Court-ordered medical interventions: where’s the line?

Daniel Hauser (MPR photo) As the Daniel Hauser saga continues (MPR story today), it raises the question of when is it appropriate for the state to intervene in the treatment of a child’s illness. “… Colleen Hauser favors the natural healing methods of a religious group known as the Nemenhah Band, which is inspired by American Indian traditions.” Jon Tevlin wrote in this Strib column last week (and more here) that the family has likely been duped by an internet sham artist. I think that’s relevant and justifies intervention.

160 comments to  (Including 6 Discussion Threads) Court-ordered medical interventions: where’s the line?

  • 1
    john george says:

    Griff- This whole thing is a real sticky wicket. On the one side, there certainly seems justification for the State to step in and mandate a particular course of action. But this precedent, that the State has authority to do that outside of the specific desires of a family or person is a little scarey. Both my wife and one daughter work directly with cancer patients, albeit from two different directions, and there are definitely adverse side effects of chemotherapy. Depending on the age of the person, there is credence to not put them through more suffering. It is a little like the old addage, the operation was a success but the patient died.

    My heart goes out to this family. Cancer is never a pleasant experience, no matter what the age of the patient. I can’t imagine that this decision on treatment was decided on a whim. I hope I will never have to face any decisions like this family has had to face. But if I do, I would hope that I would be able to make a life/death decision without interference from the government.

  • 2
    Bright Spencer says:

    I think there is a lot of alternative care that does work for various ailments. IT is so hard to tell what works and what doesn’t because sometimes the body just recovers or goes into remission on it’s own. But I think that alternatives should be allowed, and then, if they don’t work, a strong
    intervention to consider traditional therapy could be put into place without jail time. I don’t like to see neglect or abuse get the okay, either.
    Keep in mind that we have lost over 100,000 people a year in hospitals due to error and pneumonia, etc.

  • 3
    Jane Moline says:

    The court ordered test showed that the cancer tumor had grown since they went to all althernative medicine. Certainly a tough choice but the judge interviewed the boy and determined that he was not capable of making this serious decision on his own-I defer to the judge who must know something. I believe the parents are wrong and their decision is the same as neglect--good intentions do not make up for it.

    At the same time, mental attitude is very important in any disease treatment, and if Daniel is convinced that chemotherepy is not helping him, it would make the treatment less tolerable.

  • 4
    David Ludescher says:

    Griff: Where is the line? Why shouldn’t the decision be between the mother, child, and the child’s doctor? When can, or should, the government step in to force its judgment upon the child?

    It’s not as if the mother is acting against the child’s will, or taking the child’s life, as happens in abortion. If the child dies, it will be because cancer, not his mother, killed him.

    I don’t want Danny to die. Further, I think that Mom’s duty to her child is to force the child, even against his wishes, to undergo treatment. What she is doing is a sin by omission. But, I can’t make the legal jump to say that the child is neglected or in need of protection.

  • 5
    Paul Zorn says:

    David:

    You write:

    I don’t want Danny to die. Further, I think that Mom’s duty to her child is to force the child, even against his wishes, to undergo treatment. What she is doing is a sin by omission. But, I can’t make the legal jump to say that the child is neglected or in need of protection.

    You lost me in the last sentence. How can a child in the circumstances you describe not need protection? Indeed, Daniel is by no means “neglected” in the sense of being ignored, and I’ve seen nothing to suggest that his parents, however deluded, wish him harm. But a 13-year-old—least of all one who’s reported to be illiterate—is simply not capable of making informed medical decisions. So Daniel needs protection against his parents’ apparently well-intentioned but misguided opinions. Whether the Hauser parents’ behavior fits the legal standard of neglect or abuse, I have no informed opinion.

  • 6
    David Ludescher says:

    Paul: The cancer, not the mother, is causing the child harm. Even if the mother wanted the child to have chemo, the child might still refuse. In that case, would she commit neglect if she didn’t seek a court order requiring treatment?

    Mom could refuse cancer treatment for herself. Why can’t she and the child together refuse treatment? Granted, it is not the decision that I would make, and I don’t think that she and her child are making an informed decision. But, where do we draw the line?

    We let mothers decide to terminate the life of her child in utero. Obviously, that decision is never in the child’s best interest, and that child has no ability to make an informed consent on its death.

    • 6.1
      Paul Zorn says:

      David,

      You say:

      The cancer, not the mother, is causing the child harm.

      There’s a literal sense in which this is true — more or less the same sense in which a parent who lets a child play in traffic could plead that traffic, not their neglect, is at fault for an accident.

      Parents have a moral (and, presumably, legal) obligation to take reasonable and good-faith care for their children’s health. Reasonable people will differ about just what this means in particular cases. If the neighbor kid comes down with sniffles can he stay home from school for the day, or should he be medivac’ed to the Mayo?

      I don’t want anybody sued in such a situation, but the Daniel Hauser case just isn’t a hard call. Mom and Dad are nowhere near doing what needs to be done.

