Starchild Abraham Cherrix: The elephant in the room

I hadn't intended to mention this case again for a while, but an article in Stats.org brought up a point that, although I had somewhat alluded to it, I hadn't really explicitly addressed. It has nothing to do with the judicial decision, the Cherrixes' successful appeal for a new trial and the stay ordered by the higher court, or any the legal issues involved with the case.

It has to do with the atrocious reporting of this case by the mainstream media. In other words, it has to do with how the case has been framed, which has been essentially a near total success for the Cherrixes and those who support his right to choose the "alternative" therapy known as the Hoxsey treatment. This is how I described it a few days ago:

I want to emphasize one more time that, although reasonable people can disagree on where parental rights end and the obligation of the state to step in when parents undertake courses of treatment that will lead to the harm or death of their children begins or whether Abraham, now 16 years old, is old enough to make such a decision, there should be no doubt about the scientific and medical issues involved in this case. For one thing, this is clearly not a case of Abraham "giving up" and opting for quality of life over quantity of life. All you have to do is to listen to him in his interviews to realize that Abraham really thinks that the Hoxsey therapy has a high probability of curing his cancer and clings to that belief, even though his tumors have clearly grown while he's been on the treatment. The Hoxsey treatment is quackery, period. Credulous bloggers who seem to believe that it's a medically valid alternative to chemotherapy need to understand that it is most definitely is not.

While I briefly mentioned credulous bloggers who seemed to accept the Hoxsey therapy as a seemingly valid medical alternative and lamented that I was so much in the minority in my reluctant acceptance (although not entirely alone) that the original ruling was probably the least bad decision possible, the mainstream press is equally guilty--and has a lot more influence than a few bloggers such as myself. As Trevor Butterworth pointed out:

Here's an ethical dilemma: How do you report a treatment for cancer that has no basis in science, no demonstrable causal effectiveness, isn't available in the United States because it is banned by the Food and Drug Administration, and did nothing to cure the person who invented it?

Do you call the Hoxsey treatment quackery? Snake oil? A danger to public health? No, because journalists aren't supposed to decide what is and isn't proper medicine.

Unfortunately this respect for the fact that many Americans "believe" conventional medicine is less science than a matter of belief has taken a troubling turn in the case of a teen who want to take herbs rather than have chemotherapy for Hodgkin's Lymphoma. News reports on the decision by a judge to allow Abraham Starchild Cherrix to forego chemotherapy simply avoided any discussion of why the alternative treatment is banned in the United States and considered quackery by the medical profession.

Exactly. This is the very same way the media handles the whole issue of "intelligent design" creationism. They present "both sides" with a false equivalency, as though there really were a scientific debate. In the case of Abraham Cherrix, while there may be a debate about whether he is old enough to refuse chemotherapy or about how far the state can or should go in forcing him to undergo medically appropriate treatment, there is no scientific controversy at all about whether the Hoxsey therapy is a scientifically and medically valid alternative to conventional therap for Hodgkin's lymphoma. It just isn't. However, the "balance" shown in the press has allowed the Cherrixes and their advocates to successfully frame the issue not as whether Abraham should be allowed to choose a useless treatment (which is, in effect, no treatment at all) over effective treatment but as an issue of "health freedom" to choose "alternatives" or as a fight against the "nanny state," rather than a debate about how far the state should be allowed to go to prevent harm of a minor when the parents refuse appropriate medical therapy, whether by their choice or through their indulgence of their child's choice.

Mr. Butterworth listed several examples of credulous news coverage that didn't address the elephant in the room, namely that there is no evidence that the Hoxsey therapy works and in fact exists pretty good evidence that it is no better than doing nothing. I tend to agree with his assessment:

This may be a sympathetic approach to take with a suffering teenager and his family. But it is a little too sympathetic. By describing Hoxsey as a "cancer clinic operator," readers might just think that Hoxsey had medical training; he didn't. It's also misleading to say that Hoxsey was "accused" of "peddling worthless medicine" when the FDA actually forced him to close all of his treatment centers for peddling worthless medicine.

(By comparison, ABC7, Washington DC's local ABC news affiliate, did a far better job of covering the medical background to this story.)

Another problem with the Washington Post's coverage is that its earlier stories link to Abraham's Journey, a site that covers the case from his perspective and solicits donations for the Cherrix family, but there are no links to any conventional medical source on treatment for Hodgkin's Lymphoma or, crucially, the American Cancer Society's examination and dismissal of the evidence for the Hoxsey method.

I would say that it's probably a combination of factors. For example, quite correctly, there is enormous sympathy for Abraham just on the basis of his being a teen with a life-threatening cancer who has already had a bad experience with chemotherapy. Being too "skeptical" of his and his parents "reasoning" in interviews, whether in print or especially on TV or radio, carries the risk of looking as though the interviewer or journalist is attacking Abraham. It would look very bad, and you could imagine readers and viewers writing outraged letters telling the journalist to "lay off" a poor sick kid. Imagine, if you will, a journalist presenting Abraham with this study, which which shows how poorly the Biomedical Clinic in Tijuana, the center in which the Cherrixes have put their faith, fared in an analysis of how their patients did and asking gently what his practitioners told him as far as his odds of survival with the Hoxsey treatment and how it jibes with this study and the utter lack of any good scientific or clinical evidence supporting the efficacy of this therapy in lymphoma.

Instead, we see softball questions, asked almost as an afterthought, that allow Abraham's talking points regarding his "reasoning" for choosing Hoxsey to be restated, as in his interview with Ann Curry on the Today Show:

Well, the American Cancer Society says that there's no evidence, but there is plenty of evidence if they would take the time to actually look through it. I've done extensive research, and I've read the testimonies of people who have been cured by alternative medicine, and I've seen it firsthand. I've met with these people.

As usual, there is little or no followup to try to make Abraham get specific on exactly what sources he used in his research, whom he spoke to, and what scientific papers he looked at, all questions that would likely show that he used sources that are anything but reliable or scientific. Instead, Abraham gets to dismiss the American Cancer Society with a wave of his hand without challenge, and his claim to have done "extensive research" stands unexamined. I'm sure he probably did do something resembling research, but it wouldn't surprise me if the "research" he did was on altie websites like Whale.to, CureZone.com, and a variety of others. His decision has the appearance, but not the substance of having been arrived at rationally, as Mr. Butterworth points out:

This is the kind of argument that presumably led syndicated columnist Cal Thomas to write " I have heard Starchild Cherrix interviewed... and he sounds intelligent, articulate, reasonable and capable of making such a major decision [about his treatment]."

But here's the problem: Cherrix's choice to abandon chemotherapy may have the appearance of rationality - he engaged in pro and contra reasoning. And that rational exercise in relation to medical treatment is usually considered an individual right when you are an adult.

But one cannot be impartial with respect to the evidence. For Cherrix to weigh the benefits of Hoxsey over chemotherapy may seem like a rational exercise; but it is fundamentally irrational if there is no attempt to apply a common standard of evaluation to both therapies.

