Respectful Insolence

Sarah Hershberger comes home to die

It was a couple of weeks ago that I last provided an update on the case of Sarah Hershberger, the 11-year-old Amish girl from Medina County, Ohio with lymphoblastic lymphoma whose parents decided to stop her chemotherapy because of how sick it was making her. As I explained early on and on multiple occasions afterward, Sarah had about an 85% chance of long term survival with the chemotherapy regimen she was undergoing but a close to zero percent chance of surviving without it. In other words, her parents, Andy and Anna Hershberger, are committing gross medical neglect of their child. I realize that they love their daughter and are doing what they think is right for her. I realize that they don’t think they’re abusing their daughter. Unfortunately, they are. Their decision is almost certain to lead to the unnecessary and unpleasant death of their daughter sooner rather than later.

Because of this, the hospital, Akron Children’s Hospital, went to court to try to have a medical guardian appointed for Sarah, someone who would make sure that she received effective science-based treatment for her cancer. After a couple of rulings went against it, the hospital eventually won, and a medical guardian was appointed. Unfortunately, the parents fled. Where they fled is not exactly clear, but flee they did, apparently out of the country, while “health freedom” advocates and friends of the family claimed that Sarah was doing very well and “cancer free,” thanks to “natural” treatments being administered by unspecified practitioners. The quacks piled on, spinning the story as an evil, profit-crazed hospital trying to poison a poor innocent girl for fun and, above all, profit. Meanwhile, as I described last week, we learned that the Hershbergers are subjecting their daughter to the most useless and nonsensical forms of quackery, including including high dose vitamin C and B17 (the fake vitamin name given to the quackery known as laetrile), oxygen therapy, detoxification methods, as well as the IV chelation.

Most recently, a Libertarian-leaning 1851 Center for Constitutional Law, which is basically a group consisting mainly of Maurice Thompson, a got involved raising money for the Hershbergs on the basis of “health freedom.” He tries to promote “health care freedom, private property rights, taxpayer rights, school choice, political speech, commercial speech, ballot access, and voter integrity.” In this case, he has stepped in to make sure that a little girl does not get the treatment she needs to survive, if successful thus virtually guaranteeing her death. Sadly, the attacks from quacks and their supporters like Thompson have taken their toll, even on a hospital so dedicated to making sure that Hershberger gets potentially life-saving treatment that it went to court to see that it would happen. Two weeks ago, the hospital apparently gave up, and the woman appointed as the medical guardian for Sarah Hershberger resigned, at which point I lamented that Sarah Hershberger is probably doomed.

Now she has apparently finally come home with her family to die:

The Andy and Anna Hershberger family publicly reunited after many weeks in hiding as they appeared at an Amish community meeting on Wednesday. Andy and Anna alone were the last to arrive after seeing it would be safe for them to attend. (All are still waiting for the judge to approve the two-week-old letter of resignation from Ms. Schimer, court-appointed guardian for Sarah, legally acknowledging she and the hospital are backing down on their relentless and illegal pursuit of the girl. But the Hershbergers were not going to wait any longer. (Their emergence was just for the meeting after which they will retreat to an undisclosed location until it is legally safe.)

And:

The community meeting, hosted by Foundations for Health Education, was to settle fears about going to Akron Children’s Hospital and teaching legal rights and protecting oneself against medical abuse. “Now more than ever, Akron Children’s Hospital will respect your right to choose, because they know . . . and they know your know your rights. Most participants were Amish men, about 35 in all. FHE director David Augenstein introduced campaign coordinators Earl Gregory (Lorain/Medina Co.), Wayne Miller (Wayne/Holmes Co.) and Sam Miller-Schrock (Trumbull/Geauga Co.) as well as Isaac Keim, Sarah’s grandfather and Amish bishop.

It’s a heartbreaking story, but at the same time enraging.

I had never heard of any such group named Foundations for Health Education. Interestingly, apparently the court has not yet approved the letter of resignation from Ms. Schimer, even two weeks later. As you might remember, two weeks ago, David Michael, the man who has been flogging this issue, was bragging that the court would almost immediately approve the resignation. It hasn’t, which makes me wonder if things are going as well in court for the allies of the Hershbergers as Michael is trying to lead us to believe. Personally, to me anything David Michael says needs to be verified. If he told me that it was raining outside, I’d look outside before believing him. However, if his account bears any resemblance to reality, this is depressing news. It sounds as though ACH is not only throwing in the towel on Sarah Hershberger but throwing it in altogether. It sounds as though it is promising not to do anything similar in the future, which is sad. One wonders what will happen the next time that a child is taken out of treatment and subjected to quackery based on religious beliefs, even if the life of the child is endangered. I hoped that this wouldn’t happen, but I’m not surprised that it did. The belief that children are the property of their parents and that parental rights are absolute is strong in this country. It doesn’t seem to matter how many children die.

Yet, how long could the hospital stand firm. Get a load of the campaign being orchestrated against it by quacks, “health freedom” supporters, and people who mistake freedom for the freedom to choose quackery for children who are not yet competent to choose for themselves:

Isaac and others told me many Amish in Ohio are turning away from the hospital and its 80 area locations. Others have come forward with stories of mistreatment and ACH has received over 1,000 letters of protest. By their actions, ACH and Ms. Schimer have created their own backlash. Andy says he is afraid these actions will cause great fear among parents that take their children to the hospital and who do not fully agree with their opinions.

