Teen Must Undergo Chemo, Says Connecticut Supreme Court

Teen's Hodgkin Chemo Decision Tests Medical-Legal Landscape


Hodgkin lymphoma is considered very treatable, but the treatment does have side effects. According to the Hartford Courant, doctors testified at the lower court hearings that Connecticut teen, Cassandra C., would die without treatment, and that her chance of survival and complete recovery with chemotherapy was 80 percent to 85 percent. Although she had opposed the treatment, now the Connecticut teen will be compelled to receive chemotherapy against her will and against the wishes of her mother.

Hodgkin Lymphoma

Hodgkin lymphoma (also called Hodgkin disease) is one of the two main types of lymphoma. A lymphoma is a cancer of the lymph system. To understand lymphomas and the lymph system better, read the article What is lymphoma?. Hodgkin lymphoma affects more than 8,000 people annually in the United States.

After Hodgkin is diagnosed from the lymph node biopsy, a series of tests are performed for lymphoma staging and prognostic factors. Patients are then treated with chemotherapy, radiotherapy or both. See the article on Treatment Options for Hodgkin Lymphoma. Many of these individuals are diagnosed while their disease is in an early stage and are cured. Even with advanced disease, effective long-term control is  often possible.

What Happened in This Case?

According to CBS news, Cassandra, whose last name was not released, sought alternative therapies to treat Hodgkin lymphoma with support of her family.

Despite this, she had been taken into state custody and has been receiving treatment. On the one hand, some legal scholars have argued that the treatment decision should be an individual choice; on the other hand, doctors and others have equated forgoing treatment in a case like this to jumping off a bridge—something meriting special consideration, and intervention.

Cassandra and her family felt that she should be considered a mature minor--and be allowed to make her own medical choices.

What is the Prognosis?

According to the American Cancer Society, survival rates for Hodgkin disease by vary by stage. Rates are based on the stage of the cancer when it is first diagnosed.

If a cancer comes back or spreads, the survival rates may be different from those shown here:

Stage               5-year Survival Rate

I                       About 90%

II                     About 90%

III                    About 80%

IV                    About 65%

According to testimony, in this case, Cassandra's chance of survival and complete recovery with chemotherapy was 80 percent to 85 percent. According to the American Cancer Society, survival rates are based on previous outcomes of large numbers of people who had the disease, but they can’t predict what will happen with any particular person.


According to the Hartford Courant, in an oral ruling, the state Supreme Court unanimously found that the question of whether Cassandra C., 17, of Windsor Locks, “was legally competent or mature enough to reject life-saving treatment” was sufficiently explored at two Superior Court hearings earlier in the fall of 2014.

Those were the hearings that lead to Cassandra’s court-ordered chemotherapy.

So Cassandra will continue her chemotherapy. The Connecticut Civil Liberties Union also filed a brief in support of Cassandra and her mother. According to the Courant, both sides in the case agreed that the state would have no ground to interfere with Cassandra's decision if she had been 18 when she made it — nine months from now.

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