The decision is in: Starchild Abraham Cherrix must have chemotherapy

I tell you, I take a night off from blogging, not even glancing at the blog or my e-mail, instead falling into a deep slumber at 10 PM after The Dog Whisperer on TV, thanks to a somewhat stressful week and a large meal plus a beer, and what happens?

Abraham' Cherrix's uncle comments on the old blog and the legal decision regarding whether Abraham has to undergo chemotherapy is issued, three days later than originally anticipated, that's what! In this case, the judge decided that Abraham must report on Tuesday to undergo conventional therapy. Fortunately, I realize (most of the time, anyway) that the blogosphere won't fall apart if my commentary on an issue is delayed a day. However, since I've been blogging so much about this case, I'd be remiss if I didn't comment on these two developments. Contrary to what some are saying, I'm not "partying" over the ruling in the Cherrix case, although I do consider it to be probably the correct ruling.

First, a bit on the decision itself:

NORFOLK, Va. -- A judge ruled Friday that a 16-year-old boy fighting to use alternative treatment for his cancer must report to a hospital by Tuesday and accept treatment that doctors deem necessary, the family's attorney said.

The judge also found Starchild Abraham Cherrix's parents were neglectful for allowing him to pursue alternative treatment of a sugar-free, organic diet and herbal supplements supervised by a clinic in Mexico, lawyer John Stepanovich said.

Jay and Rose Cherrix of Chincoteague on Virginia's Eastern Shore must continue to share custody of their son with the Accomack County Department of Social Services, as the judge had previously ordered, Stepanovich said.

The parents were devastated by the new order and planned to appeal, the lawyer said.

I'm deeply ambivalent about this decision, but have reluctantly come to the conclusion that it is probably the right one. Here's why I'm ambivalent. I detest quackery like the Hoxsey treatment. I strongly believe that Abraham and his parents made this decision to pursue the Hoxsey treatment based on lies about its efficacy. As I have pointed out before, the clinic where Abraham wishes to go claims an 80% success rate in treating cancer, a figure for which there is no clinical or scientific evidence whatsoever. If I were in Abraham's situation and was told that I could either take nasty chemotherapy with stem cell transplant with what, by my best estimation from the news reports and a review of the lymphoma literature, probably has a probability of cure somewhere around 50-60% or that a nontoxic herbal regimen would give me an 80% chance of surviving, of course I'd pick the nontoxic herbal regimen. The problem is, the promise of an 80% chance of survival is a lie, plain and simple. It is not based on science; it is not based on clinical trials; it is not evidence-based. I detest quacks like those pushing the Hoxsey treatment who will rob this young man of a decent chance of a long and happy life. I hate seeing a young teen seduced by the siren call of such quackery and heading down a path that will end his life prematurely. Given that, I'm relieved that the judge gave him a shot at that long life, even if it was against his will and that of his parents.

On the other hand, my ambivalence derives from my inherent distrust of giving the government too much power over medical decisions and the not unreasonable question of whether a 15-16 year old is mature enough to decide for himself, even if his decision will surely result in his death at a young age. If Abraham were a 60 year old instead of a 16 year old, I would concede that he has every right to decide to use quackery instead of evidence-based medicine, while at the same time decrying the unsupported claims that led him to that decision. But Abraham is not 60 years old; he is 16 (and was 15 when he chose the Hoxsey therapy). I'll concede that this is a gray area. I'll also concede that we as a society exercise some hypocrisy in this area. For example, in some cases, society will consider a 16-year-old an adult for purposes of punishment when that 16-year-old has committed a particularly heinous crime and try such teens as an adult, with the full possibility of adult punishment. In some circumstances, 16-year-old girls can choose to undergo an invasive medical procedure (an abortion) without parental consent. In both of those cases, we consider a 16-year-old to be "mature" enough to be treated as an adult for purposes of the law. The difference in Abraham's case is that he clearly does not understand what he is doing, his protestations that he's "done his research" notwithstanding. It might be different if he understood that he is going to die if he doesn't get the conventional therapy that he needs and is opting for quality of life over quantity of life (although death by untreated Hodgkin's disease is not very pleasant). However, from interviews I've read or heard, it is clear to me that Abraham believes that the Hoxsey therapy has a good chance of curing him. Worse, rather than trying to persuade him to act to save his life, his parents are feeding this delusion.

When the parents of a minor (in this case, Jay and Rose Cherrix) pursue a course of treatment that is so obviously quackery, the state does have an obligation to step in. In the case of someone like Katie Wernecke, a 14-year-old who was diagnosed with Hodgkin's lymphoma when she was 13 and whose parents wanted to pursue high dose Vitamin C therapy rather than conventional therapy, I have to come down on the side of the state's right to prevent her parents from harming her through an acceptance of clear-cut quackery, as few would argue that a 13-year-old is old enough to make such momentous medical decisions. Her case, as far as I'm concerned, is no different than the case of a Jehovah's Witness who refuses to let his child be transfused after an auto wreck or Christian scientists who refuse chemotherapy for their child with cancer in favor of prayer. In all such cases, the state needs to step in. The only reason Abraham's case causes me pause is because he is older, on the cusp of becoming an adult.

All of this leads me to a comment left on the blog by someone calling himself Forrest, who represents himself as Abraham's uncle. Based on the tone of what he wrote, I believe that he probably is indeed who he says he is. Forrest writes:

I am a scientist and this boy's uncle. Among the other things I have read here are fair amounts of unsubstantiated character attacks on Abraham, Jay and Rose.

Those of you doing that should feel ashamed and probably need to spend some time in self-reflection.

I'd be the first to agree that eccentric is probably a good label for them, but they are not evil, and far from stupid. I am also of the camp that subscribes to treatments with proven efficacy. But I am also a widower who buried a wife who did conventional and alternative therapy for stage 4 colon cancer.

Abraham is 16 and he will die. I'd prefer it if he were 80 when it happened, but it may happen this year or next. If he asked my advice, I'd recommend chemo.

However, I was not asked and for the record, neither were any of you pompous bastards.

