-90% survival rate and depending on the chemo-drug her fertility will probably be fine.

 

[Softail]

I'm curious. For those that feel the courts "should stay out of it", is this your opinion because she is 17 and close to legal adulthood? Or are there other reasons why, beyond her age?

Would you agree the courts should "stay out of it" if the minor is 15? 13? 10? 8? 4?

Respectfully snipped....

For ME.... I'm still a bit torn, but do tend to think the courts should stay out of it because she is close to adulthood. For ME, like I said in a post above, I've seen too many people die from the treatment and not the Cancer. If she wants to pursue other treatment, she should be able to. It is her body. :twocents:

 

[Softail]

I'm curious. For those that feel the courts "should stay out of it", is this your opinion because she is 17 and close to legal adulthood? Or are there other reasons why, beyond her age?

Would you agree the courts should "stay out of it" if the minor is 15? 13? 10? 8? 4?

If age based, what age would you legally emancipate the minor to make her own health decisions? (That would be emancipation thru the courts.)

Should a parent always have a right to make, or allow a child, or teen to make, a decision to withhold lifesaving care, for their minor children? In all circumstances, or only in some? Which ones?

Jodi Picoult wrote a novel encompassing a lot of these issues, called "My Sister's Keeper", about a child intentionally conceived/ designed thru assistive reproduction to be an ongoing blood and tissue donor for her older sister's cancer treatment. The story is about the issues surrounding each of the sisters rights to refuse medical care-- in the case of the younger-- to refuse to be forced to be a donor. (The movie version significantly changed the ending from the book-- book was better, IMO.)
http://www.amazon.com/My-Sisters-Ke...=1420833833&sr=1-1&keywords=my+sisters+keeper

Saw the movie, didn't read the book. I bawled like a baby!

 

[Confusion]

Couldn't they harvest her eggs so she can try to conceive later?

 

[passionflower]

Could there be other treatments for this type of cancer? High steroid treatment?
Cancer treatments of America use different methods than the awful chemo programs.
My husband has MALT lymphma and he is on IV steroids and a chemo type pill.
He has never been sick, no lose of hair .........the only side effect so far is his highs and lows.

 

[K_Z]

Respectfully snipped....

For ME.... I'm still a bit torn, but do tend to think the courts should stay out of it because she is close to adulthood. For ME, like I said in a post above, I've seen too many people die from the treatment and not the Cancer. If she wants to pursue other treatment, she should be able to. It is her body.

BBM.

I agree, as long as that doesn't mean not taking the curative treatment. The court wasn't evaluating whether she and her mother should be permitted or restricted from pursuing ALTERNATIVE care. If there was a plan for alternative care, the attorneys for the teen would have presented it. The issue before the court was the refusal of the one treatment protocol that has been proven scientifically to have a high rate of cure, not a condemnation or prohibition of other alternatives. That's an important distinction, IMO.

I don't think either mother or teen has much of a plan beyond "something natural and less toxic" than the recommended chemo. Their comments about this are very vague in interviews, and are far more about avoidance of mainstream medicine, than seeking effective alternatives. I hear a lot of nebulous fear about mainstream treatment in their comments which, IMO, is motivating their refusal, rather than an assertive embrace of an alternative treatment regimen.

The more interesting thing, IMO, is that attorneys appointed to represent this teen's interests declined to present evidence of "mature minor" that would allow courts to emancipate her. It appears to my eyes that she has no official legal support to refuse treatment, beyond her mother. I don't think anyone in legal or medical authority thinks this teen is at a maturity level where she can make informed consent decisions to refuse a treatment which has a high rate of cure.

 

[K_Z]

Could there be other treatments for this type of cancer? High steroid treatment?
Cancer treatments of America use different methods than the awful chemo programs.
My husband has MALT lymphma and he is on IV steroids and a chemo type pill.
He has never been sick, no lose of hair .........the only side effect so far is his highs and lows.

We don't know enough about her tumor staging to make any judgments about protocols-- best left up to her specialists. However, I will say no one has even mentioned radiation in addition to, or in place of chemo, which makes me think her tumor is possibly beyond the earliest staging levels, but not at the point where she has a huge mass.

 

[K_Z]

Couldn't they harvest her eggs so she can try to conceive later?

