An Ontario court dooms a First Nations girl with cancer: Who's to blame?

At the heart of this is an assertion of 'the child' as property, here property of 'the tribe' as opposed to the more familiar 'child as property of the parent'. In both cases though the needs, concerns and beliefs of the adults take precedence over the best interests of the child. It's significant that this is in direct contravention of Article 3 of the UN Convention on the Rights of the Child, to which Canada is a signatory. Clearly though abject obeisance to primitivism is a stronger guiding light in Canadian Law than a broad principle of protection that applies the most vulnerable citizens in any society.

Spot on Orac. Yet another case where the 'rights' of a parent to believe in nonsense are put ahead of the interests of a sick child. In this case we have to add in the attitude that past oppression can be redressed by legal exemptions.
For me laws should be applied universally. If it is a necessary law it should apply to everyone, if not it should be repealed.

Great post. As a pediatrician from this area and acquainted with some of the physicians involved, I've been following this case closely and am appalled by the outcome. This is devastating for everyone involved, including the (some, not all) members of the Six Nations community currently celebrating it.

To them, McMasters Children’s Hospital, in trying to save the life of one of their children, was seeking to “undermine” the “cultures and ways of life” of aboriginal people, and the key importance of this case was that it was a victory over the Canadian government that gave them the right to use their traditional medicine on their children.

Spot on. Resisting white men's culture */supporting traditional First Nation culture was unfortunately extended to healthcare choice.

Except for one thing: the traditional/alternative medicine they are opting for is also coming from outside First nation's culture. It may bear some likeliness, but at the end of the day, they still have surrendered to white men's culture.

* I use "white men" loosely. I meant all non-First Nations cultures, so in majority from Europe. But Hindu/Chinese traditional medicine is as foreign to First Nations as mainstream medicine.

I can not relate, seeing how I am white and live on another continent. Still, the logic here is... Well, there is none.

If the girls were undergoing traditional Haudenosaunee and Anishinabe treatment I could at least see where the push against interventions comes from. It would be misguided or perhaps cynical use of individual's tragedy to protect the percieved interest of aboriginal culture. Agreeable, not, understandable, yes.

But all I am getting out of this case, mind you - as a total outsider, is a giant dose of hypocrisy. My juvenile imagination is creating an image of stereotypical injun, headdress and all, saying "We will not listen to the lies of the white man because we have the help and wisdom of the white man." Yes, it is insensitive, but sadly fitting due to involvment of Clement.

Will the parents look on Clements as a fighter for them who lost or as the charlatan that he is?

Not taking bets, just wondering.

I can only presume that the Six Nations of the Grand River and the Mississaugas of New Credit believe she is using primarily traditional medicine. The treatment by the Hippocrates Center is a separate thing altogether, unrelated to the traditional medical treatment.

The UN convention is pretty explicit about the rights of the child being of primary concern: http://www.ohchr.org/en/professionalinterest/pages/crc.aspx

I wonder if that provides a legal grounds for challenge?

Excellent, Orac!

I agree with Smith @5. The First Nations leaders involved have chosen as their hill to die on--more precisely, the hill they will allow these girls to die on--their right to choose a white man's quackery over Western medicine. If the options were traditional tribal medicine versus Western medicine, the First Nations position would at least be self-consistent, even if I didn't agree with the result. The position they have actually taken doesn't even have that redeeming quality. Clement must be happy with this decision, and presumably people who work for him would be, too. I can't see a reason for anybody else to be happy with this.

The problem has come about with this absurd need to avoid anything resembling 'racism' or 'cultural imperialism' (on the liberal side) and 'religious interference' (on the conservative side) we have a whole muddle headed concept that no matter how freakin stupid a culture's ideas may be, they must be respected (as in taken seriously).

Politicians know that if they jump in one of these issues, they're likely to be vilified.

Well said, Orac.

I have some perspective on the First Nations cultures from first hand experience and, ultimately, I'm a little disappointed in their Chief. He could have played this to both support their political cause -and- save a young girl's life.

"Thank you for recognizing our rights to govern ourselves as a First Nations people. Now, you two. Get your ass to the hospital so your daughter can get the treatment she needs. Not because -they- said so, but because -I- said so."

Steven Novella #11 "I wonder if that provides a legal grounds for challenge?"

Probably needs a Canadian Lawyer to answer that but sadly ratification of the UN Charter does not ensure its inclusion in the Law of the signatory countries - rather an additional step of formal adoption into national Law is required. There's much hypocrisy with countries signing these Conventions on the basis that it applies to other(by implication less civilised) peoples, but is not needed by the fine upstanding 'developed world' etc. Canada does have a Charter of Rights which it could be argued implies all the provisions of the UNCRC apply to Cabada, but I suspect it would require someone with the right to represent the child to actually pursue it. Obviously the parents and the tribe will argue they are the childs commanding representatives.

I suspect it would require someone with the right to represent the child to actually pursue it

McMaster University Hospital might be able to (IANAL, nor am I Canadian), but I doubt they will, for the same reason that came up in the Sarah Hershberger case in Ohio: it's a lose-lose situation for them. If the appeal were successful, they would be vilified as monsters for taking the children away from the tribe. Otherwise, they will have spent a considerable sum of money on lawyers (including lawyers for the tribes, since IIRC Canada is a "loser pays" country) that won't be available for treating patients. And that assumes that they would be given leave to appeal the decision, which I believe is not automatic in Canada.

I also suspect that many of Canada's First Nations have not ratified the UN Charter (although they have some degree of autonomy, they are not sovereign states, so I am not sure they were ever expected to do so), so even if the Canadian Parliament has adopted the necessary laws, I am not sure if they would apply to First Nations groups who have not ratified the charter.

As far as my admittedly limited knowledge of Canadian aboriginal traditional medicine goes, I believe that the largest part is shamanistic. There are certainly traditional herbal remedies used, but there isn't a vast array of them, especially when a particular tribe is considered. There has been some spread of certain things in relatively recent times, but in some cases it breaks with local traditions. (Case on point - my brother used to teach on reserves in northern Alberta and Saskatchewan. He told of one of the elder women remarking something to the effect of "why are they stinking up the place with that stuff" when she smelled sweetgrass being burned. Sweetgrass burning is an important thing for some tribes, but it was no part of the old traditions of that tribe.)
I strongly suspect the McMaster hospital would collectively bend over backwards to accommodate traditional ceremonies and even traditional medicines for the girl while she was in hospital receiving chemo. But no, so horrible foreign quack had to shove his nose in.

I don't post on Facebook, but I went to look at the page for “Six Nations Elected Council.” Below is their comment policy. The ruling was posted on 11/14, so in theory, comments would be allowed on the FB page. There are only 7 there now. The “about” section lists mail,phone, and address and I think it would be very appropriate to contact the Council.
“The following content will not be permitted on Six Nations Elected Council’s page:
•Comments/posts not related to a posted article/topic/information;
•Business solicitation;
•Profane or inappropriate language;
•Content considered to be defamatory, disrespectful or insulting to anyone including Council staff or representatives
•Content that promotes, fosters, or perpetuates discrimination on the basis of race, creed, color, age, religion, gender, marital status, status with regard to public assistance, national origin, physical or mental disability or sexual orientation;
•Sexual content or links to sexual content;
•Conduct or encouragement of illegal activity;
•Any other content deemed inappropriate by the Administrators”

The policy states no business solicitation but I see a post about "bio-mat" quackery, so they aren't enforcing that policy.

I just took a peek at the quack's website and truly, with the exception of three guys of indefinite origin ( Hispanic/ sub-continental Indian ?), it sure looks like a pack of whiteys**.. oops, I mean Caucasian people, to me.

** and yes, I can say that: I'm probably whiter than almost anyone, maybe even Orac.

Another very long post. (sigh) But only the first part addresses the topic. The rest is personal background. If you're inclined to read the stuff about the First Nations case, no need to read below the break unless you really want to...

Yesterday in the SBM thread, anyone who supported First Nations autonomy in any way got accused of excusing/enabling the deaths of these girls. But nobody was doing that. Nobody was saying a parent should have the right to substitute woo for chemo for a kid with leukemia, 'traditional Native' or 'Florida Man wacko'. There were also heavy doses of racism in the comments, not that i imagine the authors are active haters, just making some thoughtless jabs at the First Nations folks in expressing concern for the girls.

Orac states his position pretty clearly above, and has incorporated some proper reflections on yesterdays exchange. He admits he's placing priority on one moral element of the case, rejecting others, and doesn't care if he's criticized for it. That's honest and fair. A lot of the posts in the SBM thread yesterday were simply dismissing the other angles as if hey didn't exist, or were petty, and thus that even mentioning them was endorsing woo and infanticide.

First, let me say I am appalled by what the Sault family has done to Makayla, and if she dies, I would support the Canadian prosecutors in filing criminal charges against her parents, and against Brian Clement. In the hope that it's not too late for the other girl, I urged a social media campaign directed at the First Nations leaders to persuade them the best course to maintain the larger legal principle of autonomy they have just won is to get the girl into chemo so she survives.

But I still have a couple of small bones to pick with Orac. Not attacks or denunciations. Factual issues mainly.

It is argued that the Canadian government today shouldn’t make sure that this First Nations girl receives effective therapy

Well, yes and no. The problem is that "Canadian" is a bit of a red herring. I can only speak with certainty for myself, of course, but I would not at all contest the general proposition "government should make sure First Nations children receive effective therapy." Just speculating, of course, I'd guess there'd be no disagreement with that among other commenters in the SBM thread. The question is 'which government?' The fact is First Nations people, by law are only quasi-Canadian. The Nations (each individually) have a limited autonomy which makes them 'Canadian citizens' in some senses, but not in others. So the legal argument is "the Canadian government does not have the authority to make sure this First Nations girl receives effective therapy." Which is pretty cut-and-dried, and IMHO ought to be mentioned as part of the discussion.

Which still leaves the moral argument "the Canadian government should make sure this First Nations girl receives effective therapy anyway." Which I take to be Orac's position above. That's not cut-and-dried, either way. First, the history of abuse and oppression of the First Nations, including the residential schools program, cannot simply be dismissed. Second, in light of that, a court decision to force the Child Welfare agency to take the girl into custody would be an alarming precedent that would have consequences far beyond the case of one girl with leukemia, and would be a net moral minus, all things considered.

The decision was not cowardly. It was a correct application of the law. And as is always the case in the justice systems of democracy, the higher principles of the law take precedence over the specific case. We do not convict felons if their Miranda rights have been violated. In individual cases, justice is not served as a result. However, the alternative, giving free reign to police to coerce confessions from innocent suspectscoerce confessions from innocent suspects, is far worse.

Going back to the "what government?" question, I don't think anyone in the SBM thread was arguing "the Canadian government should defer to the mother even though the mother’s choice will, unless reversed, lead to the death of her child." I certainly would find such an argument reprehensible.
Unfortunately, the language in Judge Edward's decision does seem to affirm 'parents' rights' in life-or-death decisions, and that's very bad.

The argument then, is that The Six Nations and New Credit bands must — by law, and by moral and ethical standards viewed in the long term — be included in the government apparatus that makes decisions on child welfare interventions on behalf of children from those nations.

Thus, culpability for the deaths that may result from these cases would rest to some extent on the 'governments' of the Aboriginal nations. This is somewhat problematic though, as they don't necessarily have the resources or authority to set up their own child welfare agencies, though that is their stated goal.

Finally, on murkier ground to be sure, there ought to be a distinction between community 'sacrifice' in liberation struggles, and 'sacrifice' to spiritual dogma. This should be moot in this case because the people at risk of death are minor children. It seems Makayla Sault is adamant about leaving her fate in the Hands of God, and not returning to chemo, and if the Lord takes her, that's all part of The Divine Plan so it's OK. I no just world I can imagine do 11-year olds get to make that call. However the discussion fanned out, as one might expect, to any sacrifice to dogma, including adults.

But there is something more than dogma here. Again, we need to look at the political situations of Native peoples with a clear eye. Who among us would condemn James Chaney, Andrew Goodman, and Mickey Schwerner for choosing not to stay safely at home, but to work for civil rights well-knowing they might be assassinated by the KKK (which, of course, they were)? If we want to value the lives of Native children, I submit we must look at those lives in toto, not merely in regard to a specific medical decision. As I noted on SBM yesterday, the suicide rate among young Native Americans in the U. S. is more than three times the national average, and up to 10 times on some reservations.

Broad statistics lie, of course, so let me try to unpack that a bit. Tribal cultures in North America are quite diverse. Some tribes, the Navajo for example, have adapted well to living in communities surrounded by and interacting with white society. Other tribes have adapted not at all. When forced not to 'be Indians' their souls wither and they die. The suicides are just the tip of an iceberg of self-destruction. The 3X average is misleading, as some tribes would show no difference of even lower-than-average rates. Where I grew up (Minnesota) the Native population of plains Indians (mostly 'Sioux') were definitely in the 10X category.

I have no idea where the Six Nations and New Credit people fall on the adjustment-to-coexistence scale. If they've generally been adaptable, that matters in taking the Bigger Picture view of the case.

So, leaving those Nations out of it, I must note that the Native people who die when their cultures are forcibly denied them do not do so because they cling hard and firm to some superstition, dogma, ritual, etc. Throughout their history, they have actually been much more adaptable than most whites know. They reacted to white colonization by trying to go along to get along, and reconstructed their lives to adopt many of the white mans ways. But they had their limits, as you might expect, and however much they blended their culture with ours, it was never enough.
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The following may have no relevance whatsoever to the case of the First Nations leukemia patients in specific, or the argument for First Nations rights in Canada in general. I offer it here because I feel an obligation to my forebears to explain 'where I was coming from' in comments I made yesterday, in part to admit that they may well have been off the mark in terms of the present discussion, for which I apologize.

(N.B. 'Sioux' is an umbrella term devised by whites to refer to three groups of plains tribes with similar physical features, and related languages and cultures. From East to West, these people referred to themselves as 'Dakota', 'Nakota', and 'Lakota'. The differences were important to them, as were the differences between the different tribes in each group, but not to the European settlers. The three groups and their component tribes only began to form a united front against colonization in the mid 1860s, after the events described below.)

Yesterday, at SBM, I quoted the speech made by Taoyateduta (aka Little Crow) to the Dakota war council on the eve of the Dakota uprising of 1862. Taoyateduta was chief of the Mdewakanton tribe, but also the de facto leader of the Dakota in general, having gained more respect than the chiefs of the other tribes. Two young Mdewakanton braves had murdered a white family in an honor challenge, an act considered a grievous crime but in some way understandable within Dakota culture, but the worst sort of evil to whites. The Dakota knew retribution would be swift and severe, and militant chiefs had called for a 'first-strike' response that would drive the whites from the Dakota lands they had usurped through 'The Trail of Broken Treaties.'

