Is It Murder If a Mom Withholds Cancer Treatment From Her Child?
Imagine you are a single mother suffering from depression, overwhelmed with caring for an autistic, nonverbal and developmentally disabled son. If he were diagnosed with cancer, what would you do?
Kristen LaBrie, a Massachusetts mother, chose to disregard a prescribed chemotherapy regimen. On Tuesday, two years after her son, Jeremy, died at age 9, a Superior Court jury declared her guilty of attempted murder.
LaBrie learned that Jeremy had non-Hodgkin’s lymphoma in October 2006, when he was 7. It’s not that she couldn’t be bothered to administer the chemo; she testified that she couldn’t bear to watch him suffer from the toxic drugs so she did not administer treatments, which apparently caused his disease to progress to leukemia. (More on Time.com: Did Homeopathic Medicine, Breast-Feeding and Veganism Kill a Baby?)
In addition to the murder charge, LaBrie, 38, was convicted of assault and battery on a disabled person with injury, assault and battery on a child with substantial injury and reckless endangerment of a child.
Was justice done? It’s hard to know. Certainly, disabled children have rights. But moms do too, and it appears that LaBrie did not have adequate support. Being a single mother of a healthy child is tough enough. Factor in autism and a kid who can’t communicate makes it that much harder. Add non-Hodgkin’s lymphoma, and the burden is fierce.
“This is one of those cases where we have to ask, What standards do we hold parents accountable for?” says Cynda Rushton, a nurse ethicist at the Berman Institute of Bioethics at Johns Hopkins University who directs the pediatric palliative care program at the university’s children’s hospital. “On one hand, you can imagine a parent in a situation like this wondering whether going through cancer treatment is a beneficial thing in the long run for her child. Just because a disease is treatable does not mean it is curable. She may have thought, Am I hurting my child by giving this treatment?” (More on Time.com: Should a Disabled Mom Be Banned from Seeing Her Kids?)
Boston attorney J.W. Carney Jr. told the Boston Globe that LaBrie’s case should also have zeroed in on the role played by LaBrie’s doctors, questioning why they didn’t get involved as soon as it was clear that LaBrie was not complying with the treatment regimen.
“It can be so overwhelming for a single parent to deal with a child who is autistic, nonverbal, and developmentally delayed,” said Carney. “It is cruel to add to that burden a diagnosis of cancer and a requirement that the mom administer medicine that will cause the child even more pain.”
Is a parent at liberty to forgo treatment? According to the courts, apparently not.
The closest analogy appears to be a 1986 case in which Christian Scientist parents rejected surgery for their son, suffering from a bowel condition, in favor of spiritual treatment. In that situation, Massachusetts’ Supreme Judicial Court ruled that parents, despite their religious beliefs, are obligated to rely on conventional medicine to treat their critically ill children. (More on Time.com: Closely Spaced Pregnancies May Contribute to Autism)
In many ways, that situation seems more clear-cut. In general, parents have a lot of latitude surrounding their children’s medical care — how they are treated and by whom. Intentionally harming a child is not acceptable in our society, but the definition of intentional harm is refracted through a parent’s personal perspective.
“We have an obligation to protect a child whose parents abuse them or neglect them,” says Rushton. “But there is a difference between someone who intentionally hurts their child and someone who has made a decision that a particular treatment, on balance, is not in their child’s interest.”
LaBrie’s sister, Elizabeth O’Keefe, told the Globe that the jurors simply couldn’t understand the magnitude of the situation with which LaBrie wrestled. “It’s too hard for them to know what my sister was going through at that time,” said O’Keefe. “I don’t think my sister had any intentions of hurting Jeremy, ever. I never will believe that in my life, never.”
Rushton agrees. “I suspect this mother was really trying to do the best she could for him,” she says. “As parents, we always wonder if we are doing a good enough job. But what does it mean to be a good parent in this circumstance?”
Web App Advances Personalized Cancer Treatment
How individual cancer patients respond to treatment depends in part on the patient’s medical history, therapies they’ve already tried, whether the cancer has spread, and their tumor’s molecular makeup. A free Web-based application aims to help patients get more personalized treatments and provide doctors with more timely cancer research information.
That’s good news, especially for patients who don’t live close to major cancer centers and for oncologists who don’t have sophisticated IT tools or research resources.
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The Targeted Therapy Finder–Melanoma application is the fruit of collaboration between the American Society of Clinical Oncology (ASCO) and CollabRX, a company launched about three years ago by Jay Tenenbaum, a melanoma survivor, tech entrepreneur, and former chief scientist at Commerce One.
While the app for melanoma is the first tool being offered, the collaboration between CollabRX and ASCO could lead to decision support tools for other cancers as well, Tenenbaum said.
