Maturity and the Right to Refuse Treatment for Cancer: Considering the Societal, Biological, and Legal Implications of Allowing a Minor to Make a Complex Medical Decision

Treating a minor diagnosed with cancer is a difficult situation. However, cases in which doctors and the patient's family disagree about the proper course of treatment present complex scenarios when it comes to patient care. The forced treatment of Cassandra Callender came as a result of challenging interactions between the patient, the medical establishment, and the state. While the Connecticut Supreme Court mainly considered Cassandra's maturity and her mother's actions when deciding this case, there were more factors contributing to Cassandra's quality of care than her ability to make decisions. An evaluation of these factors demonstrates important implications for ensuring a minor receives the best care. Cassandra wished to pursue a means of treatment that would have fewer serious side effects than chemotherapy, but her assessment of her prognosis was markedly different than that of her doctors. While it is clear that Cassandra did not fully grasp the likelihood of death without chemotherapy treatment, her perspective should not have been fully ignored. The forced treatment inflicted serious (though short term) harm. To understand the full context of this case, this paper considers relevant legal doctrine, decision-making capabilities of minors, the problems and perils of chemotherapy, the role of the media, and the doctor-patient relationship. Developing a perspective based on these facets of Cassandra's case is important in determining how to facilitate the best interaction between doctor and patient and to make sure that future cases aid the patient and his or her family to make the best decision given the situation. Even when there is no consensus about what is best for a patient, more consideration must be given to the patient's perspective, beyond attempting to solely extend life.