Indeed. All this blather about how "rational" and "calm" Abraham "sounds" is utterly meaningless, a smokescreen. His calmness and seeming thoughtfulness does not in any way mean that his decision is rational or that he applied the same standard to the evidence for conventional therapies and the Hoxsey therapy. It doesn't mean he isn't engaging in magical thinking. In fact, as evidenced by this recent interview on the Sean Hannity Show, Abraham clearly continues his magical thinking:

HANNITY: Abraham, let me ask you a very tough question. I've come to be very impressed with you and your knowledge of your disease, your knowledge of your situation, your seeking alternative remedies, I think it's really admirable.

ABRAHAM: Thank you.

HANNITY: But at the end of the day if you make a wrong decision it could result in your life.

ABRAHAM: Yes.

HANNITY: Do you think about that?

ABRAHAM: Well, I really can't think about that, you know?

HANNITY: But don't you have to?

ABRAHAM: Well, there's always that possibility and, yes, you can look at it. But if I'm going to get better I have to maintain a positive attitude.

HANNITY: No, I agree with that.

ABRAHAM: I cannot look into the future, as I said before, and say, This is going to happen to me and I'm so scared. I can't wake up every morning and say, Oh, my gosh, I'm going to die. You know, I wake up every morning and I say, I'm going to live, and I strive to meet that goal.

So there's that possibility that somewhere along this line we made a wrong decision. But you know what? If I die, I'll die happy, and I will die healthy, and I will die in my home with my family, not in a hospital bed, bedridden and sick.

If Abraham dies of lymphoma, he will most definitely not "die healthy." Does anyone see the magical thinking there? Dying of lymphoma is not compatible with being "healthy." Abraham will almost certainly not avoid what he fears, being bedridden and very sick before the end. He might be in a lot of pain (for which, I truly hope, he will accept all the best pain management modern medicine can offer). He may even suffer obstruction of his trachea and require a tracheostomy. (This is my speculation based on news reports have stated that one of his tumors in his neck is right next to his "windpipe." Such tumors could easily cause obstruction.) This same tumor could conceivably grow large enough to obstruct his esophagus and make it impossible for him to eat without a feeding tube. A variety of other debilities and indignities are likely to occur before the end. These are the realities to which he and his family appear oblivious. Yes, Abraham may well die at home with his family around him, and there is certainly something to be said for that if he must die (I'm a big fan of hospices), but his dying at all would have a good chance of being prevented if he were to accede to conventional therapy.

I also note how deferential Sean Hannity is towards Abraham as well, agreeing with him, presenting him as brave for bucking the system and in essence sucking up to him. Hannity's "hard" question isn't, really.This sort of reaction is not unexpected, though, given Hannity's previous rants about Ritalin and ADHD that I've heard him give on his radio show. (I used to listen to Sean Hannity. I know, I know, it's hard to believe, but I did. I used to listen to Rush Limbaugh a lot too.)

In any case, the media coverage of Abraham Cherrix's legal battle has been amazingly slanted in a way favorable to him and how he and his advocates want to frame the debate. His battle is presented as one for "health freedom." His choice is represented as choosing a "more natural, less toxic" therapy (often with all too little mention that it is also a completely ineffective therapy). Skeptical questions about the Hoxsey therapy are listed almost as an afterthought, couched in phrases like, "You know, nearly all oncologists consider the Hoxsey therapy to be useless," without actually presenting the evidence and history of the Hoxsey therapy that leads to that conclusion. Because Abraham is well-spoken and calm, journalists assume that his choice must have derived from good rational thinking, even though his many interviews reveal clear evidence of magical thinking (for instance, another example is his dismissing chemotherapy because "the cancer came back" and he "already tried chemotherapy once," while making excuses for the failure of the Hoxsey therapy when his tumors continued to grow while he was on it). His religious faith is described approvingly and glowingly, even though it is clearly a significant factor in his chosing the Hoxsey therapy over conventional medicine. Thus, the issue has been framed successfully as one of freedom to choose, rather than of the state attempting to act to save a minor from his and his parents' bad decision.

Butterworth concludes:

The fact is that the way the media covers this case will have an effect on public health and the public's understanding of science. Reporters must go beyond the mere right to choose treatment in their stories and focus on what counts as a rational choice in choosing between treatments.

Don't hold your breath waiting for this to happen.

The principles enunciated by Cherrix are, at best, those of 19th century medicine. Adults have the right to choose such principles in guiding their treatment if they so wish; but they need to be aware that you can't practice 19th century medicine without achieving 19th century mortality rates.

I wish I'd said that. I'm going to keep that quote for future use.

The entire "conventional" medicine community doesn't believe that Hoxsey is a hoax without reasons that speak to the success of science and the failure of non-scientific thinking. Those reasons need to be explained by reporters. "He said, she said" journalism is not just insufficient in a case like this, it's wrong. All the hearsay in the world cannot "balance" out one rigorously-executed clinical trial. To act otherwise is to endanger the public.

Indeed not. However, people are still seduced by testimonials and often pick and choose the testimonials that fit their preexisting bias, even discounting the evidence of scientific trials. This "he said, she said" journalism is bad enough in the coverage of evolution and "intelligent design" creationism. It's even worse when it is used in the reporting of quackery like the Hoxsey therapy. Although the understanding of biology and science in society certainly suffers and the societal effects from bad science education could be dire, people don't die when they believe in ID creationism. However, people can die unnecessarily if they see such quackery as an effective "alternative" to conventional medicine.

Over the weeks that this case has been going on, I've come down reluctantly on the side of the state intervening to make sure that Abraham gets the care he needs. I've taken a fair amount of flak for it, too, with those attacking me seeming to think that I made this decision gleefully, that I didn't weigh my dislike of excessive government power versus Abraham's rights, and that I was "partying" when the decision was announced. But, contrary to what some alties think, my motive has always been that I hate to see young people throw away their best chance at a long life on a false promise by quacks. My heart has gone out to Abraham and others like him (such as Katie Wernecke), because they've clearly been deceived by false and scientifically unjustifiable promises, even though they would certainly vigorously deny that that is the case. As Abraham's case has gone on, I've tried very hard not to let my heart harden because of his obstinance in the face of so many people trying to save his life. After the last few days, I have to confess that it's getting harder and harder for me not to say, "the hell with this foolish young man, let him just use Hoxsey and die."

But I'm still trying--for now.

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?
The decision is in: Starchild Abraham Cherrix must have chemotherapy
Some questions for those who decry the decision in the Abraham Cherrix case

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Amen-- the piece you quote is one of the few reasonable essays out there when web searches are done-- the press has tended to treat the kid as a hero, rather than a person who is misguided and opting for a treatment that will lead to his certain death. Unfortunately, glamorizing this type of thinking in a manner that will likely encourage others to follow suit.

