Everyday Ethics

Everyday Ethics


13-Year-Old Daniel Hauser Refusing Chemo On Religious Grounds; Court Orders Treatment

posted by hfields

daniel_hauser_chemo.jpgOver the past couple of weeks, the news has been filled with headlines about 13-year-old Daniel Hauser, a Minnesota boy diagnosed with Hodgkin’s lymphoma. Citing religious grounds (the family are members of the Nemenhah Band of Native Americans, who are proponents of natural healing methods), the boy and his mother began refusing chemotherapy after a single treatment. The Brown County court stepped in and ordered treatment to resume. When he and his mother Colleen lost their court appeal, they went on the run. They returned Monday after a week in hiding to face a custody hearing.

The ethical implications of this story are legion. Let’s start by naming just a few. 

  • Does a minor have a right to refuse medical treatment on any grounds, religious or otherwise?
  • Does a parent have the right to decide to refuse treatment for his or her child on religious grounds?
  • Does the state have a right to overturn personal choice in either a minor or an adult?
  • Does the state have a right to take custody of a child under these circumstances?

 

Complicating this story are several factors.

The leader of the Nemenhah Band, the religious organization to which Hauser and his mother belong, apparently leaves room for debate regarding the spiritual requirements of their faith concerning medical treatment. (See Beliefnet’s Editor-In-Chief Steve Waldman’s blog post on this topic for a thoughtful dissection of the facts.) Yet Daniel, calling the chemo treatment ‘toxic’ (and anyone who has ever had chemo won’t argue the chemicals used are poisons, albeit specifically targeted ones), is refusing to have further treatment, even though Hodgkin’s is 90% curable in children when treated with chemo and radiation, and almost always fatal without. He and his mother seem to honestly believe the treatment will kill him, and that, on the contrary, the unproven alternative methods they espouse will cure the cancer.

Now, I’m a bit biased. One of my childhood friends had this same disease, had the treatment, and 15 years later is the happy, healthy mother of two adorable children. All I can say is I’m glad she’s alive. I’m not a big believer in a nanny state when it comes to adults, but when it comes to kids I think it’s a different matter–even (perhaps especially) when religion is involved. The things I believed in when I was 13 in no way resemble the things I believe now, and I’m glad I have had the opportunity to grow and rethink some of my adolescent ‘certainties’. I’m not sure that as a teenager anyone is able to make a rational choice about their future, and while adults may, if they choose, decide to risk death by flying in the face of conventional medical wisdom and leave their fate in the hands of their faith, it seems insane to me to allow (or force) a child to make that same choice. 

I’ve also read that Daniel Hauser is illiterate and was home-schooled, and may not be fully able to comprehend the full facts of his medical condition. Surely, more thoughtful heads should intervene in this case–and have, in the person of the Brown County court system.

Do you agree? 

 



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Gregory A. Beamer

posted May 26, 2009 at 4:32 pm


Most of your arguments (home schooled, religious reasons) are emotional and not logic based. Having a friend with cancer is also an emotional plea. The questions of parental rights and, to a secondary degree, religious rights, are the paramount issues.
For the record, I am the parent of a cancer survivor. We opted for chemo, as the medical science was on the side of chemo. This is not to say the alternative treatments do not work, only that the evidence for alternative treatments are anectdotal. The problem with using science as an argument are flawed, however, as the reason science is not on the side of alternative treatment is not evidence based, as there is very little experimentation on anything other than chemo, antibodies, transplants and radiation when it comes to cancer. Poison, of one form or another, is the treatment plan.
Alternative treatments have shown promise, but we generally only give them a try when medicine fails. The sad thing here is if the court decides to let Daniel and his family go the non-medical route, and he dies, the general public will see this as proof alternative and complementary treatments are failures. And, if he lives, they will see it as dumb luck, not as a possibility that alternative treatments might work.
Unfortunately, there are plenty of quacks out there in the alternative medicine crowd, which give people the opinion that they are worthless. But that is not a scientific argument against them. The question is whether one of good conscience can suggest trials on alternative methods and get the science to prove or disprove their worthiness? I don’t se eit happening any time soon.
I would like to see other treatments than poison for children. I say this as I have seen, over and over again, what chemo, radiation, etc. do to children. My daughter still suffers from the effects of treatment, although she is getting better every day. The effects are noted in medical journals, so this is not just an emotional argument.
Peace and Grace,
Greg
http://www.caringbridge.org/visit/mirandabeamer



