Judge John Rodenberg gives chemotherapy refusenik Daniel Hauser a chance to live

Over the last week, I’ve written about the case of a 13-year-old chemotherapy refusenik named Daniel Hauser, who lives in Minnesota. After having been diagnosed with a highly curable form of cancer, Hodgkin’s lymphoma, back in February and having undergone one cycle of chemotherapy that apparently made him very sick, he refused further chemotherapy and his mother actually went to court to justify this decision. As part of their justification, they tried to use freedom of religion based on Daniel’s supposedly being a “medicine man” in a cult of faux Native American wannabes called Nemenhah, which is led by Philip “Cloudpiler” Landis (who really should be called “Woo-Piler”), a white man who claims to be a naturopath and Native American “healer” peddling “cures” for AIDS and cancer. At first, I chalked this up as yet another case of religion leading to rejecting conventional medicine based on irrational beliefs, but later decided that religion was merely a convenient excuse to reject further chemotherapy because Daniel and his mother were scared by his reaction to the chemotherapy, this fear amplified by the memory of an aunt who had died while receiving chemotherapy. In the meantime, a flock of “alternative medicine” boosters have descended upon the comments of my previous post, complete with testimonials and rants against the state.

Yesterday, Judge John Rodenberg ruled on the case:

Rodenberg found Daniel, who likes to do field work on the family farm, play baseball with his siblings and go sledding, has been “medically neglected” by his parents, Colleen and Anthony Hauser.

The judge wrote that Daniel has only a “rudimentary understanding at best of the risks and benefits of chemotherapy. … he does not believe he is ill currently. The fact is that he is very ill currently.”

The judge allowed Daniel to stay with his parents, noting they love him and acted in good faith. But he gave them until Tuesday to get an updated chest X-ray and select an oncologist.

If the tumor has not grown and if Daniel’s prognosis remains optimistic, then chemotherapy and possible radiation appear to be in Daniel’s best interest, Rodenberg wrote. The judge said he would not order chemotherapy if doctors find the cancer is too advanced.

If chemotherapy is ordered and the family refuses, the judge said, Daniel will be placed in temporary custody. It was unclear how the medicine would be administered if the boy fights it.

Calvin Johnson, an attorney for Daniel’s parents, said the family is considering an appeal. For now, he said, Daniel is following the order and will have X-rays Monday.

His reasoning:

In this case, Rodenberg said, the state’s interest in protecting the child overrides the constitutional right to freedom of religious expression and a parent’s right to direct a child’s upbringing.

Medical neglect, Rodenberg said, clearly took place on April 29, when the Hausers did not follow one doctor’s advice to return to an oncologist, and on May 7, when they disregarded their family doctor’s recommendation to get the tumor X-rayed. Up until then, Rodenberg wrote, the family was seeking second opinions and alternatives.

That is undoubtedly true. The record shows that Daniel’s mother clearly went doctor-shopping, looking for a physician who would recommend something other than chemotherapy. She found none, because there is no other effective therapy for stage 2B Hodgkin’s disease Every doctor she saw told her that the child needed chemotherapy to have a good chance of survival, mainly because he does.

To me, this appears to be a reasonable ruling. Rather than taking Daniel from his parents’ custody immediately, Judge Rodenberg has made a point of putting the onus on the parents to get Daniel the medical care he needs to survive. He’s also left an “out” if the tumor is too advanced. It very likely won’t be; even stage IV Hodgkin’s disease has a reasonable shot at being cured with standard therapy. I can’t imagine a pediatric oncologist who would not recommend therapy in such a case, unless the child was moribund and already at death’s door, which Daniel clearly is not. Finally, he points out that Daniel can’t read and clearly lacks anything close to the ability to give informed consent, the latter of which is a hallmark of deciding whether a patient is competent to make his own medical decisions. He even left Daniel in the custody of his parents, the only downside to which I can see is that there is always the risk that they might flee, as Katie Wernecke’s parents did when the judge in her case ordered them to have her treated.

All of this still begs the question of what will happen after Daniel gets his next set of staging studies to determine the extent of his disease. If he refuses, medical personnel are left with the problems I discussed in detail regarding the practicality and ethics of using force to administer treatment to a 13-year-old boy who is large enough to put up considerable resistance. My hope is that, with family counseling and the judge clearly placing the onus on the parents to arrange for chemotherapy, Daniel and his mother will come around. As much as I’ve railed in the past about woo infiltrating academic medical centers, there may occasionally be a use for it if it persuades Daniel and his mother not to throw his life away, as the hospital where he would likely be treated has this:

Fear of chemotherapy is common among cancer patients, and Children’s Hospital has a program that incorporates herbal supplements, massage, acupuncture, and other alternative methods to help patients deal with the side effects of the medication. It’s unclear where Daniel will seek treatment.

There’s very little evidence that any of this does much of anything (other than massage, which at least feels good), but if psychologically it allows Daniel and his mother to justify chemotherapy it might be worth it in just this one case.

I’ll keep an eye out for reports next week on what Daniel’s repeat staging studies show.

Orac’s commentary

  1. Another child sacrificing himself on the altar of irrational belief
  2. Daniel Hauser and his rejection of chemotherapy: Is religion the driving force or just a convenient excuse?
  3. Judge John Rodenberg gives chemotherapy refusenik Daniel Hauser a chance to live
  4. Mike Adams brings home the crazy over the Daniel Hauser case
  5. The case of chemotherapy refusenik Daniel Hauser: I was afraid of this
  6. Chemotherapy versus death from cancer
  7. Chemotherapy refusenik Daniel Hauser: On the way to Mexico with his mother?
  8. An astoundingly inaccurate headline about the Daniel Hauser case
  9. Good news for Daniel Hauser!
  10. Daniel Hauser, fundraising, and “health freedom”