Taoyateduta, who has been East to visit President Buchanon in Washington, knew war was folly. He called for peace. He could not convince the other chiefs. There was going to be a war whether he liked it or not. To sum up the speech, he spoke eloquently about the impossibility of defeating the whites, and the madness of making such an attempt. And then he said he would die with his people. If he could not live as a Mdewakanton, what was the point?

The thing is, being a Mdewakanton was a lot more flexible for Taoyateduta than Liberty was for Patrick Henry. He made every attempt to synthesize Native and European cultures, generally favoring the latter. He lived in a wood frame house, wore European style clothes, joined an Episcopal church, and attempted to take up farming, as the U.S. government had dictated the Indians must.

Now, the Dakota were no more suited to farming than the German farmers settling in Minnesota were suited to hunting Buffalo, but they gave it a go anyway. They didn't have a change, though. The Feds had crammed them in to a too-small strip of land running along the Minnesota River Northwest of New Ulm, MN. As part of the treaty establishing this territory, the Feds had agreed to provide supplemental food, blankets and other supplies knowing the Dakota wouldn't be self-sustaining in the near future.

However, the government placed distribution of food and supplies in the hands of corrupt traders, who refused to pass them on to the Dakota and tried to sell them on the black market instead. (Yes, free enterprise is always the answer...) The trading posts were protected by Federal troops. With his people starving, Taoyateduta met with the BIA agent and a representative of the private traders to demand the food and supplies the Dakota had been promised. Trader's rep Andrew Myrick replied, "So far as I am concerned, if they are hungry let them eat grass or their own dung." The BIA agent stood by the traders. It was this that led the other chiefs to advocate for war in the wake of the settlers' murders.

Andrew Myrick was one of the first casualties of the uprising. The Dakota stuffed grass in his mouth and left his body on display outside the warehouse where he had hoarded their food while their wives and children starved. The BIA agent who did more than anyone to precipitate the uprising by backing Myrick with Federal authority fled into obscurity, or at least absence from further historical records.

The war failed, as Taoyateduta knew it would. He attempted to lead attacks on military targets, but was repulsed by superior firepower. Angered warriors refused to accept his commands, split off and committed atrocities among the civilian population of New Ulm. The Dakota surrendered after five weeks of hostilities. 303 Dakota men were sentenced to death for atrocities by a military tribunal, with no legal representation and no understanding of the proceeding. The vast majority of them were innocent of the charges, having being loyalists who stayed with Taoyateduta fighting the military. Some had not participated in the fighting at all, and had risked their lives protecting white settlers from violence. Most of the renegades who had committed the atrocities had fled before the surrender, and escaped capture.

Resisting pressure from Minnesota Governor Alexander Ramsey, who demanded the execution of all 303, Abraham Lincoln commuted the sentences of all but 38 — ostensibly restricting the executions to the truly guilty. However, the authorities hadn't exactly been keeping track of who was who, and a number of innocent men were sent to the gallows in place of guilty warriors who had similar names. Among these was Chaska, who had made the most heroic efforts on behalf of the white settlers, and saved the most lives.

On December 26, 1862 the 38 were executed in a public hanging in Mankato MN.* It remains the largest mass execution in American history.

The remaining Dakota were deported to a reservation in Northeast Nebraska, again instructed to take up farming, but this time on sandy soil that yielded little and no real farmer would claim. Predictably, death continued to follow death. The NE land was dubbed The Santee Indian Reservation, 'Santee" being the white name for the Mdewakanton. My paternal grandmother's maiden name was Medora Santee. She never disclosed details of her youth to my father, and only many years after her death did I learn she had been born in Niobrara, NE, the town at the edge of the Santee reservation. Based on this, and a few other scant details from my Dad's memory, we began to suspect she had been of mixed blood. Had this been true, she certainly would have hidden it as she married a German immigrant, and midwestern German-Americans could never forgive the Dakota for the New Ulm atrocities.

In the years that followed, I sometimes considered I might eventually be the last living descendant of one of the falsely convicted men who had their sentences commuted by Lincoln and got shipped off to Nebraska in chains. I never expected my ancestor to visit me in dreams, but I felt some kind of small historical debt.

I thought back to my undergrad days when I would sometimes commute to the U of M by bicycle, passing through the Native American neighborhood on Franklin Ave. Open and friendly during the day, it was filled with bars and became the most dangerous part of town at night. When I went with my friends to the punk clubs off Hennepin Ave. downtown, we'd run into older Native American men hanging out on streetcorners. They were friendly enough, too, but after a minute of conversation deep profound damage would bubble to the surface. I would feel like I was talking to one of the walking dead. At the time, I never imagined we might be tied by blood and forgotten history.

14 years later, the spotty revelations about my grandmother presented the possibility I might be descended in some sense from both sides of this awful war (though my German grandfather hadn't arrived in America until the 1900s). I took an interest in the history of the uprising, and in Native Rights in general. At one point I applied for a teaching post where part of my duites would have been helping kids from the Rez in North Dakota get into college. I sure as hell didn't want to live in Grand Forks, and that would been my reason for accepting it. I didn't get the offer anyway.

Maybe 6 or 7 years ago, after my father's death, I finally took to the Internet geneology resources to see if I could verify my grandmother's heritage. I discovered she actually had no native heritage at all (again, this was just our suspicion, she'd never made any claim of the sort, only referring to herself as "descended from French Huguenots").

It turned out she was actually mostly German herself, her father having been born in Pennsylvania Dutch country with the German surname Sante. When and how exactly it got changed to Santee I do not know, but my guess it was no accident he wound up in Niobrara, where he apparently became something of a big wheel before mysteriously committing suicide. For all I know he may have been using the coincidence of the naming to exploit the Mdewakanton for financial gain. We do know he learned to speak Dakota fluently. His wife was a Christian missionary who apparently worked on the Santee Rez. Maybe they were good people. I don't know. I thought briefly about going to NE to see what might be in the county historical society archives. But it would be a difficult and expensive trip from where I've lived, and in the end, I guess I don't want to know.

Anyway, none of this generalizes to all Native groups, and again the Six Nations and New Credit bands may have very different histories and situations. And, no, even if those bands have similar histories, that would not justify the parents withdrawing their children from chemo, or the Chiefs for supporting that decision, or the Brandt CAWS agency for washing its hands and refusing to act. It might explain those things to some small extent. Or not.

Some folks who comment here seem unable to distinguish explanation from justification. I can't fathom that. If you've read this far, I just want you to know I can't tell this story without crying: for Taoyateduta, for the victims in New Ulm, for Chaska, for the wounded men on Hennepin Ave., for the men drinking themselves to death in the Franklin Ave. bars, for the kids on the Red Lake rez even today who see no future worth living for, for America, for Makayla Sault, and for my inability to make any of this change.

I have read every history of the 1862 uprising still in print and available on Amazon. I know all the details, good and bad — mostly bad. Taoyateduta remains one of my 'heroes'.

I wish no great harm to Daniel Synder, but I'd sure like to see someone stuff grass in his big mouth (alive, of course).

If I believed in spirits, I would pray for the spirit of Taoyateduta to rise in Florida and have a little pow-wow with Brian Clement. After which Clement would be displayed in front of the Hippocrates Health Institute, his mouth stuffed with wheatgrass enemas.

Free Leonard Peltier.

Finally found the judgment, which I did not see noted on either site, and which makes for additional sad but relatively straight forward reading: http://www.theglobeandmail.com/life/health-and-fitness/health/article21…

A revolting webpage of faith-healing Christian's tryng to use the First Nations decision to justify returning an Arizona boy who was taken into custody by CPS for leukemia treatment to his Fundie Mom.

Whereas the alternative treatments, including prayer, were part of the Christian family’s faith and tradition, their heritage was not met with the same tolerance that Makayla’s family found. It is her very faith that the CPS-appointed psychiatrist called “delusional.” Though prayer and healing is an ancient part of Christian doctrine, Christopher’s removal from the mother he has grown up with was based on the accusation that Tonya “continues to cling steadfastly to her bizarre religious beliefs.” She is charged with neglect because she chose to seek alternatives, including prayer and healing, before agreeing to a procedure that her research said was risky and very painful.

Note the blatant lie that the First Nations case involved Makayla. Note also, damnit, that the First Nations decision has nothing to do with "tolerance toward family heritage." It was decided on grounds of constitutional sovereignty.
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A voice of reason, this Canadian author of First Nations descent castigates the New Credits and Six Nations chiefs for siding with 'Alternative' quackery and faith-healing, and stands up for SBM, without tossing Aboriginal rights into the garbage. (Yes, it's on HuffPo Canada, but I think the author's independent and they pulled the story from somewhere else...)

From my point of view it would be gratifying to see the cause of indigenous rights asserted on something actually indigenous, rather than upon the creative practices of a Florida massage therapist or the proposal that Jesus cures. In some hospitals, an intergrationst approach has been taken, in which elders and cultural potocols have been brought into the institution. Belief in a culture doesn't have to manifest itself in absolutist choices between supposed cultural purity and betrayal... The expressed long-term goal of many native communities is a community-developed and community-run child welfare agency that has local support and legitimacy. In my ideal world, this agency would already be in place, and it would be looking unromantically on the dubious claims of this aboriginal rights crusade.

E.g., the right thing to do, as doug has already noted #15, is let the shamans do their incantations and smoke-burning while the kid gets chemo.
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Finally, please, please watch this clip, the last 5 minutes of Arthur Penn's Little Big Man with Chief Dan George as Old Lodge Skins:
http://youtu.be/QwgnDn8ez9g?t=59s
I don't believe in magic, but if ever have to undergo chemo, I'd want that man in my room.

Ross Miles #20
Thank you so much for that link. It's very disturbing, actually.

The first revelation is that a lot of the discussion in the RI and SBM threads has been off-point due to important gaps in the news stories linked.

Nothing Judge Edward could have done could have saved the child (identified as 'J.J.') Her family had already fled with her to Florida, and even if Edward had ordered Brandt CAWS to take her into custody, they would not have been able to extract her from Florida. This, no doubt influenced his decision to base the decision on the Constitutional rights issue.

The second revelation is that the nature of Brian Clement's quackery seems to have considered not at all, and the result was a decision that appears to this IANACL as utterly wrongly decided, sets a horrible precedent, which ought to be overturned on appeal.

The case law cited in the decision establishes the criteria for a practice to be considered an Aboriginal right:
1: It must be an integral defining feature of the culture in question, such that without this practice, the culture would be "fundamentally altered or other than what it is."
2. The practice must have been integral to the culture pre-contact between Aboriginals and Europeans. The language is a bit vague at different points, allowing for some wiggle-room for evolution or adaptation of practices over time.
3. The burden of proof for both the defining character and the continuity with pre-contact practices falls on the claimant of the rights.

So, you're asking how Brain Clement's quackery meets these criteria, and so am I.

Well, first of all, McMaster Hospital and it's attorneys completely bungled the case. They apparently failed to anticipate the Aboriginal Rights issue and review the case law. They presented the case for forced custody as 'this child will die without chemo, the end' as if she was a 'regular' Canadian citizen. As such, they did not investigate Clement's treatments and distinguish them from from the traditional plant-based medicine of the band. The hospitals application read J.J.'s mother "decided on August 27th to discontinue the [chemotherapy] with the plan to treat [J. J.] with traditional medicines." (my emphasis)

WTF. Ah, but burden of proof remained with CAWS, the bands, and the family. They called, as expert witness, an Anthro Prof. from McMaster named Dawn Martin-Hill to testify about 'traditional longhouse medicine'. I don't have the transcript, but it appears that Martin-Hill spoke only to the long history of plant-based medicines among the bands, dating long before European contact. If any question about how Clement's treatment had continuity with the traditional practices (which I'm guessing they weren't, but just a guess), there's no indication whether she gave an 'expert opinion' on the continuity, or whether Judge Edward made a leap...

The telling thing though is that the hospital did not call an expert witness in rebuttal. As we now know, SBM-literate experts of 'longhouse' descent were available. (Mohawks are included in the Six Nations). They could have looked at Clement's website for a couple minutes, and testify 'no that's not traditional longhouse medicine'. But apparently the hospital did not think to seek them out. (SMH)

So now, because Clement's treatments were not scrutinized, Canada would seem to have a precedent that "traditional medicine" is whatever any single First Nations mother says it is. If a massage and cosmetology parlor has any kind of plant on the premises, hey!, that's continuity with a defining cultural tradition!

IMHO, in the wake of the decision, McMaster Hosital has made another grievous mistake by choosing not to appeal the ruling. Again IANACL, but you'd think they'd have grounds on the 'alternative is not traditional' line articulated by Wayne Spear. But it seems they have prioritized an attempt to save J.J. over the consequences this could have for many, many First Nations children in the future. An appeal would likely keep J.J. and family in Florida, and by the time the higher courts would hear it, J.J. would probably b beyond help. But it's not clear tome whether anyone but the hospital has standing to challenge Judge Edward's decision.

If the ruling stands this is very, very bad. On reading the stories in the Canadian press, I had taken the alterna-woo question as not central to the case, and the Constitutional Rights issues. And in a one way that's true, as it seems it just wasn't brought up in the hearing. But by exclusion, it seems it has actually become central to the results of the proceedings.

Brandt CAWS: Butt covering cowards
Parents: Delusional woo-bait
Chiefs: Unethical sick-child-exploiters
Clement: Monster
Hospital: Clueless
Judge: Hands tied by everyone else's mistakes
Lawyers: Lawyers

So yeah, it looks like Makayla Sault has been sacrificed to Jesus, J.J.'s future is dark... and it's just going to get worse.

What is there left to say/

Orac, I think you should care about the back stories that influence parental decision making. It does matter. And if you take it into consideration, you can make it work for you to benefit the patient, rather than against you.

We aren't going to make any headway against quacks as long as they appear to be the patient's "friend" and we appear to be the enemy. They whisper to the patient, "we're listening to you, we understand you, you can trust us."

When all we have to offer is cold facts, is it any wonder the parents run rather than walk to these despicable people?

Advocacy needs to focus on the quacks, on the actual harm they cause.

Thank you Ross Miles, for providing the link to the Court's deliberations and decisions.

I've provided care for children who were diagnosed with various types of cancer and who are undergoing treatment for those cancers. I can unequivocally state that every child and their families, were provided with extraordinary support services, during their hospitalizations and when they returned home. I have no doubts that the same type and intensity of social services were provided to the two young girls who are the subjects of Orac's blogs.

The hospital and its staff, I presume, are acutely aware of the aborigine groups of people they serve in their community and I am certain that they have effectively provided compassionate care to other members of that group.

