DCF: Big Sister Knows Best

Dying scares me less than suffering. Perhaps that’s because I’ve reached an age at which I attend more funerals than weddings. But I can imagine nothing more terrifying than to be forced to suffer. So my heart goes out to Cassandra C., the young 17-year-old kidnapped by the state and forced, against her will, to undergo chemotherapy.

Yes, I said kidnapped.

The word was chosen with care, and is calculated to rankle Joette Katz and her colleagues at the Department of Children and Families. The law may be on the department’s side as to Cassandra, but so much the worse for the law. Parents statewide can’t help but shudder over the notion that when if comes to child rearing, Big Sister knows best.

Cassandra — we can’t know her last name because the juvenile courts operate under a cloak of statutory secrecy, thus depriving the public of any realistic sense of what goes on in those courts — has Hodgkins Lymphoma. If treated aggressively, with chemotherapy, she has a good chance of survival. About 9,000 Americans are stricken with this cancer each year; about 1,100 Americans die each year from it, according to the National Cancer Institute.

Cassandra didn’t want the chemotherapy. Neither did her parent and legal guardian, Jackie Fortin. Without it, Cassandra would most likely die. So DCF moved in and got an order of temporary custody in a secret juvenile court proceeding. Then social workers and Windsor Locks police officers stormed Jackie’s home, and took her daughter into custody.

Listen to Cassandra’s words: “I was strapped to a bed by my wrists and ankles and sedated. I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated.”

She was locked up in a hospital room, and forced to undergo chemotherapy, living like a convict for more than a month in a hospital.

In the eyes of the law, Cassandra lacks the capacity to make judgments about whether to reject care because she is not regarded as an adult. Her mother, Ms. Fortin, did not consent to treatment. Medical providers were forced to stand by and watch a potentially treatable condition cascade out of control.

The politics of what makes an adult in the eyes of the law makes for interesting reading.

Adults can refuse medical treatment so long as they have the capacity to make decisions about their own welfare. A person who lacks the ability to make decisions might be appointed a conservator, a person who can substitute their judgment for that of their ward. Typically, conservators help to care for the elderly and seriously impaired.

But Cassandra had her wits about her. She is a minor in the eyes of the law, as are all people below the age of 18. Enter Ms. Fortin, her mother and legal guardian. Typically, parents have the right to substitute their judgment for that of their children. According to Ms. Fortin, Cassandra did not want chemotherapy, and so Ms. Fortin supported her daughter’s decision..

Listen to Cassandra’s words: “I want the right to make my medical decisions. It’s disgusting that I’m fighting for a right that I and anyone in my situation should already have. This is my life and my body, not DCF’s and not the state’s.”

Because Ms. Fortin honored Cassandra’s wishes, the state concluded Ms. Fortin was neglecting Cassandra’s welfare. It sought, and obtained, the right to take Cassandra out her home and to substitute the judgment of social workers for that of her mother.

There is something deeply disturbing about a young person’s decision not to fight for life, and one can’t help but wonder whether Ms. Fortin yielded too quickly to her daughter. Plenty of people survive Hodgkins Lymphoma, and describe the suffering incident to chemotherapy as a painful chapter they now are happy to have endured. Perhaps Cassandra’s decision was immature and impetuous; perhaps her mother was prepared to fail her.

But the state’s decision to invade this young woman’s home and remove her by force of arms so that she could be strapped to a hospital bed not just chills, it repels. Who gets to make life and death decisions?

There’s something wholly arbitrary about the age of legal adulthood. Many states recognize that some minors are extraordinarily mature, and are capable of making life and death decisions. Those states recognize “mature minors” as capable of making adult decisions. The Connecticut Supreme Court did not give Cassandra that right.

I was reminded as I read about her case about how the law draws arbitrary but necessary lines. In colonial times, and well into the 19th century, the age of consent for intimate relations ranged from a low of 7 years old in Delaware to 10 or 12 years old in the other states. The Women’s Christian Temperance Union pressed for increasing the age of consent, and most states responded by enacting laws reflecting the current age of 16 to 18 years old in every state of the union.

Were we a nation of pedophiles until the 1880s? Or did the law simply change? How firm should the line separating those old enough to make life and death decisions from those not capable of making such choices be drawn?

I’m uneasy about Cassandra’s case. I suspect that if she survives this cancer, she’ll one day look back with gratitude on the decision to force care on her. She’s young, and has a shallow well of experience from which to draw.

But the idea that the state can step in to tell an otherwise capable person what’s best for them bothers me.

Listen to Cassandra: “This experience has been a continuous nightmare.”

The state does not have the power to give life. It ought not to police the boundary between the living and the dead. Cassandra and her family made a dark choice in a dark time. I prefer a world where we are free to make such decisions to one in which we are blinded by the light of officious intermeddlers who tell us they know what is best.

Also listed under: Journal Register Columns


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