You may not like it, but the same government that can't even fix the potholes in Virginia's highways has no business making medical decisions for anyone. It may be Darwinian, but it's none of your damn business, so debate all you want, bue please let me join in when your wife or hubby or child is sick and command you do my bidding. Better yet, let's get some nameless hack of a bureaucrat to decide if it's going to be chemo or radiation for your cute little baby.

First, let me express condolences regarding Forrest's wife. Unfortunately, her situation is not analogous. Stage IV colon cancer is not curable. The only exception is in cases where there are metastases only in the liver that can be successfully resected surgically, in which case there is between a 20% to 30% chance of long-term survival. Sadly, only a small minority of patients fit into this category. All I can say is that alternative therapy would not have saved her life either.

Second, Forrest clearly recognizes that Abraham will die if he continues on the present course, which shows that he recognizes the Hoxsey treatment for the quackery that it is. Nonetheless, I have to point out that it is irrelevant whether Abraham has asked for my or anyone else's advice. His case raises important issues regarding the balancing of the rights of parents to raise their children as they see fit versus where the obligation fo the state is to step in when the parents are clearly choosing outrageously badly. Consequently, it is fair game for comment by anyone. I have to ask: Does Forrest object to those raging about the "tyranny of the state" or making specious references to the Nuremberg Code in this case, making impassioned defenses of Abraham's and his parents' decision, and urging Abraham to fight on, a sampling of which includes bloggers and pundits such as Below the Beltway, Bronwyn Lance Chester, SpunkyHomeSchool, or Mike Adams, among many others? Apparently, that's OK, but it's not OK for me or commenters on this post such as anjou, a prolific commenter who is also a lymphoma survivor, to comment or appear unsolicited advice if that advice happens to be: Don't fall for the false promise of the Hoxsey therapy. Yes, I will admit that some commenters in some posts flirted with going over the line with comments about Darwin or natural selection, but Forrest should also be informed that I exercise very little control over what commenters say as a matter of blog philosophy. Interventions are rare and generally only in the cases of serious trolling, comments that might represent libel, or commenters who are so disruptive that I'm reluctantly forced to ban them. I strongly believe in freedom of speech, and my blog is run accordingly.

We must remember that it is entirely possible for parents to make bad, even incredibly bad, health care decisions completely out of love and that such decisions don't necessarily mean that the parents are bad parents otherwise. For example, I'm sure the Jehovah's Witnesses who deny blood transfusion to their children or the Christian Scientists who think that prayer is the way to deal with serious diseases love their children just as much as any other parent. Similarly, none of us is claiming that Jay and Rose Cherrix don't love Abraham and want the best for him. However, that love does not mean that the state has the obligation to support their bad decision. The only gray area is not whether the state has the right to intervene to protect children from medical decisions on the part of their parents that are so bad as to constitute neglect. Parents' rights to raise their children as they see fit do not extend to clear medical neglect. The only question that matters in this particular case is whether Abraham is mature enough to be considered an adult in the eyes of the law. I would hope that we could have a reasonable debate about whether he is in fact mature enough and the other Constitutional questions raised by this case, free from the hysterical "Social Services is coming for your children" rhetoric from Abraham's lawyer and rants against the medical establishment from credulous bloggers who mistakenly believe that quackery like the Hoxsey treatment can actually cure cancer.

In reality, the judge was placed in a no-win situation. If he ruled for Abraham, he would be acquiescing to the death of a minor due to medical neglect and quackery. Now that he has ruled against him, he will be subject to unrelenting attacks from people and groups who argue either for the absolute right of people to choose non-evidence-based medicine and for parents to raise their children any way they see fit, even when, as in this case, they choose quackery that will clearly result in their child's death. (Indeed, it wouldn't surprise me in the least if he, like Judge Jones in the Kitzmiller v. Dover case, were to receive death threats.) Similarly, in Abraham's case, as in many other cases, conventional medicine is in a no-win situation. If Abraham dies despite receiving conventional therapy for his lymphoma, alties and altie activists like Hulda Clark's pit bull Tim Bolen will blame conventional medicine for "poisoning" and "burning" him to death against his will. If conventional chemotherapy and stem cell transplant succeed in saving Abraham, alties won't attribute his survival to that conventional therapy, but rather to the Hoxsey therapy that he has taken thus far and no doubt will continue to take if he ultimately submits to conventional therapy.

Nonetheless, I and (I daresay) most doctors favoring the practice of evidence-based medicine are willing to deal with such abuse and lack of credit , though, if it means that Abraham and children and teens like him survive their cancers.

Previous posts on this topic:

Two young victims of alternative medicine

Update on Abraham Cherrix
A "defense" of Abraham Cherrix and his parents?
Magical thinking versus lymphoma
Choosing quackery over evidence-based medicine: When is a patient old enough?

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Thanks for the excellent commentary on this difficult case. My outspoken comments on this topic stem from talking to a lymphoma patient on her death bed, after she followed a path somewhat similar to Abraham, regretted her decision and was desperate for the transplant when it was too late...I miss her.

I think it's the right decision, for the simple reason that the kid hasn't shown the proper competence to make the decision. I base this upon the arguments precented for his choice, which are based upon undocumented claims of a clinic outside the US, showing clearly that he doesn't grasp the concepts properly.

Unfortunately, many adults are not able either to do so, but there is a lower bar for them.

By Kristjan Wager (not verified) on 22 Jul 2006 #permalink

If this were Abraham's first bout with the cancer and chemo this may be a different case. He gave conventional treatment with its high cure rate a chance. For whatever reason it failed him. He is part of the 15-20% that it didn't work for. Now he wants to try something else. If chemo fails again as the judge has ordered it could kill him. Who pays when the state makes a decision and it fails? The bottom line is that in this country we give deference to the parents NOT the state. The parents are not medically neglectful. They went the conventional route. Now they are willing to try something else. That is not neglect. To me that is exhausting all options not just the socially acceptable ones.

If he kicks and screams in the hospital, are they going to tie him down? knock him out with a hefty dose of morphium first? Any docs here care to comment on this? How would YOU administer legally imposed medications to a young patient who's refusing it? How far are you willing to go to get the treatment in him? Kristjan Wager, how far would you go before you started to feel like a tormentor? Anjou, How would you do it If a judge ordered YOU to perform the healing? It's easy to pontificate from behind a keyboard but how about the reality of actually having to administer it? Because after we have all finished BLOGGING, someone is actually going to have to cary out the law. Any volonteers here?