Nice. Notice how these guys instigated all these letters and this backlash. True, Andy Hershberger didn’t personally instigated it, but he accepted the support of those who did, like David Michael and, likely, the 1851 Center for Constitutional Law. Through articles on David Michael’s site, which were picked up by sites like the über-quack website NaturalNews.com and others, amplifying the intended message that what ACH did was some sort of affront to freedom and parental rights, that it was doing it only for the profit it would see from the chemotherapy that it would be giving Sarah, and that the hospital was guilty of all sorts of malfeasance. Bogus charges flew, ranging from the aforementioned claim that the hospital was only in it for the money to claims that ACH had continued Sarah in a clinical trial protocol without having obtained adequate informed consent, that Maria Schimer was untrustworthy, and a bunch of claims about how ACH and Northeast Ohio Medical University (NEOMED) were corrupt in the “business of cancer.”

Many of the same charges are repeated in the latest post by David Michael. Perhaps the most outrageously idiotic charge was that ACH gave Sarah’s confidential medical information to the news media, which it appears most assuredly not to have done. All the information from news reports appears to have come from court proceedings. Meanwhile, Michael and the variety of quack advocates lamenting ACH’s alleged assault on “health freedom” keep repeating statements about Sarah’s health, claiming that she is “cancer-free,” letting the media know what treatments she is undergoing, and basically taking advantage of the fact that the hospital is bound by law and medical ethics in what it can reveal while the family is not.

It’s now been several months since Sarah Hershberger came off of treatment. We have no idea how much her disease has progressed or whether it remains in check. As I’ve explained time and time again about this case, it’s quite possible that the less than two full cycles of chemotherapy that Sarah underwent might have put her into remission. However, such remissions are usually not durable. There’s a valid scientific reason why the chemotherapy regimens for lymphoblastic lymphoma take over two years. It’s because after remission there are nearly always microscopic deposits of tumor left behind, and they will come roaring back without additional therapy, if they haven’t already. It’s possible, albeit unlikely, that Sarah Hershberger is one of the lucky ones whose remission lasts after so little therapy. Far more likely, her cancer will recur in a more resistant, difficult to treat form.

That’s why I fear that what has really happened here is that Sarah Hershberger has come home to die. Only and the family don’t know it yet, but that’s the most likely outcome. It was a preventable outcome, but the family decided to let her die, and the state appears to have given up even trying to prevent it.

Comments

  1. #1 reader
    scorched earth
    December 23, 2013

    Negative speculative front running of the headlines on individual survival, no matter how well informed of survival stats with one known method, is not science. It’s politics and poor taste.

    The current recommended treatment has built up as a series of treatments that are substantially front loaded in their differential benefit.

    Earlier there might have been productive avenues that didn’t require so much provocation and confrontation. Treatment options between equipoise and some frank extra risk might have been found outside of ACH. One might think ACH’s provocations are precisely to create resistant families as bloodied examples that get less treatment than either side expects. Jack booted handlers are not a win-lose situation won by fearsome domination tactics, they are lose-lose with wide swaths of scorched earth. Sounds like ACH business units and the like may come to understand that, too.

  2. #3 Chris HIckie
    December 23, 2013

    Reader-as a pediatrician with several patients who have undergone similar treatments for pediatric cancers (and are now long-term survivors), I can tell you the parents of those children are glad they let the oncologists treat and care for their children. There is nothing “scorched earth” about standing up for what one knows is best in the face of otherwise certain death. And, as a pediatric resident in training, I saw children whose cancer did not yield to the same treatments; when that happened, those doctors and nurses were more than willing to tell the parents that it was time to stop the chemotherapy and take their child home for hospice care.

    There are no “jack booted handlers” here, and you know it.

  3. #4 Dorit
    December 23, 2013

    Interesting news about the court not approving the resignation. I’m afraid to hope. Sigh.

  4. #5 Mrs Grimble
    December 23, 2013

    Wow, first comment and it comes within a hairs-breadth of Godwinning the whole thread.
    In any case, the ACH staff might have a very different idea of who the “Jack booted handlers” are here.

  5. #6 Krebiozen
    December 23, 2013

    reader,
    Is that prn (an occasional commenter here)? You have a very similar writing style and very similar opinions.

    Negative speculative front running of the headlines on individual survival, no matter how well informed of survival stats with one known method, is not science. It’s politics and poor taste.

    An accurate estimate of what will give this child her best chance of survival is the most important information in this case. How can you dismiss this information as being “politics”? I can’t help thinking this is only because you don’t like the best estimates.

    The current recommended treatment has built up as a series of treatments that are substantially front loaded in their differential benefit.

    I don’t think that is true. The current treatment is used because it was found that a single round or even two rounds of chemotherapy didn’t prevent recurrence. This study in 1981 found that almost half of their patients had relapsed three years after a year of chemotherapy, and other studies have found the relapse rate was even higher as time passed. That’s why a further year of treatment is now used.

    Earlier there might have been productive avenues that didn’t require so much provocation and confrontation. Treatment options between equipoise and some frank extra risk might have been found outside of ACH.

    Such as? What treatments other than chemotherapy have show any success in acute lymphoblastic lymphoma? I don’t believe there are any, in which case your “frank extra risk” amounts to almost certain death.

    One might think ACH’s provocations are precisely to create resistant families as bloodied examples that get less treatment than either side expects.

    I find it hard to make sense of this, but I think you are suggesting that ACH has deliberately engineered this child’s death for its own ends. How does this situation in any way benefit ACH?

    Jack booted handlers are not a win-lose situation won by fearsome domination tactics, they are lose-lose with wide swaths of scorched earth. Sounds like ACH business units and the like may come to understand that, too.

