Family Matters

Is It Murder If a Mom Withholds Cancer Treatment From Her Child?

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(Updated) Imagine you are a single mother suffering from depression, overwhelmed with caring for an autistic, nonverbal and developmentally disabled son. If he were diagnosed with cancer, what would you do?

Kristen LaBrie, a Massachusetts mother, chose to disregard a prescribed chemotherapy regimen. On Tuesday, two years after her son, Jeremy, died  at age 9, a Superior Court jury declared her guilty of attempted murder.

LaBrie learned that Jeremy had non-Hodgkin’s lymphoma in October 2006, when he was 7. It’s not that she couldn’t be bothered to administer the chemo; she testified that she couldn’t bear to watch him suffer from the toxic drugs so she did not administer treatments, which apparently caused his disease to progress to leukemia. (More on Did Homeopathic Medicine, Breast-Feeding and Veganism Kill a Baby?)

In addition to the murder charge, LaBrie, 38, was convicted of assault and battery on a disabled person with injury, assault and battery on a child with substantial injury and reckless endangerment of a child. Update [Apr. 15]: On Friday, LaBrie was sentenced to eight to 10 years in prison; collectively, her convictions had carried a maximum sentence of 37 1/2 years.

Was justice done? It’s hard to know. Certainly, disabled children have rights. But moms do too, and it appears that LaBrie did not have adequate support. Being a single mother of a healthy child is tough enough. Factor in autism and a kid who can’t communicate makes it that much harder. Add non-Hodgkin’s lymphoma, and the burden is fierce.

“This is one of those cases where we have to ask, What standards do we hold parents accountable for?” says Cynda Rushton, a nurse ethicist at the Berman Institute of Bioethics at Johns Hopkins University who directs the pediatric palliative care program at the university’s children’s hospital. “On one hand, you can imagine a parent in a situation like this wondering whether going through cancer treatment is a beneficial thing in the long run for her child. Just because a disease is treatable does not mean it is curable. She may have thought, Am I hurting my child by giving this treatment?” (More on Should a Disabled Mom Be Banned from Seeing Her Kids?)

Boston attorney J.W. Carney Jr. told the Boston Globe that LaBrie’s case should also have zeroed in on the role played by LaBrie’s doctors, questioning why they didn’t get involved as soon as it was clear that LaBrie was not complying with the treatment regimen.

“It can be so overwhelming for a single parent to deal with a child who is autistic, nonverbal, and developmentally delayed,” said Carney. “It is cruel to add to that burden a diagnosis of cancer and a requirement that the mom administer medicine that will cause the child even more pain.”

Is a parent at liberty to forgo treatment? According to the courts, apparently not.

The closest analogy appears to be a 1986 case in which Christian Scientist parents rejected surgery for their son, suffering from a bowel condition, in favor of spiritual treatment. In that situation, Massachusetts’ Supreme Judicial Court ruled that parents, despite their religious beliefs, are obligated to rely on conventional medicine to treat their critically ill children. (More on Closely Spaced Pregnancies May Contribute to Autism)

In many ways, that situation seems more clear-cut. In general, parents have a lot of latitude surrounding their children’s medical care — how they are treated and by whom. Intentionally harming a child is not acceptable in our society, but the definition of intentional harm is refracted through a parent’s personal perspective.

“We have an obligation to protect a child whose parents abuse them or neglect them,” says Rushton. “But there is a difference between someone who intentionally hurts their child and someone who has made a decision that a particular treatment, on balance, is not in their child’s interest.”

LaBrie’s sister, Elizabeth O’Keefe, told the Globe that the jurors simply couldn’t understand the magnitude of the situation with which LaBrie wrestled. “It’s too hard for them to know what my sister was going through at that time,” said O’Keefe. “I don’t think my sister had any intentions of hurting Jeremy, ever. I never will believe that in my life, never.”

Rushton agrees. “I suspect this mother was really trying to do the best she could for him,” she says. “As parents, we always wonder if we are doing a good enough job. But what does it mean to be a good parent in this circumstance?”