Should a 17-year-old Connecticut girl with Hodgkin’s lymphoma have the right to refuse chemotherapy treatment?
The Connecticut Supreme Court says no.
Contrary to what her mother says about her, the court ruled that the girl is not legally mature enough to decide if she should get a potentially life-saving treatment. The decision Thursday upheld a lower court ruling. The girl will turn 18 in nine months, at which time her rights to refuse treatment will be greatly expanded, the state argued.
But for now, she is being strapped down to a hospital bed and given chemotherapy treatments against her will, said her mom, Jackie Fortin.
“My daughter is refusing chemo because of poison toxins she does not want in her body. She knows the long-term effects of having chemo, what it does to your organs, what it does to your body,” Fortin told the Hartford Courant. “She may not be able to have children after this. Because it affects everything in your body. It not only kills cancer, it kills everything in your body. She knows this.”
The state Department of Children and Families was awarded custody of the girl, identified only as Cassandra C., who is “doing well” with chemotherapy at Connecticut Children’s Medical Center, a lawyer for the state told the justices.
The court Thursday heard arguments from lawyers for Cassandra and her mother, who supports her daughter’s decision to reject chemotherapy treatments.
Assistant Public Defender Joshua Michtom, representing Cassandra, said the question was whether, despite an encouraging prognosis, “a smart and knowledgeable 17-year-old (can) make the same choice, for better or worse, than she would be able to make without state interference nine months from now, when she turns 18,” the Courant reported.
“This is her human rights. Her human constitutional rights, to not put poison in her body,” Fortin, of Windsor Locks, told the Courant. “Her rights have been taken away. She has been forced to put chemo in her body right now as we speak. These are her rights that have been taken away. She does not want to put poison in her body.”
Watch Jackie Fortin relay her story to Hartford Courant below.
Doctors said the girl has an 80 to 85 percent chance of survival with about six months of chemotherapy. Doctors say that without the treatment she will die. Fortin said she supports her daughter’s decision one way or the other.
Peter Johnson Junior, an attorney who himself had Hodgkin’s lymphoma when he was a teenager but received chemotherapy and survived, sees Cassandra’s plight another way.
“The family is wrong on the law and wrong on the ethics and wrong on the humanity. The state of Connecticut has an obligation to protect the life of an infant,” he told Fox News. “If she does not get this treatment, this is a form of suicide. And, frankly, the ACLU is complicit in her death if she dies. They will be part of an assisted suicide in the state of Connecticut; I feel that strongly about it. Do 16- or 17-year-old children have the judgment, the experience to be making these decisions of life and death?”
Johnson said, “I need to speak with her. I need to speak with her mom. I need to explain the law and what can happen.”
Watch Peter Johnson make the case in favor of state intervention in treatment of Cassandra below:
Fortin told the Courant that if her daughter decides later to go forward with treatment, “that should be her decision, not the state, not the government forcing it upon her. This should be her decision, what to do with her body. Her rights have been taken away. She does not want this. It is not my decision; it is my daughter’s decision, and I stand by her 100 percent whether she does chemo or whether she doesn’t do chemo.”
But Johnson said Hodgkin’s is a very unforgiving disease, and Cassandra may not be afforded the luxury of waiting to change her mind later about the treatment.
“It will be too late,” he said. “The death bell will have been run by that point. Whether you’re a Christian or a Jew or a Muslim or an atheist, preserve life! … Can someone really be competent at age 17 saying, ‘I don’t want the treatment, I want to die, even though I can live if I get the treatment’? When we see 17-year-olds on top of a building ready to jump, do we say, ‘Jump now, fine that’s your choice; you can jump’? Or do we summon everyone in society and say, ‘No, come down’? I’ve been there on top the building. I’m saying, I can lead you down.”
Michtom argued that society permits children to be tried in adult court for certain crimes, or conversely, to be tried in juvenile court, depending on the child’s history. He said minors can seek an abortion, receive addiction treatment or give blood without parental consent.
“This is her decision, and she’s intelligent enough to make this decision on her own,” Fortin told the Courant. “She does not want poisons in her body, and she does not want to be forced, through the state or the government, to do such a thing, and right now she is being forced.”
The court agreed to an expedited ruling in this rare case involving the “mature minor doctrine,” which holds that some minors possess the maturity to make their own medical decisions, even if younger than the age of majority.
DCF put the responsibility at the feet of Cassandra’s mother.
Even CCMC issued a statement, something the hospital normally doesn’t do.
“Connecticut Children’s is working closely with the Department of Children and Families. We are grateful that the Supreme Court has agreed to take on this very important case and we look forward to their guidance.”
Fortin strongly denies that she influenced Cassandra’s decision. Mother and daughter initially complied with the court order, and Cassandra received two chemotherapy treatments – but she then ran away from home and became a subject of a police-issued Silver Alert. When she returned home, Cassandra went back to CCMC, where she had had a portion of her lymph node removed.
Fortin said doctors had “to strap her down on the bed” to do the preparatory surgery before resuming the regimen of chemotherapy.
Fortin said Cassandra believes the chemical toxins could do more damage to her body than the cancer. Michtom has said that doctors involved with her care have pegged Cassandra’s chances of surviving her bout with Hodgkin’s lymphoma at 80 percent to 85 percent if she continues with the court-ordered treatments.
DCF maintains that “[e]ven if the decision might result in criticism; we have an obligation to protect the life of the child when there is consensus among the medical experts …”
Fortin said this should be her daughter’s choice to make. Cassandra was first diagnosed with Hodgkin’s lymphoma in September.
Michtom and lawyer Michael Taylor of West Hartford, who represents Fortin, argued before the court. They have said they do not fault the order from the trial judge or DCF’s actions.
A key legal issue in the case is Cassandra’s argument that Connecticut should recognize the mature minor doctrine, which applies to minors under 18.
As of 2013, 17 states – but not Connecticut – had some form of the mature minor doctrine on the books, according to an article in the journal Pediatrics, the Courant reported. But those laws generally grant minors the ability to consent to medical treatment against the wishes of their parents, while Cassandra’s case is the flip side of that – seeking legal authority as a minor to refuse treatment.