When A 14-Year-Old Chooses To Die Because Of Religion, Can Anyone Stop Him?

[SpoonfulOSugar]

13 hours ago, SilverBeach said:

My ex husband had colon cancer and his daughter had breast cancer so I am familiar with chemotherapy. His hair didn't even fall out and he didn't call his treatment suffering, more boring than anything. His daughter died but she fought until the bitter end because of her 8 year old son.

I know nothing of the mature minor precedent and it is not relevant to me. Nor are the meta issues. I have relayed my personal stance and it shall remained unchanged. Of course to each her own, but there is really nothing to argue about here as far as I am concerned. The facts and circumstances of each case are different, but in this case of a brainwashed minor deciding he is ready to die because of cult teachings, when the child likely does not understand the real permanence of death, is simply not something I could ever support. Should the bodily autonomy of Jonestown victims who willingly drank the koolaid be respected, if they had been able to choose? Brainwashing does not allow for autonomy when it leads to death. 

 

re:  the bold.  Well, this is problematic.  How can you make an informed decision if you are not informed?  (The mature minor is the standard that the court used to decide THIS particular case.)

Further, as several others have noted, we are ALL "brainwashed" to a greater or lesser degree.  I understand your position on JW's, but it has not been adjudged a cult by the legal or medical system, so you are insisting on imposing your opinion on the system.  You may be right - but does that mean any Silver out there who is "right" should be able to intervene in someone else's care?

Finally, I'm dismayed by your casual dismissal of chemotherapy's side effects.  Your anecdotes do not prove that it is a "boring" intervention for the average patient.

[SilverBeach]

SOS, the legal/medical system does not make cult determinations.

What the court used, again, is theoretical to me. Not engaging in theoretical arguments, I can only speak for myself.

Hell no I should not be able to intervene in anyone else's care that is not my child, which is the limited scope of this discussion, NOMB otherwise. You want to let your child die, have at it, but not me.

Degrees of brainwashing are irrelevant, if there is such a thing. Cult brainwashing is a something that I read up on extensively in my own deprogramming, and I follow several cult education sites. No one wakes up and says, I think I'll allow myself to be brainwashed and join a cult today. It is an insidious process.

1 hour ago, SpoonfulOSugar said:

Finally, I'm dismayed by your casual dismissal of chemotherapy's side effects.  Your anecdotes do not prove that it is a "boring" intervention for the average patient.

SOS, you are reading casual dismissal into my statement about my husband's experience. I neither said nor implied no such thing. You implied that chemotherapy was hell for everyone and that is not true either. There are vast differences in the experiences of individual cancer patients, depending on type of cancer, staging and other factors. I wasn't trying to prove a damn thing. His daughter died a gruesome death and yes treatment had taken its toll by the time she died, but the cancer won anyway. My husband is in the number one demographic that is diagnosed with colon cancer, arguably he may be an 'average' patient.

I take no issue with those who feel differently than me. However, neither am I swayed by your arguments. I've pretty much said all In can say about this, and to each her own. There's room for varying opinions on FJ, and none of it is personal to me. It's just a discussion, not an argument.

 

 

 

[Whoosh]

1 minute ago, SilverBeach said:

the legal/medical system does not make cult determinations.

Then who does?  Do I?  I don't think a lot of people would like that.  

[church_of_dog]

3 hours ago, nellautumngirl said:

You think it's good a 14-year-old died for something he believed in? Why? He didn't rescue anyone from a burning building, to me his death is tragic and useless, it could have been prevented.

No offense, but my mind refuses to see this as anything other than insanity. As a doctor, as a judge, you have to protect human life if you can. If a child wants to commit suicide, you step in, you protect him. I see his behaviour as a mental illness.

The bolded is the sticking point -- as stated it is, in my opinion, an oversimplification.  "If you can" is not, by itself, sufficient reason to protect a human life when doing so violates a human's inalienable rights (either that same human or another -- we are pulling alongside the abortion issue here).  Preserving a human life is generally good, of course, but in my opinion it is not the sacred thing I believe it has been presented to be.  I agree with @jaelh above that our tendency to believe that death should be prevented whenever possible regardless of the situation is in itself a variant of brainwashing.

 

2 hours ago, SilverBeach said:

COD, it is fair to say that if the person in question is a minor and has been brainwashed into dying prematurely then yes, they give up whatever autonomy they have. Particularly if this is my minor, all this theoretical philosophical talk means nothing.

I don't have a good answer for the minor/consent issue, so I'm staying out of that.  I agree that a line needs to be drawn since obviously an toddler should not be permitted to make these kinds of decisions, but I don't have a good sense of where I think that line should be drawn, or even whether it should be drawn using age as the criteria.  I have been careful to note that my comments are not applicable to those on the minor side of that line.

