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Old 01-13-2015, 02:21 AM
 
Location: NWA/SWMO
2,943 posts, read 2,812,081 times
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Quote:
Originally Posted by suzy_q2010 View Post
The court decided she is not competent to make medical decisions for herself.
Well and good, but I'd refuse the patient if they were assigned to me. I don't force medication into sane, oriented, patients who do not have a mental disability. To me, that is the definition of malpractice.

On the flip side, we are not allowed to physically remove cheeseburgers and all the **** people eat from their hands right after heart surgery, either. It is the patient's right to live (and die) how they choose, and when they choose, whether it's senseless, or not.
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Old 01-13-2015, 06:46 AM
 
9,165 posts, read 9,234,637 times
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Quote:
Originally Posted by Nepenthe View Post
Sound judgment doesn't mean the decision is the one we want it to be. It's not "if you do what I want, that's sound, if you want to do or try to do something different, you are not exercising sound judgment."

Or at least it should not be. If you're brain-dead or barely able to form sentences or in a coma or legally deranged and hopelessly schizophrenic, that's not a sound mind. If you have a reasonable ability to reason and remember, that's enough in my opinion.

However, I know we have lawyers in our midst. The thread title would have been better replacing the word "Does" with the word "Should." Obviously she doesn't have the legal right to refuse, by definition, because these people are forcing it on her. I'm sure they've dotted all their Is and crossed all their Ts. And I'm sure there's some "sound mind" definition that is quite different than what I'm stating above.
--------------------------------------
Aside: I think alternative medicine, as a whole, is kind of dumb. But chemo (and other unrelated modern medical practices) can be dumb too. Someday (I hope) future people will look back at how we treated cancer and just shake their heads, the way we look at trepanning to release evil spirits. My father was a physician for forty years and went through chemo for Hep. He's been quite clear he will not be undergoing anything other than palliative care if he's diagnosed with any form of cancer that might warrant chemo.

I don't think I would opt for chemo treatment, either. Would depend on the circumstances but I wouldn't automatically opt for it by any means. And a state that would force it on me anyway would be plain evil. But I don't have kids or pets (so no dependents and no one I would be making a decision for).
Sound judgment means more than a minor not foaming and raving at the mouth when you talk to them. It would mean a detailed understanding that she will almost certainly die without treatment, that a treatment which is 85% effective is available, and that the side effects from the medication can largely be dealt with. Even so, I don't really like the idea of the "mature minor" doctrine and if I were a judge, I would limit its application greatly. Its largely a personal prejudice, but at age 17, I don't think I was competent to make life and death decisions.

Quote:
Originally Posted by stepka View Post
Right, I caught that, but my point that was buried in that whole long post is many times we have a background that drives our decision making process. That was point A.

Point B is that nothing on this earth would have been able to get me to convince my girls not to get treatment if they were inclined to do it. They love me dearly (I think) and we all have a lot in common, but chances are they would both choose the chemo and I'd have a heck of a time arguing otherwise, even if I were so inclined, which I wouldn't be in this case.

Point C from my earlier post is that if the girl strongly believes that chemo can't help her and will make her worse, the nocebo effect will very likely prove her right. For that reason, I don't think it's ever wise to force medical treatment on someone.
I read a little about the "Nocebo Effect". Most of what is presented deals with the fact that patients can have exaggerated perceptions of pain when they are told that a procedure is likely to hurt. I saw little suggesting that treatment was likely to be ineffective with such a patient. What we are really dealing with are the chemical reactions that medicines produce in a body. As long as you are dealing with a human body, I don't believe those reactions are likely to be materially different in someone because of their views about the treatment.

Quote:
Originally Posted by JWG223 View Post
Well and good, but I'd refuse the patient if they were assigned to me. I don't force medication into sane, oriented, patients who do not have a mental disability. To me, that is the definition of malpractice.

