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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 7:41:45 PM   
maybemaybenot


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quote:

ORIGINAL: justheather


There could have been made a case for not giving him the injections. So, was what we did wrong? Was it "assault"?




heather:

Did the parent withdraw the family/parent withdraw their consent to give the child the vaccinations?
If they did, then yes, you committed assault.

If they did not, but were not present when vaccine was administered, you did not.

Was it wrong? I don't think I would use that term. Nor would I say those involved were wrong. Could it have been done differently? Perhaps, perhaps not.
Were there alternatives explored ? Examples: mildly sedate the child to lessen his fear.
Was it imperitive to treatment to do it at that exact moment or could it have waited a day or two and the child slowly worked into it?
No matter the answer, the child's medical care was being dictated by the parent and the staff followed those instructions. There is no legal grounds for any type of lawsuit.

              mbmbn

_____________________________

Tolerance of evil is suicide.- NYC Firefighter

When tolerance is not reciprocated, tolerance becomes surrender.

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 7:46:02 PM   
sweetnurseBBW


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I agree. I worked peds ICU for many years and many parents didnt think the older teen was capable of being included in discussion or treatments. Lots of the times the teen knew they were dying and nothing would change that and just wanted to be without pain and die with dignity. Having a terminal illness matures a child very quickly and they understand alot more than adults think. The child should not be made to undergo treatment. Parents are reluctant to let go because it is their child but at the same time they dont understand the agony the child is going through. Animals have more rights in the US than children. I have held many children crying that just want the pain to stop and dont want any further treatment other than comfort measures. As a nurse the law says I have to do what the parents want, which is a reason I work in cardiac intensive care now and for the past 5 years.

< Message edited by sweetnurseBBW -- 7/25/2006 7:47:14 PM >

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 8:03:03 PM   
maybemaybenot


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Alumbrada:

quote:

maybemaybenot:
I am pretty outraged that this young adult will possibly be forced, against his will, to undergo chemotherapy. If he was one or two years older it would be assault and battery.

See my sentence? notice the words "forced against his will" ? I said   IF.... IF ... IF.. IF.. this person was one or two years older it would be assault and battery.  

IF is the operative word.

And that my friend is not an opinion , but fact.

I did not say the term young adult was legally correct. I said I did not misuse the term.  Euphemism or not, it is a term used in reference to teenagers 16 and beyond. If it would really really make you happy and give you some sense of one upmanship.. I will call him a young person. How's that? Feel better now?

As for me..... if there was a case with a TDO and I was ethically opposed to the order, I would remove myself from the case. That is not malpratice, nor is it unethical. It is my right as a healthcare practioner.

I stated I was not sure what direction you were going in with the delusional patient scenario.. You did not say there was a court order. I was muddy about the question being asked. I admitted that.

You are entitled to any opinion you have for whatever reasons you have, and I will respect that. I do not respect having my words recreated, nitpicking over a common usage word, as to whether it's legal or not. Young adult is not a legal term.

                           mbmbn

_____________________________

Tolerance of evil is suicide.- NYC Firefighter

When tolerance is not reciprocated, tolerance becomes surrender.

(in reply to maybemaybenot)
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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 8:09:21 PM   
justheather


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mbmn: I agree with your statements in your response. I misunderstood the facts of the case.

There are circumstances under which the state has a right to intervene in the medical management of an individual.
I don't think it was appropriate in this situation (OP) either.


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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 8:18:46 PM   
Termyn8or


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Many many good points here.

Now let's add this to the mix (most are not going to like it but it is a part of reality).

Here we have doctors in New Orleans committing euthenasia without the consent of the patient. In the case cited to me, and my opinion asked, the guy was in bed gasping for breath, fighting for each molecule of air he could get.

They gave him a lethal injection without his consent, obviously since he couldn't talk, you have to be able to breathe to talk.

Let me tell you this, I have awoken coughing badly, with saliva running down my windpipe. Thank whoever that this happens very rarely. When this hapens I MUST sit up, or it will never clear up. It has happened and the fact that I am alive means it worked.