2 hours ago, SilverBeach said:

BTW, the JW world is highly constricted and controlled. There is no talking to non JWs or reading non JW propaganda. They go so far as to post JWs by the door of hospital patients to keep non JWs out. I'll say it again, my commentary about JWs is based on experience.

I do understand that you speak from experience there and I think that is valuable.  But it doesn't change the fact that "whether or not it's brainwashing/gibberish/sincerely held belief" is subjective and thus not able to be codified into legal language without a willingness to trample the rights of many people.

3 hours ago, SilverBeach said:

I find all this talk about bodily autonomy rather hypocritical. I remember when DD was in high school and there was a three page consent form I had to sign for the school to give her ASPIRIN. Yet, she could go have an invasive surgical procedure without me knowing a damn thing about it. Not commenting at all about abortion, but it is a medical procedure and to send my beloved child home to me to care for after she has one without me knowing, let alone consenting, just fried me. Some of this bodily autonomy stuff applied to children is frankly, bullchit.

Your aspirin example is about liability more than autonomy.  Abortion of course is a whole other topic with its own issues, but the liability concern seems quite in a different category to me.

[SpoonfulOSugar]

It's rather pointless to discuss this case WITHOUT considering the theoretical or the meta - the kid is dead, has been for almost ten years.

The ethics of adolescent medical care, particularly in regards to the influence of religion, certainly is relevant, not just to this case or this site, but to pediatricians, teachers, and families.  Edit:  and ultimately, to society.  

[SilverBeach]

Just now, Whoosh said:

Then who does?  Do I?  I don't think a lot of people would like that.  

Not sure what you mean. Criteria had been established for identifying cults and it is an valid field of study, but there is no legal definition because you can call any damn thing a religion in the USA. We are free like that! But those of us who have been in cults can define the cult experience quite well.

For those who may be interested in reading more about cults, this is a good place to start: http://cultnews.net/

Again, not interested in arguing on a lovely but frigid day off from work. I'll say it yet again, to each her own. I am not going on the defense about my viewpoint concerning the 14 year old JW, which started this thread. It is what it is.

10 minutes ago, church_of_dog said:

I do understand that you speak from experience there and I think that is valuable.  But it doesn't change the fact that "whether or not it's brainwashing/gibberish/sincerely held belief" is subjective and thus not able to be codified into legal language without a willingness to trample the rights of many people.

I never suggested that anything be codified into legal language. I have no desire to imose my values on society at large, and never said nor implied such a thing.

 

12 minutes ago, church_of_dog said:

Your aspirin example is about liability more than autonomy.  Abortion of course is a whole other topic with its own issues, but the liability concern seems quite in a different category to me.

I don't agree. Abortion procedures incur liability also. Artificial distinction to me, both aspirin and abortion affect the body.

[SilverBeach]

18 minutes ago, SpoonfulOSugar said:

It's rather pointless to discuss this case WITHOUT considering the theoretical or the meta - the kid is dead, has been for almost ten years.

The ethics of adolescent medical care, particularly in regards to the influence of religion, certainly is relevant, not just to this case or this site, but to pediatricians, teachers, and families.  Edit:  and ultimately, to society.  

If this were a social policy discussion panel, I would agree with you. However, for FJ purposes, not so much.

With regard to your second paragraph, I have no problem with it at all. Once again, I stated what was relevant TO ME regarding my personal opinion. As is my right.

24 minutes ago, church_of_dog said:

The bolded is the sticking point -- as stated it is, in my opinion, an oversimplification.  "If you can" is not, by itself, sufficient reason to protect a human life when doing so violates a human's inalienable rights (either that same human or another -- we are pulling alongside the abortion issue here).  Preserving a human life is generally good, of course, but in my opinion it is not the sacred thing I believe it has been presented to be.  I agree with @jaelh above that our tendency to believe that death should be prevented whenever possible regardless of the situation is in itself a variant of brainwashing.

Where are these inalienable rights encoded? I disagree with you and @jaelh about death. FWIW, my comments have all been limited to the OPs initial post (wonder where she went), and were not meant to be extrapolated into mercy killing and the like. I suggest you both read up on what brainwashing really is before using the term out of context.

[Whoosh]

25 minutes ago, SilverBeach said:

Not sure what you mean. Criteria had been established for identifying cults and it is an valid field of study, but there is no legal definition because you can call any damn thing a religion in the USA. We are free like that! But those of us who have been in cults can define the cult experience quite well.

For those who may be interested in reading more about cults, this is a good place to start: http://cultnews.net/

Again, not interested in arguing on a lovely but frigid day off from work. I'll say it yet again, to each her own. I am not going on the defense about my viewpoint concerning the 14 year old JW, which started this thread. It is what it is.

