Should minors be allowed to refuse life-saving medical treatment?

Reply Thu 13 Nov, 2008 04:23 pm
'I know what's best for me,' insists girl of 13 who refused a life-saving heart transplant

A teenage girl who has refused a life-saving heart transplant insisted yesterday: 'I know what's best for me.'

Hannah has a hole in her heart, a side-effect of treatment for leukaemia.

But with the loving support of her parents, Andrew and Kirsty, she has made the momentous decision that she wants to spend the rest of her time at her home in Marden, near Hereford.

'I'm not a normal 13-year-old,' Hannah says without prompting from her mother. 'I'm a deep thinker. I've had to be, with my illness. It's hard, at 13, to know I'm going to die, but I also know what's best for me.

'My parents have always encouraged me to make my own decisions. When it comes to my heart, I'd much rather do things my way than have other people decide for me.

'It wasn't an easy choice, but being in hospital reminds me of bad times. I've spent long enough in hospital. I just want to be at home - even if that means my life might be shorter.'

Hannah speaks with a maturity way beyond her years, but should any 13-year-old child, no matter how much they protest otherwise, be allowed to make such a huge decision?

The 13-year-old has just succeeded in a High Court case to win the right to refuse a heart transplant which could save her life.

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Reply Thu 13 Nov, 2008 04:48 pm
@Robert Gentel,
I'm going to have to ponder this one for a while.

I can hardly believe that her parents support her in this decision.
Reply Thu 13 Nov, 2008 04:53 pm
This happened not too long ago as well, and we probably have a thread about that one.
I'm not sure what I think, though. I lean to thinking of some age distinction within those who are minors. (adds, what's the age of majority anyway? 18? 21?
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Merry Andrew
Reply Thu 13 Nov, 2008 05:35 pm
@Robert Gentel,
That is quite a conundrum, isn't it. Ordinarily I don't believe that a person that young is capable of making rational life-and-death decisions for oneself. But the quotes in the story make this particular 13-year old sound so articulate and self-possessed that I feel empathy for her in this situation. If I were her father, I know I'd be in a stressful state of indecision.
Reply Thu 13 Nov, 2008 05:48 pm
@Merry Andrew,
Do you believe a "person that young" is capable of making a decision about having an abortion?

If you do, then why do you make the distinction?
Merry Andrew
Reply Thu 13 Nov, 2008 06:00 pm
That's really off-topic, mm, but I'll humour you. As a general rule, no, I don't believe a person that young is able to make a decision about having an abortion without some counseling. But, as in the case under discussion here, each case and each individual is unique. For instance, in some cases it might be absolute folly for the girl to inform her parents of her condition. In any case, I would be against anyone forcing the girl to have or not to have the abortion. But intensive counseling is certainly indicated.
Reply Thu 13 Nov, 2008 06:04 pm
@Merry Andrew,
It wasnt meant to be off topic, I was trying to make a point.
I dont believe a child this young should be allowed to make the decision without some intense counseling first, just like I dont believe a child this young should be allowed to make a decision about having an abortion without intense counseling first.

However, there are people that would have no problem with a child this young making a decision to have an abortion, yet would have a problem with the same child refusing to have lifesaving surgery.

My point is simply that you cant say one is ok but that the other isnt.
Merry Andrew
Reply Thu 13 Nov, 2008 06:20 pm
Well, in the case of this particular 13-year old it's fairly obvious that she has been counseled. According to the last paragraph that Robert posted, the case went to Britain's High Court. So she's been counseled not only by her physician but probably a host of social workers as well.
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Reply Thu 13 Nov, 2008 06:31 pm
It is a paradox for sure. We require children to become of age in order to gain rights to do many things, but we also afford children certain unalienable rights that, in one way of looking at it, could include a choice that will certainly result in great discomfort and a lifetime of fighting off rejection or could even cost her what life she has remaining. There could also be issues of First Amendment rights for those few religions who do not believe in blood transfusions or any kind of medical treatment.

But is a child so tender in years capable of making the best decision for her? If I was her parent would I force her to have a painful operation that she does not want? And what manner of guilt does one endure if the child does not survive it?

This is indeed a tough one.
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Reply Thu 13 Nov, 2008 08:01 pm
@Robert Gentel,
These things are always kind of cute as philosophical questions, and it's really easy to be critical.

However, can you imagine actually holding down a thirteen year old, forcing a needle into her veins, cutting her body open against her will, and then forcing her to take all the drugs and forcing drips into her and the whole medical shebang that goes with such major surgery? Maybe for years? If she survived the surgery, rejection, infections etc.

I am wondering if there is not a whole backstory that goes with this, as I truly cannot imagine a hospital here going to court to try to force such a measure upon this girl and her parents.

It is certainly a difficult dilemma, but, given the girl was assessed, and the child protection folk deemed her decision to be acceptable, then I certainly wouldn't be wanting to force her to undergo major surgery with life-long medical difficulties ensuing without her consent.

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Reply Fri 14 Nov, 2008 08:59 am
That is tough question. I think in most situations that a minor isn’t capable on understanding the full implications. This child, even though she sounds mature and intelligent for a 13 year old, has only experienced 13 years of life. She may have been through a lot during her 13 years, but there is much she hasn’t experienced.

I won’t say yes or no, as every situation is different, but in the majority of the cases, I would have to say “no” " minors shouldn’t be able to make such a decision.

Maybe in this situation, it would be helpful to speak with some one who has been in her situation and is now a success story. A child often times lives in the present and cannot envision what the future could be. I am sure this is extremely hard, painful, etc. as that is probably the only thing she has experienced " how can she possibly understand life without pain and being sick.
Walter Hinteler
Reply Fri 14 Nov, 2008 09:48 am
This girl isn’t fighting for the right to die but the right to live as she wants.
A decission, she really can make - after all those years.

[This case as well as the other one this week (a top Italian court has allowed doctors to cut life support to a coma patient, though euthanasia isn't legal there) might give us Europeans the chance to reconsider the right to die ...]
Reply Fri 14 Nov, 2008 11:05 am
@Walter Hinteler,
As I said each case is different - I didn't necessarily mean this child should or should not decide her potential fate - I wouldn't have enough information to decide - I'm simply saying in most cases.

Also the question was "Should minors be allowed to refuse life-saving medical treatment?" That would indicate that this was a choice between choosing medical treatment to save your life - then what is the other alternative? If you don't accept something that may save your life, then you will die shortly thereafter. I was answering the question more so than addressing this one particular example.
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Reply Fri 14 Nov, 2008 11:16 am
@Robert Gentel,
Generally, I would say 'no'.

This reminds me of the stories we've heard about those who refuse blood transfusions due to religious convictions. In those cases, I disagree as well.
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