Hypothetical Question

[BigBlueBear]

(This has probably been asked before, but I couldn't find it with a quick search so don't get mad at me )

Let's say there is a patient who is a minor, and he has terminal cancer. He can either undergo treatment to prolong his life (but it would be ****ty) or live a shorter period of time happily.

If the kid wants treatment, but the parents decide they would rather him live a short and happy life, would the kid be able to get treatment? What if it was the other way around? Would the kid be able to refuse treatment?

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[TW4L]

When it comes to a minor, the parents are the final decision maker for the child's medical treatment. If the parents want to refuse treatment, that is their call. However, if the parent's decision is not in the best interest of the child (like if the disease is easily curable but the parents decide to do nothing) I think you can get a court order of some sort to defer the decision making responsibility, like to the doctor. I don't think a minor has the right to refuse treatment without a guardian's approval.

 

[Ellie Arroway]

How old is the child? What is the prognosis with treatment, without, and how big is the difference? What quality of life metrics are you using and how good/bad would they be in either case? You need more specific info for a good ethics assessment.

By the way, if you really want something that's hard to untangle, try this one:
https://www.msu.edu/course/hm/546/messenger.htm

 

[TW4L]

How old is the child? What is the prognosis with treatment, without, and how big is the difference? What quality of life metrics are you using and how good/bad would they be in either case? You need more specific info for a good ethics assessment.

By the way, if you really want something that's hard to untangle, try this one:
https://www.msu.edu/course/hm/546/messenger.htm

I don't think this is really an ethics question...it's a matter of what the law says. Most states say that a minor of any age does not have legal rights to make their own medical decisions. The exception to this rule is usually with pregnant minors wanting an abortion. It is possible for the minors to go around their parents and get a court order to stop treatment if the parents wanted it or allow treatment if the parents didn't want it, but this is not seen very often. As I mentioned above, I believe the rights are solely given to the guardians, unless it's pretty obvious that they are not pursuing the child's best interests.

 

[Ellie Arroway]

A lot of ethics cases go to court & result in case law, so sometimes "what the law says" changes during the course of figuring out an ethical dilemma.

 

[zedonks]

relevant:

http://minnesota.cbslocal.com/2012/08/06/parents-refuse-chemo-for-daughter-court-intervenes/


also this case is interesting
http://wwrn.org/articles/30951/?&place=united-states&section=health-medical

 

[ShenanigansMD]

Which school is this secondary essay for? I'm a bit scared of the difficulty here.

 

[thesauce]

If the child is old enough to understand the situation and really doesn't want the treatment, I personally wouldn't treat them against their will.

 

[LizzyM]

If the child is old enough to understand the situation and really doesn't want the treatment, I personally wouldn't treat them against their will.

The question was what if the kid wants treatment but the parents want comfort care only.

If the treatment held out any hope of a remission or an extension of symptom-free life, the physician(s) might feel strongly enough to go to court claiming that the parents were negligent and asking that a guardian be appointed to make decisions for the child.



As for the comment about pregnant minors, state laws vary but generally a minor can get prenatal care as well as abortion without parental permission. Furthermore, treatment for sexually transmitted infections and birth control can also be obtained in some jurisdictions without parental permisison.

 

[thesauce]

The question was what if the kid wants treatment but the parents want comfort care only.

You might want to read it again...

If the kid wants treatment, but the parents decide they would rather him live a short and happy life, would the kid be able to get treatment? What if it was the other way around? Would the kid be able to refuse treatment?

 

[LizzyM]

I guess neither of us answered both hypotheticals....

I would think that a child's ability to refuse treatment might depend on the child's capacity to understand the situation and the gravity of the situation as well as the likelihood of remission or cure. If the child were truly terminal (incurable and with less than 6 mos to live) the pediatric oncologists may work to convince the family to tailor the treatments to maximize the child's quality of life so that they can feel as if they are "doing something" while avoiding side effects and symptoms that would result in a ****ty quality of life.

This whole series of blog posts is worth your time but this installment addresses the non-hypothetical of being the parent of a young child who is terminal:
http://www.chicagonow.com/mary-tyler-mom/2011/09/donnas-cancer-story-the-bubble/

 

[thesauce]

I guess neither of us answered both hypotheticals....

I would think that a child's ability to refuse treatment might depend on the child's capacity to understand the situation and the gravity of the situation as well as the likelihood of remission or cure. If the child were truly terminal (incurable and with less than 6 mos to live) the pediatric oncologists may work to convince the family to tailor the treatments to maximize the child's quality of life so that they can feel as if they are "doing something" while avoiding side effects and symptoms that would result in a ****ty quality of life.

This whole series of blog posts is worth your time but this installment addresses the non-hypothetical of being the parent of a young child who is terminal:
http://www.chicagonow.com/mary-tyler-mom/2011/09/donnas-cancer-story-the-bubble/

The one you answered had already been answered by other posters. I didn't have anything else to add.