Judge: Teen can reject treatment on religious grounds

At 14, Dennis Lindberg is old enough to know that refusing blood transfusions may amount to a "death sentence," but he has that right, a Skagit County judge ruled today.

A Jehovah's Witness from Mount Vernon, Lindberg has religious objections to receiving blood. Doctors say he needs transfusions to survive treatment for leukemia.

Doctors at Children's Hospital & Regional Medical Center in Seattle diagnosed him Nov. 6 and began giving him chemotherapy. Because such treatment destroys the body's ability to make red blood cells, transfusions are necessary, doctors said.

Lindberg's relatives disagree about whether the eighth-grader, who remains hospitalized, should be forced to get the transfusions. His aunt, who is his legal guardian and also a Jehovah's Witness, supports his decision to refuse. But his parents, who live in Idaho, disagree.

His doctors at Children's support the boy's decision, Skagit County Superior Court Judge John Meyer said, although one doctor told the judge earlier that the boy's blood count is so low he could die overnight. The case came to court after officials at Children's reported it to the state, which went to court to force the transfusion.

Ethics experts and Jehovah's Witness officials said such a court case is unusual these days.

Most cases involving transfusions stem from surgical cases, and current policy at Children's is to inform parents that while the hospital will do everything it can to avoid transfusions, it will not let a child die for want of blood, said Dr. Doug Diekema, an ethics consultant there.

Years ago, courts routinely supported transfusions of children against the wishes of parents, Diekema said. While adults have the right to refuse any medical treatment, the courts ruled, that right doesn't extend to their children.

"The principle there is that parents can make martyrs of themselves, but they can't make martyrs of their children," Diekema said.

When a child is an adolescent, the situation is much more complex, he said. "We all know that 14-year-olds change their minds; they become adults, and they have completely different belief systems. And that makes you nervous."

At the same time, 14-year-olds can have an "adultlike" decision-making process. And when the transfusion isn't a one-time emergency procedure but a long-term treatment, there's another complexity, Diekema said.

"Then the issue is: How can we effectively treat a kid when he's not going to cooperate?"

Dr. Benjamin Wilfond, the hospital's director of pediatric bioethics, said medical providers, along with parents, typically try to balance competing needs. "You're trying to respect their wishes, their evolving autonomy, balanced against wanting to protect them. Often, it's difficult to achieve both under all circumstances."

Jim Nelson, chairman of the Jehovah's Witnesses' Seattle Hospital Liaison Committee, said Lindberg is a "very responsible young man who knows his mind and was very clear. He's a very brave young man, and he's standing firm for what he believes in."

Jehovah's Witnesses are not "anti-medicine," he said. "Dennis is willing to have any treatment except the transfusion," which members of the faith believe is Biblically prohibited.

After Lindberg went into the hospital, "it wasn't a case of older people hovering over him and insisting he make a certain decision," Nelson said. "It was his decision."

Material from The Associated Press and from the Skagit Valley Herald and Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com