Bioethicist: Why Connecticut Teen Can't Say No to Chemo

Jackie Fortin and her 17-year-old daughter Cassandra.
Jackie Fortin and her 17-year-old daughter Cassandra.Family photo via NBC Connecticut

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A 17-year-old girl, listed in court papers only as Cassandra C., is in protective custody at a Connecticut hospital where she is being forced to undergo chemotherapy treatment that she says she does not want. Americans strongly value the right to refuse medical care.

We are all familiar with situations in which Jehovah’s Witnesses say no to life-saving blood transfusions, patients refuse any more surgery or artificial ventilation, and ill people forgo proven medical interventions to follow alternative care.

But those cases involve competent adults.

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Cassandra is 17 — still a minor. Should she have the right to say no? I don’t think so.

Cassandra has Hodgkin lymphoma, a cancer of the lymphatic system, the body’s immune system. The National Cancer Institute says that more than 85 percent of those with this form of the disease and who get chemo will survive a minimum of five years. If the cancer is found early and treated quickly, outcomes are even better. So a child would need to have one hell of a reason for not wanting treatment given that this is a type of cancer for which a cure exists.

Cassandra is not invoking a religious belief in saying no. Nor is she claiming she believes in some form of alternative medicine. According to the teen's mother, Cassandra is refusing chemo because she hates the miserable treatment — hair loss, feeling sick, nausea, and being really tired. Her mother says she backs her daughter’s decision. The state of Connecticut does not. Neither do I.

Find her a doc, social worker or counselor with whom she can bond and trust, who can guide her through the hell of chemo.

Indeed, Cassandra is close to being an adult but not quite there. She is also a teenager — a group not known for always making the best judgments. I would hope her mom would be pushing her to get chemo rather than trying to honor her emerging autonomy.

The primary goal in this case is to save a young life. This is a disease where medicine can do that. Admittedly, the treatment sucks, but it works. I hope when judges hear this case Thursday, they tell Cassandra that she needs to get the chemo. But she also needs support. A lot of it.

Let her meet others her age who have been through chemo and lived. Find her a doc, social worker or counselor with whom she can bond and trust, who can guide her through the torment of chemo. Bring her mom around and get her to help her daughter through the treatment.

Respecting choice is important. Not burying a young teenage girl who would have lived is far more important.