Child of the Stars or Ward of the State?
Brian Doherty | July 12, 2006, 11:04am
A 16-year-old Virginian with lymph node cancer is sick of chemotherapy; a social worker wants him to be forced to undergo it. A judge has granted a temporary order finding his parents neglectful for allowing him to make his own medical choices, and claims joint custody of young Starchild Abraham Cherrix for the Accomack County Department of Social Services. Starchild's father summed it up well in this Associated Press account:
"What it boils down to is does the American family have the right to decide on the health of their child or is the government allowed to come in and determine that themselves and threaten one way or the other to split our family up?"
A 2001 Reason feature story from me about government and families butting heads over medical decisions about minors.
A 1997 Reason feature story from me about cancer patients--adults and children--who wanted to pursue some very alternative cancer treatments butting heads with an FDA that thought it knew best. Here is a list from the National Cancer Institute of clinical trials involving the particular alternative therapy/rank quackery (you make the call!) at issue in that piece.
MainstreamMan | July 12, 2006, 12:21pm | #
That 18 year-old thing ain't so solid in this area:
Here's, for example, the Illinois rules...note sections II & III.
I. The parent generally has the right and duty to make decisions concerning medical care for his/her child.
A. However, the minor may consent:
1. When she is pregnant, she may consent to her own medical care and surgery, 410 ILCS 210/1;
2. When (s)he is married, the minor may consent to his/her own medical care and surgery, 410 ILCS 210/1;
3. When (s)he is a parent, the minor may consent to the medical care, surgery, or dental care for his/her child, 410 ILCS 210/2.
4. When (s)he is 12 years of age or older, the minor may consent to his/her treatment of venereal disease or for abuse of alcohol or narcotic drugs, 410 ILCS 210/4.
5. When (s)he is the victim of a criminal sexual assault or abuse, the minor may consent to his/her medical care and/or counseling. 410 ILCS 210/3.
6. When she is pregnant, she may consent to an abortion if considered mature enough to make that decision or if she can show it is in her best interest. Bellotti v. Baird, 443 U.S. 662, 99 S. Ct. 3035, 61 L. Ed. 2nd 797, (1979).
B. Physicians may consent to and render emergency medical care to a child when a parent is not available during the emergency and it is the judgment of the physician that there is not additional time to await the parent's involvement. Ill. Rev. Stat., Ch. 111, section 4503.
C. Dentists may consent to and render emergency dental care to a child when a parent is not available during the emergency and it is the judgment of the dentist that there is not additional time to wait the parent's involvement. Ill. Rev. Stat., Ch. 111, section 4503.
II. The courts can and will intervene in a parent's decision which places a child in danger or leaves a child in danger of death or permanent harm. Prince v. Massachusetts, 321 U.S. 158, 64 S. Ct. 438, 88 L. Ed. 645, (1944) rehearing denied, 321 U.S. 804, 64 S. Ct. 784, (1944) [a case concerning child labor].
III. A parent's denial of medical treatment necessary to save a child's life is neglect pursuant to the Juvenile Court. Intent to neglect is not a factor Wallace v. Labrenz, 411 Ill. 618, 104 N.E. 2d 769 (1952), cert. denied 344 U.S. 824, 73 S. Ct. 24, 97 L. Ed. 2nd 642 (1952).
martin | July 12, 2006, 3:11pm | #
I'm afraid there will never be agreement on this topic.
Some of the reasons I see:
It involves a child.
Quite a number of adults simply lose reason when children are mentioned. They take the safe absolutist position, such as "He/she is not of legal age and doesn't know what he's doing." Doesn't seem to matter that, if the same kid screws up he/she gets treated as an adult all the way by the publicly supported legal apparatus.
Or they appear to not trust parents to be unsupervised. While still assigning them full responsibility when something goes wrong.
I call that hypocrisy.
When children are involved, for many the "compelling State interest" doctrine can't be expansive enough. Even if that doctrine sets bad precedent and grossly interferes with everybody's liberties.
As a result a huge public and private bureaucracy
has been created with a life, power and survival instinct typical of such bodies.
I call that illogic.
My modest proposal: Individuals and the State should stay away, hard as that will be, especially when the, thankfully rare and often anecdotal horrible cases are splashed around by the media. They mostly do it for their own purposes too, just like those idiotic politicians dreaming up stupid catchy sounding childrens' protection measures.
As long as we, by waging war (Viet-Nam, Iraq) or by inaction (Rwanda, Cambodia)cause other peoples' children to suffer far more harm than I want to imagine, a bit of modest retreat in the face of one family's tragedy would become us all.
End of sermon.
And Downward, I second that comment. Ayn seems to be a bit ignorant about the Amish.
MainstreamMan | July 12, 2006, 5:32pm | #
Chicago Tom,
As much as I respect your right to believe in it, it is disingenuous to say there is sound science behind homeopathy.
