Amish ,Cancer and Chemo-Therapy.

[Saturnine Pariah]

A 10-year-old Amish girl will not be forced to undergo chemotherapy, an Ohio judge has ruled, siding with the girl's parents, who say previous chemotherapy made her sick.

Though an appeals court sent the case back to a judge for further consideration last week, Judge John Lohn denied temporary limited guardianship to a nurse and dismissed the case in Medina County, Ohio, explaining that the Hershbergers are "good parents."

"They live a simple life, but this does not mean they are simple-minded," Lohn wrote in the ruling.

In April, Sarah Hershberger was diagnosed with lymphoblastic lymphoma, which resulted in tumors on her neck, chest and kidneys, according to court records. Sarah started chemotherapy at Akron Children's Hospital in Medina County, Ohio, but her parents, Andy and Anna Hershberger, decided to stop the treatments in June.

Sarah has an 85 percent chance of survival with chemotherapy, according to a statement from Akron Children's Hospital. Without it, the cancer is "almost always fatal," the hospital wrote on its webpage about Sarah's case.

"We've seen how sick it makes her," Andy Hershberger told Good Morning America in a phone interview last week."Our belief is the natural stuff will do just as much as that stuff if it's God's will. She would have more suffering doing chemo than not."

The Hershbergers believe chemotherapy will kill Sarah, but they don't object to resuming it "at some point in the future," Lohn wrote in his ruling.

"Akron Children's Hospital is disappointed in Judge Lohn's ruling," the hospital said in a statement. "We believe this case is about children's rights and giving a 10-year-old girl an 85 percent chance of survival with treatment."

Lohn wrote that the chemotherapy wasn't a surefire cure, and that the Hershbergers weren't informed about its side effects.

"Sarah says her doctor should be put in jail," Lohn wrote. "Even if the treatments are successful, there is a very good chance Sarah will become infertile and have other serious health risks for the rest of her life."
http://abcnews.go.com/Health/amish-girl-10-forced-chemo-judge-rules/story?id=20168395

 

[lightgigantic]

the religious aspect aside, there is quite a bit of hogwash that goes down in the name of chemo therapy - far from calling it a surefire cure, you can't even accept it as a cure when it's credited as such if the cancer doesn't reappear after 5 years and a whole bevy of other issues that seem to make it look like its more about an industry securing its consumers financial commitment than anything else

 

[wynn]

"Akron Children's Hospital is disappointed in Judge Lohn's ruling," the hospital said in a statement. "We believe this case is about children's rights and giving a 10-year-old girl an 85 percent chance of survival with treatment."

How did they arrive at that percentage?

That 85% of people with the same disease who have undergone the same treatment have recovered from the disease does not automatically mean that the percentage is the same for an individual. After all, the treatment didn't work for 25% of people receiving it, so for them the chances for recovery via that treatment were zero.

 

[Bells]

How did they arrive at that percentage?

That 85% of people with the same disease who have undergone the same treatment have recovered from the disease does not automatically mean that the percentage is the same for an individual. After all, the treatment didn't work for 25% of people receiving it, so for them the chances for recovery via that treatment were zero.

If it gives her an 85% chance survival, then why would they want to refuse?

And can I ask, where do you get the 25% from? Because 100 - 85 does not equal 25.. Just saying.

I do find it disturbing that they focused more on her fertility than her having an 85% chance of getting better from the chemo.

 

[wynn]

If it gives her an 85% chance survival, then why would they want to refuse?

Where did they get that number??

And can I ask, where do you get the 25% from? Because 100 - 85 does not equal 25.. Just saying.

Oh, sorry, it should be 15% not 25%. That's even worse. My optimism made me make a math booboo.

I do find it disturbing that they focused more on her fertility than her having an 85% chance of getting better from the chemo.

Again, where do they get that number from?

 

[Bells]

Where did they get that number??




Oh, sorry, it should be 15% not 25%. That's even worse. My optimism made me make a math booboo.




Again, where do they get that number from?

At a guess, it is the survival rate of those with that form of cancer who have undergone that treatment.

 

[wynn]

At a guess, it is the survival rate of those with that form of cancer who have undergone that treatment.

Like I already said:

How did they arrive at that percentage?

That 85% of people with the same disease who have undergone the same treatment have recovered from the disease does not automatically mean that the percentage is the same for an individual. After all, the treatment didn't work for 15% of people receiving it, so for them the chances for recovery via that treatment were zero.

