Chemotherapy and Family Rights: A Canadian Crisis

What do you do when a child refuses chemotherapy?  That's the question causing an ethical stir in Ontario, with an 11-year old cancer patient at the center of the storm.

A boy with acute lymphoblastic leukemia was forced to begin his latest round of aggressive chemotherapy last week after being taken into custody by the Children's Aid Society of Hamilton.  Diagnosed with leukemia at age 7, the boy and his family had refused further chemotherapy when his illness returned in February after 12 cancer-free months.

The boy's father was evicted from McMaster Children's Hospital after reacting in anger when the CAS took the boy into custody for treatment.  After a two-day standoff during which the father was banned from the hospital, both parties reached an agreement to allow the boy to return home after his current round of chemotherapy.  The family plans to get other medical opinions before June, when a judge is set to revisit the case.

Prior to the agreement, family and other supporters held a vigil outside the boy's hospital window.  Authorities cannot release the boy's name under youth protection laws.

The boy previously underwent aggressive chemotherapy that left his skin covered with rashes and sores in his mouth.  He experienced the vomiting and bloating typical of chemotherapy treatment, and was unable to walk on his own.  It's no surprise, then, that February's news that the cancer had returned left the boy reeling.  This time, he spurned chemotherapy for natural remedies such as chelation therapy, vitamins, oregano, and green tea.

The boy, who suffers from fetal alcohol syndrome and is mildly intellectually delayed, was deemed incapable of making an informed treatment decision.  That's when the CAS stepped in, under the advice of leading doctors.

The controversy raises a series of ethical questions:

• Is an 11-year old capable of understanding the implications of refusing chemotherapy?

• Should organizations overrule parents in cases of life and death, as deemed by doctors?

• What about a patient's right to quality of life?

• The boy received chemotherapy for several years, and the cancer came back — how long until "enough is enough?"

• What is the government's role in personal medical decisions?

The debate will surely continue in the Canadian media and elsewhere.  In the meantime, all parties involved are surely hoping for better days ahead for the boy who tragically finds himself at the center of the storm.