Saturday, January 03, 2009

Question of the Day

A couple has two children both of whom suffer medical problems though the exact nature of the problems have not been diagnosed. The reason for the lack of a proper determination of the illness: the parents possess religious beliefs for a religion in which the religious doctrine does not accept that there are mental illnesses or neurological disorders and, further, does not accept certain forms of medicine as reasonable treatments for illnesses.

Instead of drug use to treat mental conditions, the religious doctrine states that healing should be spiritual.

Question: Does the state possess an interest to intervene on behalf of the family to diagnose the medical condition and, if one is found, to provide treatment for the children even if it counters the religious beliefs of the parents?

17 comments:

harrogate said...

Harrogate's answer is yes, the state has an interest and ought to intervene.

Child abuse intervention.

thursdaynext.21 said...

Did you read about Travolta's son dieing from a seizure, and questions as to whether or not he was being medicated?

harrogate said...

Harrogate had read about this. He hopes that this death was not a product of Travolta's craziness.

But if so, then that too is child abuse. A parent refusing medical treatment to his or her sick and/or dying child is hard to differentiate a parent beating on their child or, perhaps a more precise analogy, witholding food.

M said...

The answer is, at least for me, it depends. Is the parents' decision not to treat the illness causing the child harm? Is the child in pain because the parents are refusing to treat the child's illness? Is this a case in which the treatment may do more harm than good? Are the parents trying other, alternative treatments, which, while not recognized by the medical community, may actually benefit the child? I don't think such a case (and of course, Solon, you're having us deal in generalities and hypothetical questions here) is automatically child abuse, any more than I think parents who chose not to vaccinate their children are guilty of child abuse (stupid and misguided, yes, abusive, no). Each case has to be evaluated individually.

M said...

Oh, and Harrogate, in response to "A parent refusing medical treatment to his or her sick and/or dying child is hard to differentiate a parent beating on their child or, perhaps a more precise analogy, witholding food": would this be the case if a parent refuses treatment knowing the treatment will not do the child any good and will only prolong a painful life? Paperweight and I have talked about what we would do if Wild Man ever suffered from a horrific disease like cancer. If the time came when he was not benefiting from treatment at all and the treatment were only causing him extreme pain, I hope we'd have the courage to end treatment and let him go peacefully. I don't think that would qualify as child abuse.

solon said...

In the defense of the question: to some degree, there must be ambiguity and generalities since outsiders do not know if there is a problem in the first place (unless we are all doctors and could provide a proper examination.)

This question involves the awkward intersection of liberty (religious and personal), autonomy, privacy, and the common interests of the community over health concerns.

The Roof Almighty said...

Re: "The answer is, at least for me, it depends. Is the parents' decision not to treat the illness causing the child harm? Is the child in pain because the parents are refusing to treat the child's illness? Is this a case in which the treatment may do more harm than good? Are the parents trying other, alternative treatments, which, while not recognized by the medical community, may actually benefit the child?"

How could such a thing be determined if the family refuses external diagnoses/treatment?

Barring examinations of the treatment on the child while alive, are you not asking "What if the multi-millionaire's lawyers can make a case for doubt regarding..."

And are you not then saying "Scientologists have the right; Southern Baptists don't"?

And we know what that means, Will Smith besides.

The Roof Almighty said...

To work toward solving the central ethics here, can we start with the agreement that, if the disease were even potentially contagious, parents' rights are superseded by the rights of the population, represented by the state?

megsg-h said...

Really, M? You guys are the ninjas of parenthood. My mind completely shuts down at the thought of a terminally ill child. But I ultimately have to agree with Harrogate: "A parent refusing medical treatment to his or her sick and/or dying child is hard to differentiate a parent beating on their child or, perhaps a more precise analogy, withholding food." Across the board.

M said...

Yes, really, Megs. After what our extended family went through with PW's dad's death and my great-grandmother's death, we would end treatment if Wild Man or Z were terminally ill and the treatment were only prolonging a painful end, especially if we were only ultimately treating the illness for our benefit and not our child's.