Did they try sitting this pateint up, or laying him on his stomach to help him cough this stuff out ? NO, I'd bet my life against a dollar that it never entered their mind. The entire medical community is totally incompetent. No matter what they make if you want a good life you make your own decisions. My Dad does this, and we caught mistakes that would'v killed him. He bought a PDR and straight up told doctors, " I won't take an MAO inhibitor nor a calcium blocker". They asked how he knew about this. Surprised actually.

When I got shot in the face in about 1983, they tried to force me to lay down, see the bullet had been deflected down and was causing some bleeding. I was pretty strong at the time and when four of them tried to force me to lay down they brought out the restraints. I yelled "Look you stupid motherfuckers, I am bleeding into my lungs, I will not lay down and seriously need something to spit into as I cough up shit". The restaraints were removed immediately and things went better. Thing is they brought a wheelchair and I refused to sit in it, I said "I am walking into this place and I am walking out of it". ( I also refused all pain killers and sedatives )

They might know about anatomy, but they seem to forget about gravity. The doctors in New Orleans should not be doctors anymore if they did not sit the guy up, and whap him on the back a few times, force of course commensurate with his physical size. (they should've tried this long ago)

They probably had him strapped down so he couldn't pull the IVs and leave, costing them money.

I have a bad habit of being objective, and now on the other side of the coin is my buddy Mike. He got in a really bad car wreck and he and his olady had recently split up. They had to restrain him because he kept trying to leave, see the gershift had gone through his chest. Subsequently they had to put him in an induced coma, to save his life. They did, this was long before we had ever met.

How is this relevant ? Well, his olady, and I call her that out of disrespect, was really pushing for them to pull the plug. She was a real bitch and I'm sure she wanted his insurance money. I am 90% sure of this because I know members of her family and they are some serious lowlifes.

Now, we can sit here and bitch about the law all we want, but given these different circumstances how should law be applied ? This is a serious issue I agree, but some way must be found to keep our "owners" at bay while preventing abuses that were very possible in Mike's case, had the doctors not refused to cease life support.

He didn't have any missing limbs or paralysis, no brain damage, he is as lucid as you or I and reads and writes just fine.

Here's an idea, and I am serious. Let a family sign the death order, that is to authorize life support removal. Fine. But they sign that they give up their inheritance and any insurance proceeds doing it. I mean everything. That one person gets nothing unless it is by the good graces of the rest of the family. If this were law there could be alternates written into a will. This would be at the choice of the deceased. Really though, if the whole family wants rid of this person, oh well. Abuse could still happen, but if the person raised a bunch of greedy motherfuckers, they have now reaped what they have sown.

They talk about nursing home abuse, well these are the old people who's children don't care about them, why is that ? If you abuse my Parents you will incur my wrath, don't do it. My Dad can get quite cantankerous at times, even abrasive. As such, you will learn to deal with it as I have, you are being paid to do so. So these old folks all abused, where are their families ? Some sires and bearers of children were so bad that some will purposely pick the worst nursing home they can find, and then sue later. (after the old folks are dad of course, to get all the money for themselves) It happens. When in a serious argument with Dad I actually considered it, or having him declared incompetent. I am glad I didn't do it. Things go better.

At one time I was so pissed off I would've chosen the shittiest path of treatment, the worst home to take him. I would've grabbed his assets and squandered them, out of spite. This was years ago and this is not me now, but what if .............

Luckily for me, during that time in my karma, my psyche, my attitude, he did not become infirm.

I was in my 20s. Perhaps it is time we should give up on a universal age of sufferage and  concentrate on something more valid. How about this; Each student, before graduating highschool must write a will, from scratch. It will be judged on content and will be discussed. Those who say "My CDs go to Sherry, my stereo goes to Frank, my car goes to..."(even though the car is still in Dad's name). Well we scrutinize that.

The student is given no form and no guidelines. The people who judge the document are not only sworn to secrecy, but otherwise unaffiliated with the author. Said people ar forbidden to enjoy any inheritance or benefit whatsoever. Said will shall have medical instructions as well, and none of the judges can be affiliated with the medical community either.

Really I state facts, I state problems and I make generalities, much to the dismay of LaM I guess. If I say what I do not think is the truth I am lying and I will not lie. I have no reason to lie in this forum. Real change is needed, I don't think anybody will disagree with that. Problem is, just what direction should these changes take ?

