State Supreme Court Rules Teen Can't Refuse Chemo

A teenage girl taken into state custody in Connecticut and forced to undergo chemotherapy for Hodgkin's lymphoma cannot refuse the medical treatments, Connecticut's Supreme Court ruled Thursday.

Seventeen-year-old Cassandra C. is currently confined to a room at Connecticut Children's Medical Center with a staffer posted at the door to keep her from leaving.

The state's highest court reviewed the case under an emergency appeal filed by attorneys representing Cassandra and her mother, taking up an issue previously decided by several other states – whether some minors are mature enough to make decisions about their own bodies.

On Thursday, the judges decided that Cassandra is not mature and will continue to receive chemotherapy. She turns 18 in September, a year after her cancer diagnosis.

"Connecticut Children’s respects the decision provided by the Supreme Court this afternoon. Now that a ruling has been issued, we will continue to work with the Department of Children and Families in providing care for this child," said Bob Fraleigh, director of corporate communications at Connecticut Children's.

Assistant Public Defender Joshua Michtom, who is representing Cassandra, said the case marks the first time the state Supreme Court has considered the "mature minor doctrine" recognized by several other states. The doctrine generally allows court hearings for minors 16 and 17 years old to prove that they are mature enough to make medical decisions for themselves.

"Give us the chance to prove that she has the maturity to do this," Michtom said. "One has a right to bodily integrity. It doesn't matter if it's harmful. An adult's right to refuse care is without limitation, provided they're not incompetent."

The State Supreme Court will soon decide whether or not a 17-year-old has the right to deny chemotherapy.

The teen's mother, Jackie Fortin, said her daughter was opposed to the idea of chemotherapy even before her diagnosis. Michtom said the daughter and mother's objection to treatment does not involve religion.

“She has always—even years ago—said that if she was diagnosed with cancer, she would not put poison into her body,” Fortin told NBC Connecticut in an exclusive interview last week.

Doctors at the Connecticut Children's Medical Center in Hartford say the treatment would give Cassandra an 85 percent chance of survival. Without treatment, the doctors said there was a near certainty of death within two years, according to court documents.

According the paperwork, Cassandra and her mother missed several appointments after the teen's diagnosis, prompting doctors at the hospital to notify the state Department of Children and Families.

DCF investigated and a trial court granted the agency temporary custody of Cassandra. The family's attorneys then sought an injunction prohibiting medical treatment but were unsuccessful. The teen underwent two days of treatment in November but ran away for a week, according to court documents.

Cassandra's treatment resumed Dec. 17, with surgery to install a port in her chest that would be used to administer chemotherapy chemicals. Chemotherapy began the next day and is ongoing, the paperwork says.

DCF officials defended their treatment of Cassandra.

"When experts, such as the several physicians involved in this case, tell us with certainty that a child will die as a result of leaving a decision up to a parent, then the department has a responsibility to take action," officials said in a statement.

Spokesperson Gary Kleeblatt released the following statement Thursday afternoon in response to the court decision:

"We thank the Connecticut Supreme Court for its extremely prompt decision, which will allow us to continue to provide medical treatment that will save Cassandra's life. This is a curable illness, and we will continue to ensure that Cassandra receives the treatment she needs to become a healthy and happy adult."

According to the American Civil Liberties Union of Connecticut, which filed an amicus brief supporting the mature minor doctrine in Cassandra's case, six other states – Illinois, Maine, Tennessee, West Virginia, Michigan and Massachusetts – and Washington, D.C., have held or suggested that mature minors, like other competent people, have the right to consent to or forego medical treatment.

Prior to today's decision in Connecticut, Texas was the only state to reject the mature minor doctrine, the ACLU.

"The appeal ... involves a grave threat to one of our most basic civil liberties: the right to bodily integrity," the ACLU's brief said.

For updates, follow Christiane Cordero on Twitter.

Copyright AP - Associated Press
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