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Abstract
Cassandra, a 17-year-old girl, is not legally permitted to make her own medical decisions because of her age. Her mother sides with her decision not to undertake a chemotherapy treatment. The DCF gains custody of Cassandra and decides to compel her to undergo chemotherapy treatment, posing an ethical dilemma of who is entitled to the final decision.
Summary of Facts of the Case
Cassandra C. is a 17-year-old girl in Connecticut diagnosed with cancer. The chemotherapy revealed that she had an 80 percent chance to recover. She underwent one chemotherapy process, after which she did go back after determining that the treatment was harmful. The Department of Children and Families (DCF) then seized her and compelled her to go through the treatment. The debatable issue is on whether or not Cassandra is entitled to making liberal medical decisions as a 17-year-old, one year shy of the legal age of deciding on her medical issues.
The IP Team and their Roles
The IP team members that dealt with Cassandras case included an oncologist, pediatrician, registered nurse, social worker, and psychiatrist. The oncologist recommended the chemotherapy treatment and administered it to Cassandra. The registered nurse offered supportive care and treated Cassandras symptoms as well as monitored her results. The social worker and psychiatrist offer psychosocial evaluations and treatment to the patients (Lang & Paquette, 2018). They help the patient and family to counter the experience of managing cancer. As a pediatrician, I recommended that Cassandra receives chemotherapy treatment to survive it.
Additional Information
Cassandra can be recognized as a mature minor, but legally until she is 18, she cannot make her own medical decisions. The healthcare team denied her wishes to escape the medical protocol because they defended her best interests. Cassandra has a higher chance of survival if she undergoes chemotherapy treatment as acknowledged by the States Superior Court and the DCF.
Ethical Dilemmas
Cassandras case presents an ethical dilemma that originates from a variance between two significant ethical principles: respect for autonomy and beneficence. Respecting autonomy is honoring ones right to self-determination, for instance, refusing the medical process. The beneficence principle gives practitioners and hospitals the right to prioritize the benefits of caring for patients and limit harms (Turnham et al., 2020; Sisk et al., 2017). Cassandra is legally a minor, implying that the parent makes healthcare decisions on her behalf. In this case, Cassandras mother supports her daughters rejection of treatment.
Personal Moral Position
Connecticut Childrens Medical Center is acting ethically and morally right in administering chemotherapy to Cassandra. The center is prioritizing chemotherapys advantage on Cassandra and suppressing her position which could be harmful. It is legally right to respect Cassandras autonomy, but if the physicians and the hospital recognize that the chemotherapy process will do her better than harm, then the autonomous right should be rightly overlooked.
Ethical Position of Pediatrician
Pediatricians have a moral obligation to act for the best interest of others (or beneficence). In this case, preventing the harm of Cassandra circumventing chemotherapy treatment would be a pediatricians priority since it is in the patients best interest. Pediatricians are also bound to respect the patients autonomy to accept or refuse treatment. According to Sisk et al. (2017), beneficence opposes the principle of autonomy, but in Cassandras case, she was still a minor and rightly received treatment without her permission. Another code of ethics is that pediatricians also respect parental authority whereby parents could make decisions for their children, but not at the expense of their lives. Parental authority is not absolute, and in Cassandras case, the parents rights were overruled in favor of the childs best interests.
Divergent Moral or Ethical Positions in the IP group
Ethically, the parent (the mother in this case) felt that there should be exceptions to age-based requirements, and the minor is granted equal rights like adults. The IP teams pursuit was intended for protecting Cassandra rather than harming her, specifically, preventing her death.
The Final Decision
The government should make the final decision to protect people from making careless decisions that would be harmful to them. The DCF was delegated the right by the Superior Court to decide on behalf of Cassandra, other than her mother, who perhaps did not see the overall good.
References
Turnham, H., Binik, A., & Wilkinson, D. (2020). Minority report: can minor parents refuse treatment for their child? Journal of Medical Ethics, 46(6). Web.
Lang, A., & Paquette, E. T. (2018). Involving minors in medical decision making: understanding ethical issues in assent and refusal of care by minors. In Seminars in neurology, 38(5), 533-538. Thieme Medical Publishers.
Sisk, B. A., DuBois, J., Kodish, E., Wolfe, J., & Feudtner, C. (2017). Navigating decisional discord: the pediatricians role when child and parents disagree. Pediatrics, 139(6).
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