 

[Bells]

Like I already said:

And if you had 85% chance, isn't that better? If there is 85% chance that it will work for you, would you refuse because it did not work for 15%?

 

[Russ_Watters]

How did they arrive at that percentage?

Probably the survival rate to 5 years for everyone getting the same treatment.

That 85% of people with the same disease who have undergone the same treatment have recovered from the disease does not automatically mean that the percentage is the same for an individual.

True. It matters how early you catch it, if there are any other underlying health issues, etc. But so what? There is no way to slice the data to make it 0%, which is what the odds are of survival without treatment.

After all, the treatment didn't work for 15% [corrected] of people receiving it, so for them the chances for recovery via that treatment were zero.

15% is 15%, not 0%. You're misusing probability. It's like saying after you flipped a coin and got heads that the odds of heads was 100%. No, it isn't: it is always 50%.

 

[wynn]

And if you had 85% chance, isn't that better? If there is 85% chance that it will work for you, would you refuse because it did not work for 15%?

That number is, so far, just a psychological tool to convince people.
Because it's not verified.

Probably the survival rate to 5 years for everyone getting the same treatment.
True. It matters how early you catch it, if there are any other underlying health issues, etc. But so what?

So it's not possible to calculate what exactly the probability for recovery is for a particular person. One can only talk about statistical probabilities for a particular sample, but not for a particular person.
But here, we are talking about the probablity of recovery for a particular person.

There is no way to slice the data to make it 0%, which is what the odds are of survival without treatment.

Really? There is usually a percentage of "spontaneous" remissions of a disease. There may also be other options, other than that particular treatment.
Then there is also the issue of the damage that a treatment will possibly, or surely cause, regardless whether it otherwise cures the disease or not. Individuals may sometimes consider that damage to be too great. Some believe it is better to be dead than maimed, for example. We cannot just dismiss the patient's value system and mechanically insist that the value system of doctors is objectively superior. Doctors may cure cancer and turn a person into a vegetable - and some people would rather die from cancer than risk becoming a vegetable.

15% is 15%, not 0%. You're misusing probability. It's like saying after you flipped a coin and got heads that the odds of heads was 100%. No, it isn't: it is always 50%.

The treatment didn't help 15% of people on whom it was applied. For those people, it doesn't matter that the treatment helped 85% of other people.

 

[Tiassa]

They might change their mind later, when the therapy is less effective ...?

What bugs me most here is that they're making this stand, now, because they apparently think chemo will become their daughter's cause of death, but they're not averse to resuming therapy at some later date.

I really don't get that.

Meanwhile, this is one of those facets of American law and justice I just don't get. I mean, it sort of cuts both ways if we stick with the political version of the ethics. To the one, while many religious folk object to terminating pregnancies, some advocate leaving their children to die. To the other, while we're more and more jailing those who pray their children to death in lieu of medical attention, parents still have the right to protect their children from potentially lifesaving therapy according to religious beliefs.

I cannot answer that conundrum. Indeed, I can barely wrap my head around it. That is, I see it, but I have no idea if it is significant, or if diving down that rabbit hole will lead anywhere useful.

 

[Fraggle Rocker]

How did they arrive at that percentage?

It's an 85% probability of surviving five years. That's what "survival" means when anyone is talking about any kind of cancer.

The only types of cancer in which survival to old age is realistically possible are the kinds which attack a particular organ or other part of the body, and you can completely remove it. Some types of breast cancer, after surgery, have a 98% probability of surviving ten years. Many post-menopausal women will die of something else first.

 

[wynn]

It's an 85% probability of surviving five years. That's what "survival" means when anyone is talking about any kind of cancer.

How can they say that _this particular girl_ has a 85% chance of survival with this treatment?

What are the underlying assumptions going into this?

 

[Saturnine Pariah]

How can they say that _this particular girl_ has a 85% chance of survival with this treatment?

What are the underlying assumptions going into this?

http://www.mayoclinic.com/health/cancer/CA00049

 

[wynn]

http://www.mayoclinic.com/health/cancer/CA00049

Doesn't answer my question.

As already said earlier:

So it's not possible to calculate what exactly the probability for recovery is for a particular person. One can only talk about statistical probabilities for a particular sample, but not for a particular person.
But here, we are talking about the probablity of recovery for a particular person.

 

[Russ_Watters]

That number is, so far, just a psychological tool to convince people.
Because it is not verified.