What you say makes sense if you are simply expressing your opinion and not thinking it matters in terms of what actually happens to a kid in this type of situation. 

The thing is to each their own doesn't work in a situation where professionals need to actually make the life or death decision as to whether they will be forcing treatment or not.  So, since people have all kinds of levels of personal knowledge on the topic and they filter that by personal belief systems and biases, we need a way to decide what will happen in any given case.  It shouldn't vary based on who happens to catch the case when you arrive at the hospital, etc.  Further, doctors need to be able to do their jobs without fearing huge liability lawsuits for "getting it wrong".  So, we need a standard or a rule.

How do we do that?  If there is a disagreement or a controversy, the case heads to court.  While the process is not always perfect, ideally the court will hear any expert testimony available (offered by both "sides" of the controversy).  Those people called to be expert witnesses have generally read extensively on the topic and know quite a lot (that's how it works).  It is then up to the Judge (or Judges or Justices depending) to weigh all the available information and come to a well reasoned conclusion of what the LAW should be.  The Judge/Justices then apply that law to the facts of the given case.  Again, that is just how it works.

Each expert called to give testimony in a case is probably quite sure what they are saying is right or true or correct.  They don't all agree.  Judges/Justices don't always all agree.  When there is enough disagreement, appeals happen.  If they so choose, SCOTUS may hear a case and if they issue an opinion after hearing the case, they are indeed the last word on the topic unless they decide to hear something on the issue again in the future (or unless another branch of government develops a work-around).  So - everyone vote wisely.

@OnceUponATime - the issues being discussed here are quite relevant to your question in another thread about what SCOTUS is and what the Justices do.

[SilverBeach]

17 minutes ago, Whoosh said:

What you say makes sense if you are simply expressing your opinion and not thinking it matters in terms of what actually happens to a kid in this type of situation. 

What matters to me is what would happen to MY kid. I have said that over and over. Y'all can have a larger social policy/medical ethics discussion without me.

[Whoosh]

1 hour ago, SilverBeach said:

What matters to me is what would happen to MY kid. I have said that over and over. Y'all can have a larger social policy/medical ethics discussion without me.

What I am talking about IS what would happen to your kid if you and/or your kid disagreed with the medical professionals on a life or death decision - unless you chose to violate the law and anyone who does that might wind up facing the legal consequences of that choice as they exist here on earth and in the USA.  

[justwatching]

I'm only about halfway through the thread and want to digest before deciding if I'll comment more, but may I just say that the fact the aunt is now a pediatric nurse scares the crap out of me.  Don't they have to take the oath (not sure what it's called)?  Did she say,

"First do no harm - if my religion allows it"

[jaelh]

7 hours ago, nellautumngirl said:

You think it's good a 14-year-old died for something he believed in? Why? He didn't rescue anyone from a burning building, to me his death is tragic and useless, it could have been prevented.

No offense, but my mind refuses to see this as anything other than insanity. As a doctor, as a judge, you have to protect human life if you can. If a child wants to commit suicide, you step in, you protect him. I see his behaviour as a mental illness.

Yes, I think dying for something you believe in has value to the person who dies.  Not to you, not to me, not to society, to them.  And given they're the person dying, what does it matter what you or I think is "useless"?

Again; what constitutes suicide is totally grounded in our worldview.  If you think you'll live forever if you do X, then it's the not doing x, the continuing to live, that actually constitutes suicide. 

Which I realise is alien to most thinking we're comfortable with.  But, in the same way that a JW's thinking, or a teen who satis doesn't make sense to us because it doesn't fit our world view, and we would want out our own decisions about what constituted a death we wanted respected it doesn't need to make sense to you. It can seem insane. Because it's not your death.  It's their death.

 I'm talking here about an ideological suicide, not a suicide as a result of mental illness.  Actions are not mental illness, no matter what you think nellautumngirl.  Very sane people can make decisions that we find incomprehensible.  Mental illness is faulty thinking or chemical imbalances in the brain. That someone with stable thinking and 'correct' chemical balances chooses a course of action you don't agree with doesn't make them mentally unwell.  It just means they chose something you disagreed with. 
 

 Particularly if this is my minor, all this theoretical philosophical talk means nothing.

Given that it's not your minor, even this comment is theoretical philosophical talk.  because the law, rightly I think, disagrees with you. If your 14 year old wanted to refuse treatment, most medical staff would take their opinion into account.  Wouldn't mean they would refuse treatment, just that they would consider their patient's desire. 

[Buzzard]

2 hours ago, Whoosh said:

What I am talking about IS what would happen to your kid if you and/or your kid disagreed with the medical professionals on a life or death decision - unless you chose to violate the law and anyone who does that might wind up facing the legal consequences of that choice as they exist here on earth and in the USA.  