Your genuine concern for Cherrix's well-being shines through in your posts. Anyone who can't see that is wearing blinders.
For the record, I disagree with your final conclusion. I think that a 16 year-old is old enough to make this decision (to opt for unproven quackery). He is obviously engaged in magical thinking, but I don't think that is enough for the state to step in and force him to undergo a treatment he doesn't wish.
The deference that is shown him by the likes of Hannity and Couric (never thought I'd put those two together in a sentence) is partly due to the fact that Americans love the underdog, so this is how it got framed, a young man and his brave fight against the state for his individual rights.

By gravitybear (not verified) on 27 Jul 2006 #permalink

The example put forth in much of the shoddy jouranlism coverage is that of Billy, a kid who supposedly did well after refusing further chemo for a presumed relapse of hodgkins. A likely explanation is one that occurs frequently on the lymphoma support boards. CT scans may show residual mass which may be either scar tissue or active disease. Only in the past few years has PET been used to determine if active disease is present. Have seen many frightened of recurrance by CT findings, only to have PET show no active disease. This is a likely explanation for what happened in the Billy case.

I agree with much of what gravitybear said. My argument has never been that the Hoxsey treatment is a valid alternative to chemotherapy. It was that I felt the state had a burden of proof to illustrate that Cherrix was incapable of making this decision, misguided as it may be.

If he wants to believe that the Hoxsey treatment will cure him (which it almost certainly won't) then that's his choice. That is far different than, say, a 6-year-old whose parents refuse chemotherapy in a similar situation - in those cases, I believe the state has a duty to speak for the child because no 6-year-old would be capable of making that decision.

By anonimouse (not verified) on 27 Jul 2006 #permalink

In a case with this amount of notoriety, the outcome will surely be covered -- no doubt with equal weight given to the "explanations" about why Hoxsey didn't work: the initial chemo, most likely. It won't, in other words, convince anyone...

In my area there was a front-page, three day multipage newspaper article on a woman who chose alt-med treatment for the cancer in her second breast, having been cured of the first by conventional treatment. Breathless and laudatory coverage...

Her death from metastatic cancer was buried, quite a bit later, page 6, section three.

Wonder if there is any pundit out there brave enough to had the kid a gun and tell the kid that blowing his head off would have the same ultimate effect as the Hoxsey treatment and be easier on his parents in the long run.

By justawriter (not verified) on 27 Jul 2006 #permalink

In a case with this amount of notoriety, the outcome will surely be covered -- no doubt with equal weight given to the "explanations" about why Hoxsey didn't work: the initial chemo, most likely. It won't, in other words, convince anyone...

I certainly won't argue that there are far too many stories in newspapers that are "woo-credulous". Anyone who reads a story about autism and vaccines can attest to that. A lot of that stems from people who write about science who do not have the appropriate background to understand that what the quack is pushing is simply junk.

By anonimouse (not verified) on 27 Jul 2006 #permalink

....people who write about science who do not have the appropriate background to understand that what the quack is pushing is simply junk.

Right. And if trends continue, fewer and fewer American kids will get the sort of science education that will allow such understanding. Credulity leads to acceptance of party lines; so I'm not sure the decline in education is entirely unintentional, on some fronts.

FYI, The uncle of the kid, a guy named Forrest MacGregor who's left comments here, retaliated for my blog post on the case, "Stupidity Can Be Fatal," by buying up my name -- AmyAlkon.net, biz, etc.

I've been at the receiving end of such behavior before, from J. B. Handley, high ranking member of the mercury militia, because he didn't like my critical analysis of the bogus science claiming that mercury causes autism and bought up oracknows.com. I now own several variants of "respectfulinsolence.com." The lesson J.B. taught me is not to let those domains remain open.

First, thank you for linking to my post.

I do want to say that I don't agree with the treatment that Cherrix and his parents have chosen, and I agree with you that it is a useless treatment -- that it is not really treatment at all. If it were me, I would have chosen to undergo another round of chemotherapy. However, it is not me and I do not feel that I can make this choice for this family or for any other family. I certainly don't feel that social services is qualified to make the decision; in my opinion, social services in most cases isn't qualified to do much of anything, and they make a mess of families on a regular basis.

Writing from a Catholic perspective, I believe very strongly in the dignity of human life. I also believe, though, that people have a right to refuse extraordinary medical treatment, and I think that chemotherapy is extraordinary treatment. While I would not refuse such treatment, I think that young Mr. Cherrix has every right to refuse it, that his parents have the right to either agree with that choice or not (at which point he would have to undergo the treatment), and I support his right to refuse this treatment even though I would not personally make that choice. I'm praying for him and for his family, and I hope that this will turn out well for them.

Thank you again for linking to my post.

Quote from article below:
As much as Abraham did not volunteer for Hodgkin's, the other actors in this drama were dragooned as well. When his parents took him out of conventional treatment, his doctors had no choice but to report the potentially fatal decision to Social Services. Under penalty of law, medical professionals must report minors who may die without medical intervention.

Anguished choices in Cherrix case
The Virginian-Pilot
© July 27, 2006
Last updated: 5:09 PM

Just like any mom and dad, the parents of Abraham Cherrix probably thought the day they found out about their son's Hodgkin's disease was the worst of their lives. Then came watching him suffer through chemo. And then finding out the first round didn't work. And then their son told them he'd rather take his chances with cancer than face the pain of more chemo and radiation.

Broken hearts cannot begin to describe their suffering. But even then, the worst was yet to come. When they decided to abide by their son's wish to stop conventional treatment, even with its high success rate, the Department of Social Services went to court to force Abraham into the arms of doctors, essentially accusing Jay and Rose Cherrix of neglecting the son they've raised for 16 years.

This week's court decision that will keep Abraham out of the hospital until a full hearing in August seemed an odd moment for hugs, but for the Cherrix family, at least something went the way they wanted.

This is one of those agonizing cases that takes on a life of its own, where nobody is free to pick his own path and parents end up celebrating court decisions that could lead to their child's death.

As much as Abraham did not volunteer for Hodgkin's, the other actors in this drama were dragooned as well. When his parents took him out of conventional treatment, his doctors had no choice but to report the potentially fatal decision to Social Services. Under penalty of law, medical professionals must report minors who may die without medical intervention.

Once the report landed on a desk at the Accomack County Department of Social Services, administrators were put in an impossible position. If they did nothing and Abraham died, they could be held responsible. They had to take it to court so a judge could decide.

And now the case will move through a succession of courts, most likely ending up in the Virginia Supreme Court where each judge or panel of judges will have no choice but to decide one way or the other based on deliberately ambiguous laws. How much weight should be given to the suffering caused by conventional cancer treatment? Does this particular 16-year-old boy have the intelligence and maturity to make an adult decision? Is there any real hope in the dubious alternative treatment offered by a Mexican medical clinic? Whose values should inform the final decision, the parents' or the state's?

No matter what, the results each step of the way will look messy. Every reasonable adult in the commonwealth will be able to examine the results and find fault with exactly how judges weighed the impossible.

Already the battle over this boy's life is becoming a political cause. Virginia's Republican Attorney General Bob McDonnell weighed in with a court filing arguing that Abraham should not have to undergo treatment until his appeal has been heard. Democratic Gov. Tim Kaine has argued he doesn't "think politicians need to get in the way of a court proceeding."

