Daniel Hauser and Informed Consent
I’ve been avoiding commenting on the Daniel Hauser Saga. Partially because I haven’t had time and I’ve been trying to crank out some more posts about my experiences on OB, Jadedness, and Hard Conversations. Partially because I feel it’s been well covered elsewhere.
There’s one quick, teachable moment here though, that I feel hasn’t been talked about enough.
Daniel Hauser could not have “revoked his consent”, it’s not about Daniel Hauser “making his own decision”. It’s really about informed consent. Even if you ignore age, Daniel Hauser couldn’t have given, or revoked, informed consent.
To say that you have informed consent mean that you understand the consequences of your actions.
To have given informed consent, a patient should know the following:
- The patient’s diagnosis.
- The purpose of the proposed treatment.
- The risks and benefits of the proposed treatment.
- The alternatives to this treatment, and the consequences of the alternatives.
- The risks of NOT having the proposed treatment.
- Hauser probably knows the diagnosis is Hodgkin’s lymphoma. Check.
- He probably knows the purpose of chemo is to cure the lymphoma. Check.
- He clearly does NOT understand the risks and benefits of the treatment. Clearly he understands that chemotherapy makes you feel sick. He doesn’t seems to understand the benefit – a very high cure rate. Fail.
- He clearly does NOT understand the risks and benefits of his alternative therapy – his mother explicitly said the survival rate with her “alternative therapy” is 100%, so Daniel Hauser almost certainly doesn’t understand. He certainly doesn’t understand that the biggest risk of his alternative therapy is death, by lymphoma. Fail.
- There is no way that he understands that he will very, very likely die without chemotherapy. Fail.
If you accept Daniel is “old enough” to understand the issues in theory, which I don’t, he still doesn’t understand the situation will enough to have given or revoked informed consent for chemotherapy.
Any argument that includes with “medical choice”, “his right to be left alone”, “his right to refuse treatment”, “His family’s right to choose medical care” or “religious exemption” completely miss the point.
“His right to be left alone” and, “His right to refuse treatment”, require understanding of the treatments. The same goes for “medical choice”, which would have been a dubious argument to begin with.
“His family’s right to choose his medical care”, and “Religious Exemption”only apply if their choice does not constitute neglect. The court has already ruled that not accepting conventional treatment for a disease with a 90% cure rate is neglect. Please note, this is not particularly controversial. In fact we’ve talked about this before on this blog, in comments: If a Christian Scientist family walks in with their infant who has pneumonia, they don’t get to refuse antibiotics. It may be against their religion, but they don’t get to sacrifice their infant for their religion.
As is often the case, thanks to Orac for framing the issue. Also thanks to Lee for making statements so persistently idiotic that I felt the need to respond.Education, Medicine comment below, or link to this permanent URL from your own site.