      Mom could refuse cancer treatment for herself. Why can’t she and the child together refuse treatment? Granted, it is not the decision that I would make, and I don’t think that she and her child are making an informed decision. But, where do we draw the line?

      I draw it where a vulnerable minor is involved, and where parents appear to act in reckless disregard of the best available medical opinion. Sure, Mom can refuse medical treatment for herself, but she “and the child together” can’t make good (or bad, for that matter) decisions, because a child isn’t competent to participate in this sort of decision-making.

      I don’t buy the analogy to abortion. But since you brought it up it seems fair to ask: Doesn’t your opposition to abortion argue for more, not less, governmental involvement in these matters?

  • 7
    David Henson says:

    The county attorney was grandstanding by issuing a child neglect order. Now the mother and child are in Mexico where they will not have family or the option of returning to Mayo. This is the best example of our current government – over reactive & bullying while achieving a poor outcome.

  • 8
    kiffi summa says:

    David H: you got it right: “over reacting and bullying while achieving a poor outcome”.
    Paul got it right , also in saying that the child needs protection…
    David L. got it right also when he asks where is the line drawn?

    That’s how extremely complicated this situation is, and gov’t (bless its sometimes brutal little heart) is not well suited to deal with this problem.

    The court order has only insured that the child is going without treatment.

    I’m thinking about how an appropriate, and legal , procedure could be developed to deal with a situation of this nature… Its hard to come up with something…

    What , for instance, if the 13 year old had read everything about his condition, spoken with many concerned and helpful doctors, understood he might die with or without chemo, and still refused the treatment.

    If we/the courts can declare teenagers, and occasionally even younger children to be tried as adults in serious crimes… should we then allow capable teens and younger children to make life decisions for themselves?
    The assumption in the criminal situation is that the child needs to be punished by society for what act it has committed.
    The assumption in the health situation is that the child does NOT have the capacity, or even the right, to deal with its own life.

    Generally, I am all for extensive laws which protect children from harm inflicted on them by the sometimes what might be termed “thoughtful/good” decisions of adults.

    I can’t help but wonder about a society that classifies children as adults for the purposes of criminalizing and jailing them.

    Some lines are very difficult to draw, and “laws” won’t effectively do the job.
    The law hasn’t worked here; “we” need to think more about where lines are drawn and by whom.

  • 9
    Paul Zorn says:

    Kiffi’s right that society should not classify children as adults for some purposes and as children for others. The child/adult line may sometimes be difficult to draw, but this is not such a case. Daniel Hauser is clearly a child, and in the legal sense incompetent.

    And yes, not every problem is best solved by laws and the police. (I’m especially receptive to this argument today, having just bailed my cat, Fritz, out of police custody for “running loose”. I pray that he didn’t pick up any jailhouse habits from his cellmate, a hardened Siamese.)

    Maybe the law hasn’t worked — yet — in the Hauser case. But the bottom line remains to be seen.

    Meanwhile, it isn’t clear to me that the county attorney is “grandstanding” here. For better or worse, a county attorney is a legal actor, not a moral advisor. What legal alternative would you propose, David H?

  • 10
    Jim Haas says:

    Kiffi:

    Paul Z. is right: the child in this case is only 13, so comparing this situation to a child being tried as an adult doesn’t wquite fit — that legal line is drawn (at least in Minnesota) at age 16.

    I think the child neglect laws are quite clear and unambiguous in this case: not providing necessary and proven treatment when the likely outcome is death — that’s neglect.

    The powers of the state are indeed frightening and must be used with care and restraint, but in this case the prosecutor and judge would be derelict if they didn’t try to apply the law for the child’s benefit. It’s not even close.

  • 11
    Jim Haas says:

    See specifically Minnesota Statutes 260C.007 Subdivision 6 paragraph 4. This section defines a child in need of protection or services. You don’t have to be a lawyer to see that it clearly applies in the Hauser case.

  • 12
    Griff Wigley says:

    Thanks much for chiming in here, Jim. (For others who might not know, Jim is Director of Rice County Department of Community Corrections.)

    On MPR’s Midday today, a show on this exact issue: Parental rights, ethics and the Hauser case.

    Guests:

    Arthur Caplan: Director of the Center for Bioethics at the University of Pennsylvania.

    Teresa Nelson: Legal counsel for ACLU of Minnesota.

  • 13
    David Henson says:

    So now how many people might not bring their kids to a traditional medical outlet to begin with so they won’t be reported. This is crazy bad judgement by prosecutor and judge. This treatment undoubtedly has risk factors both ways, why bother to explain these factors if the doctors/courts are going to become the parents? The government is abusing and harming the American family and should retract its roll, not expand its roll.

  • 14

    David H.,

    I was a social worker for 5 years, and I can tell you that some parents don’t seek medical help for their kids out of neglect or belief in some other form of treatment. This legal decision is going to have little effect on those parents. Those same children, however, are in school systems, churches and have contact with others (usually, except in extreme child neglect cases) who are either mandated reporters or will contact someone else who can get help to those children.