I'm dumbfounded by the sheer ignorance of the parents of these two youngsters...which is definitely not due to a lack of education or their intellectual abilities.

The hospital, rightfully so, acted on behalf of their young patient, by notifying the local social services unit, about a case of medical neglect. When that local social services unit refused to intervene on behalf of J.J., then and only then, did the hospital institute a court case, to compel the social services unit to do their job.

The judge, IMO, never fully explored, J.J.'s parents' belief system and never explored the folk medicine which the parents proposed to use to treat her cancer; Brian Clement does not practice "folk medicine".

Yeah....I'm "going there". The parents are medically neglecting their child because they cannot, or will not, deal with the realities of their child's cancer diagnosis. They'd rather stay in denial and deny their child the only chance she has for long term survival.

There seems to be a lot of opprobrium on the parents here. I'm not sure I necessarily disagree, but perhaps the question is much fuzzier especially for none medical people.
I don't necessarily believe for instance that the parents have the same assessment of the probabilites that we do, and cannot therefor be easily accused of medical neglect. They see and hear two sides, from their point of view two doctors, two types of treatment and so forth - how
exactly are they supposed to differentiate?
After all to non-medical people the quacks look like doctors,talk like doctors, have surgeries like doctors,
offer cures like doctors (and charge money like doctors...).

How are the parents supposed to know that even though this guy is allowed to operate and present himself as a bona fide doctor and charge people money for his services really they should know that he isn't one?

Its no use saying but the 'real' doctors said 'X', since as far as they are concerned he is a real doctor and therefore has an equally valid opinion.
And of course real doctors do vary anyway in their beliefs about best treatments and sometimes what works and is efficious and what isn't, and can be motivated
by other reasons (such as economics) (see Ashya King case for instance).

You have to bear in mind also that the plausibility and confidence that conmen use is a key part of their technique, primarily because psychologically it is
exactly what these vunerable people are desparate to hear.

To my mind there are only two culpable parties here - the quack and the system that allows the quack.

Whereas the alternative treatments, including prayer, were part of the Christian family’s faith and tradition, their heritage was not met with the same tolerance that Makayla’s family found.

Which to my mind argues Makayla's family's heritage should have been met with less tolerance, not that the Christian family’s faith and tradition should have been viewed with more tolerance.

@sadmar
First off, it is Brant, not Brandt, and what the he!! is CAWS?

The hospital did what it should have and what is reasonable from its position - ask the court to compel an agency with existing authority to apprehend a child to do so. If the hospital had perused an appeal or gone in with the intent of "making law" it probably would have been and should have stomped on by the provincial and/or federal governments. It is a publicly funded hospital. The job of challenging the judge's ruling should fall on the government(s), not the hospital.

doug
CAWS is either the sound crows make, a misspelling of the word for female bovines, or what comes at the fingers of someone meaning to type FACS (Family and Child Services) when some neurons misfire.*

Had you perused my post and the actual decision more carefully, you'd see how the hospital failed in its pursuit of a protection order.** The petition takes the form of 'J.J. must be taken into custody because X', with X needing to be valid under the applicable law. In preparing their petition, the hospital failed to consider how the fact J.J. is a First Nations child would affect the judgement under law. Worse, they clearly failed in their intellectual responsibility as scientists by conceding that Clement's treatments constituted "traditional medicine."

At the point J.J.'s family fled the jurisdiction, the petition became an attempt not to 'make law' but to clarify existing law. That is, it was about the principle, not the kid, as the kid wasn't anywhere Brant FACS could do anything about it.

As for an appeal, IANACL so I don't know who else might have standing to make one, but the hospital surely does as they were the party that brought the action, and lost the decision. And, uh, the judge IS the government, and I don't get the point about public funding of the hospital. If public funding makes them part of the government, then one arm of government would be challenging another arm of government. But i have no idea what kind of judicial system would let only the government challenge the government.

* There are so many different acronyms for child welfare agencies from state to state, maybe even county to county, I can't remember which is which, or exactly what they all are. I don't think any of them are CAWS, and my brain somehow inserted the 'A" from FACS into CWS — Child Welfare Service.
** That would be my tit for your tat. Or, as we're talkin' Canada here, if you're doug, i'm bob, and I just returned a "Hoser!" to my brother, eh?

lilady:
No problem 'going there' in this case. The parents were given a thorough explanation of the medical issues by the hospital so they were well aware withdrawing J.J. from chemo could lead to her premature death. The only leeway they get is taking away 'could' rather than 'would,' as they have no legal obligation to accept McMaster's opinion. However, in that case, with a credible possibility suggested, the due diligence of being a child guardian demands that investigate further, and give proper interrogation to the credentials of any 'professional' in whom they entrust the care of their child. They could have easily gone to the Web to find other sources on survival rates and treatments for J.J.'s form of leukemia (the diagnoses not have been in dispute). And if they bothered to Google "Brian Clement" they would have discovered Orac's earlier post (and probably a variety of other exposes). IANAL, but if I was the prosecutor in that district, I would be looking to charge them with neglect now, and negligent homicide if J.J. dies. Child sacrifice is not an Aboriginal Right. Again, the practical effect of this may be moot as I can't imagine Rick Scott would sign off on arresting and extraditing the parents. But filing charges would 'send a message' that Ontario's not going to stand for this sh!t.

JCL
IMHO your point about a lay persons gullibility in any field is valid in a very broad sense, but not in every specific instance. If we were talking about an individual choosing a chronic disease treatment for themselves, that would be one thing. But we're talking about people who have a legal and moral responsibility for another human being making a decision they KNOW could have fatal consequences for that other person. You don't need any background in medical science to get that turning care of a kid with leukemia over to a guy on the basis on his assertion of his own competence is flagrantly irresponsible. "How are the parents supposed to know that even though this guy is allowed to present himself as a bona fide doctor that he isn’t one?" The Internet maybe?

JGC
Makayla Sault was not involved in the court case. When she withdrew from chemo at McMaster, the hospital filed a report with Brant FACS, as the doctors felt a legal obligation to notify authorities of possible endangerment of a child. Brant FACS opened an investigation, as they are legally required to do upon receiving such a report, and all but immediately closed it. "We are satisfied that Makayla is not a child in need of protection and we are closing our case and file on the family," The hospital did not pursue the case. There is no evidence that the Sault's Christian beliefs played any role in either decision. A more likely hypothesis is that Ken Sault is prominent enough in the New Credit community that the authorities feared the consequences of intervening.

@sadmar

How do you KNOW what they KNOW? Indeed sadmar, as Im sure you KNOW, whether anyone can actually ever be said to KNOW anything is *the* epistemological question. When you add people with some sort of 'faith' - whereby they allow themselves to 'know' things (I'll stop the caps now..sure you get the point) without (indeed almost because) of the lack of rational scientific evidence, then who knows what they can be said to know or why?
However, we don't need to get too philisophical. You believe that the parents are knowingly doing something that is probably not the best for their child. I believe that the parents may well be doing what they think is best for their child because they have reached the wrong conclusions. I believe this has been substantially aided by conmen doing what conmen always do - being the plausible, confident optimitstic people insinuating themselves into vulnerable peoples lives - and I suspect that once the politics of the tribes got involved and committed to the cause it became extremely difficult for the parents to ever change their minds.

I feel sorry for these people because they have an ill child, and even more sorry because they have made a bad choice for the wrong reasons, fallen in with conmen, and been trapped by a steamrolling political cause - and they will have to live with it.

btw I can't belive that you are suggesting that they know this guy is a crook thrugh the internet! When I google him I get the first 5 results are his stuff, then some smiley pics of him (my god I trust him already - he looks soooo, trusty!) - then no 6 is RI, then the rest seems pretty upbeat about him.

I agree with Orac, when you are dealing with matters of children and medical neglect the rights of the child to life should be the only consideration. The fact that you love your child is unquestionable. The fact you want what is best for your child is unquestionable. But, what is best? Should the evangelical Christian get to reject medicine for prayer? Should the Native American get to reject medicine for a native ceremony? In both counts that answer is no. It has nothing to do with culture, only fact. If you want to add prayer, or wave incense and turkey feathers around while your kiddo gets chemo be my guest. Pray to whatever deity your like, set up an altar, hell sacrifice a chicken it matters not to me. What this is the triumph of parents wants and needs over the wants and needs of the child. And in the case of the tribal leadership the coldblooded sacrifice of a couple of children on the altar of autonomy. CPS services for the most part have been really hesitant to intervene in a lot of these cases, the kids aren't being abused per se, they are well fed, clean, clothed, etc. But it is abuse to deny them medical care that will save their lives just because you happen to 'believe' they don't need it. Parental beliefs shouldn't be allowed to overrule scientific fact. I have thought for a long time that many courts and state agencies were way too reluctant to crack down on these parents because it always plays badly for them on the internet (Sarah Hershberger) but in the end it is the life and health of the child that matters. Those going on about understanding, great, I do understand the background. But when you have made an effort to educate the family, to include their cultural preferences, when they still take their child out of treatment it is neglect and the child should be removed for treatment. Pure and simple.

A more likely hypothesis is that Ken Sault is prominent enough in the New Credit community that the authorities feared the consequences of intervening.

I'd have feared the consequences of not interfering--i.e., the avoidable deatrh of a minor child whose rights we were tasked with protecting--far more. But hey--I'm funny that way: I don't believe people have the right to sacrifice the well-being of their children on the altar of their faith.

But, what is best? Should the evangelical Christian get to reject medicine for prayer? Should the Native American get to reject medicine for a native ceremony?

An adult, of course, can choose to make poor decisions, even those that will in all likelihood lead to suffering and their premature and avoidable demise When one's instead talking about adults who are the guardians of a minor child, a medical procedure that offers that child a 90% chance of survival, and prayers/traditional services that instead offers them as close to a 100% chance of death as attainable, the answer is "No" and "No"..

JGC - just to be clear the quote you took from my post above deals with parents deciding care for minor children. If you are an adult, though I will disagree with your decision quite strongly, you are free to shove wheatgrass enemas where the sun don't shine all day long and I won't stop you. But I vehemently reject woo for children who don't have the capacity to make that decision for themselves.

@Kiiri

'Should the Native American get to reject medicine for a native ceremony?' Do you just mean life and death or does athletes foot count? Less factiously, what about clinical depression - ie where the ceremony might have some effect, but due to no research we have no evidence - gonna force the pills on them?

'But it is abuse to deny them medical care that will save their lives just because you happen to ‘believe’ they don’t need it. '
But is this the case here? The parents believe they don't need it because they believe there is something better on offer. They are wrong, but so is your characterisation. Also, I assume it is the quacks not the doctors who are asserting that the medical care 'will' save their childs life - I don't know what the prognosis with and without the treatment but its not definite life/definite death - I think if your going to force treatments on people you'd better argue from the facts not convenient simplifications.

'...when they still take their child out of treatment it is neglect and the child should be removed for treatment. Pure and simple.'
Ashya King case? The parents wanted a different treatment. The treatment they wanted was in the opinion of their doctors at best no better than the one on offer, the people offering that treatment thought differently - they were doctors too. So it appears that doctors can differ, who gets precedence? You seem to suggest that these parents were rightfully arrested and should have been carted back to the UK to face child neglect charges - pure and simple.

At what levels are we to decide that we can override the parents? For instance, lets say in the current case there is a 5% chance of recovery by natural means (ie no intervention) and 50% with the treatment. So we all agree the child should have the treament.
10%/40%?
20%/30%?
25%/26%
Remembering that these percentages also are not the actual probabilities they are the assessment of one (group perhaps) of people.
Is it just life and death? Do we need to start allowing doctors to decide 'quality of life' issues etc?

The thing is, whilst I agree in this case, my strongest agreement centres on the involvement of the quacks. Surely the solution here is not to be forcing people to do anything it is to remove the spurious options. The law allows quacks to operate, advertise, make money, do public presentations, call themselves scientists and all the rest presumably because freedom blah blah rights blah blah.

Then when some poor parent falls into their hands you want to curtail THEIR freedom and their rights and accuse them of neglect -
don't you think there is something wrong with that picture?

Kiiri has elucidated my opinions about J.J.'s care and the poor decisions made by her parents to discontinue the treatment for her cancer.

J.J. has not reached the developmental stage where she is considered competent to stop the prescribed treatments. Her mother who is her natural guardian has chosen some alternative care in lieu of the treatments which have a documented record of 90 % cure rate.

The treating hospital is blameless because they notified the local social services unit about the situation and when that unit refused to intervene, the hospital brought the case into court.

The judge, according to the Ross Miles' link, never questioned the mother about her folk remedies...in spite of the judge having a common heritage. Folk remedies/medicines/religious beliefs are accommodated by every hospital where I have worked and where family members were hospitalized.

The charlatan Clements is still in business in Florida. If Florida moved against him tomorrow, that will have no impact on the course of J.J.'s illness.

(I,m going back there) J.J.'s mother should have been removed as her child's guardian, because she has gamed the system and is medically neglecting her child.

There.is.no.excuse.for.medically.neglecting.your.child.period.

Gosh, I didn't imagine when I replied to JCL that I was arguing with a tool who'd profess that "they know COULD" is some kind of epistemology fail, and profess not to know how to use Google to check Brian Clements credentials, or the licensing of the Hypocrites Health Institute. My bad. Won't happen again.

@Sadmar
"“How are the parents supposed to know that even though this guy is allowed to present himself as a bona fide doctor that he isn’t one?” The Internet maybe? "

The internet will tell them western medicine is evil, especially that Orac guy. It will tell them vaccines are a toxic soup designed to keep us dumb and sick, and probably infertile. It will tell them antibiotics are useless and actually cause disease. It will tell them less than 2% of cancer sufferers survive five years after chemo. It will tell them there are at least 10 secret cures to cancer - from a 9-volt battery, to herbal teas, to a caustic balm to baking soda and coffee consumed through the wrong orifice - with success rates between 95 and 100%.

The internet is an amazing tool, assuming you already have the critical thinking fundamentals and at least a little trust in science. But without those things, the internet is not a guaranteed path to knowledge, no matter how badly you may wish to find the truth. Surely the worldwide anti-vax movement is ample evidence of this.

A bit more from the National Post Tuesday, including a quote from someone familiar.

@sadmar

way to go - also way to miss the point. You claimed they 'know' something as though this projection of what you know was automatic, in fact I don't see it is - I also fail to see that checking his credentials on the internet actually gets you some form of definite knowledge - it gets you a bunch of opinions from two sides, since they can't differentiate those worth listening to in their immediate vicinity I fail to see how looking on the internet will help them - perhaps you think they'll come to RI read your posts and experience an exegisis ROFL!