It may or may not be right for her particular situation. Sometimes not possible if tumor is fast growing, or condition of patient or cancer is deteriorating. She has already delayed chemo since September by running away, avoidance, court proceedings. I'd estimate that if oocyte retrieval were to be considered, it would be at least a "1-2 cycle" delay (1-2 months). Ovarian cryopreservation can be harvested any time, but less effective. (See article below.) Balancing all that against her stage of disease, progress of the disease, etc-- 1- 2 months for oocyte retrieval may not be a reasonable length of time to wait NOW to begin treatment. (Though it might have been, back in September 2014.) Preserving her life now is more important and urgent than preserving future fertility-- which won't matter if she dies. I hope she discussed this with her specialists-- the docs usually bring it up for discussion, when it's a young woman who hasn't had kids.

Some references for oocyte retrieval and ovarian cryopreservation in Hodgkins patients (first from 2006):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361234/

http://link.springer.com/chapter/10.1007/978-1-4419-9425-7_4

Noteworthy research includes:

• Infertility may occur after chemotherapy or radiation therapy for Hodgkin lymphoma. Banking or freezing eggs is also called oocyte banking or cryopreservation. Researchers are trying to determine if freezing eggs is a useful way to maintain a woman’s fertility after some treatments for Hodgkin lymphoma (Haematologica, PMID 21828120; Archives of Gynecology and Obstetrics, PMID 21431846).

• Women do not always have time to consider harvesting their eggs or freezing embryos before treatment begins. Researchers are looking at freezing ovarian tissue, which is a less complicated procedure than harvesting eggs and freezing embryos. The ovarian tissue can be implanted back into the woman after her treatment ends. Recent studies have shown that this procedure is possible and may allow women with Hodgkin lymphoma to maintain their fertility, but further research is needed (Haematologica, PMID 21828120; Archives of Gynecology and Obstetrics, PMID 21431846).

•Gonadotropin-releasing hormone (GnRH) drugs may be given before and during chemotherapy treatment. These drugs cause a woman to go into temporary menopause, which stops eggs from maturing and being released. Researchers are studying GnRH drugs as a way to maintain fertility in women with Hodgkin lymphoma. So far researchers have found that GnRH drugs are not that effective (Archives of Gynecology and Obstetrics, PMID 21431846;Hematological Oncology, PMID 20232475).

Read more: http://www.cancer.ca/en/cancer-info...in-lymphoma/research/?region=on#ixzz3OMb5N500

 

[wendybtn]

Let me pose a "thought experiment."

Let's say a 17 yo girl arrived by ambulance to a trauma ER, conscious, but bleeding to death from a car accident or some kind of trauma that is typically "fixable" with urgent ER care, and perhaps a trip to the OR. Imagine the ER staff is trying to stabilize her. The teen is saying -- "No, stop, let me die!" The mother arrives in the ER, and says, "Well, she's making her wishes known, it's ok-- stop, let her die. I support her right to make decisions about her body. Don't take her to the OR, no blood products, no IV's, leave her alone."

In this example, should the ER staff simply strip off their gloves and walk out of the room, letting her bleed out and die from a fixable injury? Or should they continue to stabilize her and send her to the OR for emergency surgery to save her life?

What would the repercussions be for the docs and nurses, whether the staff stopped, or continued to resuscitate? The hospital?

What would the repercussions be for the teen? The mother?

You keep on working because there is no living will or DNR order, of course. Hospital staff are required to stabilize her then her mom can take her home and fight in court about what to do after that.

The mom is a kook and the daughter wants to please her mom. If she tries to come back in a year when she is sicker, it will be too late. I have seen people do it both ways. My 14 year old just started a year of chemo this past week for a very curable cancer. He understands what is going on and is cooperating well. I am not sure what I would do if he was a bit older and was absolutely defying us, (myself, my husband) and the doctors. I would probably go to court to make him get it, knowing the life I am giving him is his own, even if I did not get to be a part of it. But this girl is influenced by her mom's silly beliefs, IMHO. I guess the court did the right thing, but I would have a huge problem if they started making knowledgeable adults continue useless or miserable treatments. I have seen people die from the treatments before the cancer got them due to really poor general health and lifestyle issues or just too many other medical problems. RN, '87

 

[BetteDavisEyes]

The film based on the book My Sister's Keeper is featured frequently on Lifetime or LTM. Stars Cameron Diaz, ******* Breslin, and Alec Baldwin.