Orac, you fell for the phoney line about the government making the decision. The decision to treat was made by competent medical staff motivated by the sincere belief that they have a treatment that may help.

Now, with this added delay in treatment, his chances of survival have diminished. I have NO DOUBT whatsoever that if he does not survive, the anti-science, know-nothing wackos will bleat and bray over his death and use it to "prove" that conventional treatment does not work.

Further, I predict to a certainty that these same critters will whinney and whine about the government getting involved and come up with all of the usual conspiracy crap they use to substiture for facts. I won't bother to reply to them, unless they come up with one I have never heard of before. I have heard them all.

If this were Abraham's first bout with the cancer and chemo this may be a different case.

No, it's not (see below).

He gave conventional treatment with its high cure rate a chance.

No, he didn't "give conventional therapy with its high cure rate a chance." It sometimes takes more than one round to achieve that high cure rate, and patients with relapsed Hodgkin's lymphoma still have a decent chance of surviving--if they get the right therapy in a timely fashion.

For whatever reason it failed him. He is part of the 15-20% that it didn't work for. Now he wants to try something else.

Yes, he wants to try quackery with virtually no chance of curing him in preference to conventional therapy with a decent shot at providing him with long term survival. Let's put it this way: If Abraham and his parents wanted to try crystal therapy or, like Christian Scientists, wanted to eschew chemotherapy and use prayer alone, should the state let them? If not, why not? Remember, there is no good evidence to suggest that the efficacy of Hoxsey therapy is any better than crystal therapy or prayer alone.

If chemo fails again as the judge has ordered it could kill him.

When the Hoxsey therapy fails, he would definitely have died.

The bottom line is that in this country we give deference to the parents NOT the state.

Only up to a point, and that point is when the parents actions endanger the child's health, which is as it should be. Believe me, I'm not thrilled with this entire case or how it turned out, because it places two of my belief systems in conflict, my belief in evidence-based medicine versus my inherent distrust of state power. However, reluctantly, I conclude that the judge made the right decision.

Orac, you fell for the phoney line about the government making the decision. The decision to treat was made by competent medical staff motivated by the sincere belief that they have a treatment that may help.

I don't think I "fell for" anything.

Of course competent medical personnel made recommendations for therapy for Abraham's Hodgkin's disease, but when Abraham and his parents rejected those recommendations in favor of quackery it was the state who stepped in on the side of those competent medical personnel.

First, let me express condolences regarding Forrest's wife. Unfortunately, her situation is not analogous. Stage IV colon cancer is not curable. The only exception is in cases where there are metastases only in the liver that can be successfully resected surgically, in which case there is between a 20% to 30% chance of long-term survival. Sadly, only a small minority of patients fit into this category. All I can say is that alternative therapy would not have saved her life either.

Does this mean you AREN'T a pompous bastard?

Orac, I share your ambivalence, and admire the clarity with which you explained it. As the son of a judge, I (in theory) trust the courts to some degree, and see a significant difference between a court decision and the pathetic congressional Schiavo debacle. But yes: if we had to vote in an all-or-nothing way, I guess I'd go for allowing people to make their own decisions free from government involvement, assuming it's been made clear exactly what the options are how the data behind them can be evaluated.

While the human rights issues are arguable, in view of Adam being almost adult, no one should be in any doubt as to the medical issues.

Five year survival rates at the Biomedical (Hoxsey) Centre have been published and are described here ---

http://members.bordernet.com.au/~pmoran/cancer/Alternative_studies.htm

The claim of an 80% success rate is not only a lie, it is obvious that this clinic does not keep good enough records or follow its patients up well enough to even know what its results are.

If you would like to know what the survival rate overall (i.e. including
even the most advanced and aggressive cases) with conventional treatment of
Hodgkin's disease see here

http://members.bordernet.com.au/~pmoran/Hodgkin'ssurvival.htm (Canadian
figures)

The results with early stage disease are much better with over ninety per cent ten year survival. While lacking full details of his case, Adam's chances may lie lie somewhere between with the planned radiotherapy and the latest chemotherapy.

The true challenge here in treatment will be in getting the patient and family to cooperate with a complete course of therapy. I don't know all the case particulars, but it doesn't sound like he's at stem cell treatment level yet. A full course of drugs for the months it will take to successfully treat him is going to be a challenge with their past history. I suspect they'll try to whisk him away to Mexico when no one is looking.

Another point not mentioned is that even if he is not cured, appropriate therapy will buy him extra months to years of life with decent quality of life. If he bolts after one course now like he did before, it will at least buy him a little time. At that point I'd try negotiating with them to at least accept some palliative treatments to go along with whatever woo they want to take. Salvage with stem cell supported intensive therapy is reasonable, but the cure rate ain't so great, the toxicity moderate to high, and with a reluctant patient I'd consider it contra-indicated.

This is just another chapter. In what I suspect will be a series of unfortunate events without a happy ending.

What are these legal distractions doing to Abraham's health? Whether chemotherapy will work for him this time as it didn't before; what have these doctors and lawyers and social workers already done to his state of mind?
I have to believe that his emotional health is just as important. And without any consideration by these Powers That Be. The big picture wasn't seen in the tunnel vision of control over Abraham's body.

http://www.newstarget.com/019617.html

The advice here- steer clear of conventional docs and only take your kids to naturopaths because they will support you and not report you is terrifying.

By impatientpatient (not verified) on 22 Jul 2006 #permalink

I'm still waiting to hear from our in-house docs how they would execute this court order were Starchild to refuse treatment inside the hospital.

I have to believe that his emotional health is just as important.

Having decent emotional health is pretty darned difficult if you're dead.

The advice here- steer clear of conventional docs and only take your kids to naturopaths because they will support you and not report you is terrifying.

Indeed. Mike Adams is a twit. He's exactly the sort of person I had in mind when I came up with the whole You Might Be An Altie If... schtick, only he's even more militant than that. His skepticism towards anything that resembles conventional medicine is unending, while to him everything alternative is automatically good.

