My Body, My Choice

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My Body, My Choice The United States have been arguing the ethics of abortion for decades. The woman’s right to choose what she does with her body by either carrying a pregnancy to full term or terminating her pregnancy is always a hot topic in the political world. If you add in the biological father’s rights you have an even larger list of legal issues to consider. The U.S. Supreme court ruling in Roe v. Wade is just one example of abortion cases that have continued to modify the law. However, recently some new ethical debates about a person’s right to choose what happens to their body have hit the court. It’s one issue to debate an unborn healthy fetus inside the body of another human being. Now, courts are reviewing cases that involve terminally ill patients that want the freedom to choose how they die and other cases that want the option to refuse recommended medical treatments. Most recently a court case in Hartford, Connecticut, forced a 17 year old girl to receive chemotherapy to treat the cancer. Cassandra Callender or the girl known as “Cassandra C.” in the media, was diagnosed with Hodgkin lymphoma in September 2014. Cassandra’s medical providers recommend that chemotherapy would give her an 85% chance at surviving the disease and if she were to remain untreated, it will take her life at an estimated two years. The legal battle with the state began when the Department of Children and Families (DCF), was alerted that Cassandra and her mom had missed several appointments at the hospital. Cassandra’s mother, Jackie Fortin, said they wanted to seek a second opinion and for alternate treatment options because Cassandra did not want to put that “poison” of chemotherapy into her body. Fortin stated that; “she does not want toxins in her body, and she does not want people to tell her what to do with her body and how to treat it” (Fought Cancer Treatment, para.3) After an investigation was conducted by the child welfare agency, they were granted temporary custody by a trial court. This prompted Cassandra and her mother to hire legal representation to seek an injunction to restrict medical treatment, however, they were fruitless in their attempt. In January 2015, the state Supreme Court ruled that the state of Connecticut was not violating the minors’ or the parents’ rights by requiring her to undergo chemotherapy. In her interview with CBS News, Fortin discussed Cassandra’s rejection of the chemotherapy about the refusal being based on the damaging effects chemotherapy would have on her body, she said “it wasn’t about living or dying”. ("Teen Fought Cancer Treatment," 2015, para. 4) Ultimately the Connecticut Supreme Court decided that this particular minor was unable to convince the court that she was sophisticated enough to make her own medical decisions. (Yang, 2015, para. 5) Although several other states acknowledge the “mature minor doctrine”, this doctrine is comparatively new. In 2002 only a few states had enacted the doctrine into statute. In Illinois, Massachusetts, Maine, Pennsylvania, and Tennessee and several other states their state high courts have adopted the doctrine as law. The mature minor doctrine takes into consideration the situation and the age of the minor when attempting to consider maturation. The doctrine frequently applies in cases where the minor is able to comprehend the recommended medical or surgical procedure or treatments and is sixteen years or older. ("Mature Minor Doctrine," 2010-2014, para. 6) In an Essay that Cassandra published the day of the ruling,in the Hartford Courant, she describes crying and hiding from the police in her closet, running away from home after two days of chemotherapy, and being strapped to a hospital bed to undergo treatment against her will. "This experience has been a continuous nightmare," Cassandra wrote in her essay. "I want the right to make my medical decisions. It's disgusting that I'm fighting for a right that I and anyone in my situation should already have. This is my life and my body, not [the Department of Children and Families]'s and not the state's. I am a human, I should be able to decide if I do or don't want chemotherapy. Whether I live 17 years or 100 years should not be anyone's choice but mine." (Yang, 2015, para. 7) Cassandra was hospitalized in December, with limited access to outside communication and visitors. Recently it was reported by The Associated Press that she has finished her treatment and is planned to be discharged from the Connecticut Children’s Medical Center very soon. Physicians are stating that her lymphoma is remission. Cassandra posted photos post treatment, after having the ports removed that were used to administer the chemo to her body. ("Teen Fought Cancer Treatment," 2015, para. 8) While Cassandra C. was fighting for her right to choose and alternative path to medical treatment, Brittany Maynard was fighting for her right to choose how to die. Brittany was diagnosed with glioblastoma multiforme in January 2014. She was 29 years old and this type of cancer was assertive and fatal. Although patients with this type of Cancer can live up to three years, she was given six months to live in April 2014. This prompted Maynard’s decision that she wanted to choose when and how she died. She was originally living with her husband in California when she made the decision to “die with dignity”. This decision meant that when she was ready to die she would take a doctor prescribed lethal medication to end her life. The problem with this decision is that it is only legal in 5 states and California, the state where she was born