The flip side to allowing religion into medicine is Jahi Mcmath... she's dead, except they've objected to that declaration based on religion, so the good citizens of NJ are keeping her machines going.

There is no "one size fits all" blanket rule anyone can make for medical decisions.  Do I think a 14 year old should be allowed to die because he's refusing blood? Nope.  Do I think a child should die because her parents are vegan and refuse tissue/formula/whatever made in animals? Nope.  Do I think a child with a terminal diagnosis should be allowed to discontinue futile and painful treatments just to buy a few months? Yup.

At the end of the day, I cannot accept that there is a sky god up there that would rather a child die than accept medical care.  I cannot accept that said beneficent, loving, and forgiving god would damn a child for all eternity for wanting to enjoy the gift that He Hath Bestowed.  For that reason, I cannot fathom a religious belief being a rational factor in determining medical care.  I need something quantifiable - this treatment = pain = x days/month/years of life.  This treatment = life at x%. X amount of suffering = x% at success.   I cannot accept the denial of treatment because the sentence begins with the words "I believe." 

[jaelh]

20 minutes ago, Buzzard said:

The flip side to allowing religion into medicine is Jahi Mcmath... she's dead, except they've objected to that declaration based on religion, so the good citizens of NJ are keeping her machines going.

Except this isn't quite the same.  refusing treatment need not necessarily have a basis in religious belief. Someone can refuse treatment just because they want to, the end, no correspondence shall be entered into.  

Rather : It's about respecting choice; be that choice be grounded in religious belief or something else.  

The Jahi case is fundamentally different because it's not about the patients choice. 

Anyway, this is the bit that confuses me: 

 

Quote

 At the end of the day, I cannot accept that there is a sky god up there that would rather a child die than accept medical care.  I cannot accept that said beneficent, loving, and forgiving god would damn a child for all eternity for wanting to enjoy the gift that He Hath Bestowed.  For that reason, I cannot fathom a religious belief being a rational factor in determining medical care

 

Are you really arguing you don't accept the patients reasoning, therefore their beliefs cannot constitute a rational consideration?  Really?  What if an JW doctor (of Muslim, or Christian or whatever) fundamentally cannot accept that there is no  God, therefore they must threat you according to their own rationality?  

Doctors that refuse to give patients abortions because they think it is wrong is more analogous to the type of "religion in medicine" situation here than Jahai is.  If we use our own beliefs about the way the world is ordered (God, no God, What God would want in a given situation) to trump someone else's belief about how the world is ordered and what that means for their bodily autonomy, there's something going on there that undermines all narratives about freedom, choice, and liberty.  

No one has to accept anyone else's beliefs to respect their decision to live (or dies) according to them.  I don't have to accept that Allah wants Islamic women to cover, to respect a decision to wear a hijab.  Nor do I have to think that karma exists to respect an iron deficient Buddhist's decision not to eat meat.  I don't have to be an atheist to respect someone's decision regarding their own death that's not grounded in them 'understanding' that Jesus forgives them etc..  

This is such a golden rule situation.  Even though it's reprehensible, unacceptable, would you want a JW to treat you based on their beliefs, or yours?  If you'd want them to treat you based on your beliefs, then you owe them the same. Even if you don't agree with those beliefs.

[Whoosh]

24 minutes ago, Buzzard said:

The flip side to allowing religion into medicine is Jahi Mcmath... she's dead, except they've objected to that declaration based on religion, so the good citizens of NJ are keeping her machines going.

There is no "one size fits all" blanket rule anyone can make for medical decisions.  Do I think a 14 year old should be allowed to die because he's refusing blood? Nope.  Do I think a child should die because her parents are vegan and refuse tissue/formula/whatever made in animals? Nope.  Do I think a child with a terminal diagnosis should be allowed to discontinue futile and painful treatments just to buy a few months? Yup.

At the end of the day, I cannot accept that there is a sky god up there that would rather a child die than accept medical care.  I cannot accept that said beneficent, loving, and forgiving god would damn a child for all eternity for wanting to enjoy the gift that He Hath Bestowed.  For that reason, I cannot fathom a religious belief being a rational factor in determining medical care.  I need something quantifiable - this treatment = pain = x days/month/years of life.  This treatment = life at x%. X amount of suffering = x% at success.   I cannot accept the denial of treatment because the sentence begins with the words "I believe." 

I personally agree with you and I think that medical professionals, not the government, should be in charge of setting the standards of care (and therefore when a patient can reasonably refuse treatment) in the medical field.  Under that framework, any medical professional that did not offer treatment options that meet the standard of care requirements in their own region and practice area would be held liable for their decisions under the law.  Currently, that is not how things operate and people can simply refuse their doctor's directive to get a vaccination, a blood transfusion, a medically necessary abortion, etc. unless the government steps in in some way.  I fully expect these types of battles to rage on and ultimately I believe SCOTUS will need to take a stand on some very controversial issues.