    Well, I’m in the UK where children are immediately made a ward of court for the duration of treatment when there is a conflict of this kind, when the child of a Jehovah’s Witness requires a blood transfusion, for example. I thought the same was true in the US, so this case has surprised me.

    It seems to me that this is a sensible way of dealing with these situations; the law is clear, the decision is taken out of the parents’ hands and they know they have no recourse through the courts. No “jack booted handlers” or “swaths of scorched earth” are required, though the police are sometimes involved. The parents can hold their heads up in their communities and the children get the best treatment, which is win-win, is it not?

  6. #7 T.
    December 23, 2013

    I know it may seems horrid of me, but I do hope that we will know if (I fear to say when) this child dies.
    At least, her death can be used against the quackery. I hope, fervently, that she will be one of the 15% who survives, but in the other case, at least it is something.

  7. #8 Mark McAndrew
    December 23, 2013

    If letting a child die isn’t abuse, what is?

    Twisted redneck morons.

  8. #9 Renate
    December 23, 2013

    @T
    I’m affraid the dead of this child will not help in any way in the battle against quackery. The supporters of quackery will still spin the story in their direction, for instance by saying it wasn’t the quackery that killed this child, but the chemo she got before it. It will just be another tragic death.

  9. #10 Denice Walter
    December 23, 2013

    re Foundations for Health Education

    The FHE is a project of David and Ann Augenstein who also publish ‘Living Food’ and the Journal of Natural Food and Health. They have a website and give seminars.

  10. #11 AnObservingParty
    December 23, 2013

    Never ceases to be depressing. That poor girl.

  11. #12 T.
    December 23, 2013

    @Renate

    Die-hard quacks won’t change no matter what, but fence-sitters may.

    A site that track down people who have eskewed SBM and gone to quackery with date of death and prognosy-if-SBM-was-followed may help fence-sitters in fact. Yes, anedctote are not data, but many people understand the former better than the latter.

  12. #13 Denice Walter
    December 23, 2013

    @ Krebiozen:

    Is that prn? I’m not 100% sure ( am I ever?) but phrases like ‘front loaded’ and ‘scorched earth’ cause me to prick up my ears. Talk about huge pharma profit vs low cost meds would seal the deal for me.

  13. #14 Narad
    December 23, 2013

    Interesting news about the court not approving the resignation. I’m afraid to hope.

    The probate court doesn’t even look to have approved Olberholtzer’s request to withdraw from the case. Nothing going on with the appeal, either.

    I’m not sure what the dynamics are when the lower court has been ordered by the intermediate court to do something and then you get the highest court involved before the opposing party comes back to the lowest court and tries to withdraw.

  14. #15 Sarah A
    December 23, 2013

    @T.

    The website http://www.whatstheharm.net has a topical list of cases where people chose alternative medicine and had undesirable outcomes (not always death.) Their current count (at the top of the homepage) is 368,379 people killed and 306,096 injured.

  15. #16 Liz
    Redmond, WA
    December 23, 2013

    Her parents need to be tried for at least child abuse, neglect and endangerment. How can this be seen as anything else? (I mean, aside from manslaughter/murder, etc.).

  16. #17 Denice Walter
    December 23, 2013

    OT but are ludicrous woo-meisters substituting their lurid fantasies for reality ever TRULY OT @ RI?

    You gotta love it.

    Gary Null (@ Talkback/ yesterday/ PRN) reveals that he is writing a highly detailed expose of the “quackbusters” (sic) that will EXPLAIN all about their errant ways.
    Maybe he’ll tell me how I manage to afford my extravagant lifestyle ( in the first 10-15 minutes)

    The rest of the show is rife with material about how he won the war against the AMA ( contra chiropractors), how to win races without energy sports drinks, how we are all ‘beings of light’, his family history as a sensitive, his experiments with spiritually based healing and the miraculous results (testimonials) attained at his latest health retreat.

  17. #18 Narad
    December 23, 2013

    Her parents need to be tried for at least child abuse, neglect and endangerment. How can this be seen as anything else?

    If you read the court documents, you will find that there wasn’t ever an issue of the fitness of the parents (indeed, this is why the first appeal was remanded; the probate judge injected it of his own accord). They’re (deliberately) uneducated and now being taken advantage of. Not that this lets Isaac Keim off the hook.

  18. #19 jane
    December 23, 2013

    This is indeed a tragic situation. However, I seem to recall that numbers were quoted in a previous article to the effect that the first stages of treatment for this disease offered something over a 50% long-term remission rate, more gave a 60-some percent rate, and the full boat 80-some percent. An absolute 20% or 30% difference in mortality rates is, of course, enough reason for any sensible person to pursue a full course of treatment unless it is starting to cause significant and permanent damage. Still, the lower numbers associated with lesser treatment cannot be described as a “close to zero” survival chance or “nearly always” or “virtually guaranteeing” the patient’s death.

    Exaggeration does not strengthen your case in the eyes of the undecided public, but weakens it. Saying that there may be, say, a one in four chance that this child will die as a result of the abbreviated treatment is serious enough to convince people that forcible intervention is reasonable, but it doesn’t leave you with egg on your face if she doesn’t die. If you claim that her death is virtually certain, then if the child is not further treated but is alive and well several years from now – and there are probably at least coin-flip odds that this will be the case – then true believers in the probably useless alternative treatments she’s using will say: “All these oncologists said that she was doomed; if her survival was so very unlikely, it is probable that these treatments made a difference.” Nobody’s going to go to PubMed to look up the real remission rates; they’re just going to see doctors like you saying “nearly always” this and “virtually” that. I wouldn’t be surprised if cancer quacks would be happy to quote you on the subject.