Re a 2005 case

http://www.forbes.com/feeds/prnewswire/2...HS_HSPROF1.html
ROUND-UP: PARENTAL RIGHTS IN MEDICAL CARE

Following are experts who can discuss the rights of parents to control the medical care of their children, in light of a current battle over a court order stating that a Utah boy must receive chemotherapy despite his parents' wishes:

1. JAMES "MAC" STEWART, attorney at Dallas' STEWART & STIMMEL, has been involved in several cases involving the medical care of Jehovah's Witnesses: "A parent's ultimate ability to consent or not consent to a child's medical treatment is typically a complicated and fact-driven issue. The courts, however, have recognized that the parents' rights are not absolute. The state can intervene, and in some states, minors may sometimes make decisions without parental involvement, particularly in dealing with pregnancy or the treatment of substance abuse or sexually transmitted diseases. However, minors generally do not have the capacity to make decisions for themselves, and parents sometimes make decisions that can be harmful to the child. In those situations, the state may intervene." News Contact: Rhonda Reddick, rhonda@legalpr.com Phone: +1-800-559-4534 (7/27/05)

2. ALICE HERB, J.D., LL.M., professor of the health advocacy graduate program at SARAH LAWRENCE COLLEGE: "While the parents' constitutionally protected rights to make decisions for their children is undeniable, the state also had a right to intervene as 'parens patriae' to protect children from preventable or remediable life-threatening events. The state's right to intervene when a child is in imminent danger is clear. The state, however, has the burden of proving the child's health or welfare is at stake in order to overcome the presumption that the parents make decision in the best interest of their children." News Contact: Marilynne Herbert, herbert@halsteadpr.com Phone: +1-212-734-2190 (7/27/05)

3. RICHARD WEXLER, executive director at the NATIONAL COALITION FOR CHILD PROTECTION REFORM: "A parent's right to control a child's medical care cannot be absolute. But unless there is clear and convincing evidence that a child will suffer serious illness or death, the intervention by the state is likely to do more harm to the child than allowing the parents to make choices that some in the medical community may consider unwise." Wexler: rwexler@nccpr.org Phone: +1-703-212-2006 (7/27/05)

Orac,

As difficult as this case is, I'm firmly convinced that you're conclusions and principles are correct (even when they're in tension) and thanks for keeping us up-to-date on it.

I have thought about this and read some of the comments and I have worked in the oncology ward....had a best friend die of bone cancer..and a aunt with liver cancer... I have seen first hand from relatives and patients...pure sick and half dead from the chemo and radiation....when they under go these treatments there white cells are almost none in most cases even in young adults.....and any type of germ that they may come in contact with could kill them... and I say could doesn't mean it will but theses are chances that people take....I guess what else i have to say is I have 3 children of my own...and i just had another one early last year he is healthy and well but his father is jewish i am not i am christian....we decided he would not get his shots till he was a year old due to the high levels of mercury in alot of them!!! to explain more why there have been several cases of infants dying do to these shots with high levels of mercury some babys are unable to handle it where others aren't i remmember my first son who is 8 now would have extreme and rair reactions from his shots!! like fevers of 105.0 and we would have to take him to the hospital every time so back then i sayed to the dr after this had happend a few times that i would like to pass on the shots for awhile...and he didn't really approve but there was nothing he could do... now with my new some he just started his serious of shots and he is a little over a year although he has not been exposed to daycare and such he is at home but....my thought is in rare cases these things give bad awful reactions too and its possible a unsafe thing...they con't force you to give these shots to you babys'....all they tell you is that it needs to be done or started before they go to school.... or unless it is religious purpose and the pastor or whomever rabbi signs a paper of religious reason for not to do so.. also i said i work in a hospital when a patient refuses something like medicine or blood work or things such as that we aren't allowed to do it...if we were to do it with them telling us stop it would be like rape they are saying no and we keep on how fair is it mabey chemo is the best route for this poor kid but he didn't ask for cancer no one does....I live in florida and i have seen 16yr olds get in major trouble and they stand trail....i have seen some go to jail over things and are serving a few years we just had a thing happen few days agos it was all over the paper of 3 kids under the age of 17 but at least one was 16 yr old kill and murder someoen kidnapped another and injuried a 3rd person I am sure these kids will have hell to pay for there decsion that they made when they did all of this....its just this it all torn to me i think this teenager ought to have rights!!! whether they are good bad or neither.....because you never no what will happen he could go throught all this chemo and still pass away so while going through chemo he is sick all of the time every waking moment and it does no good he has spent his final days with chemo.....I have another lady friend that choose not to have chemo she has liver cancer they tell her they can prolong her life but she will dies from this she debated long and hard of how she would live out her final year mabey months and she choose to not due chemo because she said she wante to go and see a few places and travel before she went well she has lived past a year now almost 2 she has a bad day or so gets soem iv fluids and keeps on going......I guess i belive when 3 boys committe a crime they say well they were in there right mind to make this decesion to do it so they will pay the time.....this is america land of the free people from other countries come here for just that reason.....free of speach and decesions......next they will tell me if i don't give my kids there shots they will take them away from me even if my kid has extremely rare ill effects towards them....
Sorry for any spelling and gramar i just came off of a 18 hr shift and have been up 24 hrs have a good nite...

a particularly poignant comment on this topic from a woman on a hodgkins support board:

I was really staying away from commenting on this but I just couldn't refrain anymore. I've had two auto SCTs and decided against having an mini allo SCT after a 4-month legal battle with the insurance company who denied the transplant. While I definitely agree that people have to decide what they are willing to endure and where they draw the line between quality and quantity, I just don't think this situation is in that range. This is a young kid who really has no idea how much he can endure -- or for that matter what "quality" really is. ABVD chemo isn't easy and is harder on some than others but this is a kid who had three rounds of ABVD and was nauseated and felt that was too much. An auto SCT definitely isn't a walk in the park and I can understand why if he thought ABVD was too much why he would balk at an SCT but the reality is that the success rate of auto SCTs for HD patients is extremely high. In this particular case, I think the adults in this child's life need to step up and not cave into the feelings of a kid who doesn't want to be sick. It's way too soon in the game for this kid to go the experimental treatment route and his parents should know that.