My main point here is that whlst this is being characteriszed as 'neglect' I do not believe it is necessarily so - (and this does go to their 'knowledge'). Neglect is taking no action when one should. These parents are taking action - presumably the action that they think is best - IT IS THE WRONG ACTION but it is not negelect. They have failed to realize that in the USA at least having a shiny building out there in public marked 'Cancer Center' with doctory people in it, adverts, presentations and all that stuff, isn't sufficient to differentiate hospitals from quacks. Is there any other area where conmen are allowed to set up and practise in such a blatant manner?

Sadmar - just because you, I and everyone else on this blog perceive our 'knowledge' as obvious doesn't make it a priori or indeed the only possible conclusion. You have to factor in also the lens of subjective perception also. To try to understand the steps that allow them to reach these bad decisions rather than just assuming that they are idiots is I believe more constructive in the long run.

Perfectly rational people are subjected to all sorts of cons all the time, and whole nations of apparently rational people have marched to war based on lies and sociological pressure - but you don't believe it is possible for one average and vulnerable, probably frightened set of parents to be misinformed (deliberately) and caught up in pressures (such as becoming a legal cause celebre), and reach the wrong conclusions?

Given all the sociological tripe you spout I would have thought you at least might have understood this point, but clearly you're the kind of person who reads (and quotes) lots of books, but understands few of the words therein.

@sadmar again
You have quite frequently said on this blog *what can be done about quacks and the 'battle' against them*. You have implied
it is a battle we, the rational people, are losing, possibly correctly.
So I think we with our superior 'knowledge' and intellect could start by examining the vexed question of how apparently rational and well meaning people can end up making such horrendously bad decisions - when we understand that perhaps we can begin to work out what to do about it - though in ths particualr case having some form of 'Cancer Act' in Canada, the US and every other advanced nation would clearly be a rather good practical start

@29 I did read the judgement carefully. It is a sloppy piece of work when it comes to presentation of the information.

My interpretation of the judgement is that it would not have made any difference if the hospital had undertaken to prove the quack is quack and his offerings largely useless, and/or that they have nothing to do with the traditional medicine of the tribe to which the family belonged. Similarly for the traditional medicines. The claim was made that the girl would receive traditional medicine, and it appears that that claim alone was taken by the judge as sufficient to warrant his ruling. There is nothing in the judgement precluding use, concurrent or otherwise, of any other therapy - nor could there be unless it were highly specific.
It is clear that all parties were aware that chemotherapy offered a high chance of survival and that no other treatment of any sort was likely to prevent the death of the child. A claim was made very early in the process that the gild would receive traditional medicine. The judge effectively ruled that the right of the parents to choose traditional medicine, because the use thereof was an defining feature of the culture, trumped everything else, even if it would clearly end in the death of the child. I can see nothing to suggest he failed to understand that the traditional medicine would be ineffective.

It might have been best if the hospital had withdrawn the application the moment the girl was taken out of the country, but I don't know what the implications of that would be. It might bar a renewed attempt to have her apprehended if she returned to Canada while still in need of treatment. It might have put an immediate end to the case without judgement, thereby preventing the judge from making his ruling and so leaving the opportunity for a protracted trial without regard to the case of a specific individual or the encumbrance of the ruling as it now stands.

While the hospital probably could launch an appeal, that just is not its job. It is allocated public funds to provide health care under the existing laws, not to spend vast amounts of money and resources in the courts. Any appeal, I believe, is properly the responsibility of the the governments of Ontario and/or Canada, specifically because there are constitutional matters to be considered and it concerns all aboriginal people throughout the country, not just one person and her family.

"gild" should be "girl"

Had our children been forced into treatment, it would have I have to wonder what Justice Edward's position on female genital mutilation (euphemistically referred to as 'female circumcision) would be--the practice is just as much a cultural practice integral to many cultre's traditions. Would he hold that preventing parents from handing their daughters over to the local barber for infundibulation would similarly have "a disastrous effect on their emotional, psychological, and spiritual well-being", prevenitng theim for beign proud of their own traditions and possibly learning that this teaching of their cultures was wrong and even dangerous?

Somehow I doubt it., which makes me wonder how he distinguishes between cultural traditions that are contrary to the well-being of minor children we must respect and which we can condemn..

Duh--quote failure. Ignore the initial "Had our children been forced into treatment, it would have" fragment.

The horrible thing about the judge's ruling is that it would seem to amount to a blanket barrier to any outside agency intervening in any health or well-being matter for any aboriginal child, as long as the parents assert that they will use traditional medicine. But I can see potential for great difficulty in overturning or modifying his ruling, which is why I believe that any appeal should be undertaken with great care and originate with an agency with substantial resources and a negotiating position that is very solid - most certainly not a hospital.

Fortunately, I don't think many aboriginal people in Canada reject modern medical care in general. Probably the number that lack good local access to it is vastly greater than the number that would reject it. I fear that this ruling might be used to interfere with protection of kids for whom Big Alcohol has played a big part in the inability of their parents to care for them.

One of the saddest things here is that genuine Native American therapies can be integrated into a patient care plan much the same as any other spiritual practice can be.

Now what's going to happen is when this poor child dies, it will all get blamed on the chemo having "weakened her immune system" even though it's been months since she last had it.

Thank you lilady. I disagree with both JGC and JCL (and one of you needs a new handle because I am mixing you up) about the definition of neglect. If you refuse care for your child that is by definition medical neglect. When you make a point about depression (JGC I hope) and what is essentially spiritual practice, hell practice whatever spirituality you want. As I pointed out, you can burn incense, wave feathers, stand on your head, chant to the Buddha, or whatever else strikes you fancy while your child is receiving their chemo. Hell you can feed her wheatgrass smoothies and vegan food all you want while she gets her chemo. You are basically arguing semantics. That case at hand is that with chemotherapy this girl has a 90% chance at survival. The data shows NO OTHER THERAPY that is effective. None. Zip. Nada. So we are not arguing which drugs to use, we are arguing science versus magical thinking. Think all the magic you want, but if you believe that children should under any circumstances be removed from their parents then medical neglect counts. If you starve your child they will get taken away. But if you decide you'd rather give your child juice rather than chemo then suddenly you have the right to do that. It is beyond hypocritical. In either case the child is doomed. I don't support taking children from parents lightly but in this instance a medical guardian should have been appointed to make decisions in the best interest of the child. Period. Not all cases are so clear cut. I admit that, the real world is often rather messy. In this case the facts are quite clear. In other cases more nuance may be needed to figure it out that is what we have a court system for. I don't advocate for denial of due process, but in this instance a terrible decision was made that essentially sacrifices this girl on an altar of ideals. As for JCL (I think) and FGM I don't care what your culture is carving up your child's sex organs is abuse. The child cannot consent, is harmed in the process, and culture be damned in that case. I also don't necessarily support automatic gender assignment surgery for children born intersex as research is showing that its basically a dice roll whether the child will grow up happy with their assignment. Again, when you are talking about something that can't be reversed and you are doing it to a child then you need some pretty compelling reason and just because we've always done it that way don't cut the mustard.

It takes guts for a parent to accept their child's devastating diagnosis and the responsibility to be by your child through long months of treatment. For the child whose parent cannot or will not assume that role, there is a recourse, yet the local social services agency and Judge Edward refused to consider the plight of the desperately ill child, thus condemning the youngster to a painful and certain death.

I want to share with you all, the sad death of Robin who succumbed to leukemia before there were effective treatments to treat and cure 90 % of childhood leukemias. Her family still mourns the loss of the sweet little girl:

http://www.dailymail.co.uk/femail/article-2235807/Barbara-Bushs-heartac…

@Kiiri et la
I seem to be getting a bit vilified for things I havn't said or implied. Let me be plain - I think in this case these children should certainly be required to have the proper SB treatment. I in no way condone 'magical' practises especially for such serious illnesses. I absolutely in no way condone genital mutilation, foot binding or any other parctise that harms children whatever its cultural provenance.

But anyway, it isn't 'tradition' medicine that is at question here - it is pseudo-science quackery, and that can be harder for none science based people to penetrate.

Look we allow this guy Clements to set up a clinic right there in the main street, spout pseudosciency stuff to people who may not be able to differentiate, advertise, get testimonials, fake up studies etc etc. Then he turns up and says to the parents the one thing that real doctors can never say in this situation, the one thing the parents really want to hear, which is ' don't worry, it'll be all right'.
So at this point, from the parents point of view, this isn't a case of a real treatjment against no treatment, this is a case of one treatment against another. That is not neglect - by definition - it is being wrong.
So now we have let this conman do all his stuff, operate publically, turn up and speak reassuring crap to parents, and then for some reason we blame the parents for being conned!
Sorry, but my view here is that the parents are largely a victim of a conman - without whose existence, apparently happily allowed by the state, they simply wouldn't have had the option of choosing such a bad course.

I blame the conman, I blame the system that allows the conman. To what extent I believe the parents are actually culpable here is in my mind open to question, and it doesn't seem to me that this is 'neglect' in the way I understand the word (ie conscious non-action that harms a child) - they are taking action, and I think they believe it is efficous action, therefore it's not neglect, and I'm not going to disregard logical objective analysis of the situation just to dance to the same tune as everyone else.

There were a number of cases in the UK of serious illnesses and at least one death due to Wakefield and his con. At the time, it appeared that Wakefield was a bona fide doctor, concerned for his patients, thinking only of the children, and basing his conclusions on some scientific research published in a respectable journal (very respectable - like the ony one most non-medical people have heard of!).

Due you believe those parents were neglectful?

JCL, stop changing the subject, by bringing Wakefield up.

There are many cases of medical neglect, where the local social services agency and/or a judge has utterly failed to protect a child whose medical needs are neglected by a parent. J.J.'s serious illness and her mother's medical neglect is just the latest case.

Just look at your post at # 36 above, as you argue about intervening without the facts presented by the treating physicians and by Orac. The child has a 90 % chance of total cure with prescribed treatment and a 100 % chance of dying without the prescribed treatment.

You'd do well to check out some facts about childhood leukemia treatments, remission and cure rates, before you defend the neglectful mother and Judge Edward.

@lilady
Hmm, seems you really haven't read what I'm saying. I'm not defending anyone really nor am I arguing against intervention at all. I think I made that clear in #51
What I don't get here is that sure critize the mother, criticize the judge if you want, but look from the OP

"As I described in yesterday’s post, the quack, Brian Clement, was giving talks in the area, one in particular entitled “All About Cancer and Conquering Disease with Living Foods.” The girl’s mother encountered him there. Impressed with his “confidence” she gave him a call. When he assured her he could cure her daughter, she stopped her daughter’s chemotherapy and headed to Florida with her daughter"

So you don't see that as an issue? Dr Brian Clements - practising in Florida in an open (and therefore essentially santioned manner), turns up and says 'hey I can cure that' in a confident,plausible manner and its the mothers fault for not being able to differentiate one doctor with a clinic from another?

Its not his fault for being a conman, or our fault for allowing him to exist and practise and do this sort of thing to people, vulnerable and scared people (ideal marks) at that?

I mean, can't you see who is the villian here? My point about Wakefield was entirely to the question..its not those parents fault they were misled into doing the wrong thing - its his fault and only his fault. This case may not be quite as cut and dried, but seriously, you're all jumping on the parents and not addressing the clear issue of the involvement of a conman, and the very fact we allow him to operate as though he were as legit as the real doctors is in itself confusing for these parents.

So you go burn the parents at the stake if thats what you need to do, seems like they get all your anger. So I'll reiterate again, I believe from the above quote its pretty clear that they have been conned - happens all the time to desparate people facing serious illness - and we allow it to happen - actually in the UK we don't as far as cancer goes, but you 'rational science based' medical types in the USA do - so actually its your fault for sitting on your arse typing judgments on parents instead of doing something proper about it, and allowing your quacks to be exported to prey on vulnerable people. Send him to the UK - we'll jail him.

The clincher surely is they were doing the right thing - getting chemo - until this guy turned up and convinced them he had another way - he is the sine qua non of the situation - he is the criminal, not his victims

JCL, the point is that the child's right to have treatment for her A.L.L. has been ignored by the Judge, in favor of the mother's belief in some alternative treatments.

Stop blaming the charlatan Clement for the mother's medical neglect of her child. If the mother never heard of Clement's spa and opted for treatment from a naturopath, homeopath or chiropractor, she would still be guilty of medical neglect.

What have counterfactuals to do with this? She didn't opt for treatment from a naturopath, homeopath or chiropractor she opted for chemotherapy. If she had 'spontaneously' opted for these kinbd of treatment I would join the bandwagon no problem.

But then Clements turned up and convinced her otherwise - presumably by telling her that he had 100% success rate (better than 90%) and much easier than chemo.
Would you select 100% success rate over 90% - I would. And if I opted for the 90% treatment instead of the 100% then I would be neglectful. The problem is in this case the 100% treatment doesn't exist - its a phoney, con, sham whatever - but how is she to actually know this? Just because you (and sadmar) *know* this doesn't mean it's obvious to everyone else.
Conmen work by being plausible - they have actually fairly low success rate, so they cast a wide net on likely grups til they hook a sucker. Its not nice being a sucker, but it doesn't make you the criminal.

Look, I agree we all have responsibilites to our children, and must do what is best for them, and that includes some due diligence etc - and no doubt it seems this mother was rather quick to jump ship, but I really don't see how we can allow these kind of people to operate - indistinguishable as they may well be from 'real' doctors, and then blame people when they are taken in.
I do blame Clement for this situation - very clearly I blame him - without him and his actions there would be no situation, the child would be getting the chemo and possibly we would have happy ending.

Stop absolving him and treating him like he's secondary. Not everyone knows as much about medicine as you do - these bastards cast a wide net until they hit the right kind of mark, at the right time, in the right way and make a score - and they do that not by convincing people that they have *alternative* therapies they do it by convincing them that they have *an alternative* therapy - there is a difference - just like two real doctors sometimes prescribe different treatments - as soon as these people feel he is a 'real' doctor (and why wouldn't they?) then the course of action he suggests becomes just another reasonable possiblity to them. Thats why I see them as victims not neglectful - but I sense that basically as far as your concerned a wrong choice equals neglect.

Well, the parents aren't completely absolved in my view, but I really do find it strange that you just seem to pass over Clements very active role in this in favour of panning the parents.

The purpose for bringing the case to the court was to determine the parental responsibility toward a very sick little girl. Clement does not have guardianship of J.J.

You have been busy ranting about the itinerant charlatan's competence and not addressing the violation of J.J.'s right to have the most effective treatment for her A.L.L., which trumps the right of her mother to deny J.J. that treatment.

The State has the right, indeed the duty, to intervene and remove the medical guardianship from a parent who medically neglects her child.