    I agree that this case is tricky as a philosophical issue. The legal strictures, as Jim H. and Paul Z have pointed out, are pretty clear. I believe these laws have been on the books for quite a while; so I hardly think it’s indicative of any recent or nefarious grab for power on the part of the government.

    It gets tricky for me because of the “slippery slope” arguments. If the child had an inoperable cancer, for instance, would the State be justified in mandating treatment? If this case were like that, I would be much more concerned about pushing for difficult and painful treatment that isn’t likely to help anyway, and would be more in favor of quality-of-life and hospice care for the child.

    However, the fact is this case seems to be that his lymphoma is very treatable and without treatment, he is very likely to die. (The percentages I heard were 90+% chance of survival with treatment, maybe 10% chance without that same treatment.)

    How will people react if he dies -- which is, again, very likely -- after not receiving treatment? Will people be okay with that?

    The other thought that keeps jumping into my head was the moral outrage expressed by many conservatives about the Terri Schiavo case in Florida in 2005. That was grandstanding. Apparently, it’s fine for the government -- up to and including the President -- to drop what they’re doing to intervene directly in the decision to keep someone alive (but in a persistent vegetative state), even though her legal guardian at the time, her husband, made the decision not to do so. But, it’s okay for this kid to die in the name of keeping government out of medical decisions? What that makes me wonder is -- if this kid lapses into a coma, and has to be kept alive by machine, is that when State protection will be okay?

  • 15
    David Ludescher says:

    Brendon: The law is not clear. The court is not suppose to act in the child’s best interest. It is suppose to act to prevent harm to the child. Both the mother and the child have made knowing decisions to refuse treatment.

    The Schiavo case was different in that the husband was the direct agent of death. He was granted permission to remove the feeding tubes; hence, she starved to death. In this case, neither the mother nor the child want the child to die. They think, quite mistakenly it appears, that chemo is more harmful than the treatment that they propose.

  • 16
    David Henson says:

    Brendon, you are creative and I like your Tiny Plays. But in all honesty I wouldn’t want you making health choices for other people’s children. Don’t be overly offended, as I don’t want me doing it either. Is the child’s welfare better served by losing the farm, having his mom sit time in jail, fleeing to Mexico or the family working through issues on their own? If he dies then he dies, happens every day. The far FAR greater harm is unintended consequences from the government forcing people into cookie cutter choices.

  • 17
    Paul Zorn says:

    David H:

    I don’t want Brendon making decisions for my kids either. I’ve long resented being humiliated by Brendon’s skill in the softball outfield, and don’t even mention the women’s clothes.

    But does Brendon actually propose to make health choices for others’ kids? If so I missed that part.

    More important …

    I hope I misunderstand your point, but you seem to be saying that an innocent child’s unnecessary death is almost irrelevant here. Do you really mean this?

  • 18

    David L wrote:

    The law is not clear. The court is not
    suppose to act in the child’s best
    interest. It is suppose to act to
    prevent harm to the child. Both the
    mother and the child have made knowing
    decisions to refuse treatment.

    I will certainly defer to your legal knowledge and expertise, David, but I must ask how the court would be acting “to prevent harm to the child” if they allowed a course of action that is very likely to result in his death?

    The law Jim Haas cites reads:

    Subd. 6.Child in need of protection or
    services.

    “Child in need of protection or
    services” means a child who is in need
    of protection or services because the
    child:
    …(skip paragraphs 1 -- 3)…
    (4) is without the special care made
    necessary by a physical, mental, or
    emotional condition because the
    child’s parent, guardian, or custodian
    is unable or unwilling to provide that
    care;

    What’s a judge to do when faced with that law and the facts in front of him or her? How does the State protect a child if they allow him to die?

    Regarding the Terri Schiavo case, you wrote:

    In this case, neither the mother nor
    the child want the child to die.

    The Schiavo case was also about the State interfering in the decision of a legal guardian who, with the consultation of medical professionals, decided that his wife’s care should be terminated. He knew she would die, but that’s a far cry from wanting her to die.

    The autopsy results only confirmed the unanimous medical opinion that she was beyond recovery. To the extent that this is a discussion of the State’s authority in such decisions, then the Schiavo case is very directly related.

    David H., you wrote,

    If he dies then he dies, happens every
    day. The far FAR greater harm is
    unintended consequences from the
    government forcing people into cookie
    cutter choices.

    Yes, children die every day, some at the hands of their parents or other caregivers, but why does that mean that this death should not be prevented? This is not a cookie cutter choice, as you say. It was a legal decision, based on enormous amounts of medical and legal expertise. Legal decisions are based on existing law and precedent, but are also made on a case-by-case basis. That’s the rub. Another case, though similar in nature, may have a slightly different set of variables that might lead to a different decision.

    Also, situations like this are rare; so I’m not sure how many parents this will be “forcing” into a certain choice. Very, very few.

    Paul Z.,

    No more softball for me. I might break a nail.

  • 19
    David Ludescher says:

    Paul Z.: There are two considerations that need to be separated. The first consideration has to be what is best for the child, and the family (morality). The second question is, “Given that what is best for the child is something other than what the mother is doing, where is the line (rule) that allows government to impose its will upon the decision maker?”