Consider my offerance. You can pull the plug on your family, but you are completely cut out of any money from it. To recieve one penny is considered premeditated murder. Think about it.

And, let me ask you this, why the fuck does a hospital care if a young Man gets their chemo treatment or not, or if a young Woman gets a Csection or not ? ( hint : money )

I think it is more than the bills the can write and charge an insurance company or the government. I wonder what percentage of people undergoing double blind studies actually know about it. I am very skeptical of their motives. Aren't you ?

T

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 8:39:42 PM   
Alumbrado


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quote:

ORIGINAL: maybemaybenot

Alumbrada:

quote:

maybemaybenot:
I am pretty outraged that this young adult will possibly be forced, against his will, to undergo chemotherapy. If he was one or two years older it would be assault and battery.

See my sentence? notice the words "forced against his will" ? I said   IF.... IF ... IF.. IF.. this person was one or two years older it would be assault and battery.  

IF is the operative word.

And that my friend is not an opinion , but fact.

I did not say the term young adult was legally correct. I said I did not misuse the term.  Euphemism or not, it is a term used in reference to teenagers 16 and beyond. If it would really really make you happy and give you some sense of one upmanship.. I will call him a young person. How's that? Feel better now?

As for me..... if there was a case with a TDO and I was ethically opposed to the order, I would remove myself from the case. That is not malpratice, nor is it unethical. It is my right as a healthcare practioner.

I stated I was not sure what direction you were going in with the delusional patient scenario.. You did not say there was a court order. I was muddy about the question being asked. I admitted that.

You are entitled to any opinion you have for whatever reasons you have, and I will respect that. I do not respect having my words recreated, nitpicking over a common usage word, as to whether it's legal or not. Young adult is not a legal term.

                         mbmbn


I noticed the words  '...adult forced against his will' by a court ruling, which made no sense, and that led to the question as to the use of the term in a thread about a judge's ruling.

And if this person were 2 years older, the  judge's ruling would not be 'assault and battery', it would be non-existent, unless the person were incompetent or under a TDO.
To follow up the statement about the judge's ruling ordering the forced chemotherapy with the statement that it would be assault and battery is illogical.

And your wording that created the appearance that you would let a delusional patient go without treatment rather than treat them against their wishes ('removing yourself ' was not given as an option, and is no excuse if they suffer harm, and you were the one in charge of their care... ), is alarming to anyone who has worked in that field, and deserved the request for clarification..



< Message edited by Alumbrado -- 7/25/2006 8:42:12 PM >

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 9:02:51 PM   
Emperor1956


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A few things.

 In the Abraham Cherrix case:  As of today (Tuesday, July 25) the Virginia Circuit Court reversed the juvenile court judge's rulings ordering the chemotherapy and awarding custody of Abraham to the hospital nominees.   Right now there are no restrictions or orders on his decision to forgo chemo.  What the OP didn't understand, and the news sources cited did not make clear, is that the ruling of July 21 by the juvenile court judge was based on "the best welfare of the child".  This standard, which is pretty universal in American juvenile justice, almost always results in an order for treatment because the judge is trained to preserve the child's health above all.  The issues will be tried before the juvenile judge in mid-August.

The best information I've found about this case is at Abraham's own website.  http://www.abrahamsjourney.com/   The problem with this type of complex bioethics case is that everyone jumps on the bandwagon and uses this unfortunate situation for their own purposes.  The extreme and immoral example of this recently was of course Terry Schiavo.  The news media and especially the Web has a lot of bad information.  You need to read at least 4-5 sources (which Abraham collects) to get a feeling for this case.

E.
 

< Message edited by Emperor1956 -- 7/25/2006 9:03:40 PM >


_____________________________

"When you wake up, Pooh," said Piglet, "what's the first thing you say?"
"What's for breakfast? What do you say, Piglet?"
"I say, I wonder what's going to happen exciting today?"
Pooh nodded thoughtfully.
"It's the same thing," he said.