On the flip side, we are not allowed to physically remove cheeseburgers and all the **** people eat from their hands right after heart surgery, either. It is the patient's right to live (and die) how they choose, and when they choose, whether it's senseless, or not.
Two or three points:

1. Its not malpractice because a court order takes the place of a signed informed consent by either the patient or her mother.

2. Those who are younger than 18 are often referred to by the legal system as suffering from "legal incapacity". Its something that is actually akin to a disability because the law precludes such people from being able to act on their own behalf.

3. Only those with legal capacity (18 years or older) have the right choose to live or die.

I actually don't think this was a very hard case for the judge. A hard case would have been a situation where treatment was only 50% effective in curing or stopping the disease.
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Old 01-13-2015, 07:56 AM
 
Location: Anchored in Phoenix
1,942 posts, read 3,911,171 times
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Government or not, any individual has the right to do whatever with his body, as long as he does not initiate force, threaten to initiate force, or do fraud against someone else.
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Old 01-13-2015, 08:51 AM
 
Location: 23.7 million to 162 million miles North of Venus
5,517 posts, read 5,111,558 times
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Quote:
Originally Posted by stepka View Post
Right, I caught that, but my point that was buried in that whole long post is many times we have a background that drives our decision making process. That was point A.

Point B is that nothing on this earth would have been able to get me to convince my girls not to get treatment if they were inclined to do it. They love me dearly (I think) and we all have a lot in common, but chances are they would both choose the chemo and I'd have a heck of a time arguing otherwise, even if I were so inclined, which I wouldn't be in this case.

Point C from my earlier post is that if the girl strongly believes that chemo can't help her and will make her worse, the nocebo effect will very likely prove her right. For that reason, I don't think it's ever wise to force medical treatment on someone.
She has stated that the side effects, so far, have been mild to none, other than some hair loss, acne and tiredness.
I don't believe that she thinks it 'can't' help her, rather she's more concerned about possible future side effects - such as organ damage, unable to get pregnant, etc.
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Old 01-13-2015, 09:28 AM
 
9,173 posts, read 7,040,371 times
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Quote:
Originally Posted by Howard Roark View Post
Government or not, any individual has the right to do whatever with his body, as long as he does not initiate force, threaten to initiate force, or do fraud against someone else.
Okay. So if my seven year old wants to lie on the train tracks to see what it feels like to have her body run over by a train, I should allow that because she has the right as an individual to do whatever with her own person?

Or as an adult, it is my responsibility to act like one and make informed decisions for a minor child, given that they may not understand the real life implications of being squashed flat by a locomotive?
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Old 01-13-2015, 09:44 AM
 
9,165 posts, read 9,234,637 times
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Quote:
Originally Posted by FinsterRufus View Post
Okay. So if my seven year old wants to lie on the train tracks to see what it feels like to have her body run over by a train, I should allow that because she has the right as an individual to do whatever with her own person?

Or as an adult, it is my responsibility to act like one and make informed decisions for a minor child, given that they may not understand the real life implications of being squashed flat by a locomotive?
We see these libertarian types often on CDF. What they need to understand is that Ayn Rand didn't write the Constitution and the Bill of Rights isn't an epilogue to either Atlas Shrugged or The Fountainhead
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Old 01-13-2015, 09:58 AM
 
12,694 posts, read 9,926,342 times
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Quote:
Originally Posted by FinsterRufus View Post
Okay. So if my seven year old wants to lie on the train tracks to see what it feels like to have her body run over by a train, I should allow that because she has the right as an individual to do whatever with her own person?

Or as an adult, it is my responsibility to act like one and make informed decisions for a minor child, given that they may not understand the real life implications of being squashed flat by a locomotive?
Big difference between a 7 and a 17 year old - you have made a straw man argument.
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Old 01-13-2015, 10:14 AM
 
9,580 posts, read 5,776,317 times
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I watched some interviews with the mother today after reading comments claiming that she is "mentally challenged". She's not. She said that they were seeking second opinions and alternative treatments. She stated correctly that chemotherapy is not the only option for treating cancer. The daughter only ran away after being forced into treatment the first time. Now this mother is only allowed to see her child twice a week and only under supervision. This is over the top.