 

[nrdsb4]

The film based on the book My Sister's Keeper is featured frequently on Lifetime or LTM. Stars Cameron Diaz, ******* Breslin, and Alec Baldwin.

Wow, I wonder why the filter blocked out the name *******?! ETA: Ab igail

 

[BetteDavisEyes]

Wow, I wonder why the filter blocked out the name *******?! ETA: Ab igail

I wondered, too and have contacted a mod.

 

[MsFacetious]

Because of a living victim in a sexual assault case.
I am not sure why her name is blocked out and not every other victim.

 

[panthera]

Let me pose a "thought experiment."

Let's say a 17 yo girl arrived by ambulance to a trauma ER, conscious, but bleeding to death from a car accident or some kind of trauma that is typically "fixable" with urgent ER care, and perhaps a trip to the OR. Imagine the ER staff is trying to stabilize her. The teen is saying -- "No, stop, let me die!" The mother arrives in the ER, and says, "Well, she's making her wishes known, it's ok-- stop, let her die. I support her right to make decisions about her body. Don't take her to the OR, no blood products, no IV's, leave her alone."

In this example, should the ER staff simply strip off their gloves and walk out of the room, letting her bleed out and die from a fixable injury? Or should they continue to stabilize her and send her to the OR for emergency surgery to save her life?

What would the repercussions be for the docs and nurses, whether the staff stopped, or continued to resuscitate? The hospital?

What would the repercussions be for the teen? The mother?

The same could be said, and has been argued in the courts, regarding "religions" which do not condone or allow certain life-saving medical treatments, i.e. blood transfusions. While there is understandably some disagreement regarding chemotherapy and its side-effects, what does the mother of this 17 year old propose as an alternative? I am also confused how the future inability to have children is even in question if her life is at stake.

:waitasec:

MOO

 

[jjenny]

The same could be said, and has been argued in the courts, regarding "religions" which do not condone or allow certain life-saving medical treatments, i.e. blood transfusions. While there is understandably some disagreement regarding chemotherapy and its side-effects, what does the mother of this 17 year old propose as an alternative? I am also confused how the future inability to have children is even in question if her life is at stake.

:waitasec:

MOO

Exactly. Sounds like death would be very likely without treatment. So concerns about fertility seem to be irrelevant as she wouldn't get a chance to have children if she is dead.

 

[Hiandmighty]

I'm very much against "futile" treatment, and I usually believe a person has the right to decide what goes into his/her body, but in this case... I believe she should be forced to do the treatments.

 

[Zuri]

I'm curious. For those that feel the courts "should stay out of it", is this your opinion because she is 17 and close to legal adulthood? Or are there other reasons why, beyond her age?

Would you agree the courts should "stay out of it" if the minor is 15? 13? 10? 8? 4?

If age based, what age would you legally emancipate the minor to make her own health decisions? (That would be emancipation thru the courts.)

Should a parent always have a right to make, or allow a child, or teen to make, a decision to withhold lifesaving care, for their minor children? In all circumstances, or only in some? Which ones?

Jodi Picoult wrote a novel encompassing a lot of these issues, called "My Sister's Keeper", about a child intentionally conceived/ designed thru assistive reproduction to be an ongoing blood and tissue donor for her older sister's cancer treatment. The story is about the issues surrounding each of the sisters rights to refuse medical care-- in the case of the younger-- to refuse to be forced to be a donor. (The movie version significantly changed the ending from the book-- book was better, IMO.)

http://www.amazon.com/My-Sisters-Ke...=1420833833&sr=1-1&keywords=my+sisters+keeper

Loved this book. It was heart wrenching. The book was so much better than the movie. The book is a really thought provoking look at many medical ethical/moral issues. Thank you for so eloquently posting as you have.

 

[Zuri]

I'm very much against "futile" treatment, and I usually believe a person has the right to decide what goes into his/her body, but in this case... I believe she should be forced to do the treatments.

I so agree. Let this teen weigh in when she is 80 and reflect back if it was the right decision.

 

[panthera]

Exactly. Sounds like death would be very likely without treatment. So concerns about fertility seem to be irrelevant as she wouldn't get a chance to have children if she is dead.

The girl may not realize the gravity of her condition and if there is any doubt by her mother, get a second or third opinion by medical professionals. As a generality, also, many teens have a sense of invincibility.

MOO