They're both right. The process should proceed unmolested. Once it is over, when passions cool, there will be time to tweak the system if that is necessary for future cases.

Nothing a legislature, a judge or a governor can do will change one essential fact: Life presents horrific moral dilemmas where there are no good choices. The Cherrix case is awful because a family is trapped between an awful disease and an awful cure, not because a judge or a Social Services bureaucrat or a doctor has done anything wrong.

Does this particular 16-year-old boy have the intelligence and maturity to make an adult decision?

In my mind, this is not really the question at hand. The question at hand is whether or not Abraham's parents have the right to decide upon his medical treatment when such treatment involves a choice between pursuing extraordinary treatment or refusing it. I believe that they do, and I believe that they are much more qualified to make this decision than social services or the Virginia judicial system is. This case should not even be in a court.

With that said, let's think about this for a moment. If we were talking about Cherrix committing a murder rather than refusing a medical treatment, most would say that he should be tried as an adult. If he would be considered an adult if he had committed a murder, shouldn't he also be considered old enough to give or withhold his informed consent for this treatment? And let's return strictly to the realm of medical treatment. If Cherrix were a 16-year-old girl seeking an abortion, no one -- not the state courts, the legislature, the governor, social services, or her parents -- would have anything to say about it. If a 16-year old girl can give informed consent for an abortion, and if no one can interfere with her decision, then why can't a 16-year-old boy give or withhold his informed consent for this treatment?

This BOY is a minor child by LAW and his parents are committing assisted suicide.The university of British Columbia followed up a large group of Hoxsey victims in the 50's - NONE survived 5 years and 90 percent survived less than 2 years . It is the State's responsibility to take over in loco parentis if they feel the life of a child is threatened by parental stupidity - Hodkins has a high survival rate - BTW his first name is NOT Abraham , but "Starchild"
Not calling him this is a
disengenous attempt by the MSM to try and steer away from genuine equiries about the overall nuttiness of the parents.
If you wish to gain some knowledge over this "treatment" see quackwatch.com.
Enough BS about parental rights - the Constitution does not enshrine a parental right to abuse - we would not even be having this ridiculous argument if this CHILD was 3 years old - if he interrupts his therapy now he will die - Hoxsey treatments cure only positive bank balances which is why their clinic is in Tijuana and not Minnesota.

By Familydoc (not verified) on 29 Jul 2006 #permalink

If Cherrix were a 16-year-old girl seeking an abortion, no one -- not the state courts, the legislature, the governor, social services, or her parents -- would have anything to say about it. If a 16-year old girl can give informed consent for an abortion, and if no one can interfere with her decision, then why can't a 16-year-old boy give or withhold his informed consent for this treatment?

False analogy.

The key word is informed consent. Abraham's and his parents' statements reveal that his "consent" is not really informed. Familydoc is right.

BTW his first name is NOT Abraham , but "Starchild." Not calling him this is a disengenous attempt by the MSM to try and steer away from genuine equiries about the overall nuttiness of the parents.

No, it's not, at least not from what I've read. Abraham himself prefers to be called Abraham. Very likely he's embarrassed by the flakiness of his given name, which is why he prefers to go by his middle name.

Familydoc: "BTW his first name is NOT Abraham , but "Starchild"
Not calling him this is a
disengenous attempt by the MSM to try and steer away from genuine equiries about the overall nuttiness of the parents"

Orac: "Very likely he's embarrassed by the flakiness of his given name, which is why he prefers to go by his middle name"

Pointless arguments about the "nuttiness/flakiness" of his name is a definite attempt to steer the conversation away from genuine enquiries. This one is being dodged like a hot patato: are there any volonteers for the administration of forced treatment? How far do you go?
Am I the only one who thinks this is important?

"The key word is "informed" consent. Abraham's and his parents' statements reveal that his "consent" is not really informed. Familydoc is right"

No! Informed consent is not agreeing with what we believe to be drivel! Informed consent is having been presented with all the facts and then deciding independantly on a course of action! He was presented with all the facts about the Hoxsey treatment. I have no doubt that he knows about the controversy surrounding Hoxsey. He informed himself and made his decision...right or wrong. He even admitts to that. You are simply outraged at the insanity but in your zeal to combat "stupidity" your utter contempt for basic human dignity and freedom of choice (i.e. freedom from thought control) comes to the fore.

"After the last few days, I have to confess that it's getting harder and harder for me not to say, "the hell with this foolish young man, let him just use Hoxsey and die".

Is it really so Either-Or for you? "Save him at all costs" -or- "To hell with the fool, let him die"? You have done all you could to convince him, no? Did you not e-mail him a plea of sorts since you are so concerned? Why can't you simply wish him well and spare him the indignity of being mobbed in public? However he chooses to live his final days, does it have to be in the public square with some of us spewing the basest of the basest at him, like picking on his name when death is at this family's door? ...With a court ordered familly break-up looming over their heads?...In forced care which so obviously freightens him literally to death? Now come on Docs, answer this question: How would you administer the forced treatment? How far are you willing to go? If not you, who then? Give us the real deapth of your compassion, you too familydoc.

Nate Nelson,
Thank you for your humane thinking and most considerate remarks. I hope they are not wasted on some in the audience.

Familydoc and Orac: Do you believe that Cherrix should be tried as an adult if he committs a crime? Do you believe that a 16-year-old girl has a constitutional right to an abortion that no one, not even her parents, can interfere with?

Familydoc -- I don't disagree with you that this is the equivalent of choosing to die, and I do agree with you about how effective the "treatment" he's chosen will be. I disagree with you, however, that this is assisted suicide. Chemotherapy that has already proven to be ineffective is extraordinary medical treatment, and refusing such extraordinary treatment is not suicide. It is simply choosing to die a natural death. I wonder if you took such a strong pro-life stance when Terri Schiavo was euthanized?

As for parental rights, I think it's quite a stretch to say that making medical decisions for their child is "abuse." Would you really want another doctor or social services to be able to make medical decisions for your child(ren)?

Orac -- First, I think that the Cherrixes are indeed informed. They have been informed by doctors about the chances that chemotherapy has for success, and I would imagine by now that they have also been well informed about the ineffectiveness of the "alternative treatment" they've chosen. Informed consent doesn't mean that they must also agree with the information they receive from their health care providers; it only means that they must receive the information.

Secondly, I think you dismiss my analogy to abortion a bit too quickly. Do you really think that every 16-year-old girl who seeks an aborton is well informed about the procedure she's going to have? Do you think that every 16-year-old girl knows all of the risks involved with abortion? I certainly don't think so, and I think there are in fact a lot of young girls who have had abortions without informed consent. So are you ready to argue that these girls should not be allowed to have abortions unless they are given all of the information about the procedure they're going to have? Many in your profession have argued against the idea that they should be so well informed, and the courts have tended to agree. I find that odd.

pat said "No! Informed consent is not agreeing with what we believe to be drivel! "

So do you have verifiable evidence on how well the Hoxsey treatment works? Because the only evidence favorable to it is actually pure drivel.