    For example, under abortion rights law, the innocent fetus’ death is not important enough to override the mother’s decision to abort, even though there is greater than 90% chance of life if the child is carried to term, and exactly 0% chance if there is an abortion. This child’s chances are poor without help, but greater than under an abortion. Perhaps most importantly, the child has had the chance to provide some input.

    In my opinion, the correct choice isn’t even close. The mother should do everything in her power to save her child. But, that is only 1/2 of the question. The other half involves the imposition of the government’s will upon people (constitutionality).

    The constitutionality of the decision is questionable. When Justice Douglas found the Texas abortion law unconstitutional, he noted that one of the most important rights is the right to be left alone under the penumbra of the First Amendment. The unnecessary death of the fetus is only relevant after the 26th week.

    These folks would like nothing more than to be left alone. Without a clear rule on when and why the government can step in, justice becomes a matter of judicial preference, rather than adherence to a set of rights. Presently, the law clearly favors the liberty of the mother (and child) to pick life or death.

  • 20
    David Henson says:

    Paul, Brendon said he was a social worker for 5 years (not that he was actually making health choices). My point being I would hang with parental decisions over bureaucrats.

    I guess I fail to see how the government action is “helping.” It’s like the case of Rivas who committed the biggest single mass murder in MN history right here in Rice County after being badgered endlessly by Rice County social services. His kids are all dead and now we have a woman running to Mexico. The Rivas case is never discussed because it was such a massive failure that no amount of “good” social services might bring about can over come the “bad.”

    The irony in Rivas case is he came from communist Bulgaria (the worst of the eastern block) to the land of freedom and found out it (like this woman running around Mexico with her child) that it can be more oppressive here.

  • 21

    David H.,

    The mother and child fleeing to Mexico is her decision. Not the government’s.

  • 22
    kiffi summa says:

    I heard only part of the MNPR program this AM, but I did hear the woman who was speaking for the ACLU say that MN law is not clear cut because it turns on the intent, and judges’s interpretation, of the phrase regarding alternative care.

    I wish the law had gotten involved only as a means to keep the mother and child here, in a family surrounding and in a supportive mode, emphasizing we will do everything to HELP… I just don’t think that cases like this can be dealt with by a generic law; Each is specific.

  • 23

    That’s a very good point, Kiffi, about the judge’s interpretation regarding the alternate method of care. In that sense, perhaps this case hinges on a reason versus faith argument. (I say that in a very, very broad sense.)

  • 24
    David Henson says:

    Brendon, the sort of moralism shown in your post #21 assumes we do not actually care if the policy outcomes are good or bad we just want to stick our noses in people’s business.

  • 25
    David Ludescher says:

    Kiffi presents a good point -- to date, the intervention hasn’t been supportive of the family.

  • 26

    Hmmm, David H., I honestly don’t know what your post #24 means. It doesn’t seem to apply to my post #21, or, at least, I don’t understand the application you’re intending.

    Here’s a rephrasing: The mother chose to flee to Mexico with her son. The government didn’t “force” her. She disagreed with a legal ruling handed down in a country of laws of which she is a full citizen; so she chose to defy it in this way. That is her choice, not the choice of the government. The judge, as a representative of the judicial branch, had an obligation to make a ruling on a very difficult question. She didn’t like it. She fled. That doesn’t mean the decision is flawed. That means: she didn’t like it, so she fled.

    You want to believe that she had no choice? Okay.

    Personally, I see her action as indicative of willful neglect. I’m guessing that, before this matter made it to the courts, many attempts were probably made by medical professionals, attorneys, social workers, relatives and family friends to get her to change her mind. I would go further to guess that a legal ruling was a last-ditch effort to compel treatment and a real attempt to save the boy’s life. If you want to believe this is indicative of some national trend to strip parents of rights, you’re welcome to that belief.

    I don’t at all see it that way. I don’t believe it’s reasonable to extrapolate from this very particular case, with its very particular dimensions, to a future nation or state where government inspectors make sure our children are healthy 24-7 under the penalty of swift imprisonment and confiscation of our offspring.

    David L.,

    You make a very good distinction in your comment #19. However, the child is 13, and, apparently developmentally delayed as well. For a child at that age, with cognitive impairment, your assertion that:

    Perhaps most importantly, the child
    has had the chance to provide some
    input.

    holds little water here.

    At that age and reasoning capacity, it is very possible this child believes his Mom will save him, end of discussion. But you know her course of action is not likely to do so. She’s deluding herself and pulling her son along with her.

    In my social work experience, I saw many kids in abusive homes, for instance, who wished to stay in the abusive situation rather than risk out-of-home placements because it was less scary to stick close to the fear they knew than venture off to the unknown. Yet, kids who are ultimately removed from abusive homes and placed in more positive environments, almost always, as they mature, come to realize that getting out of the situation was good for them -- no matter the fear they had in the moment.

    I think that’s something to keep in mind in this case.

