A 17-year-old Jehovah’s Witness – known only as ‘X’ – is being forced to have a blood transfusion, after the NSW Supreme Court ruled that the teenager must undergo the potentially lifesaving procedure.
The patient is suffering from Hodgkin’s lymphoma – a lethal form of blood cancer – but has threatened to rip an IV needle out of his own arm, if a blood transfusion is attempted.
Jehovah’s Witnesses believe that the Bible prohibits the ‘ingesting’ of blood – or even components of blood such as platelets and plasma – and therefore do not believe that Christians should accept blood transfusions.
Even in emergencies. Even when it is literally a matter if life or death.
Teenager X told Professor Glenn Marshall – his doctor at the Sydney Children’s Hospital – that if he were put under aneasthesia in order to be given a blood transfusion – it would be akin to ‘rape’.
When handing down his ruling that the teenager will be forced to accept the blood transfusion, Supreme Court Justice Ian Gzell said that the young patient had been ”cocooned in faith” throughout his life.
While doctors had tried to respect the young patient’s wishes for as long as possible, his case became more and more serious. Now? Treatment is the only thing that will save them.
When X was first admitted into hospital in January of 2012, he underwent seven months of chemotherapy. X initially went into remission but then Professor Marshall discovered cancer in his lungs, spleen and lymph nodes.
Because a higher dose of chemotherapy was likely to require a blood transfusion, X underwent two cycles of a lower dose – but his tumors were barely reduced.
In March this year, X developed severe anaemia and his chemotherapy treatments had to be stopped altogether. Still, the patient refused any further treatments that could result in a blood transfusion being necessary.
And then the doctors took the case to court.
Professor Marshall, who has 20 years’ experience treating children with cancer, told the Court X had an 80 per cent chance of dying from anaemia without a blood transfusion.
If he was allowed to administer his preferred treatment, he said X would have up to a 50 per cent chance of survival. Apart from ripping out the IV if he could, X and his father would otherwise obey the court order, Judge Gzell found.
”The sanctity of life in the end is a more powerful reason for me to make the orders than is respect for the dignity of the individual,” Justice Gzell said in his ruling. ”X is still a child, although a mature child of high intelligence.”
What makes this case different from so many before it is that the court’s ruling was handed down only 10 months before the patient is set to turn 18. As soon as the teenager is legally considered an adult, his wishes to refuse a transfusion would have to be respected.
Precious cases where the facts have been analogous, have always involved young children, whose parents have forbidden doctors to use blood transfusions. This time it’s different.
. Mamamia spoke to ethicist Leslie Cannold, she points out that although most mainstream media have taken the perspective of X ‘being only 10 months away from turning 18’, it is equally possible to say that he is ‘only two months over 17’.
Cannold says that “from an ethical point of view, I would definitely agree that we need to support people making decisions that are consistent with their own beliefs and values – even when we as a society may disagree with those beliefs and values.
“But when we are talking about someone who is not generally considered to be competent [such as a teenager], I think it’s really important to err on the side of caution and give that person as much time as possible to get to an age where we have to concede that they know their own mind.
“And that they are not, for instance, being so constrained in religion … that they haven’t had a chance to develop those kinds of independent thought processes, that we generally tend to associate with people making independent, autonomous choices.”
“When you’re in a sect that is so isolated from mainstream society, “ Leslie says, “your entire social and emotional life is caught up in being a part of this sect, and the cost of refusing to follow the edict means you will be shunned… Generally as a society we don’t believe that people should have to chose between their lives, and membership of a religious group.”
But in cases such as these? Jehovah’s witnesses do make such a choice.
Leslie continues, “I am very uncomfortable about that. I think that it’s worrying, and that’s why I agree that people should have as much time as possible – 17 years, 11 months, and 29 days – to get the chance to possibly get some sort of chronological maturity, or some sort of external input that might come their way, that might lead them to believe that they can choose to save their life, and that that is viable choice for them to make.”
In the case of X, Leslie says that she “[worries] that for this particular boy, it might not seem like an option. And you can’t really make a choice, when you don’t have a rage of options. The definition of choice becomes meaningless, really.”
The fact remains that if X’s life is extended for 10 months – he will then be legally allowed to refuse a blood transfusion from his doctors at that stage. And his condition is such that several transfusions will be needed for him to survive.
Doctors have won the right to extend this patient’s life for 10 months.
But not for any longer.