Please state what cancers have been cured by Hoxsey's herbs, and years of life afforded those who used it. Forget using Hoxsey... he abandoned the treatment and went for surgery for his prostrate cancer.

Remember being told a pack of lies does not equate to being "informed".

Familydoc and Orac: Do you believe that Cherrix should be tried as an adult if he committs a crime? Do you believe that a 16-year-old girl has a constitutional right to an abortion that no one, not even her parents, can interfere with?

No and no.

Does that surprise you?

Try again.

I don't disagree with you that this is the equivalent of choosing to die, and I do agree with you about how effective the "treatment" he's chosen will be. I disagree with you, however, that this is assisted suicide. Chemotherapy that has already proven to be ineffective is extraordinary medical treatment, and refusing such extraordinary treatment is not suicide. It is simply choosing to die a natural death.

I might almost agree with you if that's what Abraham were actually doing, but he isn't. He clearly believes that the quackery known as the Hoxsey therapy will save his life. He wants to live. He's also deluding himself that he will die "healthy and strong." Trust me on this: If he goes on to die from untreated lymphoma, long before the end, he will be neither.

HCN
Forgive my blunt words but...are you daft? Nowhere do I say that Hoxsey works!
I said: "Informed consent is not agreeing with what WE believe to be drivel"-I'm obviously putting myself into the "I believe it to be drivel camp". How do you make this error of assumption? Perhaps you sbscribe to the "if you're not with me you are against me" drivel. Oscar Wilde would say: "never assume becase it makes an ass- out of -u- and -me"

"Forget using Hoxsey... he abandoned the treatment and went for surgery for his prostrate cancer" - you forgot to mention that he didn't do chemo either and lived another 7 years...not bad for an old fart.

This from Websters:
INFORM
One entry found for inform.
Main Entry:in·form
Pronunciation:in-'form
Function:verb
Etymology:Middle English, from Anglo-French enformer, from Latin informare, from in- + forma form
transitive verb
1 obsolete : to give material form to
2 a : to give character or essence to > b : to be the characteristic quality of
3 obsolete : GUIDE, DIRECT
4 obsolete : to make known
5 : to communicate knowledge to
intransitive verb
1 : to impart information or knowledge
2 : to give information (as of another's wrongdoing) to an authority

Now that we have established the meaning of the english word INFORM let me make my point again: Abraham or "Starchild" if you prefer, HAS the information about both Hoxsey AND chemotherapy. He made the wrong choice perhaps but, nonetheless, a choice based on the facts and HIS interpretation of them. There is not much more you can do. You CAN"T force him to take chemo because you, Orac, Familydoc and all the other "US"es out there are obviously to coward to administer the forced treatment ourselves and that alone should convince us that what this kid does is in fact none of our business!

I have to agree with Pat here. Informed consent means receiving information about the treatment and either consenting to it or refusing to consent to it. The Cherrixes have received the information about the chemotherapy treatment, and by now they have also received information about the ineffectiveness of the "treatment" they've chosen. The Cherrixes do not believe the information they've received, and that's unfortunate -- but they have received the information. They have the right to either believe it or not to believe it, to consent to the treatment or not to consent to it.

You can't just force people to take the medical treatment you want them to take. The Cherrixes are informed; they have withheld their consent from chemotherapy and they have given their consent to this "alternative treatment." There's simply nothing else that anyone can do about that within the boundaries of law and ethics. Legally and ethically, the Cherrixes must be able to make this decision no matter how wrong it is. If informed consent is endangered here, it is endangered everywhere and for all.

Oh, and Orac -- I'm glad to know that you don't believe a 16-year-old girl has such a right to an abortion. It does surprise me.

pat said " How do you make this error of assumption?"

Because I just skim through your diatribes. I actually read the first two or three, noted that they were pointless... so I just skimmed through the rest.

HCN
Why then do you bother? If you're not going to read my post then spare me your stupidity. Also I thank you for proving to us that indeed there are no stupid questions, only stupid answers.
I also note that you think the question of how to administer forced treatment is not worth a glance. It appears that you are in good company. Thank you for your honesty.

I also found it humourous how you demanded I produce evidence for that which you have not read ;)

"I also found it humourous how you demanded I produce evidence for that which you have not read "

I'm having great difficulty deciphering the sum meaning of this and I thought I was supposed to be Hyperlexic.

And no, they are not informed. I could travel back in time and tell people the world isn't flat and they can choose to not believe me. When they do that they are choosing not to be informed because they simply don't understand the information that was relayed to them.

I can look at a sign and not know what it means, but I can know what the sign is. But merely knowing what the sign is doesn't make me informed, knowing what it means does. You're not informed about a therapy like Hoxsey until you know what the chances of it working are.

As a child I was told the moon was made of cheese. You could then say I was informed about the moon if it weren't for the fact that this isn't at all true, regardless of wether I chose to believe it or not: it does not inform if it isn't true.

By Lucas McCarty (not verified) on 30 Jul 2006 #permalink

I am curious to know: Do the Cherrixes genuinely believe the Hoxsey treatment is better than conventional tx? Or does this young man simply not want to deal with the difficulties inherent in undergoing chemotherapy again?

He tried it and he didn't like it, so he wants something easier, and he's being aided and abetted by Mom and Dad. They have themselves convinced that chemo is horrible.

I've done both chemotherapy and radiation and it ain't a walk in the park. But I'm sorry, there's no such thing as a free lunch. Cancer is a tough disease and it requires you to make some sacrifices if you want to have any chance of surviving it.

The sad part is this kid will probably make the ultimate sacrifice - i.e. an untimely death - because he didn't want to make the less drastic sacrifice of undergoing chemo.

His inability to project into the future and realistically weigh his options is a hallmark of adolescence, and precisely why he isn't really equipped to make this decision by himself.

By anonymouse (not verified) on 30 Jul 2006 #permalink

pat said "Why then do you bother?"

Purely for entertainment.

I have actually read the evidence on how effective the Hoxsey treatment is, as well as his rather checkered history in Texas. I have come to the conclusion that the salve (which is what it was at first) and the herbs, plus the diet are not effective against cancer. I provided the links in a previous Orac blog posting.

I also have two teenage sons. I have trouble convincing them that they will not run out of clean underwear if they would actually put the dirty ones in the dirty laundry basket, and not leave them on the floor, or worse... under their bed.

Or, that if one does not do their homework the result is that they fail a course... and have to take the class over with the same dreaded teacher.

Somehow, I am not convinced that a teenage boy can really make serious medical decisions.

I also agree that the parents are part of his bad decision. He did not complete the first round of treatment, and it hurt. So they want to protect him... and believing the LIES by a bunch of crooks in Mexico are willing to mortgage their house to go some less painful route. Unfortunately it is a fatal decision.

