Bioethics Cancer Medicine Quackery Religion

Would you die for your religion? part 2: What about the children?

It looks as though the Jehovah’s Witnesses have claimed another life. This time, though, it wasn’t an adult, as it was recently. This time, though, through the indoctrination inherent in the Jehovah’s Witness religion and, incredibly and inexcusably, the acquiescence of our legal system to their irrational and dubious interpretation of a text written thousands of years before blood transfusion was ever contemplated, the life lost was that of an adolescent:

A 14-year-old boy who refused blood transfusions in his fight against leukemia — based on religious beliefs — died Wednesday night in Seattle, hours after a Skagit County judge affirmed his right to reject the treatment.

Dennis Lindberg, of Mount Vernon, died around 6 p.m. at Children’s Hospital & Regional Medical Center in Seattle, according to KING-5 television. As a Jehovah’s Witness, Lindberg objected to receiving blood. Doctors had said he needed it to survive his cancer treatment.

In court Wednesday, Superior Court Judge John Meyer said that Lindberg, though in the eighth grade, was old enough to know that refusing blood transfusions might amount to a “death sentence,” and that he had the right to make that decision.

I don’t know what the background of this story was, but apparently Dennis was not living with his parents, but rather with his aunt. Even more tragically, his parents disagreed with the decision not to transfuse. Some of the issues involved in this case are to me reminiscent of those that made the case of Abraham Cherrix so difficult. The difference is that at the time of his refusal of chemotherapy, Cherrix was almost 16 years old and that the court in essence ended up making a compromise in which Cherrix agreed to undergo at least some conventional therapy (i.e., radiation). True, it was inadequate therapy that has little or no hope of curing him, but at least it’s good palliation. In this case, the court in essence allowed a 14-year-old boy to commit suicide for his religion, about which representatives of his religion could only say:

After the judge’s ruling, Jim Nelson, chairman of the Jehovah’s Witnesses’ Seattle Hospital Liaison Committee, said Lindberg was a “very responsible young man who knows his mind and was very clear. He’s a very brave young man, and he’s standing firm for what he believes in.”

Jehovah’s Witnesses believe the Bible prohibits transfusions of blood, in part because blood is sacred, Nelson said.

And it doesn’t mean the faith is “antimedicine,” he added. “Jehovah’s Witnesses do not have a death wish. We’re not arguing a right to die.”

What a crock. That’s exactly what they are arguing, and their defense of how Nelson’s religion indoctrinated Dennis to the point where he threw away his life away for no good reason sickens me. They’re arguing in essence to allow minors to commit suicide unnecessarily for their religion. I’ve discussed the specific Biblical passages that Jehovah’s Witnesses use to justify their irrational refusal of life-saving transfusions. For adults, I support that right as part and parcel of freedom of religion. I may consider refusing transfusions based on a tortured interpretation of a few lines of scripture to be the height of irrationality, but adults have the right to be irrational in making their health care choices. When it comes to children, I’m much less tolerant.

Even so, I do understand why the issues become more difficult as children become adolescents, and the article is surprisingly good in discussing them:

Years ago, courts routinely supported transfusions of children against the wishes of parents, Diekema said. While adults have the right to refuse any medical treatment, the courts ruled, that right doesn’t extend to their children.

“The principle there is that parents can make martyrs of themselves, but they can’t make martyrs of their children,” Diekema said.

With an adolescent, the situation is much more complex, he said. “We all know that 14-year-olds change their minds; they become adults, and they have completely different belief systems. And that makes you nervous.”

At the same time, 14-year-olds can have an “adultlike” decision-making process. And when the transfusion isn’t a one-time emergency procedure but a long-term treatment, there’s another complexity, Diekema said.

“Then the issue is: How can we effectively treat a kid when he’s not going to cooperate?”

How indeed?

That was an issue that I appreciated in the cases of Abraham Cherrix and Katie Wernecke, two minors who with their parents refused evidence-based therapy, particularly for Abraham, who was much older than Katie. Moreover, in the case of someone like Dennis, indoctrinated by his religion to view transfusion as a tool of the devil, the likelihood of serious physical resistance would probably be much higher. Fundamentalist religion, as we all know, is one of the most powerful motivators known to man. After all, it’s the same force that leads young people to throw their lives away murdering scores of innocents by strapping bombs to their bodies or flying jetliners into skyscrapers. Physical resistance was not a concern in Dennis’ specific case, given that he was reportedly in a coma, but it is an important issue in the general case of what to do about adolescents who refuse a life-saving medical intervention like transfusion because of their religion. On the other hand, I think that the mother of one of Dennis’ friends probably nailed it:

Several friends of Lindberg and of his parents attended Wednesday’s hearing, and some ran out crying when the judge announced his decision.

“Dennis does present himself as a very mature man. But he really is just a child trying to please the adults around him,” said Jan Curry, whose daughter, Morgan, is his friend.

Dennis’ death is all the more tragic because childhood leukemia is a highly treatable disease. Dennis probably had a greater than 70% chance of long term survival with proper therapy, including transfusions. The problem is, to achieve that survival rate, transfusion is often required to tide the patient over until his bone marrow recovers from the suppression caused by chemotherapy. In the end, there probably wasn’t much that anyone could have done to save Dennis. His indoctrination into a religion that applauds his utterly pointless death as being evidence of his great faith guaranteed that long before Dennis ever fell ill.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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