Does a mother have the right to deny lifesaving medical treatment for her child (even if the child agrees with her)? If she does opt for other treatments (less proven/ successful), can the State force her to undergo a certain treatment?
Those are some of the questions I have been pondering over for the last few days.
Consider the case of Daniel Hauser – a thirteen year old boy who is suffering from Hodgkin’s lymphoma. Apparently, with chemotherapy and radiation, Hodgkin’s lymphoma is curable more than 80% of the time. But chemotherapy can be really painful, and I am not surprised that a 13 year old boy rebels at undergoing it. What’s more surprising is that his parents should agree with him. After one round of chemo, Danny’s parents decided to stop treatment and are now pursuing alternative treatment consisting of some American Indian tradition called Nemenhah, which supposedly has cures for AIDS and cancer.
The doctor who was treating Danny alerted the authorities, and soon a judge ruled that Daniel Hauser must get medical treatment – i.e. chemotherapy. Authorities are now searching for Daniel and Colleen Hauser, his mother, both of whom have fled their home.
Over at Science Blogs, Respectful Insolence seems to think that the issue is not even religion but irrational beliefs of the parent(s) who use religion as a crutch.
I completely agree that Colleen Hauser is very unwise to seek alternative medical treatment for Hodgkins lymphoma, given that chemotherapy has a high probability of curing this cancer.
Having said that, this story raises a lot of questions in my mind about the precedents it sets.
1. What if the disease had not been Hodgkins lymphoma but some other form of cancer like, say, pancreatic cancer? About 80% of people diagnosed with pancreatic cancer die within a year despite treatment. In such a case, isn’t it understandable if such patients forego any treatment, or forego chemotherapy for other alternatives? So then, is there one law for one form of cancer and another for a less curable one?
2. Can doctors break the patient-doctor confidentiality and alert authorities if patients stop treatment at their hospital? How did this doctor know for certain they hadn’t gone to another hospital anyway? Did he do a nationwide/worldwide search of hospitals?
3. What forms of medicine are considered “treatment”? Is allopathy the only form that is acceptable? If this had been a disease where allopathy didn’t have a high success rate, would it be wrong to try homeopathy or ayurveda? Continuing with my pancreatic cancer example, if allopathy offers a 5% chance of surviving for 5 years, and another alternative treatment offers the same chance, is one inferior to the other? Especially if say, treatment with allopathy is very painful and homeopathy is not ?
4. Is considering alternative medical treatment against the law? How can a court rule that one has to take a certain form of medical treatment?
So, dear readers, what do you think of all this?
Do you think something like this can happen in India ? I believe that there is more tolerance for alternative medical treatments in India, am I right?
ak
Syahir
Preeti
shyam
I have the same argument...
Strange that I never heard about this on TV here. Well, the State is being wrong here I think so and yes, you raised pretty important questions.
The doctor-patient confidentiality should have been there and its very wrong that its broken in this case. And most definitely the court sees no differnce between cancers. Even the points about allopathy giving say 5% and say homeopathy gave more than it, the courts would still not support because I dont think they acknowledge any other kind of treatment.
The situation amongst the non-upper class in India is no better – well, they would shift doctors to see who is prescribing cheaper medicines based on if the last doc prescribed a cold medication for say 50 bucks against the common Action 500 which the initial doc had prescribed. Its weird back there – homeopathy n allopathy have a significant share but all is just belief based. Moreover, news about doctors n treatments there spreads by word of mouth which can be misleading. Something like that doctor there prescribed a medicine which cured my joint pains when all docs had given up in so and so city – we dont get into specifics and generalize diseases. Every riase in body temperature is a fever first and all you will get is a Crocin/Paracetamol for few days that too from you mom. There is more tolerance in India because its more belief based and that we are ready to try n experiment. We are a impatient lot – no?
There is more tolerance for alternate medicine in India because the state doesn’t care, it is easily available and is cheaper in most cases and there is illiteracy.
The state has a role to play at least in India because there are a large number of quacks operating here, selling Allopathic medicines although they are not trained. There are Hakims and Vaids giving steroids in the disguise of Ayurvedic concoctions who need to be checked. Tantriks and ozhas openly advertise that they can cure any disease under the sun and the illiterate and the gullible trust them. Something has to be done about them.
You can read more about Hodgkin’s and why treating Daniel is so important here:
http://bit.ly/PtgV3
Good points, Lekhni, and I was thinking about it too. One case where the State may have a greater say is when a disease is contagious and non-treatment by an individual puts other healthy individuals at risk – in such a scenario, I would have no problem going with what the courts say and either forcing someone to avail of a cure, or quarantine them. But if it is a non-contagious disease, then the individual has more say on whether he accepts a treatment or not, or prefers euthanasia/to die naturally rather than availing a medical treatment if it’s a terminal disease. The situation is complicated here because a minor is involved.