  • 27
    David Henson says:

    Ahh hmmm Brendon, I look at this as tax dollars collected and spent on a invasive government policy with the design of a specific outcome but that outcome was not achieved. Even if one is 100% in agreement that he should have chemo -- that was not the outcome. So heavy handed government involvment served no constructive purpose and in fact has put the child at further risk.

  • 28
    Cindy Jenson says:

    Did anyone from the decision makers take only Danny into a room and talk=visit=with him for a hour or so? Talking with the child by himself without his mother hanging on to him and watching all he said. I have never seen a picture or video of Danny without his mother hanging on. Yes, I know it’s scary to have the cameras, she loves her boy and is protecting him, but the only way to really know what a child is thinking and feeling is to get a one on one. In the course of a “visit”, not a third degree, they should be able to get a better knowledge of the child’s ability to think for himself or his decisions on the treatment. One 13 year old can have the mind of an 18 yr old, they next one a 10 yr old. Their understanding of a sitution can be lightyears apart.

    In extreme healthcare issues, even as an adult, listening to the doctors, hearing and understanding everything they are telling you is hard. It’s always a necessity to have at least 2 people in the room to remember everything. You are too emotional when learning about a bad diagnosis to catch everything.

    Bottom line, does Danny really understand the situation and what are his and only his thoughts about treatment.

    As a side note, having had terminally ill family members myself, I can’t believe for one minute that the Father didn’t know they were leaving and doesn’t know what direction they took!

  • 29
    kiffi summa says:

    Brendon makes a really good point in #26, about a child who wishes to remain in a bad situation, rather than face unknown circumstances. Of course this child believes his mom will take care of him.
    And that’s why Cindy in #28 is correct in asking whether any professional ever had the chance to speak to the child alone…

    If there was ever a case that cried for some extraordinary level of “law” , rather than trying to concoct a one-size- fits- all rule, this is it…

    Is there a way to create that higher and more personalized level of law for cases that are so sensitive and specific, or would that deprive those that might fall on the borderline, of their fair access to more understanding?

    I believe , as a society, we may come to a point where we understand that all “criminal” behavior is brain chemistry … not for the most part wilful
    disobedience … and then have to struggle with how to deal with the effects of body chemistry/ medical causes, which may cause anti-societal/ aberrational behavior.

    Maybe very sensitive cases like this create an avenue for that discussion, and its possible method for a resolve.

  • 30
    David Ludescher says:

    Cindy: If I recall from the court decision, the judge interviewed Danny in camera (in chambers) to determine his competency. He found that Danny was not of sufficient maturity to make an informed decision. The judge also found that everyone in the case was acting in good faith. A reading of the opinion suggests that there are not factual disputes, just conclusive disputes.

    Your post raises another distinction that deserves some attention. The judge issued an opinion that the mother was neglecting the child. The judge’s decision is just that -- an opinion. The government had and has action options based upon that opinion.

    The action option that the County picked -- treating the child and mother as criminals -- doesn’t seem to be working. If the government is going to force its will upon the child, which it appears intent upon so doing, it needs to make sure that it makes the situation better, not worse.

  • 31
    Paul Zorn says:

    David L:

    You say:

    The action option that the County picked -- treating the child and mother as criminals -- doesn’t seem to be working.

    In what way is the county treating Daniel as a criminal?

    And if you mean by not working that Mom and Daniel are still on the lam, then I guess you’re right. But this doesn’t necessarily mean that the County’s action can’t and won’t work. To all appearances Mom is seriously endangering Daniel’s health, however sincerely she may feel otherwise. What would you have “the County” do?

    If the government is going to force its will upon the child, which it appears intent upon so doing, it needs to make sure that it makes the situation better, not worse.

    Society has a legitimate interest in seeing that gravely ill children are not martyred by deluded parents — even loving ones. I don’t understand why you describe this so negatively, with language like “forcing”. What alternatives do you see?

    As for making situations better, not worse … I think that’s everyone’s goal. What do you suggest?

  • 32
    David Henson says:

    Paul Z,

    What alternatives do you see (to “forcing”)? As for making situations better, not worse … I think that’s everyone’s goal.

    There are no good alternatives to family, friends, church, etc. Sticking a gun to someones head and saying you have to behave as we see fit creates worse outcomes not better. The government cannot be a good alternative.

  • 33
    David Henson says:

    Out of curiosity, how do people think if the traditional medical odds were 51% survival with treatment and 49% survival without treatment? Would alternative medicine still be thought neglectful? If not then what do the statistics have to be for charges of neglect? And is the treating physician the ultimate source for statistics or is there some statistics source that will be deemed infallible?

    Also, is there a conflict of interest when a medical doctor calls in a charge of neglect because an alternative medicine provider is chosen? This brings up the larger issue that the AMA is effectively a price setting monopoly at war with all forms of alternative medicine. Which is one major reason why health costs are way out of control.

  • 34

    David H.,

    I commented earlier on a situation like you pose in comment #33. This is, to some extent, a “slippery slope” problem. My opinion for this particular case is largely based on the much greater chance of survival with treatment. The decision would be much more of a tricky gray area with odds like 51-49.