Here are some scientific assessments of homeopathy
http://www.cochrane.org/reviews/en/ab003803.html
http://www.cochrane.org/reviews/en/ab003399.html
This seems to cover the basic problems:
A systematic review of the quality of homeopathic clinical trials
Jonas W. B., Shasha M., Anderson R. L. and Lyons J. S. Office of Alternative Medicine, National Institutes of Health, Bethesda, MD, USA.
Introduction/Objective: To review the quality of clinical trial research in homeopathy and identify the extent of threats to validity of causal interpretations in these trials. In addition, we compared the type and extent of these threats to validity to research on conventional therapies.
Methods: A comprehensive, multiple-strategy search for all clinical trials published on homeopathic treatments was done. Inclusion criteria for studies: 1) published in English between 1945-1995; 2) examining an intervention for a clinical condition in a comparative trial, 3) be prospective and involve a parallel control group; 4) assess the outcome of the intervention using an empirical measure of some type. All trials were evaluated using an established method of quality assessment involving 33 validity criteria covering statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95.
Results: A total of 59 studies met the inclusion criteria and of these 79% were from peer-reviewed journals. In research design 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. In measurement 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. An average of 17% of subjects dropped out in studies where this was reported. Of 229 outcome variables, 32% were significantly improved from homeopathic treatment, 39% were unaffected and 2% were made worse by the treatment. The probability of a positive outcome was significantly lower when randomization and placebo were used than when another method of group assignment or comparison to conventional therapy was used. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies was similar except that homeopathic studies were more prone to sampling biases and the use of multiple outcome measures than conventional therapy. Both conventional and homeopathic studies consistently fail to report on the reliability of outcome measures used to control for heterogeneity among groups. There is a higher proportion of placebo-controlled studies in homeopathic compared to conventional medicine research.
Discussion: Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. While some of these methodological flaws may arise out of an attempt to identify specific effects of a "holistic" treatment approach, many of these problems are correctable even within such a paradigm given sufficient research expertise and support.
Maryland 1998 PBO7
And remember, one of the premises behind homeopathy is extreme dilution of a substance in water until there is not a single molecule of the treatment left in what you ingest. No plausible scientific theory has been put forward that would explain the health effects claimed. Life style changes and better diet, however, have a good history of research supporting their impact on health. To the extent that homeopathy encourages better living, and healthier eating, it is not quackery. To the extent it encourages a belief in the healing powers of the spiritual essense of substances, it is.
just some guy hanging out in front of the Y | July 13, 2006, 9:16am | #
Here's another angle. Holistic medicine is based on a completely different paradigm from allopathic medicine. The latter treats only the disease, believing in a reductionistic view of health and a cartesian dualism. The former is based on the paradigm that when one part of the body is sick then other parts are not well either - there is a relationship between seemingly separate parts of the body; the mental/emotional system is necessarily related to health and sickness as well. Therefore, the whole person needs to be treated. But this paradigm runs into problems when it is measured only with tools or methods suitable to the allopathic paradigm. The results might take longer to appear, for one thing. So a test that compares the effectiveness of both treatments, but is only measured in the same, short term time frame, and only for one condition is bound to be biased towards allopathic medicine. Given these other variables, and the fact we are measuring the health of people, not nonsentient organisms, short term quantitative studies are not sufficient. To complement these, what is needed is long term, qualitative studies, case studies, etc. that can shed more light on the long term effects as well as the overall health of the patients - studies that are in keeping with the paradigm of holistic medicine itself.
As a personal example, I was treated for a sciatica problem with cortisone treatments. My doctor, who also thought holistic medicine was woo woo, discouraged any other treatment possibilities, other than some physical therapy, from a state licensed physical therapist of course. I was also taking medication for a bronchial condition. But I was concerned about the long term effects of cortisone treatments and even my doctor warned me away from having treatments too often. So, I began to look into other possibilities. I eventually found some alternative treatments and tried a number of them. Some didn't do anything at all - but part of that might have been my impatience in wanting to heal quickly. I did eventually find some treatments that worked well. I mostly settled on these as I liked how my overall sense of well being was improving. So, through a change in diet, lifestyle, various kinds of therapies and herbs, my condition did improve. I didn't recover all the way - but about 75 percent of the way (which is another issue - when we talk about what 'works' to what standard are we shooting for?). But everything else about my health, physical and emotional had improved as well.
Btw, I want to back up the statement that not all alternative treatments should be considered equally effective. Each needs their own separate evaluation. To lump them all together is a conflationary fallacy - like saying street walkers, high priced escorts, or women trapped in a brothel, all fall under the same category. Or that marijuana is no more dangerous than meth because they are both illicit substances.
And this is also not an argument that suggests that alternative medicine is superior to allopathic medicine - just that each might have their own place, depending on the condition, the risks involved, etc. I think the term that is common now is complementary medicine, which makes sense to me. If you have a broken leg, have suffered internal injuries from a car accident, etc. by all means, get you and your loved ones to the regular hospital. But if you have a chronic condition that's been long resistant to allopathic treatments, and you find you are only getting worse - not just the specific condition but your whole sense of well being - why not try something else?
