Faith and Freedom: Leukemia in Jehovah Witness Minors

In this issue of ONKOLOGIE Tenenbaum et al., report their experience of managing pediatric cancer patients belonging to Jehovah's Witness families (1). Perhaps the most remarkable element of Tenenbaum's paper is that they succeeded in a 'continuous collaboration with the Hospital Committee for Je- hovah's Witnesses', a recourse potentially as important as seeking overrule by the courts. Using proactive oral or written clarification of the legal mandate to transfuse, in emergency situations, transfusions in these institutions are now given without signed parental consent or a court order. The state's right to interfere with the parents' right to decide for their children has changed over the centuries: English roy- alty originally had virtually unlimited power over the minors of their subjects. Over time, the Crown's power became cir- cumscribed by the rule of law, through the Magna Carta, the Writ of Habeas Corpus, and the continual evolution of the common law. In 1776, the great experiment in freedom, 'The United States of America', started government 'of the people, by the people, for the people.' Some scholars believe the free- dom ended before the ink was dry on the constitution. Posi- tively the government could become the trustee of a child, and negatively, it is claimed, Parens Patriae power has been in- voked unjustly to over-rule a parent's custodial rights. In 1839 a Pennsylvania court ruling upheld a mother's deci- sion to have her daughter committed to an institution, despite the father's petition for her release (2). A series of similar cases codified this decision and in 1991 the Supreme Judicial Court of Massachusetts supported a local court's decision to permit administration of blood transfusions to eight-year-old Elisha McCauley, as part of treatment of leukemia. The court found that, while the private realm of family life must be pro- tected from unwarranted state interference, when a child's life was at stake, the child's welfare, and not the parents' rights, were the paramount consideration. An earlier test of religious freedom came to the same conclusion, with the court ruling that 'Parents may be free to become martyrs themselves. But it does not follow that they are free, in identical circumstances,