--------------------
Anne-Marie
Diagnosed: 2/08/2002
ABVD: 3/2002 - 10/2002
Thoracotomy/lobectomy: 6/14/2002
Diagnosed with Sarcoidosis:10/2002
Spleen removed:12/02
ICE: 2/2003 & 3/2003
Tandom SCTs:5/2003 & 6/2003
Radiation:12/2003 - 1/2004
Allo BMT:Denied by insurance, sued, settled for $
Buying Time 9/26/05-2/20/2006:Gemzar/Cisplat, Modified MOPP 5/11/06 - ?

This is indeed a difficult case.

A 16 year-old should be able to take part in the decision process and if need be should be allowed to make decisions based on false hope and false information.

I note that another cancer-quack Matthias Rath is finally on trial for medical fraud in Germany.

http://www.spiegel.de/wissenschaft/mensch/0,1518,425647,00.html

In this case the victim was a nine year old boy with cancer. rath convinced the parents to stop chemotherapy and instead take his high dose vitamin preparations. Dominik died in a cancer clinic in Mexico. Rath then bizarrely claimed that Dominik was proof of the efficacy of his vitamins. Even the parents still support Rath's alternate version of reality despite autopsy results confirming that Dominik died from a massive tumour. I guess that the parents cannot admit to themselves that their decision lead to their son's death.

Should Dominik's parents also be on trial? I doubt that Dominik had much input in the decision or was old enough to make such a decision. I don't think falling false hope is a crime, however.

I hope Matthias Rath ends up behind bars where he belongs.

By Chris Noble (not verified) on 23 Jul 2006 #permalink

First of all, I think we can all agree that the only real criminals here are the deceptive altie clinic, for offering ineffective treatment under false pretenses. Unfortunately, they're beyond the reach of US law....

That said, I can respect Orac's reasoning, but I still think this decision is a Bad Idea in the long run. Consider what could happen when an altie judge makes use of the precedent! Say, a chelation sympathizer deciding how to treat an autistic kid, perhaps in an institution....

By David Harmon (not verified) on 24 Jul 2006 #permalink

lynn wrote "we decided he would not get his shots till he was a year old due to the high levels of mercury in alot of them!!! "

Please read
http://www.fda.gov/cber/vaccine/thimerosal.htm ... which shows that there is very little if ANY thimerosal (much less mercury in vaccines). So you are basically putting your baby at risk for something worse (pertussis, tetanus and HiB) because of a non-issue.

Plus, please try to be more judicious in where you get your health related information on the Internet. While researching Google on Hoxsey's herbs I came across over 100 websites claiming it worked (in other words: liars), to every website that could be considered truthful (a few of which I posted on the most recent blog comment).

When searching for health related information stick to something that can at least get you something relevant like http://www.medlineplus.gov/ (which works like Google as a search engine, only the sites have been looked at by knowlegeable humans)

There is a simple answer to this case. It's not about what YOU or the government feels is the right choice, it's about the personal choice of an individual to treat his or her own illness as they wish. He became very very ill as a result of his first chemo which was NOT sucessful and HE does NOT wish to undergo it again. Also last i checked the sucess rate of chemo was not 100% or close to it and in many cases as with my own mother the treatment KILLED her because it weakened her body so much. This young man is old enough in the laws eyes to drive a car,get a job and if he was to commit a crime;to stand trial as an ADULT so if he makes a personal choice and his parents support him then leave him alone to do what he feels is best for HIM. This is supposed to be a free country so who's place is it to tell what is in your personal best interest? NO ONE!

Aaron-- just a few errors in your arguement-- as a juvenile he would be tried as a juvenile, not in adult courts. Rare exceptions occur in instances when a juvenile commits a particularly henious crime. Please correct me if the juvenile justice system has changed significantly in the last five years when I consulted with them.

As a lymphoma patient, know many who have been in his position, done will with transplant gone on to college, one who adopted a baby and several who are just plain glad to be alive. Chemo for relapsed hodgins is very often effective. The Hoxsey treatment is not.

It's rather ignorant to refer to people who believe in another way than you as wackos and weirdos etc.. I happen to know people who have been cured of cancer by other than conventional chemo and radiation. As I have never been in that situation, I am not completely sure which route I would choose... but I have a choice. I have done some research (just in case!!) while I am still outside the situation and have no emotions tied up in a decision making process. From what I have learned, I am pretty sure I would go with what you would consider wacko. Before everyone starts spouting off, maybe you should do an in depth study of different methods of treatment. In speaking to friends that are doctors, they have made statements that in medical school they are not taught "alternative" medicine. Those that have studied on thier own have incorporated it our traditional approach with better results. Its never to late to learn something new, but you can't be close minded about it.

Before everyone starts spouting off, maybe you should do an in depth study of different methods of treatment.

Are you even remotely aware of Orac's field of expertice?

In speaking to friends that are doctors, they have made statements that in medical school they are not taught "alternative" medicine.

Neither are you taught the geocentric idea of the universe when you study Astronomy. Alternative medicine is stuff with no supporting evidence for its effectiveness. It's quite proper that doctors are not taught such things. They have enough evidence based medicine to learn.

By Kristjan Wager (not verified) on 25 Jul 2006 #permalink

With all due respect to Anne-Marie, who has obviously been through a lot, I completely disagree with her statement "This is a young kid who really has no idea how much he can endure -- or for that matter what "quality" really is". That statement shows a great disrespect to Abraham as a human being quite capable of making decisions. As a minor, his parents are legally responsible for him and they agree with his decision.
This case is very simple: does the GOVERNMENT have the right FORCE medical treatment on a 16-year-old boy whose parents agree with his wishes?
And if the answer is 'yes', how long before the government starts using it's 'better judgement' on other aspects of our lives? I shutter at the possibilities - one of which includes a 16-year-old strapped to a gurney with poison being injected into his body.

I happen to know people who have been cured of cancer by other than conventional chemo and radiation.

Do tell. Please give details. Or is this just another vague testimonial?

