This Florida Couple Is Refusing Further Chemotherapy for Their Child with Cancer
The article “This Florida Couple Is Refusing Further Chemotherapy for Their Child with Cancer” discusses the role of parents in making medical decisions that are in the best interest of a minor. It mainly details the story Taylor Bland-Ball and Joshua McAdams, a Florida couple who refused chemotherapy treatment for their three-year-old son, Noah (Strapagiel). The parents claimed that after two rounds of chemotherapy, Noah’s blood tests were not showing any signs of lymphoblastic leukemia. As a result, they discontinued the chemotherapy in favor of homeopathic treatments, such as alkaline water, herbal extracts, and mushroom tea. As Strapagiel notes, the couple was arrested 22 April 2019 for failing to take their child for a medically necessary procedure. Moreover, the police claimed that the parents had further was unable to pursue life-saving treatment for their child. Consequently, the child protective services (CPS) removed Noah from his parent’s house and granted custody to his grandmother. He also resumed his chemotherapy treatment. The parents, Taylor and Joshua, were only allowed to visit Noah with permission from CPS. Unsatisfied with the CPS arrangement, the parents filed a court case to regain custody of their child.
Constitutionally, parents have the right to determine treatment options for their child. This rationale is based on the idea that parents have a better understanding of their child’s needs and can provide the most beneficial care. Even if family members clash regarding the child’s needs, the government generally believes that parental decisions are still prioritized. However, should parents be allowed to exercise this right at the detriment of the child? Indeed, rights come with responsibilities and duties. When parents fail to make treatment decisions in the best interest of the child, the physician has the right to seek the intervention of the state. The state, through the court, will then act as the child’s guardian.
In Noah’s case, I firmly believe that the doctors made the right decision when they inform the police about the couple’s decision to discontinue chemotherapy treatment for their son. Their conclusion was based on the harm principle. The principle postulates that even though parents and physicians may conceive the idea of best interest differently, doctors may seek the intervention of the state if the decision of the caregiver can lead to severe harm on the child (McDougal and Notini 450). In such cases, the doctor’s definition of harm must go beyond the immediate physical impairments and involve future damage that the child may exhibit if he does not complete the required treatment. Thus, the doctors probably based their decisions on the harm principle when they sort the state’s intervention to overrule the parent’s choice in Noah’s case.
Moreover, I firmly believe Joshua McAdams and Taylor Bland-Ball were wrong to deny their child a life-saving medical procedure because the treatment has proven efficacy. Years of scientific evidence support the use of chemotherapy to treat leukemia in children. As Dr. Michael Nieder, a leukemia specialist in Moffitt Cancer Center in Florida claims, Noah’s disease can be treated with strict adherence to chemotherapy (Strapagiel). Also, no evidence-based research supports the use of homeopathic medicine to treat leukemia. By encouraging the parents to continue with the chemo, physicians were exercising their duty of care to the patient. According to Strapagiel, the parent’s decision to discontinue Noah’s treatment was based on the negative test results. The tests were an indication that Noah was in remission. But, stopping the medication early increases the chance of cancer spreading or being resistant to chemotherapy. As a result, Noah could develop life-threatening complications in the future.
https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/
Cha’s article, “Hospitals Consider Universal Do-Not-Resuscitate Orders for Coronavirus Patients,” discusses the decision by most of the hospitals across the United States to issue a do-not-resuscitate order (DNR) for covid-19 patients. The prevalence of covid-19 has raised a heated debate and dilemma among physicians. Since the outbreak began, physicians have been weighing between upholding their sworn code of saving a life at all costs and protecting themselves against exposure to the coronavirus (Cha). This debate was triggered by the realization that healthcare workers have a high risk of contracting the virus as protective equipment such as gowns, gloves, and masks are drastically dwindling. In Chicago, for instance, the Northwestern Memorial Hospital is debating the use of DNR regardless of the patient’s wishes (Cha). However, should physicians prioritize their life over that of their patients? Are doctors allowed to abandon from their sworn code of saving and improving a patient’s outcomes during a pandemic? These are issues that healthcare providers across the United States are striving to address.
Impressively, some hospitals have developed innovative ways of protecting their staff as the protective equipment continues to become scared. For instance, George Washington University Hospital has adopted the use of plastic sheeting as a barrier between the patient and the physician (Cha). This plastic sheeting protects healthcare providers from touching the patients’ discharge during resuscitation. Some hospitals have adopted the use of the Lucas devices to deliver chest compressions. Unfortunately, these devices are limited and cannot adequately serve the increasing number of coronavirus patients. Similarly, In Seattle, the University of Washington Medical Center has drastically reduced the number of clinicians responding to covid-19 patients with respiratory or cardiac arrest (Cha). Even though this measure reduces the number of healthcare providers who can contract the disease at any given time, it is ineffective since one infected individual can easily transmit the virus to other hospital staff. Besides, large hospital networks such as the Geisinger in Pennsylvania are seeking legal guidelines that would allow healthcare workers to overrule the patient’s wishes when there are at risk, or the protective equipment is unavailable (Cha). Such provisions are contrary to the ethics of patient care.
However, indiscriminate use of a DNR order should not be imposed as it may end up sacrificing patients who are in good health. In this regard, some healthcare workers have championed the use of selective DNR to protect the clinicians and other patients from contracting covid-19 (Cha). However, enforcing a DNR order will reduce the chances of survival for many patients. If a significant percentage of healthcare workers are infected, a crisis in the healthcare industry will increase drastically. Therefore, if hospitals risk the lives of all its staff when treating one patient, they undermine the care of future patients. Thus, selectively applying DNR orders may be a better solution in the short-term when the protective equipment is unavailable or when the physician’s life is endangered. The healthcare providers should, however, keep documentation indicating the reason for not resuscitating the patient.
The shortage of protective equipment poses a risk to healthcare workers. I believe the current lack of protective equipment in the hospital is a result of unpreparedness and challenges in the supply chain. The federal and state government have the mandate and the capability to source adequate medical equipment for healthcare workers. If the equipment is not available in the international markets, the federal government can incentivize local companies to produce them. Therefore, doctors and nurses may selectively adopt DNR for covid-19 patients, but the state and federal governments should endeavor to provide an adequate medical resource for responding to the virus.