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 9:37:46 PM   
sweetnurseBBW


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I do not consider myself an imcompetent nurse. I deal with an enormous amount of death and until you can do what I do on a daily basis don't judge me. Speak for yourself and not all medical professionals or hospitals. We have all had bad experiences in healthcare but that is not to say it all is bad. That is just your opinion.

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RE: Forced Chemotherapy- Patients Rights - 7/25/2006 10:01:49 PM   
maybemaybenot


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Emperor:
I do understand that the State believes they are acting in the best interest of the child, Saw that quote quite a few times from the Dept Of Youth Services. < or what ever the State of Va calls it> I just happen to disagree with them.
As for the other things you said, I agree in general, but there are a few cases that support Abraham and his parents decision that could be used as precident. The most notable being Katie Wernecke.
You are correct, bioethis is not clear cut nor is there an absolute right and wrong in many cases and the media and certain interest groups can and do exploit these cases.

Alumbrado:
I have every right under the law to remove myself from a case  which I am ethically opposed to. There are MD who do not perform abortions due to ethical/moral beliefs. It is their right. I am no more causing harm, by removing myself than the nurses who are not assigned to the case. If I remove myself I am no longer in charge of their care. There are alot of nurses on this site and I am guessing they would also excersise their right to be removed if they had ethical objections to whatever the situation may be.

                               mbmbn

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Tolerance of evil is suicide.- NYC Firefighter

When tolerance is not reciprocated, tolerance becomes surrender.

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 4:02:30 AM   
FangsNfeet


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So how will this end once the kid start kicking, screaming, pulling out IV's and such? Is this really going to come down to the point of restraints and sedation drugs such as an Ativan Drip? What a way to spend your last days with your family.

How many feel that it's all about the money? How many more chemo treatments will the Health Insurance pay for? That's all the hospital is really trying to do. I garuntee that once the Ins runs out, the hospital will advise to take the lad off the chemo rather than fight in the courts to keep him on it. If the family is smart, they would cancel there sons Insurance Policy and then demand that the hospital give all forced treatment for free as it is against there wishes and can not afford such medical expences to begin with.  



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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 6:56:57 AM   
Alumbrado


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quote:

ORIGINAL: maybemaybenot

Alumbrado:
I have every right under the law to remove myself from a case  which I am ethically opposed to. There are MD who do not perform abortions due to ethical/moral beliefs. It is their right. I am no more causing harm, by removing myself than the nurses who are not assigned to the case. If I remove myself I am no longer in charge of their care. There are alot of nurses on this site and I am guessing they would also excersise their right to be removed if they had ethical objections to whatever the situation may be.

                              mbmbn


That's quite true as long as you do it well in advance of assuming the duty to care, or the ethical objections were a matter of prior record. .  If someone were to wait until things got sticky to walk away, and harm followed, it becomes not so easy.

Not saying you would do that, or even entertain the idea, just pointing out that sometimes a patient refusing treatment may still get it over their objections, if those objections are not freely formed.

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 7:33:44 AM   
sub4hire


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I've been reading this thread.  I don't understand what all the arguing is about?  Anyone care to clue me in?
There are stupidpeople everywhere you look.  There are also intelligent people everywhere you look.
The kid is almost an adult and been living with this for quite some time.  He knows he doesn't have long to live so he would like to die with dignity.
In some cases doctor's allow some of us to actually die that way.  In other's we are told how to die.  That is a fact of life.  Not a good one considering we are supposed to live in a free country yet suicide is a crime even if we are dying.

The politicans all need to have children like this to live through it to learn what empathy truly is.  At that point the system will be fixed. 

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 8:03:21 AM   
Mercnbeth


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mbmbn,
 
many years before Starchild Abraham was born, one of his cousins was in a Baltimore hospital, diagnosed with cancer.  He was 77 years old.  His daughter, a registered nurse, checked him out of that hospital and put him on a plane for the west coast where he was taken to her home. she lovingly cared for him, for his remaining month of life...the last two weeks of which were spent in a coma.  no hospital bed was trucked in, no monitors.  the room where he took his last laboured breaths was 20 miles away from a hospital.  it was the same room this slave had used as a bedroom for years...and after he died, it was her bedroom once more.
 
this experience has to be one of the most important family medical decisions this slave was ever priviledged to witness--the right to die at home, surrounded by family, doctor's opinion be damned.