    In #33, you ask if alternative medicine would be thought neglectful. I think, in that situation, it would be thought pointless, since the odds of survival are very nearly the same with or without treatment.

    To the larger issue, when alternative medicine opens itself up to unbiased scientific inquiry and clinical trials, rather than rationalizing its existence as a way to feel good by fighting back against the machine of modern medicine, then I think it will gain some heft in decisions like this.

    I realize that doctors doesn’t always get it right, that mistakes are made, that the medical establishment sometimes deludes itself with its own sense of certainty, AND I think most good doctors and researchers also understand their limitations and the dangers inherent in the powerful position they hold.

    Human life span has not advanced on the healing power of crystals (to cite an example), it has made humans healthier and increased longevity largely on the scientific process. By asking of the world, what works? What doesn’t? Testing hypothesis. Developing procedures. Exposing ideas to controlled experiments. Modifying treatments.

    It’s not perfect. Mistakes are made. Some researchers are corrupt. Some companies get way too big (capitalism, you know) and do unsavory things to make sure people take their drugs and use their products. But it’s hugely better than the alternative of throwing caution to the wind because there are problem with “the system.”

    I guarantee you that if healing by crystals had huge scientific support, then Big Crystal, Inc. would find a way to force crystal healing into all our lives.

  • 35
    john george says:

    There was an article in the Strib, I think yesterday, that had an interview with the doctor involved. His comment was something like this- Because of the circumstances with the age of the patient involved, I was constrained to report this course of action to the authorities. He is covering his own tail, here, and rightfully so. If the youth ends up succombing to the disease soon, and it was found out that the attending doctor did not report the course of action chosen by the parents, there would be precedent to charge him with aiding the neglect of a child. It is unfortunate that so many parents have been derelict in their treatment of their children in the past that we have to enact laws to intervene. In a perfect world, there would be no need for these types of laws, but, as someone pointed out, this is not a perfect world. I still side with David H. on this in that I am uncomfortable with the government having this kind of authority to step into a family’s decision. This whole event has been a very unfortunate thing, and one that I’m still not sure can be as cut and dried as it has been presented in the media.

  • 36
    David Ludescher says:

    Paul Z.: The more accurate analysis is that the child and mother have liberty (freedom) interests; the government has limited power to invade freedom to maintain order. When there are questions whether or not freedoms should be invaded, government should err on the side of liberty.

    Legally, “society” is the government; as such, society’s duty is to exercise its power only when the person whose liberty interest is at stake is exercising freedom in a harmful way.

    Under present statutes there isn’t much limitation on governmental power. Courts almost always allow invasions of freedom when the County determines it would prefer a different parenting style.

    On the other hand, we have constitutional law which would have permitted the affirmative action of abortion without question, thereby terminating the child’s existence. Upon birth, the child acquired his own rights, and the protection of the law. But the government doesn’t acquire rights upon the child’s birth, only the child does.

    Here, the mother and the child are asking for protections from the law, not protections of the law. Neither mother nor child have done anything wrong, nor have either taken affirmative action to end the child’s life.

    As sad as it is, I think that the pro-choice advocates should prevail. Given the state of the law, especially with regard to pre-birth choices, I wouldn’t think that most people would have a hard time limiting the government’s involvement. The government’s duty to protect the child after birth is substantially less than its duty was pre-birth.

    I understand that the child didn’t have rights pre-birth. However, that factor is irrelevant to the child.

  • 37
    Anne Bretts says:

    Great discussion here, but I think there’s another twist to this particular situation. This isn’t a family of people who have made a strong, lifelong commitment to an established religion. This appears to be a mother who is in denial about her son’s condition and has grabbed on to a very questionable group run by a person with a history of criminal problems. The father doesn’t seem to be part of this getaway plan and in fact seems very upset and is asking her to bring him home. The boy also is reported to have told his doctor that he was in extreme pain the day before his mother left town with him. He also wasn’t allowed to meet with his court appointed attorney before he left.
    Law enforcement officials have made it clear they don’t intend to prosecute the mother, but needed to file the charges to give them the authority to find them and return them home.
    There are many doctors who are willing to work with families to end treatment when the odds are against survival. The difference here is that the odds are so strongly in favor of treatment and the mother’s rationale for her position is shaky at best. What happens when the boy dies and the mother comes to her senses? How does she explain this to her husband and her other children? What happens if she gives up this ‘religion’ because it didn’t work? Was this about what was best for the boy, or what made her feel better?

  • 38
    Paul Zorn says:

    David L:

    You say:

    The more accurate analysis is that the child and mother have liberty (freedom) interests; the government has limited power to invade freedom to maintain order.

    Here and elsewhere you keep treating the child as a competent actor. But a child of 13 is not able to assessing his or her interests. Perhaps you disagree, but if so wouldn’t it follow that you want children treated as adults in criminal matters, too?

    When there are questions whether or not freedoms should be invaded, government should err on the side of liberty.

    Quite right. But this one is not a hard call.

    Legally, “society” is the government; as such, society’s duty is to exercise its power only when the person whose liberty interest is at stake is exercising freedom in a harmful way.

