Wisdom Beyond Her Years
IT WAS midnight. Twelve-year-old Lisa, acutely ill and weak, was startled when a nurse entered her hospital room to give her a blood transfusion.
Lisa pleaded: “How can you force this on me? My dad and my mom aren’t even here!” The nurse gave it to her anyway.
The Question of Treatment
Lisa, a bright, active, talented “A” student, had enjoyed life with her parents and five-year-old brother in Winnipeg, Canada. In the spring of 1985 she was given an antibiotic for a case of tonsillitis and suffered a severe reaction. Her health waned, and soon afterward she was diagnosed as having acute myeloid leukemia, a condition that is usually fatal.
Winnipeg physicians prescribed intensive chemotherapy and multiple blood transfusions. Chemotherapy is a treatment by toxic chemicals. The theory is that these poisons kill the disease. However, Lisa and her parents wanted alternative treatment. They objected to blood transfusions for Scriptural reasons. (Acts 15:28, 29) They also found repugnant the agony and debilitating side effects of intensive chemotherapy.
Finally, Lisa’s parents took her to Toronto’s Hospital for Sick Children, hoping to find cooperative doctors. But instead of cooperation, that midnight blood transfusion was administered. The next morning, October 25, a court order was sought to authorize the hospital to use force in imposing this treatment. Judge David R. Main expressed reservations. He appointed Sarah Mott-Trille as Lisa’s lawyer. The case was adjourned to Monday, October 28, 1985.
The trial lasted five days and was held in a room at the hospital. Each day, at her own request, Lisa was wheeled into the room on her hospital bed. Although very ill, she was determined to be personally involved in decisions that involved her faith.
The hearing began with the physician’s proposal for treatment. In his written judgment, Judge Main explained: “The treatment as described by the physicians who have testified before this court is both intensive and aggressive and could go on for a considerable period of time. It is anticipated that repeated blood transfusions would be required to maintain the patient.” It was also noted that the side effects of the chemotherapy are many and extreme.
The drama escalated sharply on the fourth day. Lisa was propped up so she could directly address the judge. Everyone in the courtroom, including Lisa, knew she was facing death whether she received blood transfusions or not. There is no cure for the leukemia from which she was suffering.
Lisa’s lawyer questioned her with care and sensitivity. There were few dry eyes as Lisa courageously discussed her impending death, her faith in Jehovah, and her determination to remain obedient to his law on the sanctity of blood. She said she would strenuously and physically resist any effort to give her a blood transfusion. Her simple and bold statement touched everyone’s heart.
“Now you told us you believe in God,” her lawyer said. “Can you tell us if he’s real to you?”
“Well, he’s like a friend,” Lisa responded. “Sometimes when I’m by myself, I can talk to him . . . as a friend; if I’m scared and I’m home by myself, I ask him for help and I just talk to him like he’s in the room beside me.”
“Lisa, if someone was to say to you, what are the most important things in your life, what would you say?”
“My obedience to Jehovah God and my family,” Lisa answered.
Her lawyer asked: “Lisa, would it make any difference to you to know that a Court orders you to take blood transfusions?”
“No, because I am still going to remain faithful to my God and listen to his commands because God is a lot more superior than any court or any man.”
Lisa explained her feelings about the one blood transfusion already forced on her, saying: “It made me feel like a dog being used for an experiment, because I couldn’t control anything. Just because I’m a minor, people feel they can do anything to me, but I feel that I have a right to know what’s going to happen to me and why they’re doing these treatments and why they’re doing them without my parents’ consent.”
“Did you sleep that night?” her lawyer asked.
“No, I didn’t.”
“What were your concerns?”
“Well, my concerns were what was Jehovah God going to think of me because I know that if I go against his wishes, I don’t have his promise of everlasting life, and I was very sickened to my stomach that I was getting somebody else’s blood into me, because there’s always the possibility of getting AIDS or hepatitis or some other infection, and all I did that night was just stare at that blood and look at it.”
“Lisa, can you think of a comparison to explain to the judge what getting a blood transfusion is like against your will?”
“Well, the one I can think of is rape because . . . a rape is getting something done without your will, and it’s just like that.”
