The pain of watching children die!

The father of an 11-year-old Canadian boy with leukemia wants to stop his painful treatment. The doctors say No. Who’s right?

Decisions about medical treatment for critically ill children open up a world of competing sorrows. The case of the 11-year-old Canadian boy with leukemia, whose father refused a second round of chemotherapy for him, is no exception. The plight of the boy and his father has sparked a nation-wide debate.

The right of parents to decide on medical treatment for their children flows from a presumption that they will act in their children's "best interests". Parents have an obligation to provide their children with the necessities of life, which include the medical treatment needed to protect their lives and health. For a variety of reasons, however, parents can refuse treatment for their children that medical professionals and others regard as essential.

The right to refuse treatment for one's child is narrower than if the parents were deciding for themselves -- competent adults have an almost absolute right to refuse, which is much broader than what they can refuse for their child. It's been reported the young boy has also refused treatment. Whether that refusal is legally valid depends on his capacity to provide an informed refusal -- the flip side of an informed consent.

A valid informed consent or refusal requires the person to be competent and informed, and their decision voluntary. Competence is often in doubt with children's own treatment decisions. In judging competence, courts take into account the child's age, experience and intelligence; independence from their parents; and the reasons they give for refusing the treatment. Courts have increasingly found mature minors competent to decide about treatment, but that is highly unlikely with an 11-year-old. Ethically, however, the child's wishes should still be taken into account. When, as in this case, there is an irresolvable conflict about treatment between parents and doctors -- unless the situation is an emergency -- a court order is required.

Abortion harms your mental health

It is being hailed in Britain as a major breakthrough in professional attitudes to abortion. Last weekend the Royal College of Psychiatrists issued a statement acknowledging that induced abortion may harm a woman's mental health and advising professionals to assess and counsel women accordingly. The cautious one-page document, noting that the evidence for the association is inconclusive, may seem "anodyne" says one psychiatrist, who prefers not be named, but in reality it is "a huge step. It's a shift from being pro-choice to being neutral."

"Balanced and reasonable" is the verdict of the author of well-regarded New Zealand research on abortion showing its link with mental disorders. "The statement acknowledges the risks to mental health, but it also acknowledges the uncertainty. I think it's really exemplary in its objectivity," said David Fergusson in a telephone interview with MercatorNet. Professor Fergusson is director of the Christchurch Health and Development Study, which has followed the progress of 1265 children born in the city in 1977. Data from interviews with women in the study published two years ago showed a 50 per cent higher risk, overall, of problems including depression, anxiety, suicidal behaviours and substance abuse among those who had had an abortion. 

The issue of informed consent was tragically highlighted by a coroner's hearing in the UK last month of the case of Emma Beck, a talented artist who hanged herself on the eve of her 31st birthday after the abortion of her twins when she was eight weeks pregnant. She was pleased at the pregnancy but her boyfriend was not. Her suicide note read: "I told everyone I didn't want to do it, even at the hospital. I was frightened, now it's too late." 

Girls, unprotected

The insertion of long-acting contraceptives into the bodies of young girls does not protect them from sexual abuse. It sets them up for greater exploitation. Reports continue to grow worldwide about population and family planning organisations demonstrating their preference for administering women long-acting, provider-controlled contraceptives in the form of injections and implants that cannot be removed by the woman herself.

These methods seem to be especially promoted for use amongst marginalised groups in developed countries and poor women in developing countries, causing women’s groups on the ground to raise questions about health impacts and lack of consent. Disenfranchised groups such as native peoples living on Indian reservations in the United States have been targeted.

Now, it seems, it is Australia’s turn. Aboriginal girls living in third world conditions in a supposedly rich country are the latest target. Queensland Health recently admitted implanting contraceptive rods in girls as young as 12 after the practice was discovered in two Indigenous communities - Aurukun on Cape York and Woorabinda, west of Rockhampton. It has since emerged that girls in the Northern Territory are also being given the hormones. The practice raises profound questions about the health and safety of very vulnerable girls living on society’s margins. No one in authority can say exactly how many girls have been fitted with the implant, which has significant side effects including prolonged bleeding - the main reason women abandon its use. Indigenous women suffer rates of anaemia far higher than their white sisters. Who is monitoring the girls to check on their health status?

YOUNG BRITS ASPIRE TO MARRIAGE BUT GOVT WON'T HELP

Most young people in Britain want to get married and the main reason is very encouraging: they want to make a commitment. That's what a survey commissioned by think tank Civitas found. Seven out of 10 people aged 20 to 35 said they would like to marry, and nearly eight out of 10 (79 per cent) already living together said they hope to tie the knot. Trouble is, says Civitas in a report by Anastasia de Waal, many people are just too poor to do so. Official data show that areas where working class industries have collapsed have the highest proportion of cohabiting parents, while marriage was concentrated in parts of the country with large numbers of middle-class families.

Says Ms de Waal: "Many young people idealise marriage. If they don't find the perfect partner or if their employment or housing situation means they are not in a good position to get married, they are likely to postpone marriage or take it off the cards altogether. This has the effect of lowering the marriage rate, but doesn't mean that young people don't want to get married. For example, women choosing from a pool of potential husbands might decide not to marry if their partner is unemployed."

END MARRIAGE PENALTY FOR POOR!

People on welfare benefits in the United States stand to lose 10 to 20 per cent of their income straight off if they get married, and this could discourage more of them not to marry. Writing in the Wall Street Journal, Republic Senator Sam Brownback and marriage advocate David Blankenhorn say it is time to eliminate this marriage penalty, just as Congress has reduced marriage penalties paid by middle and higher income couples through the tax system.

The writers suggest that all newly married couples should receive all of their existing benefits for the first three years of marriage. This would give them time to realise the economic benefits of marriage and save some money to stabilise their situation before government benefits cease. "When that day comes, the government's message to low-income Americans will have changed dramatically. We will be saying: Your marriage matters -- for you and for all of us."

California court rules gays are entitled to marry!

Marriage suffered a blow this week when the California Supreme Court ruled, by four votes to three, that state laws limiting marriage to the union of a husband and wife violate the state constitution. The narrow majority ruled that there is a fundamental constitutional right to same-sex marriage, and that creating civil unions as an alternative for same-sex couples, as California has done, amounts to a violation of the state equal protection laws.

Thursday's ruling by the Republican-dominated court affects more than 100,000 same-sex couples in the state, about a quarter of whom have children, according to US census figures, the Los Angeles Times says. It came after high courts in New York, Washington and New Jersey refused to extend marriage rights to homosexual couples. The only other court to grant such rights is the Massachusetts high court in 2003.

Governor Arnold Schwarzenegger, who has vetoed two measures that would have authorised same-sex marriage, says he will uphold the new ruling and will not support an amendment to the constitution that would attempt to ban same-sex marriage. In 2000, 61 per cent of California voters approved Proposition 22 which said that "only marriage between a man and a woman is valid and recognised in California". The proposition is now the subject of a referendum petition to amend the constitution. The petition has been submitted with 1.1 million signatures and Californians will have the opportunity to vote on it in November.

Says Maggie Gallagher of the Institute for American Values: "Most Americans understand that marriage is not bigotry. It is common sense -- unions of husband and wife have a unique status in law and culture because they really are different from other kinds of unions including in this way: they are uniquely necessary because they are the unions that both make new life and connect those children to their own mother and father."