ST. PAUL, Minn. (CN) — Minnesota’s Court of Appeals ruled Monday that a county could require chemotherapy treatments for a 5-year-old leukemia patient whose parents refused to authorize them.
The child, a resident of suburban Wright County who the court’s order referred to as “K.K.P.,” received a leukemia diagnosis at the age of 4. He began a five-phase chemotherapy treatment, but his parents opted to stop chemotherapy after the first phase, with K.K.P.’s mother telling his treating physician that she would prefer natural remedies like garlic and lemon.
The doctor reported the parents to Wright County Health and Human Services, and the county soon took custody of the boy, made a petition for a "Child in Need of Protection or Services," and sought an order requiring K.K.P. to continue chemotherapy.
A district court granted the county custody of the child, placed him with his grandmother and granted the order for chemotherapy, then reiterated its orders after a trial, along with its grant of the county’s petition.
The court said K.K.P.’s parents, who lived in Texas until the discovery of their son's leukemia led them to seek emergency treatment while visiting family in Minnesota, could live with their son at his grandmother’s home as long as they complied with the court’s order. The court's ruling allowed the parents to pursue alternative therapies if they did not interfere with their son’s medical treatments.
The boy's case has attracted media attention in both Texas and Minnesota. His parents have argued, in court and in public, that their son's quality of life and safety have been compromised by the chemotherapy.
Monday’s order from the Court of Appeals affirmed all of the district court’s decisions.
“The district court’s findings are supported by the evidence,” Judge Matthew Johnson wrote in the order.
K.K.P.’s treating physician, along with the parents’ naturopath and cannabinoid expert, all testified that chemotherapy is necessary given the child’s condition, Johnson noted, and the parents’ contention that K.K.P., now 6, is no longer suffering from “active” leukemia was belied by the doctors’ contentions that an absence of symptoms does not make him cancer-free.
“K.K.P. has a physical condition that requires special care,” Johnson wrote, “and he is without that care because his parents are unwilling to allow him to receive chemotherapy treatment without a court order.”
“This evidence is sufficient to satisfy the statutory standards,” he concluded, “which require ‘necessary’ or ‘required care’ given a child’s ‘physical … health.’”
Attorneys for the parents had disputed that standard at oral arguments in January. “Fit parents get to make decisions for their children,” attorney Lucas Dawson told the appeals court panel. “After the second round of treatment, Keaton had no detectable disease.”
“Under the department’s theory,” Dawson continued, ”no parent can dispute the treatment plan for their child when there’s cancer involved, ever.” Furthermore, she argued, the court’s order for continued chemotherapy violated the parents’ due process rights to make decisions concerning the care, custody and control of their children.
Johnson acknowledged those rights in the order, but declined to extend them to K.K.P.’s case. “Neither the United States Supreme Court nor the Minnesota appellate courts have applied these principles to a case in which parents rejected a physician’s treatment recommendation for a child’s life-threatening illness,” he noted. “We have found only one opinion in which a child’s parents challenged a state’s attempt to compel medical treatment over the parents’ objection on the sole ground that such a court order would violate the parents’ constitutional rights to the care, custody and control of a child.”
That case, a 1978 decision from Massachusetts titled simply Custody of a Minor, also dealt with a child diagnosed with leukemia. In that case, the Massachusetts Supreme Court similarly affirmed an order requiring parents to allow their child to resume chemotherapy, finding that due process rights “do not clothe parents with life and death authority over their children.”
“The Custody of a Minor opinion indicates that a parent’s right to make medical decisions on behalf of a child must be balanced against the state’s interest in ensuring child welfare,” Johnson wrote. “It so happens that the facts of Custody of a Minor are quite similar to the facts of this case, and the court’s analysis is persuasive.”
Johnson briefly discussed this balance, noting that all three witnesses with medical training had testified that K.K.P. would need chemotherapy to save his life, and that should the cancer return, his odds of survival would be less than 20%.
K.K.P.’s mother’s proposed naturopathic treatments, he said, were vague and contradicted by her own witnesses. “In this case, K.K.P.’s best interests are served by a treatment plan that is likely to save his life rather than an unspecified alternative plan that is likely to result in his death,” Johnson concluded.
He also paid note to the parents’ concerns about their child’s time outside their custody, which included the possibility that it would lend support to a permanency petition from the county.
“Time spent in an out-of-home placement does not necessarily require the county to file a permanency petition,” Johnson noted, saying that the statutory provision prompting permanency petitions does not apply if a district court finds that there is a compelling reason that such a petition would not be in a child’s best interests.
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