  19. #20 Spectator
    December 23, 2013

    Any practitioner who takes the case now or at Sarah’s next relapse may be pursued later if (when?) the cancer becomes fatal. In that case, the family and quackiverse will credit the first remission to the dartboard treatments, while ascribing Sarah’s death, should that occur, to the last standard cancer treatment.

  20. #21 Militant Agnostic
    Wondering why Rogers thinks bombarding me with advertising while I am on hold forever is effective marketing.
    December 23, 2013

    @Kreb & DW

    I don’t think so, less braggadocio, and no references to being one of the self-educated elite. I also doubt that someone with as high an opinion of himself as prn would fell the need to sock puppet. The similar pompous style makes me think it is a co-coreligionist however, perhaps an acolyte.

  21. #22 Narad
    December 23, 2013

    Nobody’s going to go to PubMed to look up the real remission rates

    Um, OK, if you say so. Is there something preventing you from doing it rather than just complaining?

  22. #23 Denice Walter
    December 23, 2013

    @ Militant Agnosic:

    I don’t know for sure but perhaps it is he and he’s trying to disguise himself so that his other comments cannot be easily referenced.

  23. #24 TBruce
    December 23, 2013

    The rest of the show is rife with material about how he won the war against the AMA ( contra chiropractors), how to win races without energy sports drinks, how we are all ‘beings of light’, his family history as a sensitive, his experiments with spiritually based healing and the miraculous results (testimonials) attained at his latest health retreat.

    Too bad he can’t do something about his malignant narcissism.

  24. #25 Militant Agnostic
    December 23, 2013

    Narad @23

    I think you are being to hard on Jane – i believe by “Nobody” she means the nobody among the alties will look up the survival rates. I fear Calamity is correct in this assumption.

  25. #26 Denice Walter
    December 23, 2013

    @ TBruce:

    NO, NO, NO, Dr!
    WE’RE the narcissists and sociopaths. Worshipping “gutteral” ( sic) scientific methods, indentured forever to our reprehensible pharma masters.

    I have to stop.
    I’m going ( indoor) swimming at a colleague’s club. How frigging elitist is that!

  26. #27 jane
    December 23, 2013

    Militant Agnostic – That is correct. Narad’s habit of responding to an awkward fact with an ad hominem is well-established. Most average citizens probably have never even heard of PubMed, and that’s no criticism, because there’s no reason to expect that they should have. Consumers who do not know how to obtain and interpret published data are often forced to presume that doctors’ numbers are at least roughly true, sometimes to their detriment – keep taking that statin or else you’ll have a heart attack! – and quotes like Orac’s provide a rich lode to mine for cancer quacks who can say “See, all the oncologists said this person was doomed!” Thankee for the new nickname, by the way.

  27. #28 Narad
    December 23, 2013

    Militant Agnostic @25

    I think you are being to hard on Jane – i believe by “Nobody” she means the nobody among the alties will look up the survival rates.

    jane @27

    Militant Agnostic – That is correct. Narad’s habit of responding to an awkward fact with an ad hominem is well-established.

    I thus retract and aplogize for my reaction to a faulty reading.

  28. #29 Militant Agnostic
    December 23, 2013

    Where the hell was the ad-hominem?

  29. #30 Narad
    December 23, 2013

    ^ “apologize”, just in case the typo might come across as some sort of evasion.

  30. #31 Mrs Woo
    December 23, 2013

    Actually, Jane’s second paragraph voiced my own discomfort with this blog post. One of the big things offered by this blog is that it is science-based, and science says that, though her chances are slim, there is still a small chance of survival, especially in the short-term.

    It is likely if she looks good in six months she will be paraded around by alt-med providers as proof that big-bad Pharma was wrong to condemn them. Then, if she dies outside of the public eye two years from now, they will quietly ignore her passing, no matter how hard it is for her, or how chemo-resistant her cancer.

    Orac could have posted a follow-up post that wasn’t so absolutist in its prediction that still would have been powerful enough to compel rational, moderately intelligent readers (like myself) and fence-sitters who suspect any “alternative” that promises to cure every ill ever imagined.

    I am very upset by this case and others like this, and my heart breaks that this girl’s life is probably much shorter than it could have been because well-meaning parents have been misled. More frustrating is attempting to discuss this in any way with Mr Woo, and the heart-sinking feeling that, if statistics are right, this girl will die. If she is an outlier, Mr Woo can assure me that alternative cures are better, and are what cured her.

  31. #32 jane
    December 24, 2013

    Narad – Apology accepted, and thanks – that’s decent of you. Perhaps this argument will get more traction coming from Mrs. Woo. A 25% or 30% chance that a child will die needlessly is bad enough to convince almost all audiences that the parents are wrong. It’s neither necessary nor wise to exaggerate the facts.

  32. #33 Mrs Woo
    December 24, 2013

    jane – I am as big a nobody as could possibly comment on this blog. My only qualifications are working in marketing for a biotech company for a bit and writing training brochures for our sales people. No completed education at all. I found this blog attempting to reason with Mr Woo (still failing on that; when I find proof to discredit his beliefs, he chooses to not believe my sources because they don’t come from his echo chamber). I did finally succeed in having him not try to cure me with alternative medicine anymore. Now I’m cringing as we face a new diagnosis, because usually that triggers his obsessive search for promised 100% guaranteed “cures.”

    Merry Christmas to all, by the way!

