MINNEAPOLIS – A Minnesota judge ruled Friday that a 13-year-old cancer patient must be evaluated by a doctor to determine if the boy would benefit from restarting chemotherapy over his parents' objections.
In a 58-page ruling, Brown County District Judge John Rodenberg found that Daniel Hauser has been "medically neglected" by his parents, Colleen and Anthony Hauser, and was in need of child protection services.
While he allowed Daniel to stay with his parents, the judge gave the Hausers until Tuesday to get an updated chest X-ray for their son and select an oncologist.
If the evaluation shows the cancer had advanced to a point where chemotherapy and radiation would no longer help, the judge said, he would not order the boy to undergo treatment.
However, he said, if chemotherapy is ordered and the family still refuses, Daniel will be placed in temporary custody.
The judge wrote that Daniel has only a "rudimentary understanding at best of the risks and benefits of chemotherapy. ... he does not believe he is ill currently. The fact is that he is very ill currently."
It was unclear how the medicine would be administered if the boy fights it. Dr. Bruce Bostrom, a pediatric oncologist at Children's Hospitals and Clinics of Minnesota, said last week he would have a hard time forcing Daniel to take the medicine. Bostrom said Friday his hospital has psychologists, child life specialists and other resources to help ease Daniel's fears. He also said an ethics committee would meet next week to talk about all the scenarios doctors may encounter.
Daniel's court-appointed attorney, Philip Elbert, called the decision unfortunate.
"I feel it's a blow to families," he said. "It marginalizes the decisions that parents face every day in regard to their children's medical care. It really affirms the role that big government is better at making our decisions for us."
Elbert said he hadn't spoken to his client yet. The phone line at the Hauser home in Sleepy Eye in southwestern Minnesota had a busy signal Friday. The parents' attorney had no immediate comment but planned to issue a statement.
Daniel was diagnosed with Hodgkin's lymphoma and stopped chemotherapy in February after a single treatment. He and his parents opted instead for "alternative medicines" based on their religious beliefs.
Child protection workers accused Daniel's parents of medical neglect; but in court, his mother insisted the boy wouldn't submit to chemotherapy for religious reasons and she said she wouldn't comply if the court orders it.
Doctors have said Daniel's cancer had up to a 90 percent chance of being cured with chemotherapy and radiation. Without those treatments, doctors said his chances of survival are 5 percent.
Daniel's parents have been supporting what they say is their son's decision to treat the disease with nutritional supplements and other alternative treatments favored by the Nemenhah Band.
The Missouri-based religious group believes in natural healing methods advocated by some American Indians.
After the first chemotherapy treatment, the family said they wanted a second opinion, said Bostrom, a pediatric oncologist who recommended Daniel undergo chemotherapy and radiation.
They later informed him that Daniel would not undergo any more chemotherapy. Bostrom said Daniel's tumor shrunk after the first chemotherapy session, but X-rays show it has grown since he stopped the chemotherapy.
"My son is not in any medical danger at this point," Colleen Hauser testified at a court hearing last week. She also testified that Daniel is a medicine man and elder in the Nemenhah Band.
The family's attorney, Calvin Johnson, said Daniel made the decision himself to refuse chemotherapy, but Brown County said he did not have an understanding of what it meant to be a medicine man or an elder.
Court filings also indicated Daniel has a learning disability and can't read.
The Hausers have eight children. Colleen Hauser told the New Ulm Journal newspaper that the family's Catholicism and adherence to the Nemenhah Band are not in conflict, and that she has used natural remedies to treat illness.
Nemenhah was founded in the 1990s by Philip Cloudpiler Landis, who said Thursday he once served four months in prison in Idaho for fraud related to advocating natural remedies.
Landis said he founded the faith after facing his diagnosis of a cancer similar to Daniel Hauser. He said he treated it with diet choices, visits to a sweat lodge and other natural remedies.
UPDATE: cnn.com
Father in chemo case says mom, sick boy left country
May 20, 2009SLEEPY EYE, Minnesota (CNN) -- The father of a 13-year-old boy whose family is refusing treatment for his cancer said Wednesday he believes his son and his wife have left the country.
Doctors say Daniel Hauser's lymphoma responded well to a first round of chemotherapy in February.
"I will say this: I have left a call to where I think they could possibly be," Anthony Hauser said from his home in Sleepy Eye, Minnesota, about 85 miles southwest of Minneapolis.
Asked whether he believes that they have gone to Canada, he said, "I'm not saying it's Canada. You know, that isn't where I left my call."
He made his comments a day after a Minnesota judge issued an arrest warrant for his wife, Colleen, who failed to appear with the boy at a court hearing. A judge scheduled the hearing to review an X-ray ordered by the court to assess whether Daniel Hauser's Hodgkin's lymphoma was worsening.
A doctor testified at the hearing that the X-ray showed "significant worsening."
In a news release, the Brown County Sheriff's Office said the father had been "cooperative" in helping them find his son but added, "the investigators cannot speculate on the sincerity of the information that Anthony Hauser has provided."
The sheriff's office has been in touch with the FBI, and the boy has been entered in the Missing and Exploited Children network, it said.
Anthony Hauser testified at the hearing that he last saw his wife at the family's farm on Monday night, when she told him she was going to leave "for a time."
He later said he would like his wife and son to return.
"I'd like to tell them, you know, 'Come back and be safe and be a family again,' " he said. "That's what I'd like to tell them."
District Judge John R. Rodenberg of Brown County, Minnesota, said the boy's "best interests" require him to receive medical care. His family opposes the proposed course of treatment, which includes chemotherapy.
"It is imperative that Daniel receive the attention of an oncologist as soon as possible," the judge wrote.
During Tuesday's hearing, Dr. James Joyce testified that he had seen the boy and his mother on Monday at his office. He said that the boy had "an enlarged lymph node" near his right clavicle and that the X-ray showed "significant worsening" of a mass in his chest.
In addition, the boy complained of "extreme pain" at the site where a port had been inserted to deliver an initial round of chemotherapy. The pain was "most likely caused by the tumor or mass pressing on the port," testified Joyce, who called the X-ray "fairly dramatic" evidence that the cancer was worsening.
Rodenberg ordered custody of the boy transferred to Brown County Family Services and issued a contempt order for the mother.
Philip Elbert, Daniel's court-appointed attorney, said that he considers his client to have a "diminished capacity" for reasons of his age and the illness and that he thinks Daniel should be treated by a cancer specialist.Elbert added that he does not think Daniel -- who, according to court papers, cannot read -- has enough information to make an informed decision regarding his treatment.
Daniel's symptoms of persistent cough, fatigue and swollen lymph nodes were diagnosed in January as Hodgkin's lymphoma. In February, the cancer responded well to an initial round of chemotherapy, but the treatment's side effects concerned the boy's parents, who then opted not to pursue further chemo and instead sought out other medical opinions.
Court documents show that doctors estimated the boy's chance of five-year remission with more chemotherapy and possibly radiation at 80 percent to 95 percent.
But the family opted for a holistic medical treatment based upon Native American healing practices called Nemenhah and rejected further treatment.
In a written statement issued last week, an attorney for the parents said they "believe that the injection of chemotherapy into Danny Hauser amounts to an assault upon his body, and torture when it occurs over a long period of time."
Medical ethicists say parents generally have a legal right to make decisions for their children, but there is a limit.
"You have a right, but not an open-ended right," Arthur Caplan, director of the center for bioethics at the University of Pennsylvania, said last week. "You can't compromise the life of your child."