KG-- I think someone who as close to death and has been through as much as Anna Marie probably has a deeper appreciation of the quality of life (vs death) than most of us She is significantly older than Abraham and in an age group where hodgkins prognosis is worse.

The cancer will kill him faster than the chemo (or poisons as you call them). As a lymphoma patient, who's endured chemo-- the months were certainly worth the seven good years of life Ive had since- have had numerous trips, hiking all over the world, New Zealand planned for the fall, also deep love in my life and have even taken up painting. None of these things would have happened for me if I hadnt taken the so called poisons.

Folks I know who've been in the exact same situation as Abraham and had "the posions" have been "cured, gone on to have kids (in one pretty amazing case), adopt, gone on to college, loved, travelled etc. Abraham is opting out of these experiences-- he'll be pushing up daisy's if he pursues his chosen treatment for sure. Some dont make it, but, with a cancer like hodgkins, odds are quite good that he would. Of course my stories are "testimonials" so, why not go to the National Cancer Institute and look up survival stats for kids in his position who go thru conventional treatment. With out it, the odds are damn near zero, or zero.

Harry Hoxsey, the guy who developed the treatment they think is so wonderful..died from cancer... go figure...

"Until you've walked a mile in someone else's shoes"...No I'm not an "altie", but am dealing with the ramifications of chemo from 20 years ago.

Yes I'm alive, but it hasn't been an easy 20 years...so in the name of cetain freedoms, let the family know what you think, and what their options are, and then let THEM decide.

FWIW http://spleenlessvents.livejournal.com

If I thought you were really interested, I would give details. Since it is easy to see you are only looking to mock, there is no way I'm giving someone else's medical history to you. I won't be back to check on this blog so you needn't bother to respond.

Actually, whether you believe it or not, I was interested, and I would not have "mocked" anything. I wanted to see if your stories actually had anything about them that might make me wonder. I would, however, have applied a skeptical eye to the story, as I do with all such stories.

How convenient, though, that, when you were asked to produce some details that might let us see whether your "cases" had anything about them that might suggest efficacy of the therapies used, you manage excuse yourself from doing so because I might be too skeptical, huffing that you "won't be back to check."

I'm betting you'll probably be back.

We still haven't answered the real question here.
When this kid gets admitted for his chemo he will need an IV. What if he refuses?
Do I assault this kid with a needle?
Is the judge going to come to the bedside with his order and hold this sixteen year old down while I start his IV? This isn't some little kid we are talking about here, this is a big teenager who could kick my ass.

Talking about something means nothing. Implementing an order is a whole other kettle of fish.
How am I going to keep the kid in his room? In the hospital?
Do we lock his hospital room door?
If he pulls out his IV every time we put it in what then?

The kid is sixteen, if he doesn't want treatment he won't get it no matter what some judge says.
Unless the judge writes an order for a twenty four hour seven days a week security detail to restrain this kid until his treatment is finished he wont be getting any treatment.

I wish people would use a little damn logic when they make decisions.
Nurses will not be tying up some kid against his will and locking him in a room unless the police are involved.
I don't get paid enough for that.
Sure I think the kid is an idiot for not accepting treatment, sure I wish someone with half a brain had cared for him better when he went through chemo the first time so he wasn't so freaked out but none of that changes the facts..the kid doesn't want it and we can't force him to take it just because some judge and a bunch of social workers are involved....the social workers aren't going to hold him down while he gets his IV started are they?

Everyone will write copious notes to cover their asses and the kid will take his witches brew of fakery and there ain't a damn thing we can do about it.

My brother and nephew both died while taking "alternative" treatments for cancer from a clinic in Mexico. Both lived less than one year after diagnosis and the side effects of the "treatment" rivaled any of the chemo or radiation side effects that I have heard of. You think nausea is bad? My nephew had to undergo surgery to repair his lungs after the herbal treatment he was told to inhale ate through the lining in his lungs, resulting in bleeding in the chest cavity. Of course, the "clinic" claimed he was using the "treatment" incorrectly -- it was his own fault!

By Christine (not verified) on 31 Jul 2006 #permalink

"Harry Hoxsey, the guy who developed the treatment they think is so wonderful..died from cancer... go figure..."

Actually he did not die from cancer, he died from heart failure. He did have cancer though. His doctor was out of town and the physician signing the death certificate knew he had cancer and wrote that on the certificate. His doctor returned and said that it was heart failure, not cancer that killed him. I am sure though that you all will twist that too.

Have you ever talked to anyone who was cancer free from using alternative methods. People die who have had chemo and some live. Same with alternative medicine. How can someone be forced to do chemo when it is not a cure? I have spoken with people on both sides. It is an individual choice.
The circuit court suspended everything the juvenile court said and even had a brief written to the court in favor of the Cherrix family from the VA Attorney General. YEAH!!
Save your applause on the Junvenile court's decision Orac. It's now history. It is gone and no longer in effect. I think the Cherrix family is going to win and set a precident for other families across the USA. The oncologist told Billy Best at 16 that if he didn't finish his chemo and radiation that he would be dead in a year. He said no to chemo and was cancer free before his 17th birthday and lives a healthy life years later thanks to alternative medicine.
Open your hearts. Did you even think about the idea that Abraham is reading this. To the ones who are the negative ones saying you are going to die Abraham - ignore those heartless fools and say a prayer for them instead. Pray that God will open their eyes and hearts through you.
Go for it Abraham. Be strong and get better. Remember that every day all the stupid people in your life wake up and think of ways to make your life miserable. All of the loving people in your life think of ways to make you stronger, healthier, and happy.

Have you ever talked to anyone who was cancer free from using alternative methods.

If you could direct me to one who has verifiable clinical evidence that he/she was cured using "alternative methods," please do say so. I've never encountered such a person, and believe me I've kept an eye out. I keep hearing about all these "cancer-free" people, but no one ever seems to be able to point me to one of them whose case can be medically verified as a cure due to alternative therapies.

Did you even think about the idea that Abraham is reading this.

