(by guest blogger: Erica Graham)
How do we, as a society, decide when someone is mature enough to make their own healthcare decisions? Recently, the Connecticut Supreme Court ruled that 17 year old Cassandra C. must undergo chemotherapy to treat her Hodgkin’s lymphoma, even though she does not wish to receive treatment. While waiting for the court’s decision, Cassandra was taken into state custody, and confined to a room at Connecticut Children’s Medical center with a guard posted outside her door to prevent her from leaving. This clear violation of Cassandra’s autonomy has sparked dialogue about when a teen is mature enough to make end of life health care decisions. Currently, teens can legally make some healthcare decisions, like whether or not to get an abortion, without parental consent. Most of the discussion surrounding Erica’s case has focused on her age and maturity level. Personally, I know 17 year olds who are mature enough to make this decision, as well as some who are not mature enough. Maturity is not simply a matter of age.
So how should maturity be determined in cases like these? I propose an analysis of her reasoning, not her age, should be used to determine her level of maturity. Cassandra’s main reason for not wanting to receive chemotherapy, even though the odds of successful treatment in her case are high, was because she didn’t want to put poisons in her body. Her reasoning, not her age, shows her lack of maturity to make this decision. Her reasoning is not founded on carefully considered risks and benefits like that of a mature adult. It appears her reasons are built on fear and her lack of understanding of a treatment that will most likely save her life. While not every adult is mature enough to consider risks and benefits carefully, the law has the ability, in the case of a teenager, to prevent them from making poor decisions that they may not fully understand.
Certainly some adults refuse chemotherapy, but Cassandra’s case is a different set of circumstances. By undergoing chemotherapy she has an 85% chance of living for many more decades. Basic logic dictates that this benefit overrules the pain and inconvenience of chemotherapy treatments. Despite the fact that this decision violates Cassandra’s autonomy, I am glad the court can intervene when a lack of mature reasoning and logic is evident in a teen. I agree with the court’s decision on the grounds that Cassandra didn’t demonstrate mature moral reasoning.