    Agreed in principle. But in this case Mom clearly wants to exercise freedom in a harmful way.

    … Courts almost always allow invasions of freedom when the County determines it would prefer a different parenting style.

    Does this really strike you, David, as a dispute over “parenting style”? Doing what one can to keep one’s kids alive strikes me as more than a “style” choice.

    [Stuff about abortion ... snipped]

    I don’t see that abortion is material here.

    Here, the mother and the child are asking for protections from the law, not protections of the law. Neither mother nor child have done anything wrong …

    Here, too, you treat the child as a competent actor. He’s not. And Mom (not the child) is doing wrong by not taking reasonable steps to protect the child’s health.

    Given the state of the law, especially with regard to pre-birth choices, I wouldn’t think that most people would have a hard time limiting the government’s involvement.

    Yet again, I don’t buy linking this to the abortion issue. Maybe your point is that people who oppose government involvement with abortion but should also oppose it here. Fair enough, but wouldn’t the same logic say that those who want government involved in abortion decisions should also want government involved here?

  • 39
    Paul Zorn says:

    David H:

    You ask:

    Out of curiosity, how do people think if the traditional medical odds were 51% survival with treatment and 49% survival without treatment? Would alternative medicine still be thought neglectful?

    Of course not. But the premise is far-fetched.

    If not then what do the statistics have to be for charges of neglect? And is the treating physician the ultimate source for statistics or is there some statistics source that will be deemed infallible?

    If it were possible (it isn’t) to assign precise probabilities to different courses of treatment then there might indeed be some threshhold of neglect. Since precise probabilities can’t be assigned, a judge would presumably ask for several medical opinions (as I think happened in this case) and rule based on that. What else would you suggest?

    … This brings up the larger issue that the AMA is effectively a price setting monopoly at war with all forms of alternative medicine…

    The AMA may have its faults (I don’t really know) but IMO they have nothing to do with the question at hand. The Hauser case has all sorts of personal and legal and moral aspects, but the medical question seems pretty clear cut: Should the child receive the best possible medical treatment or not?

  • 40
    David Henson says:

    Paul Z, if precise statistics on treatment could not be determined then medicine would be in big trouble. The fact is these statistics are generated and underpin medical treatment decision making. “Professional opinion” is something used by lawyers and politicians not science. Professional opinion always sways towards whoever is paying the “professional’s” bill. When a doctor reads you off risk factors for drugs or treatments they generally can give you exact percentages (within an error ratio) of the likelihood of success or side effects. You and I might hear the same information and make very different choices. Two parents might make different choices. Two social workers might access the risk differently.

    Then you have the issue of lifestyle itself. One religious group might (and probably does) eschew alcohol, red meat and medical drug treatments resulting in longer lives for their group population at large. Members of this group could accuse society at large of abusing their children. Yet in a particular instance refusing chemo could be seen as abuse. So does one ‘judge’ broad statistics or narrow.

    The idea that courts and prosecutors can step into this process and improve outcomes is farfetched and silly. The results in this particular case should prove that out for you.

  • 41
    David Ludescher says:

    Paul Z.: From both the mother and child’s perspective, this is a clear pro-choice question. Although the child is not a competent actor, together with the mother (and father) they are the ones that have the choices.

    The government is intervening because the child with and through the mother have made a choice with which the government disagrees. The government’s choice is, in my opinion and without a doubt, the right choice. As Jim Haas said, it is not even close.

    But, that isn’t the end of the analysis. The difficult question revolves around how to draw the line to make sure that the power of the government is limited sufficiently so that the government doesn’t intervene every time it thinks someone is making a bad choice.

  • 42
    Peter Millin says:

    This is a tough issue either way and by no means black and white.
    I understand both sides of the story and sympathize with both.

    As a parent though I have to wonder, why a mother wouldn’t do everything she can to save her child. The odds are clearly in favor for him to survive, if he goes to take chemo.

    Personally I’ll put life first over any doctrine or religion.

  • 43

    Anne,

    Thank you (for comment #37). I was going to point out that aspect of this case. This isn’t a life-long Christian Scientist devotee, for example. This sounds like a parent who panicked and was persuaded into a lame cult-like movement while understandably in a vulnerable and very anxious state about her son’s serious health problem.

    And you hint at it, Anne, but I’ll throw it out there more specifically -- are the father’s rights to protect his son’s life somehow less than the mother’s? There does appear to be some dissension within the family itself.

    Also, suppose the boy dies, does the mother get charged? Involuntary manslaughter? We certainly charge parents who abuse and neglect their children, so I’ll throw a final question out there, which Paul Z. helped me formulate with his comment #38, can a parent hide behind “parenting style” for any such decision they make that obviously brings harm to their child?

    It seems to me that we have to look at the line from both sides. Meaning, there have to be some judgments about where protecting parental choice meets protecting the child’s life. Which child-rearing methods or decisions deserve protection as “parenting style” and which methods or decisions can we say amount to abuse / neglect?