7 minutes ago, jaelh said:

The Jahi case is fundamentally different because it's not about the patients choice. 

Technically, when any person is deemed incapable of making medical decisions under the law, their right to make those decisions transfers to a specific individual or individuals as defined under the law.  So basically in the Jahi case, the parents do speak for the patient and are the voice of patient choice (as a spouse is in the case of an unconscious adult, etc).

[jaelh]

9 minutes ago, Whoosh said:

Technically, when any person is deemed incapable of making medical decisions under the law, their right to make those decisions transfers to a specific individual or individuals as defined under the law.  So basically in the Jahi case, the parents do speak for the patient and are the voice of patient choice (as a spouse is in the case of a comatose adult, etc).

Sure, but we're talking philosophically, not legally, no?  Legally, yes, they're speaking for the patient. But the decision to keep someone alive on a feeding tube rests with the next of kin.  We have all sorts of useful legal fictions, but they remain exactly that  - fictions. 

If indeed it was about the actual wishes of the patient, the next of kin never would have been able to refuse to permit transplants that the patient indicated they wanted done. 

[Whoosh]

4 minutes ago, jaelh said:

Sure, but we're talking philosophically, not legally, no?  Legally, yes, they're speaking for the patient. But the decision to keep someone alive on a feeding tube rests with the next of kin.  We have all sorts of useful legal fictions, but they remain exactly that  - fictions. 

If indeed it was about the actual wishes of the patient, there never would have been laws allowing next of kin to refuse to permit transplants that the patient indicated they wanted done. 

I agree with you, but it is also a fiction to believe that Jahi would make a choice different than that of her parents.  The inability to make important medical decisions is far from unique to Jahi.  In fact, that issue and how we make that determination is central to these cases that involve minors.  Basically, I don't think there are easy answers and I would much prefer to see the hard decisions left in the hands of medical professionals rather than in the hands of the government - but that is not the direction the USA seems to be heading.

[Buzzard]

14 minutes ago, jaelh said:

Except this isn't about letting religion into medicine, necessarily. 

Someone can refuse treatment just because they want to, the end, no correspondence shall be entered into.  

It's about respecting choice.  The Jahi case is fundamentally different because it's not about the patients choice. 

Anyway, this is the bit that confuses me: 

 

 

Are you really arguing you don't accept the patients reasoning, therefore their beliefs cannot constitute a rational consideration?  Really?  What if an JW doctor (of Muslim, or Christian or whatever) fundamentally cannot accept that there is no  God, therefore they must threat you according to their own rationality?  

Doctors that refuse to give patients abortions because they think it is wrong is more analogous to the type of "religion in medicine" situation here than Jahai is.  If we use our own beliefs about the way the world is ordered (God, no God, What God would want in a given situation) to trump someone else's belief about how the world is ordered and what that means for their bodily autonomy, there's something going on there that undermines all narratives about freedom, choice, and liberty.  

No one has to accept anyone else's beliefs to respect their decision to live (or dies) according to them.  I don't have to accept that Allah wants Islamic women to cover, to respect a decision to wear a hijab.  Nor do I have to think that karma exists to respect an iron deficient Buddhist's decision not to eat meat.  I don't have to be an atheist to respect someone's decision regarding their own death that's not grounded in them 'understanding' that Jesus forgives them etc..  

This is such a golden rule situation.  Even though it's reprehensible, unacceptable, would you want a JW to treat you based on their beliefs, or yours?  If you'd want them to treat you based on your beliefs, then you owe them the same. Even if you don't agree with those beliefs.

But thats just it, I dont want anyone treating me based on beliefs.  I want to be treated based on science.  If a medical provider doesnt want to provide a service thats a totally different situation that a patient, specifically a CHILD patient, accepting a life ending course of treatment.

 

[HerNameIsBuffy]

4 hours ago, SpoonfulOSugar said:

It's rather pointless to discuss this case WITHOUT considering the theoretical or the meta - the kid is dead, has been for almost ten years.

The ethics of adolescent medical care, particularly in regards to the influence of religion, certainly is relevant, not just to this case or this site, but to pediatricians, teachers, and families.  Edit:  and ultimately, to society.  

These are very important issues and what's so difficult in discussing them is it's near impossible (at least for me) to even think about them in a theoretical sense without mentally putting myself in the various shoes.  In that sense it would feel personal, even though it's still a theoretical discussion.  

I am not speaking for @Silver Beach, but that's how I read what she was saying.  That her posts were about how she would respond if it were her/her family and not so much about imposing her beliefs on society.  I could be wrong.

