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  • Writer's pictureSociety of Bioethics and Medicine

Can Teens Refuse Chemo?

Written by Pooja Suganthan

Edited by Jacquelyn Tang

In September 2015, Cassandra Callender, a 17-year-old girl from Connecticut, was diagnosed with a rare lymphatic cancer, Hodgkin’s lymphoma. Chemotherapy treatment for Hodgkin’s has high success rates, ranging from 82-94%, depending on the patient’s stage of cancer. Despite these promising numbers, Cassandra refused the chemotherapy because she believed it was poison for her body.

Jackie Fortin, Cassandra’s single parent, supported her daughter’s decision. She claims, “Nobody, whether it's her age or an adult, should ever have to go through this by herself." However, the state believes that Cassandra should undergo the potentially life-saving treatment option. The Supreme Court ruled, in favor of the state, that Cassandra must be forced to undergo treatment and be kept in custody of child welfare authorities.

Disappointed by the Supreme Court’s ruling, Jackie responded, “I know more than anyone, more than DCF [Department of Children and Families], that my daughter is old enough, mature enough to make a decision. If she wasn't, I'd be making that decision." However, the mature minor doctrine fails to apply in this situation. This law grants mature adolescents the right to consent to medical care. When the minor is between ages 14 to 18, they can provide consent for minimal risk treatments, when they demonstrate maturity and can make adultlike decisions. According to the court, the 17-year-old teen failed to demonstrate her maturity for this life-or-death decision. Cassandra’s Assistant Public Defender, Joshua Michtom, stated, “a smart and knowledgeable 17-year-old (can) make the same choice, for better or worse, than she would be able to make without state interference nine months from now, when she turns 18.” This is true. There isn’t a magical transformation between one’s last moments as a minor and an 18-year-old. However, the 18-year mark sets a point in time that adolescents can prepare for by being involved in their health and decision-making as a young adolescent.

Cassandra and her supporters often utilized the line “my body, my choice” to advocate for the teen’s decision. Her mother states that Cassandra’s decision is not about life or death, but about keeping Cassandra’s body free from toxic injections.

It is puzzling that Cassandra’s mother would support her choices when her medical professionals explain Cassandra’s treatment is lethal without treatment. It is true that adults can decline helpful treatment, but it is possible that Cassandra’s strong opinions against chemotherapy may be influenced by her mother’s beliefs.

Jackie has a record of initially ignoring Cassandra’s diagnosis, failing to take Cassandra to appointments, and interfering in the middle of biopsies. Jackie has stated, “It not only kills cancer, it kills everything in your body. She knows this,” which misconstrues how chemotherapy works. This behavior from a loved one can shape Cassandra’s own understanding of health care, and potentially shed negative light on treatment options.


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