I don't address these issues because I agree in toto with all that has been said about them on this blog - I have said this a number of times. I agree the child should have the chemo, I agree the state should intervene if the mother refuses it - I have not said anything different.

The only thing I disagree with is the characterization of the mother as 'medically negligent'. Perhaps 'medically incompetent' or some other phrase should be used here. Perhaps you can give me your definition of 'negligent' because mine requires *willfully* avoiding action, whereas
it is my belief that it is at least possible that this mother was in fact taking the action she thought was best, and that is not negligence, however wrong it is.

You seem to feel that by saying that I am somehow siding with the mother or something, I am not. There is however a difference between someone who causes harm to their child because they wilfully and knowingly do the wrong thing (or do nothing) and someone who causes harm inadvertently believing that what they are doing is the best thing. This is a bigger and more general problem with 'woo' which I am trying to discuss - namely that many of the people inflicting these things on there children seem to geneuinely believe they are doing the right thing. I want to know how they get to a point that seems to me (us!) so clearly wrong, because then we might have some chance of preventing it, and in this case it certainly seems fairly clear that the mother got there because of the direct intervention of a conman.
That I believe is perhaps the situation here. It doesn't alter the fact that the state should take remedial action to ensure the childs health and saftey to the best possible SB technique we have - but it does highlight that perhaps it would be better if the state took preventative action to not allow conmen anywhere near vulnerable parents of sick children.
I don't really know why you are objecting to that statement, or my focus on the person without whom none of this would ever have happened.

JCL:
Yes on #42. Let's talk about what 'what is to be done' rather than 'who is to blame'. The answer to the last question is pretty much 'everybody.' so if we want fewer kids to die, we look to things we might — in some hypothetical way at least — imagine could be changed. And indeed, here we land first and foremost at the door of "the system that allows the conman". I've been digging into Clement and the Hippocrates Institute for a couple days, and each new bit of info generates another facepalm to the effect of "how can anybody stand for this?"

And first on the list of inactive parties is the government of Florida which seems to have no regulatory apparatus at all: not laws, not oversight agencies, not police, not prosecutors. By terms of the legal system as I understand it, Clement and his associates should be serving life in prison. Clement is nothing less than a serial murderer, and after 34 years of cancer quackery, slipping the dying 'guests' quietly out of HHI so the other marks don't see what's likely to happen to them, I put the chances he actually believes in his wheatgrass cure and thinks all the deaths resulted because chemo or some other sbm thing destroyed the immune system or mucked up the innate ability to self-heal are slim and none.

The 'allowing system' isn't just government. Its also the medical profession, which should be up in arms against this guy, running him out of town on a rail, and more importantly putting pressure on governments as every level to put a stop to this sort of thing. Finally there is the business community, which basically embraces this death merchant as AOK because he's a successful merchant of something .

We could start by examining how apparently rational and well meaning people can end up making such horrendously bad decisions. When we understand that perhaps we can begin to work out what to do about it.

100% agreed. That's the position I've taken regarding other cases discussed here, and any assignment of 'blame' I have suggested or will suggest is not meant to negate that at all.

As for prosecuting J.J.'s parents, yeah I think that should be done, not out of some broad principle of 'taking your kid to a quack is neglect' but based on very specific details of this case. I certainly wouldn't advocate the law being hard on them (i.e. I certainly wouldn't want them to serve jail time), and there would need to be an actual crime first — i.e. J.J. would have to pass. i guess at this point we're all with Pastor Sault and his faith healer, hoping some 'Act of God' (i.e. random chance) let's these kids beat the very bad odds.

'Superior intellect' or 'greater knowledge' don't have anything to do with it. I think people get duped for the most part because con-artists exploit their psychological weakness. It's not that they're unintelligent or don't know things in general, but that they're inclined for some reason to think about X rather than think about Y. So, even if I say, 'they should have used The Google to do X,' that's a kind of abstract proposition because there is a reason they did not that does not involve any sort of malice. Just as turning J.J. over to Clement was 'a bad decision' not checking up on Clement first was 'a bad decision.' So yeah, the questions are 'why' and 'what to do' about it. And I do have sympathy for victims of cons. My mom, who was not at all stupid or uneducated was a sucker for all sorts of scams. I used to swear there must be some invisible hobo sign on our front door: "easy mark here!" It wasn't that I was 'smarter', just that as life had tumbled out for me, I was more tuned into those thing than she was. I was able to talk her out of a couple of them before she got robbed blind, but she'd fall for the next one anyway. Thankfully they weren't that financially draining...

Nevertheless, if we take a moral position that includes any notion of 'responsibility', such that we fault quacks for the harm they cause, and fault the system for allowing that harm to occur, it seems we ought to grant that being duped out of your own money is one thing, and being duped into letting your child die is another. 'What to do about it' remains a sticky question with no easy answers, IMHO.

In an imaginary, hypothetical realm where I could make such decisions, prosecuting J.J.'s parents could fall under 'what to do' for the following reasons. This is a 'the whole world is watching' moment, and taking the parents to trial would generate continued media coverage that would serve to inform people about the danger of quakery. Essentially I would put Clement on trial in absentia, making a 'they should have known if they didn't' argument by how thoroughly obvious the scam is to anyone digging a little. The trial would also put pressure on lawmakers in Ottowa DC and FL to do something about dangerous quacks. It would basically all be theater, and I might even seek to collude with the defense council in putting on the show.

My goal would be to secure a conviction that establishes a precedent that First Nations Rights to 'traditional medicine' don't moot a parent's obligation to keep their kid from dying — but then I'd ask for probation/suspended sentence whatever, to keep the parents out of jail. Then I'd play up the mercy/respect angle big time in a press conference with a warning that "if this happens again, the guilty parties are going to stir!" Or something.

Of course, this 'hypothetical' is basically scriptwriting, and IRL there'd be lots of other factors involved, of which we have no knowledge, so I don't know if that could happen or whether it would work.

Personally, I don't believe in retributive justice, attempting to balance some moral scale via punishment, establish some 'deterrent' blah blah blah. People should only be imprisoned when they present "a clear and present danger" to the community.

But, by all means, let's have more discussion trying to puzzle out why and how people get seduced into 'bad' choices, and what might be done to stem the tide.

"The State has the right, indeed the duty, to intervene and remove the medical guardianship from a parent who medically neglects her child."

Yes, in general, but First Nations people are only subjects of the Canadian State in some senses, while in others they are subjects of their aboriginal nation, as a matter of Canadian law. There is a very complex social/legal problem at work here. The 'state' that has the right and duty to intervene in custody is the Six Nations band, but they do not have an apparatus to do so because Canada has allowed them to establish one. Furthermore the FACS does not have an option to impose 'medical guardianship' as no such thing exists under the law. They can put a child into protective custody, but that severs the parents' guardianship completely.

As will eventually post in more detail, McMaster Hospital does bear great blame here. Canada does have a govermental body that can mandate treatment plans for a patient incapable of making their own decisions (e.g. an immature 11-year old with leukemia). It's called the CCB. It was McMaster's choice to seek FACS to take guardianship away from the parents completely, instead of seeking a treatment mandate from the CCB.

errr, "because Canada has NOT allowed them to establish one."
"As _I_ will eventually post" etc. etc.

Application of de jure law is always constrained by defacto situations on the ground. Once Clement got his hooks into J.J.'s parents there was nothing anyone could do to actually force them into putting her back into chemo.

By law, an FACS agency has to do an investigation before putting a child in protective custody. They can't just go grab the kid upon receipt of a notice of possible neglect, which is all a physician can provide. There's no mechanism for custody that doesn't put the parents on alert, and if they have the means and desire to flee the jurisdiction, game over.

'Should' and $2 Canadian gets you a cup of coffee at Tim Horton's.

JCL: The discussion on this thread is directed toward J.J.'s care, not the itinerant or homegrown charlatan(s) who are as common as dirt, and who prey on credulous individuals. If you want to notify the State of Florida about Mr. Clement's activities...then go for it...but it will have no impact on J.J.'s life-saving treatments, which her mother will not provide consent.

"The only thing I disagree with is the characterization of the mother as ‘medically negligent’. Perhaps ‘medically incompetent’ or some other phrase should be used here. Perhaps you can give me your definition of ‘negligent’ because mine requires *willfully* avoiding action, whereas
it is my belief that it is at least possible that this mother was in fact taking the action she thought was best, and that is not negligence, however wrong it is."

There is nothing in the court record to indicate that the mother is "medically incompetent or some other phrase...".

It's not how I define the mother's decision to deny her child life-saving treatment, it's how the law defines "medical neglect".

http://www.legalmatch.com/law-library/article/medical-neglect-of-a-chil…

"What is Medical Neglect of a Child?

Medical neglect is defined as a parent’s failure to provide adequate medical or dental care for their child, especially when it is needed to treat a serious physical injury or illness. In some cases, this can also include a failure to provide for psychiatric care if the child needs it. Also, some jurisdictions may hold other parties liable for medical neglect, such as custodians or guardians who have a legal duty to care for the child.

Medical neglect is generally considered to be a form of child neglect, and is usually listed under a state’s child abuse laws. Some jurisdictions require failure to involve emergency circumstances, but some courts may find medical neglect even in long-term, non-emergency situations...."

Perhaps you can give me your definition of ‘negligent’ because mine requires *willfully* avoiding action, whereas
it is my belief that it is at least possible that this mother was in fact taking the action she thought was best, and that is not negligence, however wrong it is.

Ergo, opting for prayer over medical treatment isn't negligent.
So long as it's what the parents think is best.

@lilady
I wasn't actually aware that the thread was so tightly constrained or indeed that you were the arbitor. Generally I see discussion on these threads moving around the issues and what it is directed to is whatever people happen to respond.

But I don't think I was particularly off topic - in fact here is the title:

An Ontario court dooms a First Nations girl with cancer: Who’s to blame?

I am postulating a clear opinon in answer to that question and trying to have an intelligent discussion about that opinion - which is not entrenched by the way, but certainly won't be changed by people calling me names or trying to shut me up because they disagree with me - though I'm not sure you are even making the attmept to understand what I am saying, let alone engage intelligently with it, despite it being a clear answer to the question posed in the title.

I understand that the legal definition of 'medical neglect' may be slghtly different from what I would consider the naive definition of neglect. Looking at that link I see this:

Ignoring medical recommendations by a physician with regards to a treatable condition
Failing to administer medicine to the child as prescribed by a doctor

The problem here is that of course there may be more than one opinion - perfectly reasonably in some cases. So it can't really mean what it says because if I have two mutually contradictory prescriptions from two perfectly respectable physicians
I have to choose one, and therefore not the other, and therefore by the direct wording of this must be neglecting my child.

Now I don't' think that Clements is a medical doctor, but I'm pretty sure that he can
produce them as required to give out his recommendations. Therefore by these definitions, if Clements produces a legally registered physician who recommends his treatments and you DON'T follow it, you are medically neglecting your child. You follow that I assume?
Again we come to this point - if there are two apparently (ie in their perception) equally valid medical opinions, then it is not neglect to choose the one you think is right - it is only neglect to choose neither.
So, either prove that Clements did not provide a medical recommendation from a doctor, in which case you are right in a formal legal sense, or you have to admit that by the wording here she was not negelecting her child.

In fact if Clements was the ONLY person she saw, and he produced a doctor that prescribed this treatment, then she would,according to this, be neglecting her child by not following that recommendation! There is also the problem that in some places quacks such as naturopaths are pushing or even succeeding in being officially regarded as physicians - that means that in a couple of years we could be looking at someone getting done for medical neglect because they didn't give their child a bleach enema as recommended by that 'physician' - and you will have to agree with it!!

So much for the legaleze - I think reading the actual law, and getting a legal opinion would be necessary. I concede that perhaps there is a formal legal sense in which she is negligent, but also in a formal legal sense you would have to prove inadequacy of Clements treatment, which might be harder.
But I am taking about actual culpability of the person, her intententions, her motivations and so on. I am talking about whether she deserves the opprobrium etc that comes with the label, or whether she too is a victim. In other words lilday, I am talking about the topic of the thread.

@sadmar I would like to respond, because I think its a very interesting and relevant topic, illustrated by this story. But I fear I have made the mistake of not parroting liladys opinion sufficiently and must spend my time rereading all of her posts on RI so that I am able to agree with her with more alacrity in the future

JCL: I apologize that you think in some way you are being picked on, that was not my intent. I agree something should be done about the quacks. However, with disturbing and distressing frequency more and more states are opting to give pretty much everyone who shows up carte blanche to open a pseudoscience 'clinic'. There is the abysmal regulation of 'supplements' which only require the oft lamented on this and other skeptical websites quack Miranda warning. Plus you have naturopaths, chiropracters, acupuncturists, and others who are gaining state credentials and opening up shops. We totally agree that it is wrong and should stop. Unfortunately these groups are well funded and well organized. And politicians are cowards. They don't want the controversy so they rubberstamp a bill to give them a license and send them on their merry way to fleece the public. We have railed against it, written our congress critters about it, blogged about it, educated our friends about it. I believe almost every regular commenter on these pages has done one or in most cases all of these things. But we are few, with few resources. And we face the mighty tides of government apathy or outright powerlessness (for example read the many tales of the Texas Medical Board vs. Burzynski). Clement is a charlatan and a crank. However it is doubtful that anyone in any position of authority in FL is going to shut him down. And even if they did I would bet you dollars to donuts he would have a new shop set up in 5 minutes flat. Probably in TX which has become Mecca for quacks the world over. We can do our best but we can't stop them without some kind of political will and at this point it seems sorely lacking.
I take some issue with your seeming support of the mother in this case. Yes, she has been conned. But here is the thing she let herself be conned. She went for the easy way out. You don't have to get very far in this life to begin to understand that when something is presented to be too good to be true that it is. I don't envy her situation it is truly horrible to have a child diagnosed with cancer. Even more horrible to know that they will suffer (for two years) through treatment that grown adults shouldn't have to suffer through. But at that point you have to be the adult you have to step up. You have to hold their hand, and reassure them, and be the parent. Because in the end your child will suffer and you will wish with all your soul to take that suffering into your own body and spare them the pain. But in the end you will have a great likelihood of holding your child in your arms. Your only other option is to be mourning at their grave. To me that's not an option. In this case when the parents were duped by a conman and wanted the easy way out the courts had the opportunity to do their duty and save this child's life and they failed spectacularly to do so. The only person who is going to suffer from this is a young girl who is too young to know better and too young to make her own decisions. And that is what makes me cry. The parents are misguided and deluded and they act out of love but that doesn't excuse it. It doesn't excuse the religious who don't believe in medicine only prayer, and it doesn't excuse those who want pseudoscience over medicine.