This is a complex problem but my visceral reaction would be to come down on the side of preserving life over bodily autonomy for minors.  I was a smart kid but no way would I have been competent to make that call at 14.  Ditto my kids.

If it were my minor kid absolutely if need be I'd get a court order to force him to comply with best medical advice even if that meant he hated me for acting against his beliefs.  The same way I'd do whatever I could to stop him from killing himself in any other way.

If it were an adult child?  I know the respectful thing to do would be to try to understand their right to their own belief system - but if that meant acting against best medical advice in something so serious ...I'll be honest.  Respect for their beliefs is out the window and I'd do whatever was in my power to get them to make the medical choice that had gave them a shot at survival.  The same way I wouldn't stand by and respect their adult choices to marry an abusive partner or develop a drug habit.  I may not be able to legally stop them - but I wouldn't stand by and let them endanger their lives without a fight.

I am not saying this is right - I'm saying I would be incapable of doing anything less.  I'd rather them hate me for being a control freak stomping all over their autonomy as long as they were alive to do so.  

I would take circumstances into account, and no I wouldn't even suggest someone I love prolong pain and suffering for another few months.  I've seen slow deaths with no quality of life and I don't want that for anyone.  But a shot at a significant chance of recovery.  If it's in my power for force it I will.  If it isn't ...I'd try.  

On the age thing I know there are mature 14 year olds who can deal with more complex adult issues than most - no question.  But there are also (a small minority) 14 year olds who deliberately try to get pregnant.  There is a vast spectrum of maturity at that age level and so IMO there can never be a one size fits all plan for this - it has to be a case by case basis due to the wide variance of the kids ability to make an informed decision and the medical circumstances.

But the reason we don't let 14 year olds vote anywhere in this country is because we don't think they have the maturity to understand the complexities of the issues or the life experience to understand.  Granted - a lot of adults don't have either - but the point is we've made a choice that it's not okay for kids that age to do it because it's beyond the scope of what we (as a society) think the vast majority of 14 year olds are capable of.  If they aren't (as a whole) considered capable of throwing a vote when their single vote won't matter...why would we let them make life and death decisions for themselves where the stakes couldn't be higher?

 

 

22 minutes ago, Buzzard said:

But thats just it, I dont want anyone treating me based on beliefs.  I want to be treated based on science.  If a medical provider doesnt want to provide a service thats a totally different situation that a patient, specifically a CHILD patient, accepting a life ending course of treatment.

 

How do we get you appointed to SCOTUS?  Because this - all of this!

[nellautumngirl]

I'm not good at arguing. I'm not even especially good at explaining my opinion, Buzzard did that much better.

But I think "dying for something you believe in" is a nicer term for suicide. What does it matter to me? I think it should matter to everyone, everyone is responsible for looking out for the person next to them. You can't tell adults what to do, I get that. If someone is told "stop drinking/smoking etc or you'll die" and they don't stop, there's nothing you can do about that. But a vulnerable, innocent minor needs to be protected from himself if the alternative is death that could have been prevented.

 

I think a fanatic belief in a God that goes so far that you don't care if you lose your very real life on earth is a mental illness. That's my personal opinion, no one needs to agree with me. What I know is that this life is real, and no one can prove that there's more, so I think this life trumps the 50/50 chance of an afterlife, so to speak.

 

 

 

 

[church_of_dog]

2 minutes ago, HerNameIsBuffy said:

These are very important issues and what's so difficult in discussing them is it's near impossible (at least for me) to even think about them in a theoretical sense without mentally putting myself in the various shoes.  In that sense it would feel personal, even though it's still a theoretical discussion.  

I am not speaking for @Silver Beach, but that's how I read what she was saying.  That her posts were about how she would respond if it were her/her family and not so much about imposing her beliefs on society.  I could be wrong.

This is a complex problem but my visceral reaction would be to come down on the side of preserving life over bodily autonomy for minors.  I was a smart kid but no way would I have been competent to make that call at 14.  Ditto my kids.

If it were my minor kid absolutely if need be I'd get a court order to force him to comply with best medical advice even if that meant he hated me for acting against his beliefs.  The same way I'd do whatever I could to stop him from killing himself in any other way.

If it were an adult child?  I know the respectful thing to do would be to try to understand their right to their own belief system - but if that meant acting against best medical advice in something so serious ...I'll be honest.  Respect for their beliefs is out the window and I'd do whatever was in my power to get them to make the medical choice that had gave them a shot at survival.  The same way I wouldn't stand by and respect their adult choices to marry an abusive partner or develop a drug habit.  I may not be able to legally stop them - but I wouldn't stand by and let them endanger their lives without a fight.