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Some researchers believe that malignancies are a compilation of many rare diseases caused by a combination of numerous factors. Among those factors are various gene mutations that often differ between individuals who are diagnosed with the same general type of cancer, whether it’s melanoma, breast cancer, leukemia, and so on.
The new Web tool, which can run on mobile devices like iPhones and iPads, helps doctors and patients identify diagnostic tests, treatment options, and clinical trials for specific subtypes of melanoma and specific patient characteristics, said Tenenbaum in an interview.
Patients or doctors enter information about the individual’s melanoma, including the disease’s stage, origin, metastatic sites, and genetic mutations, and the tool helps narrow down drugs and clinical trials to consider.
Hyperlinks connect doctors and patients to additional information about the drugs and clinical trials, as well as definitions of terms and descriptions of specific mutations.
The melanoma tool is powered by expert knowledge from an open source database set up by CollabRX called Cancer Commons, Tenenbaum said.
That expert knowledge includes data from molecular disease models, including a melanoma disease model that was recently published in PLoSOne, an international, peer-reviewed, open-access research publication site.
As part of their collaboration, ASCO is also providing CollabRx with access to all of its published melanoma content, including data presented at the society’s annual meetings, and study results described in peer-reviewed journals.
The goal of the Cancer Commons database is to include outcome information about how patients are responding to various treatments. The hope is that these insights–for instance, the success of certain drugs for patients with various subtypes of cancer–can be disseminated more quickly, Tenenbaum said.
“Every day in oncology, there are thousands of experiments that go on but no one captures that data,” he said. That includes patients who receive various chemotherapy cocktails in hopes of targeting specific subtypes of cancer. The ability to share outcome data on those patients who have uncommon combinations of genetic mutations, chronic conditions, and other characteristics could help make it easier for oncologists to zero in on treatments for other patients who have rare similarities.
Clinical trials for new treatments are often considered failures if only a handful of patients out of thousands respond positively to the new drugs, Tenenbaum said. But for those few patients who do respond well and have renewed hope, those trials are hardly failures.
Services offered by CollabRX eventually could also be useful to clinical trial organizers to recruit potential patients.
Is Hyperthermia A Good Alternative Cancer Treatment?
While there are numerous conventional cancer therapies that can be helpful, the effectiveness of alternative cancer therapies like hyperthermia mustn’t be discounted. Sometimes patients choose alternative therapies to enable them to stay away from the uncomfortable and quite often debilitating side effects of the classical cancer treatments. However, in other instances patients are simply looking for complementary therapies which could assist and improve the overall effectiveness of traditional treatments. In either case, doctors and researchers like Dr. James Haim Bicher have proven that hyperthermia is an effective therapy option whenever a patient is fighting cancer.
Fighting Common Misconceptions About Alternative Therapy
Some individuals immediately think of ineffective treatments, unscientific practices, and medical quackery should they hear the words “alternative cancer therapies”. Legitimate alternative cancer therapies can be immediately dismissed by people as a result of these common misconceptions. Unfortunately, this will cause some people that may be helped by alternative cancer therapies like hyperthermia to miss out on the chance to learn how effective they might be.
Sometimes, such as is the case with hyperthermia, much study, research and even scientific clinical trials have already been devoted to testing and investigating the treatment. Just because a possible beneficial therapy doesn’t fit the common treatment protocol does not mean a patient should discount it when they’re fighting cancer. If you are battling cancer, it’s vital to search for every possible advantage that can be used to weaken and kill cancer cells. It’s important to bear in mind even when a therapy doesn’t use radiation or toxic chemicals, it can still be effective. In fact, sometimes it may be more effective, particularly if it is used in combination with other cancer treatments.
Making Use Of a Targeted Approach in the Fight Against Cancer
One of the unfortunate issues that the patient must deal with in using standard cancer treatments is the fact that when cancerous cells are damaged, healthy cells can also be damaged. Although radiation treatments and chemotherapy are designed to minimize this damage, significant problems and negative effects could occur. However, when you use a cancer therapy such as hyperthermia, there can be far fewer detrimental side effects. Hyperthermia works because tumor cells, being disorganized and abnormal, cannot tolerate heat the same way that normal cells can. As a result, when hyperthermia treatment therapy is administered, the cancerous cells are weakened and even killed, while the surrounding healthy cells remain undamaged.
Hyperthermia May Be Used To Augment Traditional Cancer Treatments
Although hyperthermia has been shown to have the ability to weaken and kill cancer cells, studies conducted by Dr. James Haim Bicher and others have shown that these therapies, when coordinated with other treatments including chemotherapy and radiation, may also be beneficial. Because heat can increase the flow of blood, it may help to make certain that the tumor receives maximum benefit from the chemotherapy treatments. Radiation treatments can also be more effective once the cancer cells are already weakened by hyperthermia. As an alternative to depending upon just one cancer procedure, better results are often obtained by combining both traditional as well as alternative cancer therapies.