    Bear with me for a couple fanciful examples here, but how would we feel about a parent who swears by prolonged fasts for their young child as a means of curing them of a dangerous condition? How about a parent who thinks that keeping their child consistently drunk helps “purify” them? These are odd examples, but I hope you see my point.

  • 44
    David Henson says:

    Here is an interesting article:
    http://www.kare11.com/blog/hult_article.aspx?storyid=723436

    The question is not which treatment is better. The question is has social services, the courts and the criminal justice system involvement improved the child’s future. The obvious answer would appear to be “no.” They would probably be at home now deciding, “Should we change our minds and go with chemo?” Instead they are on the run and being put under wild stress levels.

  • 45
    Patrick Enders says:

    Daniel Hauser returns, taken from parents
    http://www.startribune.com/45990387.html

  • 46

    I thought this last part of the article Patrick linked to (comment #44) was interesting:

    An FBI affidavit alleges Colleen
    Hauser fled to avoid being prosecuted
    on two state counts of depriving
    another of custodial or parental
    rights.

    Can a lawyer tell me what that means? My guess would be that the father is being deprived his parental rights by the mother, but wouldn’t he have to bring that charge himself?

    It would seem odd, because, earlier in the article, it mentions one attorney representing both parents.

    Any help on this point? David L.? Britt?

    Also, from another article where Daniel’s doctor (Bostrom) predicts that “within the next few weeks” the tumor in his chest will suffocate him:

    Daniel and his mother, Colleen Hauser,
    apparently fled on Monday, hours after
    his family doctor in Sleepy Eye took a
    court-ordered X-ray that showed the
    tumor, which had shrunk after the
    first of six planned treatments, had
    grown back.

    “I think he probably still has a good
    prognosis, maybe still a 90 percent
    chance of recovery or better with
    treatment,” Bostrom said. But he
    added that Daniel has “very little”
    chance of recovering without
    conventional treatment.

    “There is no evidence, from the X-ray,
    that the cancer has spread,” Bostrom
    added. “We’re just back where we
    started.”

    I thought it was interesting also that this doctor said that it was the first time in his 25 years of practice that he had to make a call to county child protection workers for a parent that kept their child from getting treatment.

  • 47
    David Henson says:

    This could be the Harpers Ferry for the fascio-socialist state depending on how it plays out. Imagine if the kid does not make it (I bet if the state keeps him then he gets the best docs on the planet!)

  • 48

    David Henson wrote:

    This could be the Harpers Ferry for
    the fascio-socialist state depending
    on how it plays out. Imagine if the
    kid does not make it (I bet if the
    state keeps him then he gets the best
    docs on the planet!)

    I write:

    Oh, please. That’s going way beyond the pale, David H. Have you been watching Glenn Beck or something?

    • 48.1
      Patrick Enders says:

      Aside to Brendon:
      One no longer needs to listen Glenn Beck. One now receives Glenn Beck by direct digital download, via chips implanted at the base of the skull by rogue elements of the CIA.

  • 49
    David Henson says:

    I don’t even know who Glenn Beck is?

    But Harper’s Ferry seemed like a small event when it happened but the repercussions were wide spread.

  • 50

    Okay, David H., a possible, but tenuous, historical linking of the event with Harpers Ferry, but it was really “the fascio-socialist state” bit that smacked of Glenn Beck’s (xref: Limbaugh, G. Gordon Liddy, Michele Bachmann, etc…) paranoid ramblings.

    So, to that portion of your statement, I ask a la Seinfeld: Really? As in, do you really see this as a harbinger of a fascistic regime overthrowing our representative democracy? That socialist forces are behind protecting this kid, or, conversely, that a purely capitalist dream-world would leave the parents be and let the kid die? (Despite the fact that Big Capitalist Drug Companies and Big Capitalist Medical Companies are certainly reaping the benefits of his treatment, and the treatment of so many others.)

    Play along with me here: Let’s say it’s 1953 again. Commies are bad. Capitalism is universally good. All children listen without question because rock and roll is still a couple of merciful years off. Women are cooking ridiculously large meat- and lard-based suppers and wearing house dresses. But, oh no! The all-American teen down the block comes down with a very terrible but very treatable disease, possibly caused by the lead-based paint he’s strenuously applied to the white picket fence in the springtime of our nostalgic otherworld. Now, the doctor says: “Let’s cure him.” They try it. It’s working, but it’s yucky; so mom and all-American teen don’t come back. In this 1953 world of our collective mythologizing mind, does everyone in town say: “Thank God! Better to allow his folks the right to kill him than to flirt with the Red Menace of government intervention in the health of a minor!”

    I’m being silly to make a point; I think envisioning this event as the rocky shoal upon which our ship of state breaches its hull borders on parody.

    I’m thinking 1953 teen and parents might have faced the same legal ruling. There have been child protection laws on the books for a long time; this is simply an application of existing law. The judicial branch interprets law. It’s their Constitutional burden. Interpretation is not perfect; there are “tricky gray areas” all over the place. Happening upon a “tricky gray area” like this one, however, does not warrant calls of Big Brother or secret police or martial law.

    These are not the jack-booted thugs you’re looking for.

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