Like I said before, the state should have the right to speak the mother and child and present their evidence regarding why they feel the teen should undergo chemo. They should not have the right to force the child to stay in the hospital, cut ties with her mother and be forced into having chemo. This is so wrong.
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Old 01-13-2015, 10:56 AM
 
9,165 posts, read 9,234,637 times
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Quote:
Originally Posted by MissTerri View Post
I watched some interviews with the mother today after reading comments claiming that she is "mentally challenged". She's not. She said that they were seeking second opinions and alternative treatments. She stated correctly that chemotherapy is not the only option for treating cancer. The daughter only ran away after being forced into treatment the first time. Now this mother is only allowed to see her child twice a week and only under supervision. This is over the top.

Like I said before, the state should have the right to speak the mother and child and present their evidence regarding why they feel the teen should undergo chemo. They should not have the right to force the child to stay in the hospital, cut ties with her mother and be forced into having chemo. This is so wrong.
Unless those alternative methods of "treatment" are supported by some reputable medical study (preferably studies) the use of the word "treatment" is inappropriate. Treatment implies that a certain regimen will cure a patient.

This is the problem with much of alternative medicine. It cannot be scientifically or empirically proven as effective. Perhaps, this mother could have succeeded in having her way if she had actually done some research and found the kind of studies that I refer too and specified the exact treatment that her daughter would be receiving. I doubt it though. Simply because I don't believe alternative methods of treatment generally work or that reputable studies exist that support that particular choice. Whatever the alternative "treatment" is, it is not par with methods that can be proven through reputable studies to cure Hodgkin's Lymphoma 85% of the time.

Like I said before, the system provides in this situation that if Mom cannot make a responsible choice for her child, a guardian can be appointed by the court to do it for her. Some may not like that, but it is established law in this country

Last edited by markg91359; 01-13-2015 at 11:06 AM..
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Old 01-13-2015, 11:25 AM
 
Location: NWA/SWMO
2,943 posts, read 2,812,081 times
Reputation: 2932
Quote:
Originally Posted by markg91359 View Post
Sound judgment means more than a minor not foaming and raving at the mouth when you talk to them. It would mean a detailed understanding that she will almost certainly die without treatment, that a treatment which is 85% effective is available, and that the side effects from the medication can largely be dealt with. Even so, I don't really like the idea of the "mature minor" doctrine and if I were a judge, I would limit its application greatly. Its largely a personal prejudice, but at age 17, I don't think I was competent to make life and death decisions.



I read a little about the "Nocebo Effect". Most of what is presented deals with the fact that patients can have exaggerated perceptions of pain when they are told that a procedure is likely to hurt. I saw little suggesting that treatment was likely to be ineffective with such a patient. What we are really dealing with are the chemical reactions that medicines produce in a body. As long as you are dealing with a human body, I don't believe those reactions are likely to be materially different in someone because of their views about the treatment.



Two or three points:

1. Its not malpractice because a court order takes the place of a signed informed consent by either the patient or her mother.
Not really. You may think it does, but you'd end up being sued in a heartbeat. What the power of attorney and patient say, is what goes. Period. Yeah, you have a text-book answer "The court said...", and you'd end up explaining that to the court. I'll pass. Not worth it. I watch people with signed and notarized living wills get intubated all the time because the POA demands it. What you think should happen, and what will happen...very different. "Who can sue?" determines who makes the calls.

2. Those who are younger than 18 are often referred to by the legal system as suffering from "legal incapacity". Its something that is actually akin to a disability because the law precludes such people from being able to act on their own behalf.

3. Only those with legal capacity (18 years or older) have the right choose to live or die.
Her mother qualifies.

I actually don't think this was a very hard case for the judge. A hard case would have been a situation where treatment was only 50% effective in curing or stopping the disease.
I won't argue that "in the end" you would be exonerated, but I refuse to place myself in a situation like that. Pass.
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