Ethics Committees

Case for review:

Jimmy is an 11-year old boy who suffers from lymphoma.  His oncologist has indicated that without chemotherapy, he is likely to die within 6 months.  She has also indicated that in most cases, chemotherapy provides an effective cure in only 20 percent of cases like Jimmy’s; in most cases, chemotherapy produces at best an additional 3-6 month extension of life. 

Jimmy is also compromised by an incurable neurological disease.  This disease will eventually make it impossible for him to walk, talk or use his hands effectively.  Already, he speech is slurred and he cannot hold a pencil.  Even without lymphoma, the prognosis– because of the neurological disease– is death by the age of 18. 

Jimmy has been raised in a strong religious environment, and his belief in God has been an important comforting factor to him.  After having the facts fully explained to him, he has accepted his situation and the inevitability of his death at a young age.  He says he does not want the chemotherapy and that he is ready to “go to God.”  His parents, however, cannot reconcile themselves to losing Jimmy.  They want to override his decision/proceed with chemotherapy. 

Clergy/Chaplain: From a clergy's standpoint, I would side with Jimmy. If he is ready to "go to God" and has made peace with the strong possibility of death, then, as a clergy, I would support that decision. I would speak to the parents about his decision and explain that he is ready to return to God, and that it is part of God's will to listen to their son.

Jesus said, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these."-Matthew 19:14

 Also, the chemotherapy would likely cause bad side effects like anemia, fatigue, hair loss, nausea and vomiting, and appetite changes. I'd explain, if I were a chaplain that the boy has decided on his fate, and that it would be selfish of his parents to force him into chemotherapy. I'd also urge the whole family to pray about the decision, and let them know that no matter what ends up happening, it will be God's plan. 

Psychologist: As a psychologist, I would sit down with the entire family. I understand both points of view. The parents want to save their son and keep him around as long as possible. But the son wants to "go to God" and not have to suffer through chemo. So I would let the family know that I understand how each side feels. I'd have the parents explain to their son why they believe what they believe. Then, I'd have the son explain to his parents about his point of view. I'd try to urge the family to find a compromise. Maybe they try chemo for a short amount of time and see if it works, what side effects he gets, etc. If it didn't work well, maybe it's not meant to be. I'd urge the family to reach some sort of agreement so that there is no bitter feelings at all during the tough time.