A Washington State judge allowed a 14-year-old Jehovah’s Witness sick with leukemia to refuse a blood transfusion that could have saved his life, a decision that has stirred controversy among medical ethicists.
Dennis Lindberg of Mount Vernon, Wash., died shortly late Wednesday in his bed at Children’s Hospital and Regional Medical Center, the boy’s biological father, Dennis Lindberg Sr., told the Seattle Post-Intelligencer.
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Earlier Wednesday, Superior Court Judge John Meyer denied a motion by the state government to force Dennis to have a blood transfusion, saying the eighth-grader knows “he’s basically giving himself a death sentence,” according to local media reports. Lindberg’s biological parents, who do not have legal custody, also wanted to force their son to have the transfusion.
Parents and classmates of the boy, who had lived with his aunt for the past four years, reportedly cried in disbelief at the judge’s decision. His biological mother fled the courtroom in tears. Dennis’ aunt, Dianna Mincin, is his legal guardian and is also a Jehovah’s Witness. She supported his decision to refuse treatment.
The case forced the judge into a difficult balancing act: weighing Lindberg’s right to make his own decisions with the need to protect him, medical ethics experts said. Adults have the right to refuse medical treatment, and courts typically will defer to the decision of a child’s parent or legal guardian, said Sharona Hoffman, co-director of the Law-Medicine Center at Case Western Reserve University School of Law.
But courts have frequently forced young children to have blood transfusions against the wishes of their Jehovah’s Witness parents. Several ethicists questioned whether a 14-year-old was mature enough to decide to refuse treatment.
“The critical question is: Was this decision voluntary and knowing?” said Robyn Shapiro, director of the Center for the Study of Bioethics at the Medical College of Wisconsin.
“These issues give me pause,” she said. “I’m surprised and I’m concerned” about the judge’s decision.
Adolescents are more inclined to agree to things in order to appear heroic and are more susceptible to pressure, said Rosamond Rhodes, director of bioethics education at Mount Sinai School of Medicine. They also frequently change their beliefs as they get older.
“They’re more likely to think in terms of black and white where adults see gray,” Rhodes said.
Dr. Benjamin Wilfond, director of pediatric bioethics at Children’s Hospital in Seattle, who was not involved in Lindberg’s case, said Lindberg’s situation was different in that he would have needed ongoing treatment and repeated transfusions. It would also be difficult to force Lindberg to cooperate with the treatment.
“It’s not typical to physically restrain children of that age for medical intervention,” he said.
“You balance trying to respect them and protect them,” he said.
After hearing from Dennis’ parents, his aunt, social workers and doctors, Judge Meyer denied the state’s request, according to local news reports and people who attended the hearing.
Meyer said Dennis had been give a 70 percent chance of surviving the next five years with the transfusion. He said he believed Dennis was mature enough to make his own decisions.
“I don’t believe Dennis’ decision is the result of any coercion. He is mature and understands the consequences of his decision,” he said, according to The Associated Press. “I don’t think Dennis is trying to commit suicide. This isn’t something Dennis just came upon, and he believes with the transfusion he would be unclean and unworthy.”
Lindberg left school in early November when doctors diagnosed him with leukemia and began treating him with chemotherapy. They stopped the treatment, which often prevents the body from creating new red blood cells, a week ago because his blood count was too low, the Skagit Valley Herald reported.
But Lindberg refused a blood transfusion on religious grounds. Jehovah’s Witnesses believe it is impure to receive a blood transfusion; they do not typically refuse other forms of medical care.
Lindberg’s biological parents, Lindberg Sr. and Rachel Wherry, believed their son should have had the transfusion. Dennis’ doctors supported his decision, but the state government sought a court order to force the transfusion.
Mincin did not return messages left by ABC News. She has previously declined to talk about the case.
The boy’s father told the Post-Intelligencer that he decided not to appeal the court’s ruling after visiting his son Wednesday. He said doctors told him Wednesday evening that the boy, unconscious since Tuesday, had likely suffered brain damage.
“Dennis was very strong in his beliefs,” Patricia Shanander, a teacher and Lincoln Elementary School in Mount Vernon, where Dennis went to school, told ABC News. “He did what he felt was right.”
With reporting from The Associated Press