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KES

posted May 26, 2009 at 6:11 pm


I’m conflicted on a lot of different levels, but overall I do not think the State has a compelling interest in this case.
This kid has a survivable cancer with a low morbidity and mortality rate when treated by modern medicine. It bothers me a little bit that what should be an easy and obvious choice is complicated by non-medical (in this case religious) issues. In general I would like to see him receive treatment as I think it will give him the best possibility of survival. I have an interest in the general good, but it doesn’t really matter to me what specifically happens to this kid or his family.
The situation is complicated by the fact that he is a minor. The age of majority is an interesting aspect to consider. Here in the US we somewhat arbitrarily established the age of 18 as the age of majority, but there are certain exemptions (ex. emancipated minors) presumably based on circumstances where the minor has displayed the requisite need.
An interesting twist to this situation is that he is also illiterate. I feel that his education level plays a part in his ability to understand the consequences of his potential actions, and also plays into his minor status. I can see the State’s argument if it were based on these factors.
Does a parent have the right to decide to refuse treatment for his or her child? Yes, I believe parents have the right to refuse medical treatment for their child. If parents have the right/responsibility to consent to medical treatment for their child, they also have the right/responsibility to refuse medical treatment. We should generally assume that their decisions are based on the best interest of their offspring. It should not matter what their consent/refusal is based on, as long as it is an informed consent/refusal. The State has an interest only if it can be demonstrated that the parents are not acting in the best interest of their offspring, or are uninformed.
The fact that their refusal is based on religious reasons is interesting, but overall is probably irrelevant. From a religious standpoint his belief system is not considered mainstream. I do not believe that this should make a difference, as I think an argument based on the “legitimacy” of a religion or belief system is extremely dangerous. OTOH I am not sure that simply claiming that a belief is based on a religious conviction should automatically exempt that belief from examination. Claiming membership and belief in the tenets of “The Church of the Flying Spaghetti Monster” (for example) should not necessarily validate their belief system in the eyes of the Constitution and automatically convey legal protections.
I believe in the rights of the individual, and am opposed to the creation of a nanny-state deciding what is best for us. I would like to see the kid get chemo and live, but overall I do not think the State has a compelling right to strap him down and administer the meds against his will. The State should be extremely careful in its reasoning behind the restriction of individual liberty, and should only step in after demonstrating overwhelming evidence of a compelling interest.



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Your Name

posted May 26, 2009 at 7:18 pm


I wished I live in a country that was free. What happen to freedom of choice? What happen to freedom of religon? I know of another country that controls their citzens lives. China and Cuba. Wake up America!!! You are not free anymore.



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Lee

posted May 27, 2009 at 12:02 am


Writing as a parent, I simply don’t understand why one wouldn’t do everything within one’s power to help his or her child survive an illness of any kind. The odds are pretty good that Daniel would survive with treatment, or at least they’re much better than if he goes without chemotherapy. I would not wish this choice on any parent or child, but believe that parents must look at what objective evidence is there to make a decision regarding medical care for a dependent/minor. Perhaps the Hausers have realized this now (at least that is what they said in court today).
I agree that it’s the parent’s decision, not the child’s, nor the State’s. I agree with KES that if it’s up to a parent to authorize treatment, he or she should be able to refuse it as well. I don’t wish any harm to any child but ultimately, it’s his parents who must live with their decision regarding his care. I doubt many 13-year-olds would choose a second round of chemo treatments if given the option and many lack the perspective to understand the gravity of that decision. I understand that existing laws require that the State intervene in cases of life or death. But in this situation, the State cannot demonstrate that Daniel’s life will be saved by continuing chemo and should not make that decision for him and his parents.