Fortunately, I have not had to deal with cancer. I do have one with several health problems... and I would be very sure to check out every claim for a "cure" or "treatment". These include cranial sacral (though how waving ones hands over the head would cure damage done to Broca's area from seizures eludes me) and homeopathy (I have never gotten a good answer on how it would work better than the betablockers for his hypertrophic cardiomyopathy, or if it would cure the damaged mitral valve).

I do not know about cancer first hand... but I do know what it is like to have a health impaired child. For some reason I get lots of unsolicited advice: most of it pure drivel.

Lucas McCarty
"I'm having great difficulty deciphering the sum meaning of this and I thought I was supposed to be Hyperlexic"
-Perhaps the root cause of your temporary hyperlexia lay in a missing coma, which I have now inserted.
"I also found it humourous how you demanded I produce evidence "for that" (Hoxsey's supposed cancer success and my supposed enthusiasm for it), (coma) which you "did not read" ("HCN:..Because I just skim through your diatribes" ...AND it is not even in my diatribe to be skimmed over in the first place).
"I also found it humourous how you demanded I produce evidence for that, which you have not read ;)"
Why HCN challenges me for evidence as to the effectiveness of Hoxsey's treatment is beyond me. HCN may be testing some new "Random Target-Drivel Generator" software.
I concede that my original sentence, which I suspected set the HCN.01 trolling progamme into mode, might have been poorly formulated and misleading:
"No! Informed consent is not agreeing with what we believe to be drivel"
Should read: "No! "Informed consent" does not mean, "agreeing" with what most know to be the truth"
Maybe the programme isolated the word "we" and erroneously spewed out random anti-altie verbiage due to a possible fatal cataloguing glitch.
Had HCN.01 bothered a few more lines none of this would have occurred...maybe not in the case of a glitch in the code.
"I could travel back in time and tell people the world isn't flat and they can choose to not believe me. When they do that they are choosing not to be informed because they simply don't understand the information that was relayed to them."
You told them the world isn't flat. They didn't believe you. Go back again and apply better arguments, at least better than taunts of "flakiness" and "nuttiness", which I am not attributing to you I stress. Wrong choices are made, by definition, by "mistake" and again he concedes himself that he might be wrong; it's a widespread human trait as old as our history. So is arguing in the world about the truth.
I understand your point about the urgency to communicate accurate information, however, many analogies have been made about this case accusing abuse or neglect by the parents and foolishness or gullibility on Abraham's part but what all seem to overlook completely is the fact that it is HIM who doesn't want to do chemo again. Anonimouse; that you've gone through it and healed is great news to all of us. Surely your experience can serve better to sway him in his decision than any one of us who haven't had your difficult experience and this is also where we get to the culminating, very practical, very emotional yet very "skimmed over" point of my "diatribes", which I notice you too have not cared to answer: How would you enforce the law? How far would you go? If not you (certainly not me) who then? You see If you and I, with or without medical skills, are not WILLING enough to actually force the medicine onto this kid ourselves then we really have no business butting into their lives and also no business in expecting someone else to do the job for us, which would be cowardly. Not much unlike a mob when challenged to action, melting away slowly, mumbling excuses about being late for this or that appointment. If you can see any merit to my question about the emotional and ethical limits in forcing medicine on this nonetheless 16-year-old kid you'll quickly realize that we haven't done enough to convince him. It's that simple. If he agrees to the treatment then I we're all off the hook.
On the lighter side but still to the point:
Why is a martini set considered an outdoor survival kit? Because if you ever get lost in the wilderness all you have to do is pull out your kit and start mixing a martini. Within minutes someone will appear out of the bush and tell you how to make a "real" martini...and also show the way out of the woods hopefully.
PS: surely, you were also told that the moon was more like a big, dead dry rock too, no?

HCN
"Purely for entertainment."
You argue out of bad faith and consider the subject of my question mere entertainment. I hope you will not hold it against me if I don't read and comment on your posts.

ps: you have made you point about the Hoxsey hoax ad nauseam to the Nth degree and I have yet to disagree with you.

Anonymouse said:

His inability to project into the future and realistically weigh his options is a hallmark of adolescence, and precisely why he isn't really equipped to make this decision by himself.

And if he was 18 instead of 16 and made this same decision, we would do what? By the law, nothing. My problem with this case has nothing to do with the non-treatment Cherrix has chosen, but rather the arbitrary cut-off point the law makes for such decisions which seems to change based on what we're talking about.

An abortion at 16 is acceptable by the law, yet choosing one's one path for cancer treatment is not. In both cases, I believe, the burden should be on the state to show that the individual in question CANNOT make that choice for themselves. You can't argue (as many have) that by choosing the Hoxsey treatment that Abraham is incapable of making the decision for himself - that's circular reasoning. You have to show that Abraham doesn't understand what he's getting into, and from what I've seen to date I'm not entirely convinced of that point.

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

Pat, if such people denied the truth about the shape of the world out of hand, they are choosing not to be informed. Were they to ask me why I believe the world is round, then they would be making an effort to inform themselves. I can't simply phrase a better arguement if it won't be heard, I can phrase the bestest possible arguement but it is no better than the worst possible arguement if it isn't being listened to. In this case, Starchild has not apparently made the measure of enquiry that would inform him even though he says he has, no one has bothered to ask him difficult questions about his own 'research' into the matter.

I personally don't think Starchild accepts there is even the slightest possibility that he may be wrong even though he explicitly stated that he could be. It's contradicted by his expressed view that the Hoxsey treatment will only work if he believes it will work(like so many alternative therapies; they emulate the principles of Voodoo), so from his point of view it would be against his best interests to actually acknowledge that he could be wrong. Secondly, if he accepts that he could be wrong, he would vigorously hunt for evidence that would prove it. When a scientist suspects they may be wrong, they hunt down proof that they may be and eliminate every possible alternative to their own opinion until they hit a tangible contradictor.

Chemotherapy doesn't fail until the patient is dead. His cancer was stopped then it came back. You could argue that the flu vaccine doesn't work because you need it every year when a new strain comes back but it is disingenous. Starchild is not applying the same level of scrutiny to Hoxsey as he did to Chemo: Chemo got rid of the cancer which then returned, Hoxsey didn't do anything and the tumours became larger. Starchild accepted the bogus excuse often-used excuse in alternative medicine, that it gets worse before it gets better, without any evidence but rejected Chemo when something happened that is known to happen in around 1 in 8 cases(maybe less). The cancer came back, he now had a just over 50% chance of success which is now less with the delays.

If he was choosing one equally-valid treatment over another, it would be entirely his or his parent's decision(still a lot of grey areas when he's close to 18).

