Dr. Lainie Friedman Ross of the University of Chicago’s Center for Clinical Medical Ethics discussed the question “Can Adolescents Refuse Medical Treatment?” yesterday at the University of Virginia’s Medical Center Hour.
During her presentation, Ross told the story of Abraham Cherrix, a 2006 patient of the University Medical Center. Diagnosed with Hodgkin’s disease in 2006, Cherrix underwent chemotherapy for three months, but refused the next, more intense phase of treatment. He convinced his parents to help him find an alternative treatment in Mexico, and his parents were arrested for neglect of their child.
The case was appealed in Virginia v. Cherrix, and soon “Abraham’s Law” was passed, allowing children of 14 years or more to refuse treatment for life-threatening illness if their parents support the decision.
While this law seems to mean an increase in the freedom of minors to make their own medical decisions, Ross said it is not. She presented her argument by first outlining the three possible ways to handle the different situations that arise when providing treatment for an adolescent: giving the decision-making power to responsible minors, giving it to parents or simply trusting it to the hands of medical staff.
Ross said the existing system places power with the parents and the commonwealth’s court system, which, while not ideal, is the best way to properly care for minors needing treatment.
“The health care precedent to respect family refusals in [situations] of life-threatening cases is morally inconsistent with having increased respect for minors,” Ross said.
Virginia v. Cherrix thus set precedent not for adolescent autonomy, but for increasing the power of parents to make decisions in the best interest of their children.
Margaret E. Mohrmann, University associate professor of pediatrics and medical education, spoke next, clarifying where exactly the difficulty lies — the consensus age that marks the ability to make autonomous medical decisions.
“We don’t receive [the ability to make] good decisions as a birthday gift at 18,” Mohrmann said. “The legal bright line is the age of 18. It’s not perfect but it seems to be the best way at the moment ... It should make us feel uncomfortable.”
Fourth-year College student Era Kryzhanovskaya, who attended the presentation, also expressed some discomfort with the system.
“It doesn’t necessarily sit well with me,” Kryzhanovskaya said, although she noted that she felt some sort of boundary was needed.
In her presentation Ross noted that she also feels that the system is not always perfect.
“There are some times that I want to move it back to 16,” Ross said. “And other days I want to move it up to 25, or sometimes even 30.”
Ross noted, however, that while letting mentally stable parents make medical decisions based on what they believe to be in the best interest of their minor child is by no means a perfect system, but it is the best available.
Despite this belief, Ross explained, it can still be very difficult for a physician to treat a resistant adolescent patient.
To illustrate the difficulty, Ross told the story of 17-year-old E.G., a 1989 patient who refused a blood transfusion for her chemotherapy with her mom’s support. A judge found E.G.’s mother guilty of neglect, and E.G. was appointed a new guardian. The case was eventually appealed, but during the appeal E.G. still received a number of blood transfusions.
“Imagine giving blood to E.G., who says that every time blood starts dripping [from the I.V. bag] she feels like she’s getting raped,” Ross said. “She had to be sedated so she didn’t feel like that. It’s a really hard thing to watch, but you know you’re saving their life.”By Matthew Denton-Edmundson
Cavalier Daily Staff Writer
Dr. Lainie Friedman Ross of the University of Chicago’s Center for Clinical Medical Ethics discussed the question “Can Adolescents Refuse Medical Treatment?” yesterday at the University of Virginia’s Medical Center Hour.
During her presentation, Ross told the story of Abraham Cherrix, a 2006 patient of the University Medical Center. Diagnosed with Hodgkin’s disease in 2006, Cherrix underwent chemotherapy for three months, but refused the next, more intense phase of treatment. He convinced his parents to help him find an alternative treatment in Mexico, and his parents were arrested for neglect of their child.
The case was appealed in Virginia v. Cherrix, and soon “Abraham’s Law” was passed, allowing children of 14 years or more to refuse treatment for life-threatening illness if their parents support the decision.
While this law seems to mean an increase in the freedom of minors to make their own medical decisions, Ross said it is not. She presented her argument by first outlining the three possible ways to handle the different situations that arise when providing treatment for an adolescent: giving the decision-making power to responsible minors, giving it to parents or simply trusting it to the hands of medical staff.
Ross said the existing system places power with the parents and the commonwealth’s court system, which, while not ideal, is the best way to properly care for minors needing treatment.
“The health care precedent to respect family refusals in [situations] of life-threatening cases is morally inconsistent with having increased respect for minors,” Ross said.
Virginia v. Cherrix thus set precedent not for adolescent autonomy, but for increasing the power of parents to make decisions in the best interest of their children.
Margaret E. Mohrmann, University associate professor of pediatrics and medical education, spoke next, clarifying where exactly the difficulty lies — the consensus age that marks the ability to make autonomous medical decisions.
“We don’t receive [the ability to make] good decisions as a birthday gift at 18,” Mohrmann said. “The legal bright line is the age of 18. It’s not perfect but it seems to be the best way at the moment ... It should make us feel uncomfortable.”
Fourth-year College student Era Kryzhanovskaya, who attended the presentation, also expressed some discomfort with the system.
“It doesn’t necessarily sit well with me,” Kryzhanovskaya said, although she noted that she felt some sort of boundary was needed.
In her presentation Ross noted that she also feels that the system is not always perfect.
“There are some times that I want to move it back to 16,” Ross said. “And other days I want to move it up to 25, or sometimes even 30.”
Ross noted, however, that while letting mentally stable parents make medical decisions based on what they believe to be in the best interest of their minor child is by no means a perfect system, but it is the best available.
Despite this belief, Ross explained, it can still be very difficult for a physician to treat a resistant adolescent patient.
To illustrate the difficulty, Ross told the story of 17-year-old E.G., a 1989 patient who refused a blood transfusion for her chemotherapy with her mom’s support. A judge found E.G.’s mother guilty of neglect, and E.G. was appointed a new guardian. The case was eventually appealed, but during the appeal E.G. still received a number of blood transfusions.
“Imagine giving blood to E.G., who says that every time blood starts dripping [from the I.V. bag] she feels like she’s getting raped,” Ross said. “She had to be sedated so she didn’t feel like that. It’s a really hard thing to watch, but you know you’re saving their life.”
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