    With warmest regards,

    Mrs Woo

  33. #34 Calli Arcale
    December 25, 2013

    Krebiozen:

    Well, I’m in the UK where children are immediately made a ward of court for the duration of treatment when there is a conflict of this kind, when the child of a Jehovah’s Witness requires a blood transfusion, for example. I thought the same was true in the US, so this case has surprised me.

    In the US, it generally requires extraordinary circumstances to place children into the state’s custody, and the system is more set up to do this in the case of more obvious types of abuse than medical neglect. And the system tends to favor the parents. (Unless there are drugs involved, naturally; the US’s reputation for ridiculously excessive penalties for drug crimes is well-deserved. I mean, I’m solidly against illegal drugs, but you just have to look at the prisons to realize how insane this has become.)

    There are far too many tragic stories of the state not intervening even in cases of frank abuse until the child died for me to be surprised by this.

  34. #35 rancidbrainmatter
    Fly-over Land
    December 25, 2013

    This child, Sarah, will live or die at this point based on her inborn ability to fight the cancer with only minimal treatment. Her odds aren’t good. Her parents are ignorant– that’s a fact– let’s stop justifying that with pleas of “religious freedom”-and her fate is in their hands–pathetic. Why does this ridiculous pretense of “freedom” continue in this country? The Amish are ever so “charming” aren’t they? No! They are ignorant and steeped in superstition.

  35. #36 Angel
    December 26, 2013

    In the end everyone involved will try and justify her death.But in reality in their hearts they will know that she probably could have been saved if not for their egos and vanity!I pray that she will not suffer as I have seen those suffer losing their battle with cancer.The price someone so young may have to pay for the ignorance of so many is so disheartening!

  36. #37 Narad
    December 26, 2013

    There’s news. Maurice has filed an appellate brief (PDF). (Olberholtzer is not listed.) By page 7, it’s looking pretty sad, but the take-home is that this one still lies with the Ninth Judicial District. Oral argument requested.

  37. #38 Narad
    December 26, 2013

    ^ Page reference is to the PDF itself, not the numbering of the main text. Holy f*ck, check out the underscored “infertility” on page 9 (“3″). Five’ll get you ten this is mostly plagiarizing Olberholtzer on the Ohio supreme court side.

  38. #39 Militant Agnostic
    December 26, 2013

    @Angel

    she probably could have been saved if not for their egos and vanity/

    Hubris is at the bottom of this and young Sarah will pay the price.

  39. #40 Scared Momma
    December 29, 2013

    Took a sanity break from RI . . . and come back to more insanity. Poor child.

  40. #41 A Mom Who Can Think For Herself
    December 30, 2013

    Unbelievable. That poor baby.

  41. #42 Narad
    December 31, 2013

    FHE seems to have been fleshing out their portfolio. The photo presented for Schrock does not appear to correspond to a quadriplegic. Oh, wait, I already knew that Augenstein was prone to taking other people’s work without proper credit.

  42. #43 herr doktor bimler
    December 31, 2013

    The photo presented for Schrock does not appear to correspond to a quadriplegic

    Stolen from here, says Google Image Search:
    http://www.pbase.com/image/111898420
    (“No unauthorised use of any images”).

  43. #44 herr doktor bimler
    January 1, 2014

    The “demure Amish girl” silhouette Augenstein uses in his “send us money for Sarah” advertisements comes from here —
    http://www.pinterest.com/pin/300544975104344590/
    but rotated to make it more submissive and eyes-downcast.

  44. #45 herr doktor bimler
    January 1, 2014

    Augenstein was prone to taking other people’s work without proper credit.
    Sorry, Narad, I failed to see your hypertext and therefore presented my own detection results as if they were original.

  45. #46 Narad
    January 1, 2014

    Sorry, Narad, I failed to see your hypertext and therefore presented my own detection results as if they were original.

    As you’ve likely noticed, I do that sort of thing all the time. The uncredited buggy image that I pointed out to Getty seems to have gone bye-bye, though, if under the umbrella of an omnibus replacement post.

  46. #47 Narad
    January 6, 2014

    I just heard back from the owner of the photo. He does not approve. He does now have the contact information for the designated agent and a template DMCA notice at his request, though.

  47. #48 Narad
    January 6, 2014

    I’ve just noticed one other bit of Augenstein image hilarity. Compare the multiethnic picture here with the original. Now, the crude erasing of the text is obvious, but why does the Black dude at top left have more hair?

  48. #49 Narad
    January 6, 2014

    Country Clip Art has been notified.

  49. #50 dingo199
    January 6, 2014

    I guess the extra hair was added to cover the remains of the writing behind his head when the pic was “cut out” of the original picture.

  50. #51 Narad
    January 6, 2014

    I guess the extra hair was added to cover the remains of the writing behind his head when the pic was “cut out” of the original picture.

    I really shouldn’t be staring at this, but it’s starting to look as though he simply dropped an oval on top to mask a particularly clumsy use of the eraser.

  51. #52 Renate
    January 6, 2014

    The lady on the left seems to have less hair, than on the original.

  52. #53 Narad
    January 8, 2014

    Schimer’s appellate brief has been filed. It’s straightforward.

  53. #54 Narad
    January 10, 2014

    Just by the by, one might wish to compare Augenstein’s donation logo with somebody else’s.

  54. #55 Narad
    January 10, 2014

    Fairtransplant.org has been notified.

  55. #56 thenewme
    January 10, 2014

    Why am I not at all surprised that they have the classic quackvertising scam, aka network marketing affiliate program? Their “Generous Affiliate Program for Bloggers, Webmasters and Food Clubs” is sure to encourage participation among the self-referencing woo promotion club. ACK.