So much for the legaleze

That would have been a good choice.

I think reading the actual law

Which one would that be?

I concede that perhaps there is a formal legal sense in which she is negligent

Yah.

but also in a formal legal sense you would have to prove inadequacy of Clements treatment

How do you figure?

@Narad
I think that if someone believes truly that what they are doing is the best for their child, then it is in fact hard to construe them as negligent. Wrong, misguided and so on yes, but negligent, no. I do not believe in any religion, but apparently some people do and very strongly at that. So if these people are acting in a genuine belief that what they are doing is best I don't think they can be called negligent - dangerous, ignorant lunatics yes - negligent no. To my mind negligence is failure to act when it is indicated - and failure to act according to what you think is best - the most any of us can really be required to do. If someone acts in a medical situation by consulting a priest not a doctor because they think that is the best course, I abhor their action, but I do recognise it as an action with the right motivation.

Take the MMR thing again. Some people did not give their kids the jabs because they genuinely believed that there was an issue. They did not take the best action-with some tragic consequences - but they did take the best action as far as their information and perception of the situation and so on went - were they negligent, or just badly misguided?

What if the dodgy decision has been strongly affected by some baleful deliberately acting to confuse and mislead these people - is this still negligence?

This is really a matter of semantics - perhaps this whole 'negligent' thing is actually a red herring, though there does seem to be some sort of psychological thing going on here, where the mother absolutely must be labelled negligent, despite the clear mitigation of being conned - I donno why, maybe its just easier to see things in clear cut black and white or something.
Anyway it actually matters little what their motivations etc are for immediate practical purposes - if they are taking the wrong course of action in such a case then there should be intervention.
I'm not really interested in what we call the mother in this case - I am interested in how we characterise her actions though, and I personally think the active and critically important intervention of an extremely practised conman at the very least mitigates her negligence.

@Kirri
I'll respond in detail in a minute (I'm on fire tonight :), but this stood out:

*Yes, she has been conned. But here is the thing she let herself be conned*

You think? Put 'rape' in there instead of 'conned' and see how you feel about blaming the victim now

In for a penny.... This is U.S.-centric, but JCL's comments seem to lie in the realm of the abstract.

It should be noted that child neglect is a matter of state law. I just took a quick look at Connecticut's summary page, and it makes clear that intentionality is irrelevant.

That takes care of that one. Shall I proceed to the analysis of whether religious withholding of care is comparable to choosing a quack shack?

@Narad

Ok, well thats good and now I know something new and relevant.
As far as deciding whether the state needs to intervene that sems very sensible. I entirely agree that this is as it should be, as I think you'll find I have said.
But what about in the criminal sense? My question stems from the who is to blame part of the OP. I concede if you wish that when people have been using 'medical negligent' they may have been correct in a very legal sense as far as whether care should be foreced by the state. And of course the law has some relevance to the question. But I am really talking more ethically. I'm gonna try to distil the exact question.

A person is pursuing course A which we consider 'good'
A malevolent agent with evil purposes targets A with the intention of changing their course to B, which is to their detriment, and his advantnage
The agent succeeds

Thats the scenario, it covers (or is meant to be an abstration of) murder,rape,theft,conning,assault a huge range of scenarios.
At what point in this does the person become to blame for the outcome?

How for instance is Clements actions different in substance from theft and murder of her child? Someone mugs you in the street and steals your wallet whilst knifing your baby to death. This is your fault?

@Narad again - wrt Shall I proceed to the analysis of whether religious withholding of care is comparable to choosing a quack shack?

Yes please!

"I think that if someone believes truly that what they are doing is the best for their child, then it is in fact hard to construe them as negligent. Wrong, misguided and so on yes, but negligent, no. I do not believe in any religion, but apparently some people do and very strongly at that. So if these people are acting in a genuine belief that what they are doing is best I don’t think they can be called negligent – dangerous, ignorant lunatics yes – negligent no. To my mind negligence is failure to act when it is indicated – and failure to act according to what you think is best – the most any of us can really be required to do. If someone acts in a medical situation by consulting a priest not a doctor because they think that is the best course, I abhor their action, but I do recognise it as an action with the right motivation."

You're dead wrong JCL. Parents who medically neglect their children have been charged and convicted for their medical neglect:

http://whatstheharm.net/children.html

You do realize, don't you, that J.J.'s mother agreed to the treatment, which apparently did not conflict with her aborigine beliefs, practices or aborigine "medicine".

What type of aborigine "medicine" is used within that group? According to the Judge's decision, aborigine "medicine" was not part of the court record. In fact, the only mention of religion was some sort of folk lore about a sky woman...quite typical of the folk lore one hears about from other indigenous groups to explain natural phenomena.

J.J. was on her tenth day of the prescribed chemotherapeutic treatments, when her mother telephoned Mr. Clement, because she "heard" about the therapy (raw vegan diet), he prescribes for his spa customers in Florida. Two days later the mother withdrew her consent and J.J.'s prescribed chemotherapeutic therapy regimen was halted.

Newly elected Chief Ava Hill and the Six Nations Elected Council are elated because they stuck it to The Man by sacrificing Makayla and J.J.:

https://www.facebook.com/Six.Nations.Elected.Council/photos/a.282105425…

@Narad

second last paragraph of my #69 - you will see that this is in agreement with my previously stated views - just sayin' :)

@lillady
I am not in anyway saying that in all cases, or even in this case, people are not charged or shouldn't be charged with medical neglect. Where did I say that? If people are neglecting their children in any sense then damn right they should get done and the state should intervene.
But you are helping me clarify a little here. We all agree that the *intention* of the parents should not be part of the decision in respect to whether the state takes action, forces treatment etc.
What we do disagree with is culpability of people. I don't believe necessarily that this person, or other faith types, or even some more general woo types are in fact negligent in the standard sense of the word - or sall we just say not culpable- depending on many factors such as their beliefs (meant in a general sense).

Some of the people who need intervention have the right intentions but undertake the wrong actions. Some may have gone too far in their religiousness, some may just be intellectually challenged or have other issues, some may have been deliberately mislead. What they need isn't being labelled 'negligent' and criminalized - what they need is to agree action to learn/change, probably supervision.

So in a nutshell:
As far as 'medically negligent' in a civil sense, meaning requiring state intervention and so on. I agree
As far as 'medically negligent' in a criminal sense, meaning culpable, in this case I disagree.
We should intervn and force the treatment. We should attempt to help her understand why her kid is being given this treatment, and what a narrow escape she has had - but as long as the kid has the treatments I actually see no reason-in this specific case, I'm not making general rules here, for pursuing further actions against her (unless there is more to the story).

The involvment of the tribe and making this some kind of test case I view as being very pernicious, especially as it is not a traditional method. I totally agree that this aspect seems very screwed up. It seems that somewhere an opportunity was definiely missed on that basis. And to my mind strikes me as pure politics somewhere. I wonder for instance if Clements helped them to this lidea. I wonder indeed how he ever came to be there, I doubt he chooses his speaking engagements on a random basis. But why do you not see this as further mitgation for the mother? Did she stir up he chiefs? Or did they decide themselves to make this unfortunate person their political tool - and seriously - where was Clements in this process?

But what about in the criminal sense?

With the caveat that I have only recently paid attention to this thread, as it mostly seemed to be an exchange with sadmar, I am confident in stating that this comment is an attempt to change the subject.

@Narad

second last paragraph of my #69

What constitutes a paragraph is unclear in that comment. Let's go with what appears to be the ultimate one:

This is really a matter of semantics – perhaps this whole ‘negligent’ thing is actually a red herring

Then why on G-d's green earth have you been nattering on about it?

I think that if someone believes truly that what they are doing is the best for their child, then it is in fact hard to construe them as negligent.

Which is to say that there is nothing to "construe," the word has no meaning.

But why do you not see this as further mitgation for the mother? Did she stir up he chiefs? Or did they decide themselves to make this unfortunate person their political tool – and seriously – where was Clements in this process?

This is seriously the worst example of JAQing off that I've seen in ages. Try passing Go before aimlessly pondering the value of building a hotel on Marvin Gardens.

@Narad
How so? The question in the title was Who's to blame?

No-one seems to disagree that the state should have intervened, that the tribal politics bit seems a bit screwed, that there have been failures in many places. I would say I was giving the thread relevant body.

btw I must also humble myself by admitting that I have been wrong about the exact meaning of 'negligent'. I see now that it probably doesn't generally imply the intentionality that I'm giving it. I suppose it doesn't help trying to get my point across - sorry..
However, my point isn't actually about the meaning of words its about the attribution of blame in this case. I see this child and her mother, at least to some degree, as victims.
I see her failure as the failure to be properly equipped intellectually to deal with making a critical decision about her sons life made more difficult by the fact the the whole situation, starting with their being any decision to make at all, and progressing through lies and deliberatel false statements actually designed to decieve her. And decieved she has been.
Now I don't know every full detail here of the whole process of course, but in so far as the scenario is like I have describbed, I hold the mother blameless.

@Narad

Ok fair enough I'll stop nattering defeated as I am by the completeness of your answer. Good point, well made.

You know when I started commenting on this thread I believed that the question of how much the mother was to blame, especially given the active role played by Clements, and there being the characteristics of a con in place, was both relevant, exactly on topic and would possibly lead to some interesting discussion.

epic fail

@Narad #77

Fair enough on the formatting. You took the last pararaph, but completey failed to look at the section:

'Anyway it actually matters little what their motivations etc are for immediate practical purposes – if they are taking the wrong course of action in such a case then there should be intervention.'
which is clearly of direct relevance to your #71

And
'Which is to say that there is nothing to “construe,” the word has no meaning."
Huh? Which word? Yes, grammatically correct would have been 'construe their actions' rather than 'construe them'.

Nitpicking grammer,sematic quibbling,sophistry and paragraph formatting! You certainly are a formidable force to oppose.

I put my new post on 'who's to blame' on the Friday open thread.

http://scienceblogs.com/insolence/2014/11/21/off-to-skepticon/#comment-…

There's actual information in it that hasn't been posted on RI, should anyone be interested in the facts. I share opinions, of course. Feel free to disregard them as usual.

JCL: lilady and Narad are dogmatic. They think what they think, and express themselves in ad hominem mode. You never have a point. You're just wrong, stupid, heartless, arrogant, stupid, dishonest, stupid. Did i mention stupid. They don't do 'discussion'. They are who they are. This is an open forum. They get to write what they like. So do you. If you want to reply to them, that's your choice. (I try not to. The feeling's mutual, i'm sure.) You're not going to get dialog. But a barb may have it's utility, definition of negligence etc. a valid point buried in the venom and the nit-picking. Narad's knowledgable about legal stuff, among other things. But if you're not 'in' with a certain long-time RI circle, everything you write is going to be taken with the least-charitabe assumptions possible, e.g. that you using interrogative sentence form "to make wild accusations acceptable by framing them as questions" (I didn't now what JAQ was and gad to look it up) not because you want to indicate "well, this is what I think, but I'm not sure and i might be wrong."

Especially wrtiing in these little text boxes, I know I'm likely to frame something as a rhetorical question or joke at one point (i.e. intended as firm statement) and then a few lines down frame something as a question because i sincerely want to ad a qualifier to the thought, because I really don't know. And I'm sure it's difficult for readers to pick up the difference without the tone of voice that would clearly distinguish the two in meatspace conversation.

Most people have some sort of hot-buttons that set them off. lilady definitely has a hot-button for anything that can be remotely interpreted as sympathetic to parents who cause any sort of harm to their child. She sees this as making excuses for unforgivable sin, a moral abdication that can only be met with outrage. My problem with that is I see outrage as having zero utility in any effort to prevent similar harms in the future.

btw: It's 'Brian Clement' no 's'.

To the discussion:

What I see in the thread above is words that can mean different thing, or encapsulate different degrees of similar thing, being interpreted differently by different people. E.g. I take what you mean by 'blame' to be different from i meant by 'blame.' And my guess is there are different meanings AND degrees of 'negligence' being referenced as well, now somewhat cleared up by Narad's note of the legal definition in CT. But 'negligence' may be a more philosophical concept, in which do/did define it around a component of intent, while lilady does not. Not to facilitate JAQ-ing, but I'd suggest clarification requests might be more productive than making assumptions.

I see her failure as the failure to be properly equipped intellectually to deal with making a critical decision about her sons life made more difficult by the fact the the whole situation, starting with their being any decision to make at all, and progressing through lies and deliberatel false statements actually designed to deceive her.

Can you clarify what you meant by "properly equipped intellectually"? That could be interpreted as pretty demeaning.

Regardless, the word "failure" in "failure to be equipped" suggests one could also succeed in being equipped. Thus, once malice is removed from the definition, I'm having trouble distinguishing your description from 'negligence.' Perhaps you and lilady might agree that by using Narad's definition in the non-legal/philosophical sense the parents' decision to pull J.J. from chemo falls under 'negligence' but disagree about the severity and what consequences, if any, might be in order.

"Now I don’t’ think that Clements is a medical doctor, but I’m pretty sure that he can produce them as required to give out his recommendations."
Highly unlikely. I've been reading up on him. This is not your typical Alt-med practitioner that can get a real MD to front for them. This guy is Murder, Incorporated.

"No-one seems to disagree that the tribal politics bit seems a bit screwed,"
The politics are very screwed, but that is not the fault of the band (I guess that's the Canadian usage, and they don't say 'tribe' as we do in the US).

"Making this some kind of test case I view as being very pernicious."
Not really. It was McMaster that made it a test case. They had no malice toward J.J. certainly, if that figures into your defininition of 'pernicious.' They had a failure to be properly equipped intellectually to deal with making a critical decision involving custody of a First Nations child, or to be more precise the process that would take place once they set a custody issue in motion.

Yes, Clement specifically targeted this group. I don't know whether he was just targeting The First Nations, or whether there were other ripe marks in that part of Ontario. But it's a good bet Clement knew something about the mistrust of white institutions, including hospitals, among the native population and cynically chose to exploit that. He's the worst racist in the bunch. I have gotten the impression that the Six Nations and New Credit bands are not exactly impoverished. A similar mistrust of hospitals probably exists in poor African-American communities, but being poor they wouldn't offer Clement the profit potential so he headed North.

The parents didn't the lead the chiefs, and the chiefs certainly didn't lead the parents. The chiefs might have been dragged along by the Sault family, as dad's can be assumed to have a certain influence as the Church Pastor in New Credit. The parents were led by Clement. The chiefs were making the best out of a bad situation. By the time they were drawn in, the kids were as good as dead, unfortunately. Clement had the parets, the parents had the kids, they were all in Florida (or could be) no one was letting go. Bad deal all around.