Day five was climactic. From the beginning Judge Main had been fair and balanced. Would his kindness be reflected in his decision? He concluded: “The child Lisa Dorothy K. is to be returned to the custody, care and control of her parents.”
Judge Main explained the reasons for his judgment in much detail. Among other things, he said: “Lisa’s position is now and has been from the day she saw a documentary on this disease, that she does not want any part of chemotherapy and blood transfusions. She takes this position not only because it offends her religious beliefs, and I am satisfied that it does, but also because she does not want to experience the pain and anguish associated with the treatment process. . . . I refuse to make any order which would put this child through that ordeal. I find the proposal that she undergo this treatment totally unacceptable.”
Concerning the surreptitious midnight transfusion forced on Lisa, Judge Main said: “I must find that [Lisa] has been discriminated against on the basis of her religion and her age pursuant to subsection 15(1) [of The Canadian Charter of Rights and Freedoms]. In these circumstances, upon being given a blood transfusion, her right to the security of her person pursuant to Section 7 was infringed. As a result, even if she could be said to be a child in need of protection, the application must be dismissed pursuant to subsection 24(1) of the Charter.”
Finally, Judge Main reaffirmed his personal admiration for Lisa, noting: “Lisa is a beautiful, extremely intelligent, articulate, courteous, sensitive and most importantly, a courageous person. She has wisdom and maturity well beyond her years and I think it would be safe to say that she has all of the positive attributes that any parent would want in a child. She has a well thought out, firm and clear religious belief. In my view, no amount of counselling from whatever source or pressure from her parents or anyone else, including an order of this court, would shake or alter her religious beliefs.
“I believe that Lisa K. should be given the opportunity to fight this disease with dignity and peace of mind. That can only be achieved by acceptance of the plan put forward by her and her parents.”
Integrity to the End
Lisa and her family left the hospital that day. Lisa did, indeed, fight her disease with dignity and peace of mind. On November 17, 1985, she died peacefully at home, in the loving arms of her mother and father.
During the trial, Lisa described a conversation with her mother at the time her leukemia was first diagnosed, explaining: “I discussed with my Mom all the possibilities I have, and we read the Bible together, and we read other books from our religion together, and I told her, . . . ‘If I do die, I will see you in the new order, and I will have a guaranteed hope of seeing you and living forever on a paradise on earth.’”
A Lesson for Hospitals and Doctors
Canadian medical-legal writers L. E. and F. A. Rozovsky noted in Canadian Health Facilities Law Guide: “Hospitals and physicians alike can draw certain lessons from this decision. In particular, they should proceed carefully with treatment over the known objection of pediatric patients or their parents. Care should be taken to avoid forced treatment to areas mapped out as ‘discriminatory’ in Section 15(1) of the Charter, including age, sex, religion or ethnic origin.”
Yet, how should physicians “proceed carefully” and avoid such religious discrimination? The Rozovskys point out a balanced solution: “It must be remembered, however, that the basic duty of the health facility is not to be the patient’s adversary. The real task is to do what is in the best interests of the patient. In this case the court found that the best interests favoured an alternate form of care.”
Obviously, where the patient is one of Jehovah’s Witnesses, his best interests will be met where family and physician cooperate in providing an alternative to blood transfusions. Doctors who have followed this course have not sacrificed good medical care. As the pediatric specialists at M. D. Anderson Hospital in Texas reported:
“Transfusion therapy is not necessary as often as it is used. In this series of patients with cancer and related diseases, good medical care did not suffer as a result of withholding transfusions.”
The implications of the case of Lisa are far-reaching. Already, following the lead of the Canadian court, a California judge has refused to force treatment on a 14-year-old girl. Additionally, on February 11, 1986, the British Columbia Health Association issued a directive to all hospital administrators based directly on Lisa’s case, stating: “This case constitutes a new precedent.”
In an area of legal and medical confusion, this decision has lit a beacon. It is just and right. The future will tell us how many doctors, hospitals, and judges will follow the humane and sensitive lead given us by Judge David R. Main and by Lisa.
[Blurb on page 19]
There were few dry eyes as Lisa courageously discussed her impending death
[Blurb on page 20]
“This case constitutes a new precedent.”—British Columbia Health Association
[Picture on page 18]
Lisa, age 12, maintained her integrity under great adversity and opposition