Nonsense/conspiracy theory. I'm not quite sure what agenda you are trying to push here, but hospitals/doctors/government agencies keep and publish statistics. Unless you believe the are all conspiring to lie about them, you should take that as a verified statistic.

So it is not possible to calculate what exactly the probability for recovery is for a particular person. One can only talk about statistical probabilities for a particular sample, but not for a particular person.

Correct. Unlike a coinflip, the probability has no exact value.

But here, we are talking about the probability of recovery for a particular person.

False dichotomy. That particular person is part of the sample group. Your quibble that the probability listed is not exact is just not useful: the fact that the probability is not exact does not mean it isn't useful. It is still one of the most useful tools available for determining the course of action for treatment.

Really? There is usually a percentage of "spontaenous" remission of a disease.

For cancer, that number is so low that is truncated out of the survival rate statistic because it is too small to be useful in terms of significant digits and presentation of results.

There may also be other options, other than that particular treatment.

We're talking about the difference between treatment and no treatment here, but sure, when deciding on a course of action, doctors definitely consider the efficacy rates of different treatments.

Some believe it is better to be dead than to be maimed, for example.

Certainly, but no human has the right to decide that for another human. Not even a parent.

We cannot just dismiss the patient's value system.

You mean parents' value system. The patient here is 10 and doesn't have a legal right to make decisions for herself. And in that case, the govnerment places limits on what one person can decide for someone else. In short, they err toward life.

Doctors may cure cancer and turn a person into a vegetable - and some people would rather die from cancer than risk becoming a vegetable.

Sure, and people are allowed to decide that for themselves. But not for others. Not even for their own daughter. And in any case, that's not what the Amish are arguing anyway. And that's even setting aside the fact that that determination can be made after the fact, with a prior directive (get the treatment, then if you become a vegetable, have an order in place to pull the plug. Happens all the time).

The treatment didn't help 15% of people on whom it was applied.

Correct.

For those people, it doesn't matter that the treatment helped 85% of other people.

100% of other people. Jeez, you're bad at this. But anyway, no, nothing matters to someone who is dead. But we're not talking about after-the-fact judgement, we are talking about prior decision-making. From a strictly mathematical/probability perspective, the fact that the person died does not make the decision to treat them wrong. It was still the right choice.

The way to judge that is if you'd make the same choice again in similar circumstances. Consider this: If I roll a die and offer to pay you $1 if it comes up 1, 2, 3, 4 or 5 and you pay me $1 if it comes up 6, would you take the bet (strictly based on probability)? If it comes up 6 and I offer the same bet to you a second time, would you take it a second time or not? (assuming no trickery) Of course you would. Failure last time doesn't change the odds for next time.

 

[Russ_Watters]

Doesn't answer my question.

As already said earlier:

Yes, the statistic is imperfect. So what? No amount of adjustment can ever make it less than zero. So what is your point?

 

[Fraggle Rocker]

How can they say that _this particular girl_ has a 85% chance of survival with this treatment?

It's just statistics. 85% of the people who get this treatment survive five years, and 15% don't.

What are the underlying assumptions going into this?

None, really. Except, I suppose, that in the next five years the statistics won't change.

She could die in six months, and all there'd be to say about it is that she was one of the 15%. There's no way to assign people to those categories in advance.

 

[Dinosaur]

This is a sticky situation.

If the 10 year old opted for treatment, it is a slam dunk: Treat her & the hell with her parents religion based view.

The child would probably side with the view of her parents, which makes the issue murkier.

I do not think that the religion-based view of the parents should carry any weight: I believe that the medical experts should be allowed to decide what is best for the child.

Suppose that the child had a broken leg & the parents denied medical treatment in favor of prayer, not allowing setting the bone & using a splint. This would be a no brainer. The treatment for cancer is a similar situation, but a bit more difficult to analyze.

In the case of a minor, I favor allowing the medical experts to make the decisions.

We no longer allow the inquisition, the burning of witches, & other archaic religious activities. We should not allow religion beliefs to over rule medical experts.

Of course an allegedly sane adult should probably be allowed to make stupid decisions relating to medical treatment.

BTW: My life partner & BFF (Gloria) has asthma. Several year ago, an asthmatic child was allowed to die due to the religious views of her parents.

The legal system took no action against the parents. Gloria was furious. She said (from experience) that if one of the parents had asthma,
they would accept treatment. The instinct to want to breathe would over rule religious belief.