@sadmar

Thanks for the information.I hadn't researched the tribe matter (wasn't that relevant to the point I was trying to make), and it seems to have a different complexion than I thought, fair enough. It did seem to me likely that Clement didn't just arrive there by accident - so really the mother was
compassed by an evil scheme that she had no knowledge of before she ever heard of him.

I personally think here is a valid question here and it doesn't make me a monster for asking it. It seems pretty relevant to the OP question and the whole disucsison viz a viz woo and mothers who practise it on their children, namely (for about the 8th time):

If a person is deliberately targeted by someone intending to deceive them, and they are deceived, to what extent are they to blame for the consequences of that deception?

I can see there can be different view points - I was hoping to elucidate some of them, turned out to be hard work! Lilday and Narad seem to think that its simply caveat emptor and have no problem allowing these con artists to operate and target vulnerbale people - its simply your fault if your conned. I was genunely surprised to find this reaction on this blog.

Re the phrase '“properly equipped intellectually” I was trying
to express that her whole mental aparatus, her logic, knowledge, understanding of science, presence of mind, crticial thinking etc, cultural context, whatever aspects are required, has suffered a failure of some sort to allow her to be conned in this manner. It wasn't meant to be demeaning per se - but unfortunately in cases of being caught up in cons there usually is some failure - even just the failure to 'see the obvious that everyone else sees'. In this specific I off course don't actually know what the factors were. Its not meant to be demeaning per se, but I was struggling to find yet another way to express the same thing. However, the fact is being caught in a con can leave a person feeling pretty stupid and humiliated when it is revealed to them, and in some respects it is a demeaning thing in and of iself. However, that in no way makes it the victims fault.
And yes I have agreed that 'negligence' in the sense used by lilday is right, and tried to focus on the question of actual malice. ie I agree that intentions have nothing to do with negligence - always did as far as taking civil action was concerned, but the point here is not about what word should be used (though I agree it would help if I was able to say what I meant with more precision), but to what extent the deliberate actions of the conman modifies the mothers 'blame' - especially, most especially in this case that without Clement intervention, the whole thing would never have happened. Thats pretty good reason for saying 'Clement caused this situation'.

To what extent the mother is can actually be said to be fault here I don't know. I think it would need detailed investigation and a judge to eventually determin that. Basically the list of 'blame' you wrote on the next thread seemed about right to me.

Oh and btw - thats interesting that you think Clement doesn't have some medical doctor in his pocket. I looked at his clinic site and could only see one guy who might be some form of medical doctor, as usual it hard to get facts.
If he did not in fac have a medical doctor to basically recommedn his treatment, then that probably does shift things a little against the parents. It certainly does shift things badly against the authorities in general (who already appear rather incompetent and appear to have had several failures at multiple levels) - if there can't even be said to be some form of 'differing opinion between doctors' then the whole medical neglect thing becomes much clearer legally (already pretty clear scientifically to most of us).

JCL: Your initial premise that it's hard for people to know who's a real doctor kind of moots the necessity of a quack to have a real MD as a front. Everything about Clement is deception. Naturopaths refer to themselves as NDs. Clement claims to be an NMD. Now, putting that M in there is clearlt meant to muddy the waters, which is why actual naturopaths don't do it. They want to be accepted a legit on their own terms. But then Clement isn't even a real naturopath. He bought his 'NMD degree' from a diploma mill. So from the parents' points of view it could still be a '‘differing opinion between doctors’.

But the parents' choices are still a bit weird, though we don't have enough details to explain them. If we propose that as First Nations folks, they have a distrust of white medical insiitutions, why would they embrace a white guy from Florida uncritically even if they can't tell a fake doctor from a real one. You'd think they'd be suspicious of any paleface promises. (?) But then, this all started with the Sault family, whose identity may be more defined by Evangelical Christianity than by aboriginal heritage. So they could have been seduced more by an appeal to faith, belief in God's miracles.

Unlike J.J., who is reportedly immature, tentative, and defers to her mother whenever asked a question, Makayla Sault evidences her own will, and speaks firmly for herself. What also appears under-reported as the case has gone forward is that Makayla was having severe side effects from the chemo that had put her into the intensive care unit. She felt the chemo would kill her before the leukemia would. So she made pleas to God. Sonya Sault said "I remember I would just watch her, and listening to her pray, ‘Oh, God. Come and get me, come and take me from here'." Then Makayla reported a vision of a long-haired man appeared in her hospital room:

I asked him, ‘Can you heal me,’ and he said, ‘You are already healed,’ and he held out his hands to me and I saw the holes in his hands and I knew that it was Jesus. And he told me, ‘Do not be afraid.’ So if I live or if I die, I am not afraid. God the creator has the final say over my life."

By all reports, the chemo withdrawal was Makayla's idea. She asked her parents to take her out of the hospital. She'd been in intensive care. She said she saw Jesus. What would anyone expect Evangelical parents to do?

Sonya Sault told reporters what the McMaster Dr.s had said about taking Makayla off chemo. They'd cited a 75% survival rate for Makayla's condition, Her doctors told her family that she would have a 75 per cent chance of survival, and, “They basically said she would have 100 per cent relapse and she would die if we discontinued chemotherapy. And that going the route of traditional medicine has zero per cent success rate." Which is why I said earlier they knew the choice could be fatal.

So my guess is it went something like this: the Dr.s hadn't warned the Saults about the level of side effects Makayla experienced. When she went into intensive care, they bagan to question the Docs. The kid said she believed she was dying from the treatment, had prayed to God, and Jesus had appeared in answer to her prayers. So the devout parents aren't just looking for a miracle, they're expecting a miracle.

So they say they're going with traditional medicine because they have to say something. But the 'traditional healers' in the community are probably well known to them, and if they thought those healers were All That, they probably wouldn't have had Makayla in McMasters to begin with. Besides, as Christians, why would they have faith in 'healing' concepts based in pre-contact aboriginal theology? So I think it's just an excuse to justify meeting Makayla's request to get out of chemo, and wait for a miracle.

Enter Brain Clement. He appears out of nowhere, promising 100% cure with no side-effects whatsoever in as polished a presentation as a veteran con man can. He shows slides of HHI in West Palm. It doesn't look like a hospital. It looks better than a hospital. Maybe that looks to the Saults as the sign from God they've been expecting. Maybe Evangelicals don't double-check signs from God.

J.J.'s case seems to have a different dynamic entirely. The National Post had called McMaster's decision to refer Makayla to Brant FACS into question and argued the case should have gone to the CCB two days after FACS closed its investigation of Makayla and announced it wouldn't seek custody. So the whole CCB vs. FACS issue was in the public discussion well before McMaster referred J.J. to FACS, making that choice seem all the more bizarre,

We know a lot about the Saults from press reports. We know little or nothing about J.J. and her family. Those details could move any sort of evaluation of her case quite a bit, one way or another. E.g. was the chemo making her as sick as it had Makayla? What are these parents beliefs?

I have the feeling we're nowhere near the heart of the onion.

@sadmar

So we could say they were predisposed towards looking for something miraculous, and of course going through an emotional crisis. In other words exactly the kind of mental state that leaves them open to professional manipulation.
Clement finds a likely spot to cast his nets, and even though it might have huge holes in it, at least some of the fishies are attracted to the shiny baubly bait and get reeled in.

I expect that Clement like any good business man does his research on likley markets - in his case those might be any group who might be slightly more predisposed to 'woo' or have 'prescientific practises' as still some active part of their lives, who have perhaps some trust issues with general authority, and are potentially able to generate a bit of cash. Them being in a jurisdiction that might allow them to circumvent bothersome legal restrictions on what they can do to their children is certainly a bonus. I wonder how easy it would be to try and track his speaking engagments, or other marketing - have other native americans been victims?

Btw I see this characterzation of the band as being distrusting of *white mans medicine* or similar - and noting the irony of them falling for a white guy - I've seen that a few places on this thread.

Is that actually how the band themselves characterize the situation? I just wondered, because it seems almost like the projection of a (racist?) stereotype onto them. ("Me indian have strongeum medicine than pale man")

Isn't it possible that they are actually more politically sophisticated and modern and its actually just Government and Authority that they have a probem with, especially in regard to the upbringing of their children - and they have moved on from an essentially racial viewpoint on this?

‘Which is to say that there is nothing to “construe,” the word has no meaning.”
Huh? Which word? Yes, grammatically correct would have been ‘construe their actions’ rather than ‘construe them’.

Negligent. If you are going to say that "I think that if someone believes truly that what they are doing is the best for their child, then it is in fact hard to construe them as negligent" (while, as far as I can tell, arbitrarily excluding doing nothing regardless of belief), then you have stripped the word of meaning.

Nitpicking grammer,sematic quibbling,sophistry and paragraph formatting! You certainly are a formidable force to oppose.

I am not the one who elected to personally redefine a legal term. That is not semantic "quibbling" or "sophistry." You would have done better to have simply stuck to this from the outset:

I see her failure as the failure to be properly equipped intellectually to deal with making a critical decision about her sons life made more difficult by the fact the the whole situation, starting with their being any decision to make at all, and progressing through lies and deliberatel false statements actually designed to decieve her. And decieved she has been.
Now I don’t know every full detail here of the whole process of course, but in so far as the scenario is like I have describbed, I hold the mother blameless.

This would have made clear that the position you were advancing – in the context of a court decision – had no bearing on the law.

Isn’t it possible that they are actually more politically sophisticated and modern and its actually just Government and Authority that they have a problem with, especially in regard to the upbringing of their children – and they have moved on from an essentially racial viewpoint on this?

That's my reading of the chiefs, Judge Edward, and (just guessing) most of the community. Thus, my thought that 'trad med' is but a MacGuffin here. In that sense 'white' and 'aboriginal' now function largely as figurative references to uneven distributions of power. If you look at the statements by the chiefs, they say things like "We're not going to let them take our children away again." That is the use the general pronouns. They don't say "We're not going to let the whites take First Nations children away again."

To any extent First Nations folks may see things in racial terms, that's likely largely a reflection of mainstream society's conceptions of 'race' and policies reflecting that concept.

As I noted back at #19, Native Americans in the U.S. didn't really begin to see themselves as part of any unified racial identity until the mid-19th century. The Mdewakanton thought of themselves as Mdewakanton first, and Dakota second. They would have understood the Lakota as similar, but not the same. Cheyenne or Chippewa? No connection. This is reflected in Little Big Man where the Cheyenne word for 'Cheyenne' translates as "The Human Beings." Other tribes were not "Human Beings".

So, yeah the distrust of McMaster wouldn't be because it's literally 'white.' It's a lot more complicated. But the point remains that however the bands might identify themselves, I don't see how Brian Clement fits. So I'm still thinking the Saults vulnerability was way more a fundie Christian thing than a First Nations thing.

And yes, I think this would have t figure into any moral judgement one might make of the Saults. But the legal case is about J.J. We don't know what her parents's beliefs are. We don't what J.J.'s beliefs are, if she has any of 'her own' in the sense Makayla does. We don't know if J.J.'s chemo had put her into intensive care, or was just routinely painful.

I'm pretty sure, though, that when J.J.'s parents pulled her from chemo. Makayla had returned from Florida, was in high spirits, proclaiming herself 'cured. The leukemia had probably been knocked back by the chemo, and no longer on the IV nasty, she was feeling great. Post hoc fallacy: it must have been the wheatgrass! So maybe J.J. was just the next domino. Maybe more will be revealed... who knows?

^ Although it should be noted that what you've mostly been talking about is neglect, which related to – but not the same as – negligence. The latter is a cause of action after an injury; the former is a basis for state action to prevent injury (as well as to prevent further injury, but that's not what this case is really about).

Seeing Narad's boldface #87 I speculate JCL may have fueled the fire by using the apparently unequivocal 'blameless'. Legal definitions and judgements aside, while on a philosophical basis I'm willing to cut the parents some slack for a variety of reasons, 'blame free"? No. It seems to me that no matter how devout a 10-nyear old may be, a kid that age isn't competent to make her own decisions, and parents have some responsibility to look beyond dogma in a decision qualified experts have told them is a matter of life and death. I'm not prepared to say how much, but it's not zero.

I'm trying to read this discussion with JCL and though I can see the mother was neglecting what was best for her child, I still fail to see much difference with a parent that falls for mr. Burzynski's scheme. In both cases there is a so-called doctor, pretending to be able to cure a disease, and in both cases there is a parent seeing a child suffer and wanting the best treatment. The only difference is that in this case, there is a treatment that has been proven to work and with mr. Burzynski, there isn't.

Renate, there seems to be a vast difference between J.J.'s case where the physicians at the McMaster Children's Hospital, and the well- were able to provide J.J.'s mother with the provable data that the particular type and staging J.J.'s A.L.L responds to chemotherapeutic drugs....as opposed to Burzynski's free-standing clinic without hospital affiliations, without any qualified physicians who are trained in pediatrics, pediatric oncology/hematology

Sorry for the double post...I must have hit the "Submit Comment" button too soon.

Renate, there seems to be a vast difference between J.J.’s case where the physicians at the McMaster Children’s Hospital, who are well-trained pediatric oncologists/hematologists who were able to provide J.J.’s mother with the provable data that the particular type and staging of J.J.’s A.L.L, responds to chemotherapeutic drugs….as opposed to Burzynski’s free-standing clinic without hospital affiliations, without any qualified physicians who are trained in pediatrics, pediatric oncology/hematology and the especially false hope they raised for pediatric and adult patients who have intractable-to-treatment cancers.

Burzynski is a licensed medical doctor, as are his son and the other doctors who work for that clinic. Mr. Clement possesses at N.D. certificate from a diploma mill, whose only "consulation" appears to be a short telephone conversation with J.J.'s mother....yet Judge Edward labeled the vegan diet and some positive thinking mumbo jumbo as evidence that J.J.'s mother is following tribal religious practices.

J.J. and her parents were offered every conceivable service which we have come to expect from a terciary care children's hospital, close to home...as opposed to the downright shoddy care offered at Burzynski's clinic, where the recourse is to haul the patient in a taxicab to a hospital for admission to try and revert the dangerous hypernatramia, caused by the anteneoplastins which Burzynski prescibes to his patients and other chemotherapy drugs which have no proven record of putting patients in remission...or curing those patients. He also only makes those other drugs available through the pharmacy he owns....jacking up their costs to further fleece patients.

Clearly J.J. has been victimized by her parents' medical neglect. If those parents don't bring the child into McMaster (or another hospital) to continue her treatment, she is going to die as a result of that medical neglect.