By Lucas McCarty (not verified) on 31 Jul 2006 #permalink

I agree with all the arguments that Abraham and his parents are woefully missguided. This point has been beaten ad nauseam too and it is apparently quite obvious. What all have still to wrestle with is how is this kid going to get his court ordered chemo? If he adamantly refuses, are we going to have to tie him down and force this medicine on him? There comes a point where forced help because unwanted torment. It is at this point that the any court ordered therapy becomes ethically untenable. At this point we're going to have to pull back anyway and plead with him further for him to accept this therapy. My argument is that the legal intervention is redundant. If he still resists, the pleading must begin again unless of course you have no ethical problems with restraining him and pouring the medicine into him against his wishes. Did I make my point clear? Enforcing a court ordered treatment is only tenable if you have no personal or ethical problems with restraining him against his wishes. I have such problems therefore believe that state intervention is in and of itself pointless. I find it personally distressing how no one thinks beyond the legal technicalities of this case and demanding legal intervention here is more a sign of your frustration than anything else. If Abraham is unconvinced it is simply because of a failure of argument. It is a lot like hitting unruly children; it is a sign of parental failure. Forcing medicine onto Abraham is a sign of the medical establishment's failure to convince him.

I personally don't think there is a chance in Hades they will actually tie this young man down and stick the IV into his arm. It is assault, pure and simple.

By going through all possible legal channels, those involved have demonstrated they are trying to "do something," whatever that may be. In good conscience, once the petition landed on a judge's desk, it could not have been dismissed. Think of the liability.

Although I am a 10-year survivor of non-Hodgkins lymphoma, I can't say it hasn't cast a shadow, physically and psychologically, over my life. I seriously question whether I could ever do chemotherapy again. I just don't think I could handle it again. But then again, I am 30 years older than Abraham and have had a chance to live my life with no regrets.

We're never gonna agree on this. It is an ethical quandary.

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

"I personally don't think there is a chance in Hades they will actually tie this young man down and stick the IV into his arm. It is assault, pure and simple."

I thank you for your response. You actually agree that the forced imposition of chemotherapy is pointless and possibly even constitutionally illegal. Where then the quandry? Let him go home.

I also fully understand that judge had no choice once it landed on his desk. He needed to cover his ass against liability, unfortunatly, at Abrahams expense.

Uhm, I don't agree it is pointless. He needs the chemotherapy a lot more than he needs Hoxsey treatments. I just don't think, at the end of the day, that anyone will have the stomach to forcibly infuse him with the ABVD or whatever protocol he's on.

There's been a legal decision in this case and I happen to think it's the right one. But it's not realistically enforceable unless the patient decides to cooperate. To insinuate otherwise - that he's going to be tied down and administered chemotherapy while he's kicking and screaming - is nothing more than an emotional scare tactic.

About the age question: It was once thought that the human brain was fully mature by adolescence. Now researchers know the brain continues to develop well into early adulthood.

We have all these arbitrary age cut-offs - 16, 18, 21, etc. etc. Maybe none of them is right. Maybe 18 is too young to be drafted. Maybe 16 is too young to get an abortion without parental permission. Maybe 21 is too long to wait before someone can legally drink. Comparing Abraham with a 16-year-old's ability to get an abortion doesn't cut any ice with me. Sorry.

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

His inability to project into the future and realistically weigh his options is a hallmark of adolescence, and precisely why he isn't really equipped to make this decision by himself.

That's just it -- he does have somebody to help him make this decision, and that somebody is his parents. It is not the place of social services nor any judge to make this decision for the Cherrix family.

I see no ethical quandary here. The boy does not want extraordinary treatment, his parents do not want him to have extraordinary treatment, therefore he should not have extraordinary treatment. That's called informed consent, no matter how much you folks would like to try to twist the meaning of informed consent. The doctors, social services, and the first judge are only making things worse by their actions.

Anonymouse,
I stand by my assertion that legal action by the authorities is nothing more than a failure of persuasion.
I don't know what you mean by "emotional scare tactic" when you yourself agree that forced treatment is ethically untenable. I can't be "on the fence" with this one and have it both ways. We'll simply have to agree to disagree on this one.

The parents are failing in their duty of care as parents by supporting a decision which will kill him. That is not informed consent because they refuse to accept that it is going to kill him and he will not be healthy when he nears death. In any other circumstance where parents are endangering the life of their child, the state rightly has a duty to intervene. I see no invisible lines that can be drawn making this a special case. If Nate Nelson believes Chemotherapy to be an extraordinary treatment, let him explain how.

Democracy is founded on the core principle that individuals have the right to be wrong, which is the freedom which would allow the parents to kill their son by inappropriate action. But like all freedoms it is weighed against other freedoms. There is the right to life and other have the responsibility to preserve that life even where individuals don't want to preserve their own. What if Starchild wanted Chemo but but the parents disagreed? Would their parental perogative overrule his choice or the opposite? Would it be the same if he didn't want Chemo but the parents disagreed with that?

We have to be clear about who has the authority to make the decision about Abraham's treatment: his parents or himself? If it is himself, then we have to ask if he is commiting suicide(which means he understand he is going to die) or is he making a choice as is his right as an individual? If it is ultimately his parents who decide his treatment, then they do not have an infinite monopoly on this: parents who actually harm their children have to be removed from them and that includes killing them by action or inaction because they are abusing their role.

I don't believe there has been a failure of persuasion at this stage because I don't know what questions and challenges have been put Abraham and his parents. The ones on TV and in the media are quite pathetic. Because they get treated with kid-gloves, it will mean his death.

By Lucas McCarty (not verified) on 31 Jul 2006 #permalink

Lucas writes:

The parents are failing in their duty of care as parents by supporting a decision which will kill him. That is not informed consent because they refuse to accept that it is going to kill him and he will not be healthy when he nears death. In any other circumstance where parents are endangering the life of their child, the state rightly has a duty to intervene. I see no invisible lines that can be drawn making this a special case. If Nate Nelson believes Chemotherapy to be an extraordinary treatment, let him explain how.

The problem is that the parents are not endangering his life; cancer is endangering his life. I approach this issue from Catholic teaching on euthanasia and assisted suicide, which states:

Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected (Catechism of the Catholic Church, #2278).

Chemotherapy, especially a second round of it after the first round failed, is an extraordinary treatment in that it is burdensome and dangerous.

What if Starchild wanted Chemo but but the parents disagreed? Would their parental perogative overrule his choice or the opposite? Would it be the same if he didn't want Chemo but the parents disagreed with that?

Because he is sixteen, I believe his parents have the exclusive right to decide upon his medical treatment. In this situation, they agree with his own wishes; if they did not, then I would be supporting their decision over his wishes. I have to believe that parents have the right to decide whether or not their children will receive extraordinary medical treatment, a right that should not be superseded by the State.

I have also made the argument, though, that if Abraham had committed a crime or if he were a 16-year-old girl seeking an abortion, he would be treated as having the competency of an adult. No one can dispute that this is the case.

So I have to wonder why so many are disputing his rights and favoring the State's rights when in so many other cases it would be the reverse. Some of the same people who supported euthanizing Terri Schiavo, who support legal and unrestricted abortion even for minors without parental consent, who support charging teenagers who commit crimes as adults rather than juveniles -- some of those same people say that Starchild Abraham Cherrix and his parents do not have the right to make this decision. The biggest problem with our society is that it has lost all consistency, because it has lost the rule of law.