I am not saying this is right - I'm saying I would be incapable of doing anything less.  I'd rather them hate me for being a control freak stomping all over their autonomy as long as they were alive to do so.  

I would take circumstances into account, and no I wouldn't even suggest someone I love prolong pain and suffering for another few months.  I've seen slow deaths with no quality of life and I don't want that for anyone.  But a shot at a significant chance of recovery.  If it's in my power for force it I will.  If it isn't ...I'd try.  

On the age thing I know there are mature 14 year olds who can deal with more complex adult issues than most - no question.  But there are also (a small minority) 14 year olds who deliberately try to get pregnant.  There is a vast spectrum of maturity at that age level and so IMO there can never be a one size fits all plan for this - it has to be a case by case basis due to the wide variance of the kids ability to make an informed decision and the medical circumstances.

But the reason we don't let 14 year olds vote anywhere in this country is because we don't think they have the maturity to understand the complexities of the issues or the life experience to understand.  Granted - a lot of adults don't have either - but the point is we've made a choice that it's not okay for kids that age to do it because it's beyond the scope of what we (as a society) think the vast majority of 14 year olds are capable of.  If they aren't (as a whole) considered capable of throwing a vote when their single vote won't matter...why would we let them make life and death decisions for themselves where the stakes couldn't be higher?

 

 

This (especially the bolded) makes sense to me.  As a kid we are told in all kinds of situations that we don't have the perspective needed to make X decision for ourselves yet.  Even when we think we do.  This would be just another of those.  The question would be, is the legal threshold of "age of majority or emancipated child" really the appropriate threshold for that particular distinction.  And the answer seems to be "we don't really know but we don't have a better suggestion so we'll go with that" and can hope that the parent or legally-deciding adult knows the kid and the situation well enough to know if there is some reason to lean in the harder direction, whichever that may be in any given situation.

Re @Buzzard's comment -- I do agree that medical professionals should have higher authority than government in general -- but they are apples and oranges in some ways -- ie I wouldn't want government taking actions that reduced my options, but if government makes laws that increase my freedoms I favor that -- in other words, if government establishes laws that provide for competent adults to have autonomy to choose death/higher risk actions or to decline treatment for personal reasons, I do value that freedom more than I value the overall preservation of more lives by always having the recommended medical industry action prevail.

And I agree with those who have responded that personal autonomy is not always about religious views.  I, for example, have zero religious or even spiritual beliefs.  Seriously, zero.  At the same time, I have a very strong distrust/dislike/disapproval of some aspects of the mainstream medical industry and in certain situations I would probably prefer to opt out of some treatments, even at risk of my own death.  Not that I would want to die per se, but my assessment of how much risk I'm willing to accept, or how much the supposedly lifesaving treatment might expose me or others to other, unacknowledged risks, might not agree with the mainstream, pharmacological- and liability-oriented medical industry's assessment of how I should respond to various risks.

As I said earlier, I believe we should all have the right to choose to take or refrain from taking actions in our own lives, regardless of the risk, as long as we don't violate the rights of others.  I really don't see the distinction between me choosing not to have chemotherapy, for example, in a situation where it is recommended, and someone decided to take up drag racing.  There are risks and probabilities in both situations, and differing opinions about the magnitude of those risks and to what extent one's personal enjoyment of life might outweigh the risks.  Once we decide that a person is capable of making their own autonomous decisions at the highest (life & death) level, we should (again IMO) respect their right to do so even if they are choosing death.

[Buzzard]

27 minutes ago, nellautumngirl said:

I'm not good at arguing. I'm not even especially good at explaining my opinion, Buzzard did that much better.

But I think "dying for something you believe in" is a nicer term for suicide. What does it matter to me? I think it should matter to everyone, everyone is responsible for looking out for the person next to them. You can't tell adults what to do, I get that. If someone is told "stop drinking/smoking etc or you'll die" and they don't stop, there's nothing you can do about that. But a vulnerable, innocent minor needs to be protected from himself if the alternative is death that could have been prevented.

 

I think a fanatic belief in a God that goes so far that you don't care if you lose your very real life on earth is a mental illness. That's my personal opinion, no one needs to agree with me. What I know is that this life is real, and no one can prove that there's more, so I think this life trumps the 50/50 chance of an afterlife, so to speak.

 

Except the ones who have to die because Jesus says that they have to turn down available treatment because Jesus?   "They are weak but He is strong..."  Yes, children are weak... which is why we protect them with science (and vaccines)... 

[Whoosh]

One thing I just want to point out is that to some extent people are talking about two different situations here.  One situation is when a person who is a minor under the law agrees with their parent, guardian, or whoever is in charge of making their legal and medical decisions that they want to reject critical treatment.  That was the case with the minor in question.  The other situation is when a person who is a minor under the law wants to reject critical treatment and the parent, guardian, or whoever is in charge of making their legal and medical decisions disagrees with that and wants to force treatment.  

