Must Have Been A Tough Call

The story: 16-year-old kid gets Hodgkin's lymphoma, a nasty form of cancer that is often incurable and fatal. He undergoes treatment which includes chemotherapy. He reacts badly to chemo. So he wants to discontinue chemotherapy, and start taking an "alternative" treatment instead. The "alternative" treatment, called the "Hoxsey Method," has not been legal in the United States since 1960 and the herbal components of which must be imported from Mexico, had not survived any kind of scientific testing for efficacy on Hodgkin's lymphoma.

This tears me up inside. Some sixteen-year-olds are likely to be intelligent and mature enough to understand what it means to forego medical treatment that the overwhelming weight of conventional treatment wisdom tells him to take; to understand that not following a doctor's advice while undergoing treatment for cancer is literally risking one's own life; and that such a young person is able to weigh that risk against the alternatives (including doing nothing). I can see someone with maturity and intelligence comparing the trauma of chemotherapy to his curent medical condition and deciding that maybe the pain and weakness isn't worth the marginally improved chances of survival that he would gain.

But a lot of sixteen-year-olds would not be so mature, I think. They would tend to make more impetuous decisions and deal with the issue from the standpoint of a disbelief in personal vulnerability. Death was a hard concept for me to understand as a sixteen-year-old, and I think I was a pretty mature and intelligent sixteen-year-old. Not until some of my relatives and friends died did I start really thinking hard about death and my own mortality. Still, let's give this young man the benefit of the doubt -- he's been sick for a while and has probably pondered these things much more than his peers.

So who are we, as a society, to require a person of sufficient maturity and intelligence to accept medical care that he does not want? Certainly we should satisfy ourselves that he is really making an informed, voluntary choice in not getting this medical care, but once we have satisfied ourselves of that, my basically libertarian principles tell me that society's role in the process is now complete and he can make his own decision and live (or die) with the consequences.

But then I see that he is relying on an effectively disproved treatment method, one which is probably being pushed on him by charlatans espousing the evils of the "traditional medical establishment" with some foggy-headed appeal to hope based on nothing reasonable or provable. If this young man is a person of faith, then by all means, an appeal to the diety of his choice for healing or palliation is in order, and that can be done consistently with getting medical care. But an appeal to quack medicine is just not something I can endorse. Suggesting that this alternative treatment is somehow equivalent to chemotherapy is simply incorrect. The shame of it is if he really thinks this other procedure will help him.

I guess if he has faith in it, that's worth something. But faith and prayer simply aren't good tools for healing the sick. At best, they create a kind of placebo effect; one recent study actually had cardiac patients who received intercessory prayer suffering more complications than those who did not. Of course, there are also statistical apologetics for prayer's purported healing effects, and I tend to think that the real value of scientific studies on the medical value of prayer neither confirm nor deny its value but instead strongly confirm the observer-expectancy effect. This comment isn't directly about the medical value of prayer anyway -- and seeking divine aid to recover from his illness is not mentioned in a lot of the reports about this story.

The point is that this young man is consciously choosing to take therapy that has been amply demonstrated to be quackery. He seems to be placing real hope in this course of treatment that lacks substantial scientific support. That suggests that perhaps his decision to forego chemotherapy is not so well-informed after all.

[The previous two paragraphs were edited from a previous version of this post -- TL]

I wouldn't have wanted to have been the judge in this case. That must have been a very difficult decision. But I suppose, on balance, that allowing this young man to get quack medicine instead of chemotherapy was effectively the same thing as allowing him to get no treatment at all if that were his decision. So I guess it was the right call. But it leaves a bad taste in my mouth.

(A footnote, directly appropos of no substantive issue this story raises -- the 16-year-old in question bears the unlikely name "Starchild Abraham Cherrix." If he's sixteen now, that means he was born in 1990. What kind of a parent decides in 1990 to name their son "Starchild"? They can do it if they want, I guess, but that seems like the sort of thing that hippie parents would have named their kids in the late 60's or early 70's. This young man with a lot of more important things on his mind than silly issues like baby-name fashions apparently prefers to be called by his middle name, "Abraham," which seems like a pretty good idea to me, or at least a less flaky one.)