And Roof, you raise a valid point. Since Solon offered a hypothetical scenario, I imagined a scenario in which the parents were willing to get a complete diagnosis and go through a discussion of treatment options and then either refuse the conventional medical treatment or choose to go through an alternative treatment. I can't imagine not wanting to know what is wrong with my child even if I ultimately refuse treatment.

AcadeMama said...

I'm left wondering when we recognize a child's right to control his/her own body and any medical treatment he/she may determine is needed. The question, for me at least, is not one of my rights vs. state's right, but rather my child's right to decide what is best for herself. I realize this approach is based on the case of a chronologically, intellectually, and emotionally more mature child than a toddler, for example, but the underlying issue remains. I believe just as much in my child's right to control her own body as I do my own, and to violate this right would, in my mind, also equate to a certain kind of abuse.

p-duck said...

Academama -
Jodi Picoult's novel My Sister's Keeper is an interesting discussion of the issue of a child's right to decide.

M said...

Excellent point, Academama. I've heard of many cases when teenage children suffering from terminal illnesses wanted to end treatment but their parents refused to let them. At what point is a "child" allowed to make these decisions for him or herself?

The Roof Almighty said...

...and is your answer the same when the treatment the child wants (or refuses to undergo) is partially cosmetic or sexualized?

In other words, is a child mature enough to go against parents' will and have his seizures treated-- or get an IUD-- also mature enough to get his/her stomach stapled, get breast implants, or start sexual reassignment?

Amy Reads said...

To jump into the fray, Friends.
1) At what age to do stop this? What, for example, is one to do in the case of Terri Schiavo?
2) What if someone is chronologically "of age" but not mentally "of age"?
3) Is 17 any different than 18? Technically, a child can still be a "child" at 17, but not at 18?
4) In cases such as these, by the time the state or federal government intervenes, there often exists little time to be of use (Roe vs. Wade, for example). Should there be immediate action on part of the government, with no time for appeals from the parents?

Just some devil's advocate-y thoughts.
Ciao,
Amy

solon said...

Amy Reads....

Interesting questions. It seems that the problem is not age of consent but the ability of people to make a decision. The Supreme Court has discussed this issue in two contexts, juvenile death penalty cases and restrictions on abortions for minors, provided the public with nothing but a contradiction. On one hand, the Court argues that juveniles should not be put to death because they do not have the proper mental development to make informed choices though minors, aka juveniles, can have access to abortion services. even without parental notification, though they may not possesses the mental capabilities to make a "reasoned" judgment.

However, placing the burden of proof on the mental development does not clarify this matter any more than an age of consent as there are many people who will never be mature (or smart or fill in the blank) to make a decision in the eyes of the government, the courts, neighbors, television voyeurs, desperate housewives, Seinfeld viewers, cigar aficionados, etc....

If there is a controversy then the Due Process clause would prevent the government from acting before the parents have the ability to respond.

Going back to the original scenario, so long as the parents to not prevent treatment for the spread of a contagious disease (an other regarding action), I am not sure what else can be done. Until the child is deemed old enough or attempts to fight for his or her ability to seek treatment, then the parents or guardians are in control of the situation.

But this answer may just be a way to avoid the slippery slopes of forced sterilization etc.

AcadeMama said...

Roof: a delayed response, but an answer nonetheless... Yes, the case remains the same for me, with the caveat that the treatment, surgery, procedure, etc. is legal. I realize this may sound a tiny bit crazy, but such is the value I place on the right to control ones own body.

Would I cart one of my daughters off to the plastic surgeon and pay for her boob job? No. Would I encourage unnecessary surgical risks? Of course not. But, if she is legally allowed to get an IUD (or oral contraceptives, tattoos, piercings, OR decline medical treatment for her ADHD, etc.) on her own (without my consent), I respect her right to do so no matter how much I may disagree with her decision. As an example, I allowed my 9-yr. old daughter to make her own decision regarding her ADHD medication last summer, when she asked to be taken off of it for the summer break. When things went dramatically downhill within a week, she asked to go back on her medication, and I complied. One of the things my daughter has taught me over the years is that some children, even at what is normally considered a very young age, can be extremely attuned to what their bodies need and don't need. I think it's part of my job as a parent to accept this and respond (or not) as needed.