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 11:37:51 AM   
Termyn8or


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Thanks alot folks. With all these varied and valid points (which I would not want to live without) you have again proven that there are no easy answers.

Though I'll say this much, when you have a nine year old kid deathly afraid of needles, why not gas him first and give him the shots while sedated ?

I think part of the reason I don't trust doctors, that we research every drug they try to give to my Dad is twofold. First of all doctors are too damn busy, even the really good ones only have so much time for you.

The much bigger reason is education. For some reason the educational system does poorly at teaching any real problem solving, not always, but alot of the time. There is so much to learn and memorize there is little time for independent thought. Engineers are the same way. Recalls, product revisions etc.

Add to that the fact that researchers are specifically paid to prove a certain assumption and you have the mess we are in now. Supposed facts cannot be counted on as being facts, we have so much post hoc ergo propter hoc now that the best sources for up to date information are frequently very old.

I think it is the thought process itself that has changed, mainly that people want to win, to prove that they are right. It is very easy to unconsiously make mistakes in your favor in the privacy of a research laboratory.

I may have digressed here, this thread is not about whether the "suits" are right or wrong, it is about their ability to impose their judgement on others. That is a clear cut case. If the patient says no it should be no.

But then there are exceptions, the mentally ill, the depressed who want to commit suicide.

I have counselled people who wanted to commit suicide, and in one case I was unsuccessful. In other cases I recounted my guilt for the heinous things I've done in my youth, things that I cannot live with but do live with. I express that I should be dead, but only live on for family and close friends because of what my demise would do to them. But then there are those who do not have that reason. They could be estranged from their family and not have any really close friends, and that happens usually because of their highly defensive personality. In some cases the family was very small and has died off. Then what do you do ?

Usually the mental pain that causes suicide is temporary, but the person does not realize this. Therefore I employ "You can always do this tomorrow instead of today". Can you take it for one more day ? I'll stay on the phone with you all fucking night and miss work tomorrow if you want.

This has happened more than once, but like I said I did fail once. Rich had Huntington's disease. It is inherited maternally and there is no cure. There are tremors and some degree of clumsiness, but as Rich explained to me, eventually a certain form of dementia sets in.

I used to work with Rich and we became friends. He told me about his Mother, how her dementia caused her to do stupid things, sometimes involving driving. Causing injury and not giving a shit. He said he could feel the tremors. Drinking abated the tremors but he knew that was no way to live, drinking all the time.

He recounted to me seeing his Mother in the hospital all tied down and constantly thrashing about. He told me he didn't want to hurt people and he didn't want to eventually wind up like his Mother. He also didn't want to have any children because he was not sure that he would not pass the Huntington's on to them.

He made a very good case, but "You can do it tomorrow instead of today" worked a few times.

Funny, the day we met we almost both lost our lives. This is true. Like I said we worked together and it turned out my house was on his way home. I didn't have a car at the time so we were on I-90 westbound in the fast lane. Well a truck decided to change lanes and didn't see his Ford Escort, and we wound up under the semi, between it and the concrete wall. While laying on the horn, he did some really precise driving and prevented our deaths. Now this is a guy who gets tremors. Glad it didn't happen just then. Not only did he have to steer very precisely, he had to match speed exactly with the semi we were under.

The semi eventually changed lanes again, and I wonder to this day if the driver ever saw us. The first words out of my mouth were "Get off this fucking freeway and go to the nearest bar". He eagerly complied.

I was one of the last people to see him alive. He showed up at my house out of the blue with a bunch of young (jailbait) Women. Taking him aside he explained that he wanted to be around some people who had a positive outlook on life. The next day I waited for him to pick me up to go to work. He never showed, and I mean never.

I called work and asked "Where is Rich ?", they said "Rich is dead".

Turns out that Rich had this habit. He would setup a hangman's noose in the garage and stand on a chair for hours, with the attitude that if he couldn't control this he would rather die. One day  he did.

I don't think anyone could've saved him, he was convinced he had Huntington's, and actually saw suicide as an altruistic act. How do you fight that ?