  56. #57 Sandrop
    January 14, 2014

    Where did you get the information that she was “coming home to die”? Maybe I didn’t read the article carefully enough, but I don’t recall seeing that.

  57. #58 Mephistopheles O'Brien
    January 14, 2014

    Sandrop – that is Orac’s prediction of how events will unfold. If her family is still not planning to provide her with care that has a known success rate, then her odds of surviving are low. While “coming home to die” may be considered a tad dramatic by some, she is coming home; she (in Orac’s opinion, and who am I to gainsay it?) will likely die sooner than she would if she had received effective treatment.

  58. #59 Narad
    January 14, 2014

    The “demure Amish girl” silhouette Augenstein uses in his “send us money for Sarah” advertisements comes from here

    The Sarah fundraising stuff appears to have been scrubbed from the site. I can’t find a “goal reached” announcement, just gone.

    And Augenhead has finally come to grips with what I could have told him in the first place.

  59. #60 herr doktor bimler
    January 14, 2014

    The Sarah fundraising stuff appears to have been scrubbed from the site.
    Still at the site:

    Scene depicting reunited Amish family leaving the community meeting at the old school house on Wednesday.

    Google Image search soon led to the original version of this documentary footage; Augie cropped it to remove the prominent banner labeling the image as the property of “worldofstock”.

  60. #61 herr doktor bimler
    January 15, 2014

    The Sarah fundraising stuff appears to have been scrubbed from the site. I can’t find a “goal reached” announcement, just gone.

    Does anyone have standing to request an accounting for moneys donated? Or is just a case of Caveat Donor?

    Would-be visitors to Raw-Milk Guy’s site should be warned that his journalistic style is, um, feculent and cheesy in its general over-ripe sentimentality. I realise that his scam requires him to portray Anabaptist groups as romantic naifs and prelapsarian innocents, untouched by our corrupt modern world but also unequipped to cope with it (therefore give moneys to RMG to help defend them). And I realise that his target audience are not over-supplied with working memory, and therefore need reminding every couple of sentences that they are reading about the Amish. But still. It is as if RMG is under some sort of Goidelic Geis requiring him to include the word “buggy” at least once in every single paragraph.

    It is how an Edwardian missionary might describe his flock of quaint West African converts, in a letter home asking the local pupils at Sunday School to give more of their pocket money to the cause, if that missionary had been studying the techniques of contemporary televangelism.

  61. #62 Narad
    January 15, 2014

    Looks like there’s indeed a remnant. The Gofundme page is still there (7.9% “processing fees?).

    Augie cropped it to remove the prominent banner labeling the image as the property of “worldofstock”.

    I see that he’s brought back the Cain/Getty buggy image without credit, as well. “World of Stock” was only ever a licensing broker (and the terms for this one specify “NO UNLICENSED USE”); I’ll notify the photographer.

    The bit about one dose of consolidation chemo “turning [Sarah’s] teeth black” had escaped my attention previously.

  62. #63 Angel
    January 17, 2014

    Surprised no comments on Maurice’s latest brief.I wonder what his definition of negligent is.Still bothers me that Sarah’s parents brought her to ACH because she had a toothache.Forget all the lumps and the fact that she couldn’t breath!Hope she is still doing well,guess no news is good news!

  63. #64 Narad
    January 18, 2014

    Surprised no comments on Maurice’s latest brief.I wonder what his definition of negligent is.

    That’s mostly in the Ohio supreme court brief. It’s also toast: The issue was settled in the first appeal, and he doesn’t get to relitigate it. If you look at Schimer’s supreme court reply brief, it becomes clear what Maurice’s ulterior motive is, i.e., using the Hershbergers to try make a show of challenging the constitutionality of the third prong of Ohio Rev. Code § 2111.06, “A guardian … shall be appointed as to a minor … whose interests, in the opinion of the court, will be promoted by the appointment of a guardian.”

  64. #65 Narad
    January 18, 2014

    Still bothers me that Sarah’s parents brought her to ACH because she had a toothache.

    Wait, what? Is this in one of Maurice’s briefs?

  65. #66 lilady
    January 18, 2014

    IIRC, it wasn’t a toothache that caused Sarah’s parents to being her to the ACA. According to the earliest legal papers, (a petition for the Court to appoint a medical guardian), Sarah had large tumors which caused her respiratory distress and intubation was necessary to treat Sarah’s hypoxia until radiation treatment shrank those tumors and Sarah could breath on her own. When the parents and the interfering ignorant grandfather refused to have Sarah continue with prescribed chemotherapy on an outpatient basis, during the induction stage of therapy for her cancer, it was necessary to petition the court for the appointment of a medical guardian to oversee Sarah’s cancer treatment.

    Everyone who is involved in this sad case, including the parents, the interfering grandfather, and the absolute strangers has an agenda, to promote their own alternative treatments, which are not based in an science.

    Meanwhile, Sarah languishes as the highly treatable cancer eventually becomes untreatable and Sarah dies a painful, senseless death. The parents who should have been her advocates to give her the best chance for long term survival/cure have failed Sarah, by allowing cranks and strangers to meddle and score notoriety; truly a tragedy of monumental proportions.

  66. #67 Narad
    January 18, 2014

    during the induction stage of therapy for her cancer

    Induction was completed; the guardianship didn’t come up until they promptly abandoned the consolidation round (without full remission, according to Schimer’s briefs).

  67. #68 Angel
    January 18, 2014

    lilady@it wasn’t a toothache,If you read Narad’s comment Jan.8th.you can read Schimers brief,Statement of facts.Sarah was brought to ACH because she had a toothache.