@Narad etc

Actually I didn't introduce the discussion of the actual legal terms - and I have admitted now several times that I probably have put too much on 'intention' in my original definition of 'negligence', and I have said many times that what I am intersted in generally is:

If a person is deliberately targeted by someone intending to deceive them, and they are deceived, to what extent are they to blame for the consequences of that deception?

and then how whatever the answer to that question applies to this specific case. I find this interesting not least because I'm not entirely sure where exactly I stand on either the general or the specific, and I was under the impression that perhaps people on this blog might be able to help me clarify the issue and the answer.

It doesn't seem like that hard a question to understand, and I think that anyone reading my posts with the intention of trying to understand what I am saying would understand that -though they might admittedly have to contend with some dodgy language useage, and yes in trying to get my point across against a vertiable wall of abuse I have made the mistake of getting into semantic arguments that were, from the point of view of what I am trying to discuss, a bit of a side issue.

Narad you seem to be reading my posts simply for the purpose of finding some semantic quibbles,grammatical nitpicking and so forth, whilst skipping over the content. I'm sure that someone with your intelligence could *choose* to put that effort into trying to understand the point instead of simply trawling through them looking for examples of my misuse of language etc, but you have chosen not to, for reasons I know not, but certainly it diminishes you in my view.

So lets agree that I'm not very good at English, not very good at constructing arguments, in fact generally pretty stupid - lets take that as read. So won't you help the poor ignorant confused person understand the question as posed? Or are you going to once again trawl this post just to expose my grammatical inadequacies?
If your not interested in the question I'm posing, and since you clearly think I'm an incompetent dickhead, why are you even bothering to spend the time replying? Why don't you do something constructive like help me to express myself properly, elucidate the question clearly, or at least give me a clear understanding of why in your view the fact that *at least to some extent* this person has been victim to a conman, you don't feel that *at least to some extent* this mitigates her blame for the situation?

JCL: The subject of "medical neglect" was brought up at the top of the thread and you had ample opportunity to find out for yourself what constitutes "medical neglect"...and you didn't.

When Narad and I linked you to the legal definition of "medical neglect", you apparently do not think that applies in the case at hand. You've come up with a new definition (medical incompetence), to explain the parents action for denying their child a 90% chance of survival.

Nothing that I have stated and nothing that Narad has stated are ad hominem attacks directed at you. When you come up with a cogent argument that mitigates the parents' medical neglect, feel free to state it.

@lilady

Indeed, I made a mistake in the definition of 'medical neglect', thinking that it implied more intent than it does. This error has confused the point I was trying to make. I have held my hands up to this mistake numerous times now.

However:

'When Narad and I linked you to the legal definition of “medical neglect”, you apparently do not think that applies in the case at hand.'

This is simply untrue. I have acknowledged my mistake and most clearly many times said that I absolutely believe that it *does* apply to this case - in fact I agree in toto with almost all your statements in content (I have already said this), and stated this many times also. I believe the state should intervene (already said it numerous times), I believe the state should have intervened earlier (already said it numerous times). I completely believe that in this situation and other like it the state should interven whatever the motives etc of the parents. Said that also many times. I completely concur with:

"Clearly J.J. has been victimized by her parents’ medical neglect. If those parents don’t bring the child into McMaster (or another hospital) to continue her treatment, she is going to die as a result of that medical neglect."

I therefore have no argument about there being mitgation for their 'medical neglect', since I now understand that 'medical neglect' is really an objective statement of the situation and involves no judgement on their intentions or any other factor - I'm not even sure that it is the kind of thing that can even be said to be mitigated. If you should do me the favour of actually reading what I have written, you will undertsand that my point has nothing to do with what should happen viz a viz the children, or what should have happened. I regard these aspects as pretty incontroversial. I have said very explicitly that I don't believe practises of any sort that bring harm to a child should be allowed.

So, are you going to keep beating me up for a past failure - now admitted, corrected, and much regretted and attempt to address the question I have posed?

That question has nothing to do with the definition of 'medical neglect', or whether they can be said to be neglectful, which obviously they are, it has to do with actual fault, blame,guilt etc, on which I think the large part belongs to the conman not the conned.

You may have a different opinion on the matter - I would like to hear it and your reasoning. I think it is an important and potentially difficult ethical and moral issue, which this case highlights.

The conman is not a doctor and under the law does not have the duty to provide care (or agree to the provision of care), that J.J.'s parents have. That, after all, is the crux of the matter.

You raise extraneous issues about the conman and other conman (Andrew Wakefield), and have redefined "medical neglect" as "medical ignorance", in a feeble attempt to defend the parents' medical neglect of their child.

The first story of the unnamed girl that i read was full of PC hooey. Some of the blame goes to the ridiculous sjw mentality that is getting out of hand in Canada.

@lilady

Of FFS.
"That, after all, is the crux of the matter." Its the crux of the matter that you want to talk about - and it seems that you want to constrain anyone else from talking about anything else - its not the crux of the perfectly relevant question that I am trying to discuss. Do you set the agenda round here? If you think its OT or something (its not as faras I can see) why keep replying?

"have redefined “medical neglect” as “medical ignorance”"
Have done no such thing - did you even read my last post? At the point of saying that I was mistaken in my belief of what 'medical neglect' meant and was seeking for a phrase that implied the lack of care without necessarily intention to have lack of care. I have been corrected by yourself and Narad, I have moved on - can't you?

"in a feeble attempt to defend the parents’ medical neglect of their child." Defend? No - I don't defend any kind of neglect.

Understanding how the neglect has arisen, what steps led these people to make these horrendous decisions for their children, that is what I am after doing. I am interested in this sort of thing never arising again - I am beginnning to feel that you are quite happy for it to continue to happen as long as you get to be first in the queue for crucifying the parents

I am not that interested in 'legal duty of care'. Of course the parents have such a duty. The parents were failing in that duty. The state should have intervened to ensure the safety of tha child.
What interest me here is that JJs parents seem to have failed in their duty, in some part due to the intervention of a deliberately lying conman.

He is not extraneous - he is in my view central - you may differ from that view (for some reasons that you choose to keep hidden), but I really, really don't see how holding that view is a matter for vilification - and frankly
except for Sadmar, who does seem to understand what I am talking about - I see no rational engagment from you or anyone else with the question at all.

FFS, indeed JCL. You chose to believe that the parents were duped by the White conman from Florida, when we have proof that the mother sought him out by placing a call to the conman, after J.J. had begun her therapy. The conman definitely does not practice tribal medicine and the parents definitely do not adhere to tribal medicine when they follow the conman's raw vegan diet, cleansing enemas and "thinking good thoughts".

Judge Edward was supposed to evaluate tribal medicine, which he did not, before he issued his decision. The tribal leaders, used both cases to score political points against the Canadian government for past grievances and none of the political leaders has spoken out on behalf of Makayla, who is now dying and on behalf of J.J., who most certainly will die...both human sacrifices to tribal politics.

"He is not extraneous – he is in my view central – you may differ from that view (for some reasons that you choose to keep hidden), but I really, really don’t see how holding that view is a matter for vilification – and frankly except for Sadmar, who does seem to understand what I am talking about – I see no rational engagment from you or anyone else with the question at all."

Heh. Are you accusing me of having a hidden agenda because I don't dwell on the conman...when the court case did not address the conman at all?

I suggest you back off your defense of the medically neglecting parents which is, in fact, the crux of the matter...and the reason why Makayla and J.J. will die.

@ pat: It's all PC hooey, when parents from a minority group uses past grievances as a shield, to deny their child life saving treatment.

@lilady

"I suggest you back off your defense of the medically neglecting parents" Again with the false characterization of what I'm trying to do or anything I have said.- I am only trying to have a discussion about a certain issue. Thats the only thing I'm trying to do - have a discussion about one particular aspect - an aspect that has struck me in a certain way, and soliciting views on that aspect.

Am I not entitled to express an opinon or point out something that seems of relevant interest, or solicit discussion, just because it doesn't happen to be the exact way you want to discuss it, or your view is that its not important enough, or whatever?

"Are you accusing me of having a hidden agenda because I don’t dwell on the conman…when the court case did not address the conman at all?"
No. Don't know how you read that. Look, I see that you view the essence of the matter as being about a court case, actions of a judge, the bands and other actors, what shoud have happened wrt the childs welfare - you see Clement as pretty irrelevant really as far as that goes.

Fair enough, as far as I can see I agree pretty much in total with just about everything you've said on all these matters. I've told you that already.

The only real difference is that I happen to think Clements involvement in certain aspects is more central. Thats my view - but even if he is really quite periphery to the issue, why am I not allowed to focus on that aspect if I want? If everyone thinks its irrelevant, then I just won't get replies and thats the end of that.

Ironically, your last post almost contains what would be a plausible answer.

"You chose to believe that the parents were duped by the White conman from Florida, when we have proof that the mother sought him out by placing a call to the conman, after J.J. had begun her therapy."

Well I don't actually choose any belief here - being fully aware that I am short of facts - in fact we all are.

You propose you have proof that she saught him out rather than vice versa - well thats relevant information pertinent to the question - its not an answer to it, because theres a general scope to the way I have phrased it, but as far as the specific case goes it is certainly relevant to what extent marks are pulled rather than pushed.
Bt we'd also have to discuss th fact *that he confidently assured her thtat he could cure her child*. That bit is the con going in, and I personally would like for instance to hear from some of the pschologically trained minions hereaouts about the effect of confidently presented, opimistic and reassuring statements presented to people who are predisposed to believing it.
If that topic doesn't interest you, or anyone else, why not just leave it alone - no-one here is trying to justify parental negelct.

However, my point isn’t actually about the meaning of words its about the attribution of blame in this case. I see this child and her mother, at least to some degree, as victims.

Who is blaming the mother? Let me remind you of your first comment:

There seems to be a lot of opprobrium on the parents here.

Where the hell was it? In the 25 preceding comments, the only thing close was this statement by lilady:

The parents are medically neglecting their child because they cannot, or will not, deal with the realities of their child’s cancer diagnosis. They’d rather stay in denial and deny their child the only chance she has for long term survival.

The first sentence is unquestionably factually true, leaving the second as the "lot of opprobium" that you stepped in to correct. Since then, you have gone off on a fruitless tangent, complained that nobody's heeding your insistence that your bland observation "lead to some interesting discussion," and done nothing else that I can discern.

Gah, cat-on-arm strikes again. I'll just repost, and if Orac sees this, he can flush the comment from "Marad":

However, my point isn’t actually about the meaning of words its about the attribution of blame in this case. I see this child and her mother, at least to some degree, as victims.

Who is blaming the mother? Let me remind you of your first comment:

There seems to be a lot of opprobrium on the parents here.

Where the hell was it? In the 25 preceding comments, the only thing close was this statement by lilady:

The parents are medically neglecting their child because they cannot, or will not, deal with the realities of their child’s cancer diagnosis. They’d rather stay in denial and deny their child the only chance she has for long term survival.

The first sentence is unquestionably factually true, leaving the second as the "lot of opprobrium" that you stepped in to correct. Since then, you have gone off on a fruitless tangent, complained that nobody's heeding your insistence that your bland observation "lead to some interesting discussion," and done nothing else that I can discern.

So,
'There seems to be a lot of opprobrium on the parents'
'seems' indicates my perception - if it is incorrect then something like:
'JCL I think you are mistaken that there is a lot of opprobrium against the parents' - would have been an answer. Your right maybe its simply subjective view. Coloured no doubt substantially by the fact that I feel personally some anger and disgust to the parents. Funny how no-one has conradicted me and said this - so are you actually saying that you and lilady feel no anger whatsoever against the parents - you don't feel disgusted by them, not even a little bit?

'Since then, you have gone off on a fruitless tangent'
Whether its tangential is debatable - I don't think so, you do - apparently round here its simply not allowed to disagree with you about what might be relevant or interesting to discuss. It is certainly fruitless now - even if anyone wanted to put in some form of actual reply you and lilady have made it pretty plain that thy will be clubbed to death for their temerity in having an opinion or wishing to discuss something not sanctioned by you.

"complained that nobody’s heeding your insistence that your bland observation “lead to some interesting discussion,"
I've mainly complained that my apparently bland,tangential, uninteresting and irrelevnat obvservations are being made the subject of a major shutdown operation - and you know what? I can't even figure out why you regard it as so objectionable.

So, obviously you guys have nothing better to do than spend time reading my posts purely for the purpose of 'catching me out' rather than with any attempt to actualy engage.

I am struggling to understand what you think my motives here are, or what you think you are catching me out at.

I don't think one sentence that you or lilady has written have addressed any of the substance I'm trying to get across, and you have completely failed to give me any idea at all about what specifically you find so objectionable.

@ Narad:
'
As long as it wasn't Marad Sade.

at least my creature doesn't sit on my arm: he sits on the keyboard and/ or the satelllite receiver ( he's large enough to cover both)

I once knew a multi-millionaire who's son was diagnosed with a terminal cancer. The father chose an alternative medicine including gold-enemas and whatever else. The son is alive today (who knows why - bad initial diagnosis?) 40 years later. No one dared question that father's right to decide for his son. And therein lies the question. Should the state decide the fate of a child over the parents? Assuming of course, that the parents are generally of sound mind and honestly believe that their decision is in the child's best interest. This question is fundamental when you consider the miserable consequences when the state made these decisions for aboriginal people in the not so distant past.

Should the state decide the fate of a child over the parents? Assuming of course, that the parents are generally of sound mind and honestly believe that their decision is in the child’s best interest.

There's a lot of detail buried in "generally of sound mind," now, isn't there?

http://www.cbc.ca/news/aboriginal/florida-spa-that-treated-first-nation… "Florida spa that treated First Nation girls with cancer faces lawsuits from ex-staff
Director Brian Clement giving false hope, putting patients at risk, nurse says"

Thanks, jypsy, I was just about to post that link. The interview with the director says all you need to know.

Pugh's complaint, No. 502014CA002611XXXXMB in Palm Beach County, was filed in March. It appears that the others have been consolidated under it.

Orac said (emphasis added):

The statement above is simply untrue, and, given that the chiefs must know that what Brian Clement offers is not traditional medicine, it’s hard not to see this statement as, under the most charitable interpretation, disingenuous as hell, and a lie if you’re not as charitable. (At the very minimum there’s a massive case of cognitive dissonance.) Indeed, the other girl, Makayla Sault, is also relying on Brian Clement. Ironically, she is was not even led to her decision to refuse chemotherapy by following the traditional beliefs of her people in that her father is a pastor at an evangelical church and Sault stopped chemotherapy after reporting having seen a vision of Jesus in her hospital room telling her that she was already healed. She is now critically ill, her cancer having predictably relapsed several months after she stopped her chemotherapy.

Makayla Sault has died. See:
http://doubtfulnews.com/2015/01/aboriginal-rights-trump-necessary-treat…