Debate This: Should This 17-Year-Old Have The Right To Refuse Cancer Treatment?

When 17-year-old Connecticut teen Cassandra was diagnosed with Hodgkin lymphoma, she refused chemotherapy treatments, arguing that she didn’t want to poison her body. After several missed appointments and arguments with doctors over her diagnosis, the state removed Cassandra from her mother’s care in December. She’s currently in the custody of child welfare services and staying in a monitored hospital room where she’s being forced to undergo chemo. Now, the court is trying to determine whether she has the right to refuse further treatment.

There is no question that Cassandra will die without treatment, but with doctors’ help, her type of cancer is more curable than most forms of the disease. Hodgkin patients who undergo chemotherapy have a roughly 85 percent chance of survival, so she would be very likely to go on to lead a healthy, full life after treatment. She’s an only child and her mother, Jackie Fortin, has been a single mom for Cassandra’s entire life. Fortin says the two have never been separated until now. Child welfare authorities took Cassandra’s cell phone in case her mom is somehow coercing her, so the two can rarely speak, and visits with Fortin are supervised by a welfare worker. It’s likely immensely traumatic for Cassandra to go through chemo without her mom — but where does Fortin stand on Cassandra’s decision? Based on the previous missed doctor appointments it stands to reason that she backed Cassandra’s refusal at least on some level, and she’s publicly supporting her daughter’s decision, but her comments on the matter have been confusing.

Fortin told NPR, “This is not about death. My daughter is not going to die. This is about, ‘This is my body, my choice, and let me decide.'” At first I took that to mean that this woman is in massive denial and spreading that misinformation on to Cassandra, but I think what Fortin really means is that this situation will be resolved before things get that dire. I think that in Fortin’s eyes, it’s not about if Cassandra will receive treatment, but when. She doesn’t want her daughter to go without chemo, she just wants her to undergo it on her own terms.

She expanded on this when she told NBC News:

“Does she know she will die? Yes. And do I know that? Yes … In my heart, I feel when the timing is right, when Cassandra feels right, or if she starts getting sick, she will come to me and say, ‘Mom, I am ready to do chemo.’ Right now, she is backed up against a wall and forced to do something (after) she said, ‘I don’t want poison in my body.’ “

She also said Cassandra “knows what the poison can do. She knows what the effects can be long term for her body.” It’s true that chemo is brutal on a person’s body and I wouldn’t wish it on anyone, but I still find this statement totally nonsensical — does Cassandra not understand that there will be no long-term anything for her body, or her life at all, if she doesn’t get treatment?

Adults have the legal right to refuse any kind of medical treatment, no matter how life-saving it may be. Cassandra’s status as a minor is what’s keeping her from that right, but she is just nine months shy of her 18th birthday, which is what calls her case so strongly into question. Her attorneys are insisting that maturity doesn’t magically appear at a specific age, and that the state should consider the mature minor doctrine, which evaluates whether a teenager is capable of making their own health care decisions. A huge pet peeve of mine is when young people’s opinions are dismissed simply because they’re young, so that’s not what I’m trying to do when I say this, but I think it’s worth noting that it can be hard for teenagers to see the bigger picture of situations — not because they’re idiots, simply because they lack life experience. If Cassandra is staring at a scary diagnosis, she may feel more rashly about it than a person who’s a bit older, and not be able to see that things have the capability to get much better.

It seems that Fortin’s goal is to recognize her daughter’s right to her own body, and wait for her to realize on her own how badly she needs this treatment. The problem with this line of thinking is it recognizes that Cassandra doesn’t have the perspective to realize how dire this situation is, which deems her too immature to call the shots and essentially answers the court’s question. It doesn’t mean she’s not smart, it means she’s a young person in a terrifying situation, and that she needs guidance in handling it, like most teenagers would.

It’s awful that any young person should have to go through this at all, especially while separated from her parent, but what’s most frustrating about this as an outsider is how treatable the disease is. In many cancer diagnoses, the chances of survival are so slim that it’s questioned whether treatment would just make the patient’s remaining time alive more difficult or just buy them a few more weeks before passing away. I could see Cassandra’s argument being more polarizing in that kind of situation, but this is not one of those cases — she’d likely be cured. That said, her body belongs to her alone. So, what do you think? Does she have the right to say no?

[NPR]

[NBC News]

[Image via NPR/Jackie Fortin]