  68. #69 Angel
    January 18, 2014

    Sorry,had to leave for awhile.To lilady @ it wasn’t a toothache.The brief states on page 5,second sentence that on April 13,2013 she was brought to ACH by her parents because she had a toothache.It was the Dr. examining her that found the tumors and realized that she was having difficulty breathing.As a parent I noticed every bump or bruise on my children.I can’t imagine that Sarah didn’t bring her problems to her parents attention.Maybe I’m wrong about that,I sure hope so.I agree with you about everyone involved having ulterior motives.If they weren’t getting something out of their involvement with this family they probably wouldn’t be involved.Sad world that we live in!!

  69. #70 susan
    Cleveland
    January 19, 2014

    Just found out that a friend of mine knows Sarah’s family, mostly the grandfather. Unfortunately my friend bought the story of the heavy handed evil state & hospital. They say she is cancer free. :(

  70. #71 Narad
    January 19, 2014

    Just found out that a friend of mine knows Sarah’s family, mostly the grandfather.

    Isaac Keim is a quite prominent figure in his Swartzentruber subschism.

  71. #72 anna
    January 20, 2014

    Medical money-grubbing propaganda. Sarah is alive and well. Chemotherapy is ritual murder. Hospitals are slaughterhouses. When more people start thinking for themselves instead of believing the whitecoats, things will change in the blink of an eye. In the meantime your programming is: run to your doctor, take your meds and die.

  72. #73 herr doktor bimler
    January 20, 2014

    Hospitals are slaughterhouses.
    The revolving knives were a bit of a giveaway.

  73. #74 Narad
    January 20, 2014

    Medical money-grubbing propaganda. Sarah is alive and well.

    Do you base this on first-hand knowledge, including evaluation of the Tijuana diagnostics?

  74. #75 Narad
    January 20, 2014

    Chemotherapy is ritual murder.

    But thanks for the nod to the Jew World Order, all the same.

  75. #76 Dangerous Bacon
    January 20, 2014

    “In the meantime your programming is: run to your doctor, take your meds and die.”

    I thought the popular meme is that MDs keep us alive but chronically ill, so they can keep us coming back for more ineffective treatments. If they’re actually killing us off right and left, why are the waiting rooms so crowded?

    It’s like a rerun of the Pharma Vaccine Conspiracy To Depopulate The World. I just can’t see it as a viable business model.

  76. #77 novalox
    January 20, 2014

    @anna

    Yawn, typical pharma shill gambit, please come up with something a little more original.

    Also, if Sarah, FSM forbid, does die of her cancer that wasn’t treated because of quacks, would you come back here and apologize? Doubtless you won’t as you’ll be blaming everyone and everything else except the quackery that you seem to promote.

  77. #78 Maned Wolf
    January 20, 2014

    Unintentional hilarity: my DNS blocks Raw Milk Guy’s site as a phishing attempt and has some explanation stating sites like this use false pretenses. If the hat fits…

  78. #79 Krebiozen
    January 20, 2014

    Yet another “Wake up sheeple!” rant from someone who has swallowed a bunch of idiotic nonsense about conventional medicine without bothering to spend any time at all checking its accuracy. The irony inherent in these tirades used to amuse me, but now I just feel a faint sense of disgust.

    Anna presumably doesn’t realize that many of us here are “whitecoats”, and know through study and personal experience that the claims of CAM are bogus, especially in regard to cancer. As Da Vinci put it, “such an opinion can not exist in brains of any extensive powers of reasoning.…”

  79. #80 Narad
    January 20, 2014

    Unintentional hilarity: my DNS blocks Raw Milk Guy’s site as a phishing attempt and has some explanation stating sites like this use false pretenses

    What on earth are you using? It’s not listed in any of the DNSBLs.

  80. #81 Maned Wolf
    Pelennor
    January 20, 2014

    @Narad

    OpenDNS. It did strike me as odd since I’ve never gotten that warning before when looking at the site. I suppose I should report that it’s not phishing…

  81. #82 Krebiozen
    January 21, 2014

    Maned Wolf,

    I quit using OpenDNS because of fake warnings like that – I suspect it is a little too easy for malicious (or in this case well-meaning) people to get sites blocked. I use the Google DNS servers instead (8.8.8.8 and 8.8.4.4) and find them satisfactory.

  82. #83 Narad
    January 23, 2014

    I see that he’s brought back the Cain/Getty buggy image without credit, as well. “World of Stock” was only ever a licensing broker (and the terms for this one specify “NO UNLICENSED USE”); I’ll notify the photographer.

    I just heard back from this fellow, who had been traveling. He says that he’s all but given up on pursuing infringers but is going to make an exception for Mr. Augie, as he doesn’t care for his profiting from a “fraudulent scheme.”

  83. #84 Angel
    January 23, 2014

    Doubtful News -Inquest opened into death of child removed from cancer treatment in 2009
    by Sharon Hill • January 12, 2014 • 1 Comment

    Shades of Sarah Hershberger with this story. Back in 2009, the parents of 10 year old Tamar Stitt removed her from hospital care in Western Australia, chosing instead to pursue natural remedies. She died two months later.

    Coronial inquest in death of Tamar Stitt, whose parents refused chemotherapy to treat her cancer.
    Anyone know anything about this case?

  84. #85 Narad
    January 26, 2014

    The image last mentioned is gone. The rights holder, however, proceeded by leaving a comment on the post itself. (The comment itself, of course, has also been sent down the memory hole.)

    It’s a start.