Hmm…point to ponder.
But I think one be allowed to consider alternate medicine. No form of cure is 100% certain. But its a decision to be taken after a lot of research and not just because the local ‘ojha’ has recommended it.
And I also think you are right about it being more accepted in India. religious belief and faith, is my guess. Many literate people swear by homeopathy…so illiteracy isn’t the only reason.
Nice post
I have thought about it in a personal context . One of our family friends’ lost their daughter after a 3 month fight with cancer. She was hospitalized for those 3 months. Then I volunteered with AADP to find marrow donors for 3 Asian Americans and while all 3 found their matches, they lost the battle. It really broke my heart and I did find myself thinking that may be it was better to spend those last few months at home, with family and seek less painful treatments. My sample size is still too small but if I increasingly see people losing their battles after aggressive chemos and successful transplants, I might not want to go through it at all. Hard to say. But these few incidents were enough to shake my belief.
i know nothing about this kind of cancer – but i do know someone in india whose mother was told that she’d have to go for chemo and they chose ayurveda instead. she’s fine now.
i think the reason why its a debate is because its abroad. in india it would be no biggie. i for instance treat my daughter’s eczema and asthma through homoeopathy and my PCOS too.
i cant imagine why or how anyone else should be given the right to decide something for us if my child and I are in agreement. right now my daughter’s two – but if a 13 year old child and his parents are in agreement on a treatment, the state should butt out…
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You are missing the key element here. The patient in question was a minor, and the decisions were being made by someone else anyways (an irresponsible parent here).
While we trust parents in most cases to do the right thing, that is not always the case. When they are making bad decisions, we want the government to step in and take over (child protection?).
While we are doing hypotheticals, lets add another hypothetical (and possibly real) tidbit to the story. What if the child had a large life insurance policy on his name, and the disease is life-threatening? That shows why the government needs to step in such cases.
Now if the patient in question was the mother (an adult) and she chose to take this step for herself, the government, rightly, would not have bothered.
Regarding the doctor-patient confidentiality (or any confidentiality, for that matter) it does not hold if there is knowledge of possible future illegal activity. That is the case in this situation.
3. What forms of medicine are considered treatment? Is allopathy the only form that is acceptable? If this had been a disease where allopathy didnt have a high success rate, would it be wrong to try homeopathy or ayurveda? Continuing with my pancreatic cancer example, if allopathy offers a 5% chance of surviving for 5 years, and another alternative treatment offers the same chance, is one inferior to the other? Especially if say, treatment with allopathy is very painful and homeopathy is not ?
Allopathy need not be the only form acceptable, but it is the only form of treatment with strong ties to science and hence the only one whose claims are properly evaluated. If practitioners of Alternative Medicine accepted the same standards of rigor as Allopathy, they will have the same credibility and your second question won’t arise because success rates of all three can be compared. Similarly for the third question: if the success rate of the alternative treatment has been as rigorously established as allopathy, then both are equally good unless of course one is less painful than the other.
How can a court rule that one has to take a certain form of medical treatment?
State (acting through court in this case) is supposed to exist for the benefit of the individual. And state is likely to know better about medical treatments than the parent just as the parent is likely to know better than the child. If the state is not expected to perform its primary function of protecting its individuals we might as well do away with state itself.
But as I said state is *likely* to know better than the parent. If a parent thinks it knows better than the state it can take the matter to the courts. Just like a child can talk to her parents if she thinks she knows better. There’s nothing more that can be done about it.
The issue here is not “a certain form of treatment” but “the most trustworthy form of treatment”. The trustworthiness of allopathy is a consequence of its strong ties with science and its rigorous procedures. That’s why allopathy does and should takes precedence over other forms of treatment. If allopathy can cure a cancer with 80% success rate whereas the success rates of alternative treatments (which are not as rigorous as allopathy) haven’t even been determined, then the state is *expected* to enforce allopathy even if it’s painful.
The state is actually parenting the parent here and with good intentions.
Can doctors break the patient-doctor confidentiality and alert authorities if patients stop treatment at their hospital?
NO. But I don’t think the doctor in this case informed the authorities merely because the patient stopped treatment at his hospital.
How did this doctor know for certain they hadnt gone to another hospital anyway? Did he do a nationwide/worldwide search of hospitals?
Because *somehow* he found out what the patient and his parents were actually up to. Otherwise I don’t think he would go to the trouble of alerting the authorities.
So then, is there one law for one form of cancer and another for a less curable one?
Law cannot take everything in consideration by default. If someone feels strongly that this distinction be made, he should go through the appropriate channels.
Lekhni: Another one on alternative medicine called “prayer”.
http://news.bbc.co.uk/1/hi/world/americas/8180116.stm