Teen in Connecticut seeks right to refuse chemotherapy

Willie Grace | 1/8/2015, 6:37 p.m. | Updated on 1/8/2015, 6:37 p.m.
Medical experts testified at a November hearing that Cassandra had an 85% chance of survival if treated with chemotherapy. If ...
Medical experts testified at a November hearing that Cassandra had an 85% chance of survival if treated with chemotherapy. If not treated, they said, the girl faced "a near certainty of death within two years."

Michtom and an attorney separately representing Fortin will argue that Cassandra has the right to refuse treatment, even as a minor. They want the state to determine Cassandra is a "mature minor" and able to make such a decision.

The attorneys also will argue for a competency hearing, noting that there has been no evaluation of her maturity and ability to make a sound decisions about her own medical care.

Attorney Michtom concedes that maturity doesn't happen overnight. But in Connecticut, and many other states, 17 is old enough for a person to get contraception, undergo an abortion, seek psychiatric care or donate blood, all without parental consent.

However, says CNN Senior Legal Analyst Jeffrey Toobin, it doesn't matter if a person is 7 or 17 -- a minor is a minor.

Cassandra will be 18 on September 30.

Arthur Caplan, director of the Division of Medical Ethics at NYU Langone Medical Center, says 18 years "is somewhat arbitrary, but we don't amend it because you are close."

Cassandra's age, as an "older young person," makes this case unusual compared with those involving younger children, Caplan says. The case also stands out because it's purely about the right of a person to decline proven medical care, whereas similar cases have argued religious freedom or the validity of alternative medicine, he says.

Caplan said that regardless of what the court decides, doctors want to rely on persuasion, not force, to give Cassandra the treatment she needs, and likely will try anything they can think of to sway her -- for example, adjusting the treatment regimen to make it easier on her, or going with a different doctor, or counseling with a cancer survivor, or getting her friends to talk to her.

CNN's Toobin says the state has solid footing in this case. Cassandra's mother does not have the right to let her commit suicide, he says, nor does Cassandra, and the court won't allow it.

Slightly more than 9,000 new cases of Hodgkin's lymphoma are diagnosed per year in the United States, according to the American Cancer Society. It's most common among young adults ages 15 to 40 and older adults over age 55.

There is no known cause for Hodgkin's lymphoma, also known as Hodgkin disease. Symptoms can include, but are not limited to, lumps under the skin, fatigue and enlarged lymph nodes.

Chemotherapy is the common first-line treatment, according to the Leukemia & Lymphoma Society, and doctors usually combine four or more drugs that are delivered through a surgically placed catheter.For more information go to http://www.cnn.com