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Forced return to Vancouver angers girl

Jehovah's Witness upset by prospect of being sedated for blood transfusion

VANCOUVER -- A 14-year-old Jehovah's Witness girl who has waged a bitter cross-country fight to refuse a blood transfusion is back in Vancouver poised to undergo more chemotherapy, which could prompt doctors to give her the blood she opposes on religious grounds.
The girl, who has bone cancer, lost a court bid in Ontario this week to be treated in a New York hospital. She is angry about her forced return to B.C., her parents' lawyer said.

The girl, who is from the British Columbia Interior, was airlifted from Toronto to Vancouver on Tuesday night after an Ontario judge upheld a B.C. court order allowing doctors here to proceed with a transfusion if they think it's needed to save her life.

Doctors at Vancouver's Children's Hospital have told the family they will consider sedating the girl to ensure she receives the transfusion, an upsetting prospect for the teen and her parents, all of whom are devout Jehovah's Witnesses.

The religion forbids blood transfusions.

The girl had her heart set on a treatment option available in New York, lawyer Shane Brady said. Schneider Children's Hospital has a so-called bloodless medicine program that avoids giving patients blood products except in life-or-death circumstances.

She cannot be named under publication bans in Ontario and B.C. protecting the identity of minors.

Doctors there had agreed to begin chemotherapy treatments on the girl who was diagnosed with cancer last fall. She had already undergone surgery and chemotherapy when the case landed in a B.C. provincial court because she told doctors she didn't want blood transfusions.

It was at that point that B.C. child welfare authorities stepped in and obtained a court order to give doctors the right to proceed with a blood transfusion if they believed it was warranted. Blood transfusions are common among cancer patients because chemotherapy can inhibit the growth of blood cells.

The girl appealed to a higher court, arguing that she was old enough to decide how she is treated for her disease. She lost that bid and within weeks, she and her family travelled to Toronto's Hospital for Sick Children.

It was then that the family arranged for the girl to be treated at Schneider Children's Hospital. The family worked out a financial arrangement, with the U.S. hospital agreeing to waive part of the cost.

But an Ontario Superior Court judge refused to hear her arguments and upheld the B.C. order. In a terse ruling, Mr. Justice Victor Paisley said he believed the girl was gravely ill and ordered her home to B.C. to start treatment immediately. The judge said entertaining other treatment options at this late stage represented a delay and threatened her life.

Mr. Brady disagreed and accused the B.C. government of fanning an unnecessary panic.

"This is a responsible family, and the young woman . . . herself is committed to getting her cancer dealt with," Mr. Brady said from his law office in Georgetown, Ont. "She just wants it dealt with on her terms by a team that's experienced doing it."

He added: "This is not a fly-by-night centre. This is one of the top centres in the U.S. How can the state possibly justify denying giving her that choice?"

B.C. child welfare authorities say they can and they will.

Jeremy Berland, B.C.'s assistant deputy minister of Children and Family Development, denied that the province has over-reacted.

"What we're into right now is trying to save this girl's life," said Mr. Berland, who travelled to Toronto from Victoria to attend the court hearing and ensure the girl's return.

The girl's U.S. treatment plan was denied in Ontario because the family is considered a flight risk, Mr. Berland said. The B.C. ministry agrees.

"We won't consent to allowing her to leave the country, he said. "She has a bad track record on flight."

Mr. Berland said it's unfortunate the case has generated ill will between the family and his ministry.

"It's not really the way we'd like to work with people. Hopefully we'll be able to restore a relationship with her parents."

Michael LaCourt, of Schneider Children's Hospital, said the bloodless treatment has gained currency among medical professionals and patients, and not just on religious prohibitions.

Blood transfusions carry the risk of acquiring diseases such as hepatitis, HIV and West Nile virus, he said.

In the B.C. girl's case, Dr. LaCourt said the hospital agreed to a chemotherapy treatment plan that would attempt to avoid a blood transfusion unless her life depended on it.

Too often, doctors order transfusions as a "knee-jerk" response. The bloodless medicine approach starts from the premise that a transfusion be ordered only when a patient's life is in danger, Dr. LaCourt said.

Friday, May 6, 2005, Page A2
CORRECTION

Dr. Michael LaCorte is the director of the bloodless medicine program at Schneider Children's Hospital in New York. His surname was spelled incorrectly in an article yesterday.

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Mr. Jan B. Wade
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Enhance Outcomes - Control Cost
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