I sincerely hope that Abraham has read some of my posts. He needs to know the truth about what quackery the Hoxsey therapy is, and if he's old enough to decide not to undergo chemotherapy he's old enough to hear the truth about his disease. I also hope that he reads the post in which I described a bit how dying of untreated lymphoma is anything but pleasant and certainly not dying "strong and healthy," as he thinks he will die. Those tumors in his neck may obstruct his trachea as they grow, requiring a tracheostomy for him to breathe. They may also obstruct his esophagus, so that he can't eat or drink, necessitating the placement of a feeding tube. He may experience severe, unrelenting pain before the end, and a number of indignities. He needs to know these things, not to scare him, but to teach him that he's living in a fantasy world if he thinks that if he dies while on the Hoxsey therapy it will be peaceful. He could well suffer for many weeks or months before the end.

I tend to doubt that Abraham has read my blog, although my linking to his site and his his uncle's having showing up in the comments of one of my posts gives me hope that he may have. I doubt it would matter much though, as he seems to have shut out any evidence that might challenge his choice in this matter.

So you will believe someone who says that chemo got rid of their cancer but not someone who says that alternative methods did?
You may not agree with the person who wrote the book Curing Cancer without Killing Yourself but in his book he shows photos of his oncologist's medical records. Do you go through people's records that have had chemo? No I doubt you do. You just take their word. You assume everyone else is a liar.
You are probably right about it not mattering to Abraham about what you say. He is smart enough to see right through your bull.
I noticed that the well publicized Billy Best story shoots down your theory of alternative medicine not working and you avoided that one. The oncologists said he only had a year to live without chemo. Duh? They were wrong. Of course you will probably say that the nationwide media lied.

So you will believe someone who says that chemo got rid of their cancer but not someone who says that alternative methods did?

Roger's inadvertently pointed out the fundamental difference between alternative medicine and scientific medicine. To alties, the basic mental process for evaluating treatments involves applying belief to persons, whereas for scientific practioners it involves applying knowledge to evidence. Science involves taking an impersonal view of the physical world, and this is offputting to a lot of people. Part of the problem is the "Vulcan" stereotype, in which people mistakenly assume that a scientific worldview requires one to be cold and emotionless; science does not require that one be socially "geeky, dorky, or nerdy" (nor does it require that one not be; the two things are simply independent). But a bigger part of the problem is that way too many people, and I think this is particularly common among the affluent in developed societies, suffer from a form of narcissism in which they expect, or perhaps demand, that the bare facts of physical reality give meaning to their lives. They expect themselves, and those they like, to play a starring role in the universe. They're simply looking for meaning and fulfillment in the wrong place. They're trying to fill a void in their lives, but they're filling it with make-believe stuff.

Ultimately, this form of narcissism turns into laziness, as one becomes convinced that merely wishing for something to happen is the same as making it happen. And that laziness turns into gullibility.

A thirteen year old is old enough to have a baby or have an ABORTION and many young girls can do it WITHOUT their parents permission, 16 yr olds can marry, become emancipated, be tried as an adult, drive a car, if they are given the right to abort (KILL) a baby then who do we think we are to say that the government or any doctor has the right to remove his right to decide on his own what treatment to get. Government is far overstepping their boundaries and all of the fools supporting it will be the first to CURSE and scream when the government takes away your guns, etc. - how hypocritical, the parents and the boy should be left alone to do what they feel God leads them to do - and people should start tending to their OWN business and families and stay out of others, this is definitely not an abuse case, move on to the underage who are killing babies and take that right away because it is MURDER and that should be illegal!

By Rev. Lowery (not verified) on 11 Aug 2006 #permalink

So, Rev. Lowery, would you agree that the scam artists in Mexico who run the clinic that takes money for worthless cures from desparate cancer patients are also murderers?

Unfortunately, the outcome for the patients using Hoxsey therapy or others (like Hulda Clark's zapper) is most often death.

Where is your anger towards those that sell false cures?

Rev. Lowery is clearly arguing from emotion, rather than reason. That's the problem with this debate. There is clearly no rational or scientific argument to favor the Hoxsey therapy over conventional cancer therapy, as far as eliminating Abraham's cancer, which is clearly Abraham's goal, as he has stated in multiple interviews. Consequently, it is clear that he is not basing his decision on a rational evaluation of the data. Even so, we should be able to have a rational debate about whether Abraham Cherrix is old enough to reject conventional therapy by his own decision and how far the state should go in trying to protect minors from quackery and their parents' bad decisions. I'm even fairly ambivalent about this case, given how close to the age of majority Abraham is (note, however, that he was 15, not 16, when he was diagnosed and when he initially decided to go with the Hoxsey therapy) and my inherent distrust of government power.

Sadly, too many arguing for Abraham's right to let himself die of his lymphoma (which, let's face it, is exactly what they are doing, although alties will deny it and fallaciously claim that the Hoxsey therapy has a good chance of curing him--yet another level of irrationality) are quick to represent the doctors and social workers trying to save Abraham's life as some sort of jackbooted thugs and to throw around truly ridiculous comparisons to Dr. Mengele and the Nazis, rather than make the calm, rational argument that Abraham is old enough to decide for himself, even if he is wrong and even if his decision will result in his dying of his lymphoma. Obviously, I don't entirely buy into it, but that's their strongest argument, not appeals to the nonexistent efficacy of the Hoxsey therapy or comparing the State of Virginia to Nazi Germany and the doctors wanting to give Abraham chemotherapy to Dr. Mengele and his horrific experiments. Such comparisons are based on pure emotion.

They let little girls get abortions and kill little helpless babies, no matter the age.....because it is "their choice!" (unbelievable in itself) This poor guy doesn't want to go through the hell of another chemo treatment, and our wonderful system is going to forcefully shove it down his throat! I hope he & his family move to Mexico immediately. This country is turning communist & going to hell in a hand-basket. MOVE TO MEXICO ABRAHAM & be as well as you can be!

By Ms. Green (not verified) on 12 Aug 2006 #permalink

Geez, do these people all read the same talking points? They nearly always mention abortion (which, BTW, "Ms Green," I never mentioned and if I did I would say that in general I oppose letting minors have abortions without parental consent) and they always use terms like "shove it down their throat" or "fascist." As for "being as well as he can be," if Abraham sticks with the Hoxsey therapy, "as well as he can be" will soon be dead, sadly.

