Discuss the ethical issues associated with cancer treatment among children

In this assignment, you will discuss the ethical issues associated with cancer treatment among children. Although children (under age 18) are the ones with the illness and therefore the recipients of the treatment, the legal responsibility lies with the parent.
For this module assignment, read the article found below.
“12 of 21 DOCUMENTS
The Boston Globe
November 23, 1994, Wednesday, City Edition
Billy Best’s case reveals gray area of patient rights BYLINE: By Richard A. Knox, Globe Staff
SECTION: METRO/REGION; Pg. 1 LENGTH: 653 words
Even if Billy Best’s parents and doctors wanted to force the 16-year-old cancer patient to undergo more chemotherapy, authorities in law and medicine say that course may be impossible, for all practical purposes.
The case of the Norwell youth, who fled to Texas rather than undergo a second round of cancer therapy, raises issues with which US courts apparently have never dealt.
Unlike cases in which parents have been overruled when they tried to withhold potentially life-saving treatment from younger children, legal scholars say they know of no case in which a US court has ordered such therapy forced on an adolescent.
Best, diagnosed last summer with the lymph system cancer called Hodgkin’s disease, is thought to have an 80 percent chance of cure through chemotherapy and radiation. Doctors at Dana-Farber Cancer Institute, where he has already undergone five months of treatment, want him to have another four months of treatment to eradicate a tumor near his windpipe. But the teen-ager says he has had enough toxic therapy.
Legal experts say they doubt a judge would force Best to undergo more cancer treatment, even if someone – the teen-ager’s parents, his doctors, the Dana-Farber or the state of Massachusetts – would be willing to bring such a civil suit and have legal standing to do so.
“The question is what would they ask for?” said Leonard Glantz, a Boston University professor of health law and an authority on children’s rights. “They have parental consent to treat him, so it’s not a child neglect case. So what would you be asking the court for? The authority to tie him down?”
In Massachusetts and many other states, teen-agers inhabit a gray zone when it comes to patients’ rights. In terms of their right to consent to treatment, they are legally presumed “mature minors” rather than children, who can be compelled to undergo invasive procedures.
The “mature minor rule” was adopted in the 1970s to permit teen-agers to consent to certain medical treatments when their parents were not available. This includes therapy for contraception, venereal diseases, other infections and mental illness.
However, the mature minor doctrine has not been tested to support an adolescent’s right to refuse treatment deemed medically necessary. “The rule has not been used as a source of authority for kids to receive life-saving treatment,” Glantz said. “It hasn’t been used anywhere solely on the basis of the minor’s refusal to be treated.”
Glantz’s BU colleague, George Annas, also an authority on patients’ rights, concurred that the dilemma does not
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Page 2 Billy Best’s case reveals gray area of patient rights The Boston Globe November 23, 1994, Wednesday, City Edition
have a legal solution.
“There’s absolutely no point in going to court on this,” Annas said. “What you do is talk to the kid and just keep talking to him. You’ve got a much better chance of persuading him than persuading a judge.”
Gerald Koocher, chief of psychology at Children’s Hospital, agreed with this advice. Koocher believes Best was “making a statement” by running away. “It was a wake-up call,” said Koocher, who is not involved in the case. “I suspect he was saying, ‘I’ve got some anger, some concerns that aren’t being dealt with.’ I think that now his parents and caregivers are going to be listening to him differently. That fact by itself will make a difference.”
Koocher said once or twice a year teen-age patients at Children’s Hospital declare they do not want to go through with treatment. Except in clearly terminal cases, he does not recall a single case in which treatment was not resumed – perhaps in modified form, to address the patient’s concerns.
“The thing that sets many adolescents off is their feeling that grown-ups and authority figures are always telling them what to do,” the psychologist said. “So the stance I find helpful is to let them know that they are in charge of the decision. But the downside is: You’d better not do it unless you’re willing to live with the decision they make.”
LOAD-DATE: November 24, 1994 LANGUAGE: ENGLISH
Copyright 1994 Globe Newspaper Company

WRITE THE FOLLOWING:
Paragraph 1: Identify the individual you have chosen to write your assignment about and write a short summary of the situation, based on the articles provided. Your summary should be at least 4-5 sentences.
Paragraph 2: Explain your stance on whether or not you think the “right’ decision was made in the case of that individual (i.e., who gets to make the decision on whether or not a minor (under 18) receives treatment for cancer- the minor, parent, or court).
Paragraph 3: To conclude your assignment, clearly state what you feel the Policy should be regarding cancer treatment for minors (be specific as specific as possible). Following your policy, describe why you feel this should be the policy, identifying and describing at least one ethical principle to explain and support your policy (Beneficence, Autonomy, Nonmaleficence, Justice, Fidelity & Veracity).
Be sure that you clearly address each point above and elaborate on your answers.


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