  85. […] of her tumor, I intentionally chose a rather inflammatory title in which I proclaimed that she was coming home to die. I didn’t do that lightly. Rather, I did it because I was thoroughly depressed because David […]

  86. #87 Geordie
    Uk
    February 8, 2014

    There seems to be lots of mixed information in this discussion so I thought I would actually give some stats. Currently with appropriate treatment we expect more than 90% to go into complete remission and around 70% disease free survival. Considering she had only two cycles of either a 4 or six cycle induction regime and no follow up this would suggest the likelihood of complete remission of around 24% and the chance of long term survival at around 10%. She could go back into treatment and still improve her chances but I suspect that might be difficult now. I hope she does well, but I expect that if she doesn’t her parents will end up in prison. I think people do have a right to their own opinion and those who believe in magic have the right to die for those beliefs. The problem is when they use their opinions to control or influence others. It isn’t just the fact that there is no evidence supporting most CAM’s treatments, the majority are underpinned by theories that are simply incredible. Your not just denying mainstream medicine your denying most of the principles of mainstream science.

  87. #88 John
    New York
    February 15, 2014

    This is all absurd. Of course the you’d think along these lines as I can see your demeanor expressed through writing, surgeon/scientist. Your biography is riddled with blind arrogance. The parents should have full control over the well-being of their child, especially since chemotherapy is known to cause cancer despite what you may drone. It’s not fair to have a one sided story with such biased claims. I encourage others to research and not only trust the word of one who asserts their recommendations with positional authority.

  88. #89 Renate
    February 15, 2014

    @ John
    Over the wellbeing of the child? What wellbeing will that be, is she is bound to die, while continuing with chemotherapy might have saved her life?

  89. #90 Orac
    February 15, 2014

    This is all absurd.

    Wanting a girl who is going to die because of her parents’ decision instead to live is absurd? Make no mistake, that’s what we’re talking about. Sarah’s parents are unwittingly killing her.

    Of course the you’d think along these lines as I can see your demeanor expressed through writing, surgeon/scientist. Your biography is riddled with blind arrogance.

    Even if that were true, it would not make my arguments wrong. If you want to refute them, you’ll need facts and reason, not rants. You have neither thus far.

    The parents should have full control over the well-being of their child, especially since chemotherapy is known to cause cancer despite what you may drone.

    Parental rights do not trump the right of a child to live:

    http://scienceblogs.com/insolence/2014/01/28/once-again-caring-more-about-parental-rights-than-the-rights-of-the-child-being-subjected-to-quackery/

    As for late cancers due to chemotherapy, yes, that’s a known complication, but given that without treatment the child will die long before she could ever develop a secondary cancer, it’s a tradeoff that is understood and usually worth making. It’s really stupid to argue in this case that if Sarah gets chemotherapy she might get another cancer because of it when if Sarah doesn’t get chemotherapy she will almost certainly die long before then.

    It’s not fair to have a one sided story with such biased claims. I encourage others to research and not only trust the word of one who asserts their recommendations with positional authority.

    It’s not fair that Sarah will die because her parents are subjecting her to quackery. Also, “personal authority” has nothing to do with it. I back my arguments up with data. You have not. Instead you’ve just whined about “unfairness” and “arrogance.” Try presenting some data or something resembling a coherent argument and you might get somewhere. Right now, all you merit is dismissal.

  90. […] Amish girl with leukemia refused further chemotherapy for her, an action that will almost certainly result in her death, unless she was lucky enough to be in the minority who achieve long term remission after induction […]

  91. #92 reader
    update on SH
    March 11, 2014

    A video update on Sarah H. Orac linked here today.
    http://reason.com/reasontv/2014/03/11/amish-family-defends-medical-decisions-f

  92. […] Maurice Thompson, had taken the case. When last I left the case, Sarah Hershberger apparently had come home to die. (I realize that that’s not what Thompson and the Hersbhergers were saying, and certainly […]

  93. #94 Angel
    March 12, 2014

    This video is going to cause huge repercussions in the Amish community and certainly isn’t going to help Sarah.This is totally against their Ordnung!

    • #95 Orac
      March 12, 2014

      Could you elaborate? The preface says that the video was shot in accordance with Amish beliefs. Although I’ve taken care of quite a few Amish people in my day (I did my residency in Cleveland), that was 18 years ago, and I don’t know enough about the fine detail of their beliefs with respect to technology.

  94. #96 Angel
    March 12, 2014

    @Orac,Check out Uncle Leroys facebook page.Apparently quite a few Amish showed up during the taping.They were there to voice their disapproval.It is against their Ordnung 2. What about photography and videography? The film shows Amish people, but also says they cannot be photographed.
    Amish churches forbid individuals to pose for face-on photos for two reasons. First, they cite the second of the Bible’s Ten Commandments: “Thou shalt not make… any graven image, or any likeness of any thing….” (Exodous 20:14). Second, in a communal society that values humility, posing for photos is a sign of pride that calls attention to oneself and rubs against Amish beliefs about the importance of deferring and yielding to others.

  95. #97 Angel
    March 12, 2014

    Although Isaac Keim is the Bishop & Sarah is his granddaughter I believe that there are certain rules in the Amish Ordnung that even he can’t bend.

  96. #98 Sun
    March 17, 2014

    Does she really need to go through the whole torture of chemotherapy. These poor kids go through hell and get cut up piece by piece then they finally die. Yet they are survivors!!! They may have maybe 5 years of misery and pain. Why can the parents decided how they want this poor kid end her days.

  97. #99 Shay
    March 17, 2014

    Chemotherapy =/= surgery, nosewipe. And the survival rate for children with Sarah’s kind of cancer is better than 80%.

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