and raised, was not one of them. In an article from CNN, Britany’s description of hurdles she had to overcome just to be recognized by a state that has the death with dignity law in order to achieve her goal of dying on her own terms was very overwhelming. “I met the criteria for death with dignity in Oregon, but establishing residency in the state to make use of the law required a monumental number of changes. I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver's license, change my voter registration and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job. The vast majority of families do not have the flexibility, resources and time to make all these changes.” (Maynard, 2014, para. 9) Oregon enacted the law in 1997, and it follows a strict set of guidelines when it comes to determining when a patient qualifies for the medication. Five out of six requests for the lethal medication are rejected by Oregon licensed physicians. In order for a patient to obtain the fatal drugs, they must meet the following three criteria. The patient must have only six months to live, have a terminal diagnosis, and that diagnosis must be confirmed and agreed upon by two physicians. After they have met the three criteria, they can still be denied if they have any underlying mental-health issues. Once they pass the initial stages of the process, they must make one request orally and one in writing. There is a fifteen day waiting period in between the requests and both requests must be verified by two witnesses. The underlying mental-health issues can be a bit of a problem, because the majority of dying people are depressed. However, the depression is one of the main reasons a physician would be apprehensive to prescribe the fatal medications. In October 2014 Brittany visited the Grand Canyon with her family, this was the last thing on her bucket list. She announced that she would end her life on November 1, 2014 and she followed through with it by taking the lethal yet legal doctor prescribed medication. She wrote "Goodbye world," "Spread good energy. Pay it forward!" (Kahzan, 2014, para. 10) Brittany became the poster child of the Death with Dignity law. After her death, Washington, D.C., California, and 2 other states have introduced right-to-die-legislation. The bill is using Oregon’s Death with Dignity law as a guideline. The bill would require two independent physicians to conclude that a person is mentally capable to make a life ending decision. According Oregon Public Health Division, “1,173 patients have the “end-of-life” medication, and 752 have chosen to ingest it.” (Sanburn, para 5) A 48 year old man, Dan Swangard, is a physician who also has a rare form of metastatic cancer, had portions of his pancreas, liver, gall bladder, and his entire spleen removed because of this cancer. He also knows that there is a strong chance that the cancer will return. “There is only so much medication can do” Swangard says. Swangard sees many patients die each year from cancer. He supports the ethical movement for assisted suicide, and he says that taking care of the patient, also means, letting them choose how and when they pass on, and when they are ready. In part to Cassandra and Brittany for being advocates and spokespersons on the right to choose for your body, new legislation is being received and laws are being reviewed. About 3,000 patients a year, from every state, contact the advocacy group Compassion & Choices for advice on legal ways to reduce end-of-life suffering and perhaps hasten their deaths. (Eckholm, 2014, p. 11) Although Cassandra and Brittany are both young adults who are helping pave the way for more states to review their laws on the body, this is happening at a time when more and more baby boomers are seeing their parents suffering with prolonged and painful deaths. This is causing a lot more states to consider new laws. Conclusion Ethics is something that a court cannot rule on. Ethics is a personal venture that one must endure and chose what is right. The relationship between a physician, and his/her patient is confidential. In the case of terminal illnesses, assisted suicide; planned death, or whatever you want to call it; a court, an activist group, or another person should not choose the way you pass on. It is unethical not to allow a terminally ill person, to pass on, in their own terms. References Connecticut Teen Fighting Who Fought Cancer Treatment Heading Home from the Hospital. (2015). Retrieved from http://newyork.cbslocal.com/2015/04/27/connecticut-teen-fought-cancer-treatment-home/ Eckholm, E. (2014). ’Aid in Dying’ movement takes hold in some states. Retrieved from http://www.nytimes.com/2014/02/08/us/easing-terminal-patients-path-to-death-legally.html?_r=0 Kahzan, O. (2014). Brittany Maynard and the Challenge of Dying with Dignity. Retrieved from http://www.theatlantic.com/health/archive/2014/11/brittany-maynard-and-the-challenge-of-dying-with-dignity/382282/ Maynard, B. (2014). My right to death with dignity at 29. Retrieved from http://www.cnn.com/2014/10/07/opinion/maynard-assisted-suicide-cancer-dignity/ The Mature Minor Doctrine. (2010-2014). Retrieved from http://healthcare.uslegal.com/treatment-of-minors/the-mature-minor-doctrine/#sthash.PCCmXnXY.dpuf Sanburn, J. (2015) More States Considering Right-to-Die Laws After Brittany Maynard http://time.com/3678199/brittany-maynard-death-with-dignity-legislation-california/ Yang, S. (2015). Why a 17 year old with Curable Cancer is fighting for the Right to Refuse Chemo. Retrieved from http://www.businessinsider.com/connecticut-teen-cassandra-c-fights-to-refuse-chemo-2015-1
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