Picture this: You’re locked in a room and tied down to a bed. A man stands guard night and day. Your phone has been taken from you and your family is only allowed to visit a few times and only under supervision. Daily, you are subjected to radiation that makes you feel sick and nauseas. You are held down, against your will, during these sessions, as your body is poisoned. Eventually, you are sedated. When you wake up, you discover your chest has been cut open so that a port could be inserted inside you.
Is this a nightmare? Are you a prisoner of war?
In September 2014, seventeen year old Cassandra C. was diagnosed with Hodgkin’s Lymphoma, a cancer that is fatal if left untreated. Doctors explained to Cassandra and her mother that chemotherapy had an excellent chance of saving her life, but mother and daughter refused any chemotherapy.
The Connecticut Department of Children and Families (DCF) petitioned for temporary custody of the child, on the grounds that the mother’s refusal to side against her daughter’s decision was a form of child neglect. The DCF obtained legal custody of Cassandra and the seventeen year was taken from her mother. Cassandra agreed to undergo chemotherapy if she would be allowed to return home.
After two sessions of chemotherapy, Cassandra ran away from home. During the week of November 18, 2014, DCF and police searched for Cassandra. The mother claimed to have no knowledge of her daughter’s location. Cassandra returned a week later. The trial court ordered Cassandra placed under DCF custody again and authorized DCF to make all medical decisions on Cassandra’s behalf. DCF decided Cassandra’s cancer should be treated with chemotherapy, despite Cassandra’s complete refusal to any further treatment.
Cassandra and her mother appealed the decision, but the Connecticut Supreme Court ruled against the young woman.
Who Can Be Forced to Undergo Treatment?
Normally, people in the United States cannot be forced to undergo treatment they do not consent to. Indeed, this principle is the basis of a personal injury claim, medical battery. However, this principle only applies to legal adults, persons eighteen years or older. Doctors and hospitals only need the consent of the legal guardian to perform medical treatments on minors.
In some state, however, some minors may have the ability to make their own medical decisions. Under the “mature minor doctrine,” a mature minor is judged to have the same capacity as an adult to make decisions regarding their health. The Connecticut Supreme Court refused to recognize such a doctrine, so Cassandra’s case was over. Even if the high court had recognized the doctrine though, Cassandra still wouldn’t have won. The trial court had already decided that Cassandra wasn’t mature enough, so that judgment would also have to be overturned for her to win.
Healing the Body While Destroying the Soul
This story has already received a great deal of attention on the Internet. People more medically savvy than I am have described what death by cancer looks like. Cancer means constant vomiting. Tubes protruding from your stomach to drain fluids until the day you die. Starvation until you look like a concentration camp victim. Chocking on your own secretions. Cancer is not a pretty way to go and chemotherapy is often the only thing between cancer patients and a slow, painful end. The state has an obligation to preserve life and cancer is one of the worst ways to die.
But if I don’t fully appreciate what it means to die with cancer, many physicians don’t fully appreciate what it means for the state to seize complete control of your life.
The state’s brief to the court (a 131 page volume) has an interesting view of events. State attorneys emphasized, over and over again, that it was the mother’s fault that Cassandra refused treatment. The mother failed to bring her daughter to appointments. The mother didn’t cooperate when the police looked for her missing daughter. The mother did most of the talking at the hospital and before the court. The state points out that the mother is a single parent and that she homeschooled her daughter. The state uses every detail to make the mother the bad guy in the story.
As a legal strategy, this makes sense. Cassandra’s argument is that she does not consent to chemotherapy. If Cassandra is refusing only because of her mother’s influence, then Cassandra’s consent is no longer an issue.
It’s questionable whether Cassandra was influenced by her mother to the degree that the state believes. Cassandra was separated from her mother twice and Cassandra did not change her mind. According to Cassandra herself, she only agreed to treatment the first time because she wanted to go home and then she ran away from home because she wanted to avoid anymore therapy. Both events are evidence she is immature, but they are also evidence that Cassandra’s mind is her own. Attacking the mother’s integrity was unnecessary and will only antagonize the mother and daughter.
The state insists that this case does not violate any rights. However, the court order removing Cassandra from her mother’s custody was extremely draconian. The mother is ordered to “allow DCF to enter the premises and inspect premises whenever DCF wishes to do so. The respondent mother will cooperate with all home visits, announced or unannounced, and will allow DCF unfettered access to all areas of her home.” The mother is also ordered to sign all documents that the DCF needs to review Cassandra’s medical files and the physician who testified against Cassandra is ordered to be her treating physician. Cassandra has lost all control over her medical treatment and her mother has lost all legal control over her daughter.
Well, Cassandra and her mother have lost until Cassandra turns eighteen. In nine months, everything Cassandra and her mother have suffered will be considered illegal and unjust. In the meantime, Cassandra will be tormented endlessly. She will be isolated from the mother who tried to stand by her daughter. She will be treated by a doctor she loathes, who will subject her to a medical treatment she despises. The state will have the power to rummage through her house at any hour of the day without consent or announcement. And her mother is required to be a party to this madness.
But at least she’ll live. There’s no reason Cassandra and her mother would resent Connecticut for that, right?