I am now drained. If anyone is listening it was good to get this off my chest. Thank you for being here.

T

PS: I know this offers nothing in the way of solutions, but once I got started oh well. Perhaps it only serves to prove that there are no solutions.

T

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 12:00:40 PM   
maybemaybenot


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quote:

Mercnbeth: checked him out of that hospital and put him on a plane for the west coast where he was taken to her home. she lovingly cared for him, for his remaining month of life...the last two weeks of which were spent in a coma. 


((   hugs )) beth:

and a much more a " radical " concept in those days. He was given the greatest gift one can give at that time. Peace, familiarity and love thru out his death. I applaud his daughter.
< your Mom??>


If I have come off as a hard ass, I apologize. I am not anti chemo or anti treatment for anyone. My criteria for treating/caring for my patients is that they are in control and I am their to guide them thru which ever road they decide to travel. My, perhaps idealistic, view of medicine is that we are the secondary caregivers, not the primary. The patient is in control of his or her own destiny, after being given full disclosure of treatment, options and disease progression. I am there as a support person.

sub4hire: the arguing has taken away from the topic and I share the blame for that. I usually take my debates to e mail when the arguing has nothing to do with the topic, but with content or interpretation of my own words. I suppose it is my passion for the subject that made me very defensive.

alumbrado: I took your posts as to be questioning of my ethics, hence the "wet hen" responses. If I interpreted incorrectly, I apolgize.
                       mbmbn

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Tolerance of evil is suicide.- NYC Firefighter

When tolerance is not reciprocated, tolerance becomes surrender.

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 12:15:56 PM   
Alumbrado


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Sorry they came across that way. My background is more legal than medical, and I saw this article as being about a court case, not about the ethics of those providing the chemo, and I asked questions about the OP from a standpoint of clarifying the legalisms.

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RE: Forced Chemotherapy- Patients Rights - 7/26/2006 12:33:51 PM   
maybemaybenot


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Truce ! We were coming at the subject from opposite directions, so to speak. Glad we cleared it up.
                   mbmbn

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Tolerance of evil is suicide.- NYC Firefighter

When tolerance is not reciprocated, tolerance becomes surrender.

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RE: Forced Chemotherapy- Patients Rights - 7/28/2006 11:07:46 PM   
Emperor1956


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quote:

many years before Starchild Abraham was born, one of his cousins was in a Baltimore hospital, diagnosed with cancer.  He was 77 years old. 


beth, you are related to Abraham Starchild Cherrix?

E

_____________________________

"When you wake up, Pooh," said Piglet, "what's the first thing you say?"
"What's for breakfast? What do you say, Piglet?"
"I say, I wonder what's going to happen exciting today?"
Pooh nodded thoughtfully.
"It's the same thing," he said.

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RE: Forced Chemotherapy- Patients Rights - 7/29/2006 6:51:29 AM   
Mercnbeth


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quote:

ORIGINAL: maybemaybenot

... I applaud his daughter..< your Mom??>



thank you, yes that was this slave's mom...and the best nurse this slave has ever had the pleasure to know!!!

quote:

beth, you are related to Abraham Starchild Cherrix?

E ...orig:  Emperor1956



yes...so as not to hijack the thread with boring genealogy, this slave tried to send you a CM mail....but couldn't locate your profile, so send a note on the mail side if you are interested. 

< Message edited by Mercnbeth -- 7/29/2006 6:55:03 AM >

(in reply to maybemaybenot)
Profile   Post #: 39
RE: Forced Chemotherapy- Patients Rights - 8/16/2006 12:37:06 PM   
HollyS


Posts: 230
Joined: 1/5/2006
Status: offline
This case has been resolved today:  Starchild Abraham Cherrix is free to forgo chemotherapy, as long as he keeps in close consult with the oncologist of his choice until he is either cured or turns 18. 

You can read the news release here via the AP

The case was settled before going to hearing, so it is doubtful that any precedent has been set for future cases.  Still, I'm glad he is being allowed control over his own decisions. 

~Holly



_____________________________

I wish my lawn were emo, so it would cut itself.

(in reply to Mercnbeth)
Profile   Post #: 40
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