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K.

posted May 27, 2009 at 6:56 pm


Whereas is true tha science can help this child live, it is also true that mentals disposition is paramount to survive anything. The power of mind over body is proved by the placebo-effects of countless studies, an effect that many say is what make alternative medcine work.
I am by no means an expert, but I do wonder: if this cancer is easily treatable by quimo and with good chances of surviving, does it not mean that it is not as grave as to not let alternative methods a chance? The reasons, wherever religious, filosofical or cultural do not matter. What does is that this child and his inmmediate support system do not see regular science as a positive thing, so the optimum mental disposition needed for a fast or even true recovery is lost. Imagine an ultra orthodox Jew being forced to eat non-kosher pork, because science says it will save is life…I doubt the results can truly be positive.Many alternative treatmants have been around before there was a USA and is common to see scientists nowadays validating ancient practices, once they have finally understand the scientific method behind them.
And can we surrender our powerof choice to the State? Today is a child forced to accept a treatment he does not want. And tomorrow? People jailed until they eat their greens? Soldiers pointing their rifles to reluctan would-be joggers? Pregnant teenageres strapped to tables until they give birth or abort, depending on who’s in charge?
I think we should also ask, if this child were to die due to complications with the quimo, what legal accountability would the court have or would parents also be denied the right to seek justice?



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Ronald B.

posted May 28, 2009 at 6:47 am


The article was true. Daniel Hauser decided not to undergo chemotherapy for his Hodgkins lymphoma. His mother, Colleen Hauser, took him to Mexico to avoid conventional treatments. Billy Best proclaimed the efficacy of Essiac tea. Essiac is touted as an herbal remedy good for treating cancer, and it won’t send you running for payday loans with no faxing for it. Essiac is an herbal tea (that’s right, fighting cancer with tea) that has ingredients known to be good for one’s health, such as red clover. Billy claims that he cured himself of his Hodgkins without low interest loans for chemo and thorough the use of Essiac.



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HL

posted May 28, 2009 at 6:00 pm


An aside that is relatively unrelated to the ethics portion of this debate, but why is it that the religious beliefs of the family allows one chemo treatment, but then “does not allow” a second or third? The decision of the mother (and son secondarily) rests on the suffering of the child, which no parent wants to endure, and the 13 yr old child who probably does not fully comprehend the consequences of his decisions as in the case of most 13 yr olds. As a famous 21st century philosopher once said (and I often relate to my patients) “you have to be cruel to be kind” (Actually that was Cheap Trick, but the sentiment is fitting).



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MJ

posted May 28, 2009 at 6:19 pm


That is such a tough one. I’m really torn on this issue. On one hand, they believe in modern medicine enough to seek a diagnosis, but, on the other, don’t believe in the treatments statistically proven to be effective. I have no idea what the “right” answer is here.



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D. P.

posted May 30, 2009 at 12:37 am


I am really tired of fringe populism getting center stage. Really, really tired. I know nothing about Daniel Hauser. Supposedly, he has been ‘home schooled’. And, we all know that means he is much, much smarter than the average. And his parents must be much, much smarter also. (Smarter than …. ???) So, medical science doesn’t know the truth. And the general population of our country doesn’t know the truth. Then let the family decide.
Let the boy die.
If that’s God’s choice.



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M.A.M

posted November 14, 2010 at 1:35 am


IF THE FAMILY WANTED TO GO THE NATURAL ROUTE THEN THEY SHOULD OF LET THEM. Hodgkin’s Lymphoma is one of the cancers were the patients are more likely to survive…I know I am a recent survivor 5 months in remission. I assume he probably had ABVD treatment, which is the typical treatment most of H/L patients get. If you have never had cancer then you would not know how he feels to go through chemo and getting all the poisons in your body. I was doing holistic treatment before i started chemo, and I am did some while i was doing chemo. Now that I am done with treatment I take my natural supplement. ANAMU (Petiveria alliacea) is the best! It made me a model patient in my docs eyes, but little did he know it was the natural herb that was making me that star patient.
science only does so much, PEOPLE NEED TO UNDERSTAND THAT BEFORE CANCER TREATMENTS WERE EVER EVEN THOUGHT OF, PEOPLE WERE USING NATURAL FORMS OF MEDICINE TO TREAT SICKNESS AND TO STAY HEALTHY. modern science is not the all and all, natural works perfectly well, and it works well with mainstream stuff also (considering my case).
SO THEREFORE, I DON’T BELIEVE ANYONE SHOULD BE FORCED TO GET CHEMO.



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