The irony is that these "pro-life" commentators seem to promoting a more "pro-death" course of action.

I think he has every right under the sun to decide what happens to him. And his parents ought to be "thanked" for supporting their son. This is probably the single most important thing they have ever had to do. They have realized the gravity of the situation by now. It did not work the first time. How could they let him go through that pain all over again. Who in their right mind would want to? Someone want to give them a guarantee it will work? Can the judge do that for him? I do not think so. The only thing he will do is sentence him to a time of misery and pain. What is right and what is wrong? Who is right and who is wrong. No one. I always thought that Social Services was suppose to do what is right for the child. Well, he is not a "Child" anymore. This boy is not 6, he is 16. Every parent in the world has told their teenagers to "Grow Up" and the parents of males have told them to "Be a Man" Well Starchild is there. He is being the grown up man who has decided which path he wants to pursue. Let him be.

By Traci Guldner (not verified) on 12 Aug 2006 #permalink

I am quite willing to let young Master Cherrix "be"... but I think there should be more focus on those who sell false hopes to desparate people. Mainly the clinics in Mexico who charge lots of money to people for worthless "cures".

Where is the outcry against the crooks taking the Cherrix's money for worthless treatments? Will the full tragedy of these Mexican clinics not be realized until the boy dies?

Actually no... this has happened before and nothing happened:
http://www.ratbags.com/rsoles/comment/cancerbusters.htm

Traci writes "[Chemo] did not work the first time. How could they let him go through that pain all over again. Who in their right mind would want to? Someone want to give them a guarantee it will work? Can the judge do that for him? I do not think so. The only thing he will do is sentence him to a time of misery and pain."

A time of misery and pain, yes, but one that has the possibility of saving his life. As I see it the Hoaxsey [sic] treatment is a doubly false hope: not only is there no evidence whatsoever that it will cure his cancer, but as his disease progresses he will almost certainly experience all of the pain and anguish he now hopes to avoid.

I wonder if the Rev. Lowery is the same Reverend Lowery I interviewed in the early 80s and the March On Washington when I was a summer intern at United Press International. Coretta Scott King was there, too. Now, she's another victim of the Mexican "cures." Sad, huh?

The Parker Jensen case is especially fascinating. Either he was three misdiagnosed by three different oncologists, or he was cured by an alternative cancer treatment. Either way, for some it's a very inconvenient truth that's best left ignored.

So do you now have a verifiable study of what the actual cure rates are for cancer between alternative and Hoxsey's? Please provide the index link from www.pubmed.gov with that reference.

Seems Parker Jensen has evolved into the proverbial Elephant in the Living Room. Just ignore an "inconvenient truth" long enough and it will go away.

I have been closely following your coverage of the Cherrix case with an equally skeptical eye...and one that knows all about the problems making medical decisions for minor children. I was essentially the opposite of this case, for it was my parents who insisted on treatment when the doctors had essentially given up on me as a lost cause and for "as good as dead". So my views are probably a bit slanted from this background, but I still stand behind the belief that anyone who is still a MINOR should not be allowed to make crucial medical decisions for themself. Yes, give some input if they're old enough to understand the implications, but if the parents aren't sensible enough to do the right thing,(in this case, a repeat course of chemo, as opposed to the unproven Hoxsey treatment) and the child simply goes along because (s)he's been effectively taught inappropriately, then I say there is nothing wrong with someone stepping in to do the right thing if it stands a good chance of saving the child's life. It shouldn't have to come down to the law, but sometimes the law is the only source of any degree of common sense.

By medrecgal (not verified) on 14 Aug 2006 #permalink

NY said "Just ignore an "inconvenient truth" long enough and it will go away."... What inconvenient truth about Parker Jensen.

That the lawsuits his parents filed has been dropped? That is really all the article said that could be verified. The only mentions of the boy's health is by his relatives, because he himself did not show up. For all we know he could be bedridden.

Also, as far as Billy Best and the others who found 714X effective, please make sure they see this:
http://www.cancer.gov/cam/714-x-request.html

If you actually read the article you'll find out two things:

1. The lawsuit against state employees has been allowed, and is proceeding through the federal courts.

2. Parker is alive and well.

Definition from Wikipedia:

The Elephant in the Living Room is an English idiom for a question or problem that very obviously stands, but which is ignored for the convenience of one or more involved parties. It derives its symbolic meaning from the fact that an elephant would indeed be conspicuous and remarkable in a small room; thus the idiom also implies a value judgment that the issue should be discussed openly. The idiom is commonly used in addiction recovery terminology to describe the reluctance of friends and family of an addicted person to discuss the person's problem, thus aiding the person in his denial.

NO... you do not learn that "Parker is alive and well". All you will learn is that his "family declares him alive and well". Those are two different concepts.

There is no verifiable evidence the either Hoxsey's treatment works (which also goes for 714X) and that Parker Jensen is actually well.

The folks who run the clinic that administers Hoxley's therapy claim that several thousand of its patients have been cured. Yet, they have not, nor are willing to do a proper follow up of these patients. So there is still no verifiable evidence that it works.

If you produce a photograph of young Parker Jensen actually walking and talking... AND perhaps an independent medical report showing he is cancer free --- then you would have evidence.

Often in the case for alternative cancer patients there is often a bit where they say "It's working, it's working!". But when things go downhill, there is never any notice, and often not even a retraction. Because the victims of alternative med scams do not like admitting they were wrong, or even scammed.

For instance... take a person who documented his journey with cancer on www.sumeria.net. That website stayed up even after he died for a year or so detailing how he was going to cure his cancer with alternatives. Then it disappeared. Here it is from the Wayback Machine:
http://web.archive.org/web/20041015143842/http://www.sumeria.net/health…
And here is his obituary:
http://obits.abqjournal.com//results?obit_id=56606

NY - all I can find about Parker Jensen is that it appears that he had surgery on the initial tumor and refused follow-up chemotherapy, although it's hard to find anything definitive. It appears to be Ewing's Sarcoma, although this is not definitively given. A complete cure with surgery would be unusual, it seems, but probably not unheard-of.

By Andrew Dodds (not verified) on 15 Aug 2006 #permalink