Ultimately, I think we are talking about several distinct questions: 1) at what age or point of incapacity do we deem someone incapable of making informed and reasoned medical decisions (in which case the right to do so transfers to the next of kin or other legally appointed entity) and indeed are some people "partially capable", 2) at what point do we overrule a competent patient and/or the decision maker and put the decision in the hands of someone else, and 3) when we do override the patient and/or their decision maker, how does that work - who is making decisions (medical professionals, the government, their church, etc) and does it matter if the patient disagrees with their parent, etc.  There is of course some overlap when we go about answering these kinds of questions.

[SpoonfulOSugar]

2 hours ago, Buzzard said:

The flip side to allowing religion into medicine is Jahi Mcmath... she's dead, except they've objected to that declaration based on religion, so the good citizens of NJ are keeping her machines going.

There is no "one size fits all" blanket rule anyone can make for medical decisions.  Do I think a 14 year old should be allowed to die because he's refusing blood? Nope.  Do I think a child should die because her parents are vegan and refuse tissue/formula/whatever made in animals? Nope.  Do I think a child with a terminal diagnosis should be allowed to discontinue futile and painful treatments just to buy a few months? Yup.

At the end of the day, I cannot accept that there is a sky god up there that would rather a child die than accept medical care.  I cannot accept that said beneficent, loving, and forgiving god would damn a child for all eternity for wanting to enjoy the gift that He Hath Bestowed.  For that reason, I cannot fathom a religious belief being a rational factor in determining medical care.  I need something quantifiable - this treatment = pain = x days/month/years of life.  This treatment = life at x%. X amount of suffering = x% at success.   I cannot accept the denial of treatment because the sentence begins with the words "I believe." 

I believe, though, that in the Jahi McMath case, physicians can and have declined to provide care because they believe it is inappropriate.  The fact that physicians and a facility are still willing to take the family/society's money is unconscionable.  

I also personally believe that a difference exists between a single acute situation (child is injured and requires a transfusion) and the type of long-term intervention required for the original case.

The problem with your last paragraph is that it requires a type of medical certainty that 1. doesn't exist and 2. elevates medical professionals to the role of gods.  While it would be ideal, it's as nebulous as the concepts of autonomy and ethics that we are circling in this discussion.

@HerNameIsBuffy  I went back and re-read all of SB's posts in this thread, and I'm pretty confused about what she was saying.  I'm certain she thinks practicing JW's are brainwashed and therefore, no JW's minors should be allowed to make medical decisions - but that puts them all in the position of requiring legal intervention.  Since in the OP, his legal guardian concurred with his belief, as did the providers, I'm not sure how that outcome would be changed.  But she has indicated she doesn't want to argue, so I wasn't really going any further with that.

 

http://pediatrics.aappublications.org/content/pediatrics/107/Supplement_1/979.full.pdf looks at this same discussion without the religious overtones.  I find it interesting that all of the respondents concede that a point exists where the patient's preferences should be honored, even if he is a minor.

 

[jaelh]

5 hours ago, Buzzard said:

But thats just it, I dont want anyone treating me based on beliefs.  I want to be treated based on science.  If a medical provider doesnt want to provide a service thats a totally different situation that a patient, specifically a CHILD patient, accepting a life ending course of treatment.

 

I'm not sure what your point is.  Genuinely. 

That you want to be treated based on science doesn't mean that others might not want to be treated based on different priorities.  And it's exactly the point: you would want a JW to respect your decision to be treated "based on science", but you don't respect a JW decision to chose based on a position they hold. 

And you're kidding yourself if you think your decisions about treatment wouldn't be based on belief.  It's based on your belief about what constitutes appropriate considerations in determining treatment.   (and everything SoS said about what science can actually tell us). 

There are loads of questions that science can't answer - e.g.: what does it mean to live a good life?  how do I determine moral action and so on.  Science can contribute to answers to those questions, but it doesn't answer them. You've worked out your way of answering them (or maybe you haven't; I don't know), and your answer to the question of what should be considered is a result if your reasoning. Other people -indeed, teenagers too - will devise their own answers. 

And yes: not providing a treatment is different, the analogy is poor. But the central point is the respect for a patient's medical autonomy. 

FWIW: when it comes to vaccinations, I'm pretty pro-mandatory vaccines, because of the harm that not getting vaccinated poses to others.  

and last: would love for the courts to spend some time on 'sincerely held belief.'  That seems to me to matter most; at least, it seems more oriented to respecting patient autonomy than establishing what constitutes the "standard of care requirements in their own region and practice area," which any hospital requiring staff to treat according to said standard would have to establish.  Who gets to be involved in working out what those standards are?