You can endager life by action and *inaction*, that includes refusing the appropriate intervention in this case. Cancer endangers life but Ababraham's life is even more endangered by the decision his parents make for him. Just because cancer is there doesn't exclude the possibility that his parents can do him harm through it.

I still don't understand how you are managing to claim that Chemotherapy is extraordinary treatment. The first round did not fail as keeps erroneously being claimed, the cancer was removed by it. Chemotherapy in no way contributed to it's return.

Parents have duty of care to their children and with that goes the rights of parenthood, but those rights cannot be allowed to overrule that duty of care; they do not have the power of life or death. When they are given the choice of life or death for their children, they are duty-bound to choose life until it is futile. In this case it was certainly not because even with a second round of Chemo his chances were higher than 50%. We would not have made this kind of progress in cancer research ever if people gave up at 50%. We wouldn't have this level of ability in treating it if they gave up at 10 or 5%.

Abraham was only able to even have the oppotunity to be cured because many people who have already died volunteer for treatments with pitifully low chances of success so that the best could be discovered and developed. He does not have a duty to choose appropriate treatment for the sake of future victims of cancer, but this dilemma has obviously not been put to him: he could save lives even if he can't save his own by opting for Chemo again.

Can you please also stop comparing this to the hypothetical situation of Abraham commiting a general crime and being tried as an adult. Except for incredibly regressed states like Texas, teenagers are only ever tried as adults for heinous crimes like brutal murder and rape. This is also not the same as abortion as there are unique dilemmas in that issue: if a girl is not competent enough to decide on an abortion, she is also not competent enough to have a baby but you can't force her decision even as a parent.

There is more consistency than you acknowledge, different medical decisions have different issues and therefore the age of responsibility in each has to be different. If they were all the same it would be entirely dispproportionate and inconsistent. You can't treat abortion, buying alcohol an driving as they are the same and are age-neutral because they simply are not.

His rights are being disputed because he is not an adult. He does not have the right to choose a treatment which will allow him to die until he is an adult. Until then it is his parents responsibility, but that seems to be the word people ignore: responsibility. When they make choices that are wholly irresponsible, they are failing their duty of care towards Abraham.

By Lucas McCarty (not verified) on 01 Aug 2006 #permalink

I remember reading that the Cherrixes believe that Chemotherapy will kill him. In their minds it is this belief that I believe is driving their decisions. Twisted though it may seem both Abraham Cherrix and the social services who are fighting to force chemo on him are both fighting for his right to live.

[i]His inability to project into the future and realistically weigh his options is a hallmark of adolescence, and precisely why he isn't really equipped to make this decision by himself.[/i]

I doubt he isn't going to get that much smarter in two years. It's almost irrelevant anyway. Abraham is old enough to be physically capable of refusing chemotherapy. Even his own doctor has stated that its probably not feasible to force chemotherapy on someone who is outright refusing it.

At this point I'd say the problem is with his doctors. Somehow Abraham got it in his head that chemotherapy will kill him. ( I can't find any statistics on the actual death rates of chemo, but it's probably skewed by different levels of chemo needed for different cancers as well as chemo on the elderly who can't handle the strain ) He probably felt that he almost died the first time. This strikes me those providing the treatment failed to provide adequate counselling about the treatment or that his treatment was badly handled and he did nearly die the first time.

I'd suggest a compromise. A trial will, win or lose, simply polarize the two sides further apart. Rather than wasting time doing that I'd make the Cherrix's an offer. Give some experts a few days to present Abraham with all the evidence they can muster supporting the survival rate using chemo, explaining that chemo though difficult is generally not lethal, and that Hoxley is unproven quackery. If after that time Abraham still wants to go with Hoxley then he can do it. If that's the case then his mistrust of chemotherapy is so deep that they're wasting their time with legal actions. He simply won't do it and dragging him to a hospital and strapping him to a bed for three months simply isn't realistic.

My Rant was about the nazi-istic attitudes of the State. At 16 Abraham is old enuff to be emanicipated. He is old enuff to make his decisions. The FDA admitted in court that there was success with hoxleys method. I for one have not read it. But if someone investigates and wants to try it who the HELL is the state to come in and so NO? Chemo is NO answer! Just as many die from chemo poisoning as they do other methods... there are NO guarantees in life or medicine..... In fact more people die at the hands of there Drs. then Gunshots and Car Accidents!

We live in a World where it is perfectly OK for a woman to KILL her child in her womb sometimes right up to the day of birth, as long as the head is still encased in the womans loins, but A woman is NOT allowed to make her decision on the medical care of her child! That shows the insanity of the world we live in!

I for one will NOT sit while a is gun pointed at my head as far as medicine is concerned. I lost people to Drs'. and hospitals' malpractice. I watched bodies fall apart because of all the pharmacueticals and I helped heal others thru alternative treatments ( when conventional medicine failed).

Peter said: "His inability to project into the future and realistically weigh his options is a hallmark of adolescence, and precisely why he isn't really equipped to make this decision by himself....."

REALLY? CAN ANY ADULT PREDICT INTO THE FUTURE? Can an adult do this and be considered emotionally ready to make that decison? Fact is NOBODY is ready... When you are hit with a death sentence like cancer, it is extremely difficult for any person no matter their age to make that decision all the time with any kind of certainty.

Just who says chemo is the responsible choice? The pharmacueticals? the oncologists?

I remember a few yrs back when stem cell research and treatment was considered quackery, now it is being embraced!

What of all the others who survived without chemo? Were they just lucky?

The FDA admitted in court that there was success with hoxleys method. I for one have not read it.

If you haven't read it or don't know where this assertion came from, then don't be surprised when I don't believe a word of it. Until you can produce verifiable evidence that the FDA ever did in fact write or say any such thing, you're better off not mentioning it.

But if someone investigates and wants to try it who the HELL is the state to come in and so NO?

In the case of an adult you might have a point. Adults can choose quackery if they want. But Abraham is a minor. It can be argued that perhaps he is old enough to make this decision, but it is very clear that he has no clue that what he is choosing is quackery, that, in essence, he is choosing to die. He is mistakenly believes that his death from lymphoma when the Hoxsey therapy fails will be pleasant and that he will be "strong and healthy" at home when death comes. He might be at home, but the ravages of Hodgkins disease will leave him anything but strong and healthy before the end. I hope he will avoid that fate, but he won't if he sticks with the Hoxsey quackery.

[....]

I remember a few yrs back when stem cell research and treatment was considered quackery, now it is being embraced!

Actually, no I don't remember stem cell research ever being considered quackery, although, I would point out, there are a number of quacks now who are taking advantage of people's interest in stem cell research to sell bogus "stem cell" therapies. I've written about this before.

What of all the others who survived without chemo? Were they just lucky?

There are occasional spontaneous remissions in Hodgkin's lymphoma, but the rate is very low. As for "all of the others" who allegedly survived without chemo, if you look closer you'll find that most of them did have surgery, chemo, and other forms of "conventional" therapy before turning to alternatives.