Thursday 12 July 2012

When a child's health is at stake

Parents resisting urgent medical care for seriously ill kids may face court order
By Melissa Pang, The Straits Times, 11 Jul 2012

PARENTS who resist medical advice that their sick children undergo established treatments may well find themselves being investigated by the Child Protection Service (CPS).

A Ministry of Community, Youth and Sports (MCYS) spokesman said yesterday that hospitals and doctors who come across such cases can refer them to the CPS.

Officers from the service, which comes under the ministry, will work with counsellors and medical staff to get the parents to 'voluntarily agree' to steps that are in the best interests of the child.

If needed, a Care and Protection Order may be taken to safeguard the child's safety and well-being. Such an order can also be taken when doctors recommend that treatment is crucial because the child is seriously ill and requires urgent care.

The spokesman gave these details when asked about the steps that MCYS had taken in a case involving a cancer-stricken, three-year-old boy whose parents did not want him to undergo chemotherapy.

The Straits Times reported yesterday that the mother, in particular, believed the 'natural therapy' advocated by Our Place International, an alternative health centre in Arizona, would be better.

Even though the boy's doctor at KK Women's and Children's Hospital said the child had an 80 per cent chance of recovering if he had chemotherapy, she rejected this.

The hospital then referred the case to MCYS. The CPS came into the picture and a Care and Protection Order was issued by the Juvenile Court, said the ministry spokesman.

Hearings were set for a judge to determine the type of care the boy should get, but before the final hearing, the parents agreed to chemotherapy, although unwillingly in the mother's case, because his condition worsened.

Lawyer Eric Tin, head of the medico-legal practice group at Donaldson & Burkinshaw, said such cases are rare in Singapore although similar cases have occurred overseas.

In a 2009 case in the United States, a judge ruled that then 13-year-old Daniel Hauser, who suffered from a treatable form of cancer, had to seek medical treatment. His parents had opted for alternative medicine based on their religious beliefs. After chemotherapy and radiation, the teen appeared to be cancer-free.

Parkway Cancer Centre's medical director, Dr Ang Peng Tiam, said it was most unusual for a hospital or doctor to approach the authorities.

'This is only done in situations where conventional treatment has been shown to offer a high chance of success,' he said.

'In most cases, doctors would prefer to convince the patients' parents by showing them the clinical data, introducing patients who have been treated successfully, and spending time to understand their fears and misunderstanding,' he said.

Local studies have shown traditional Chinese medicine (TCM) to be one of the most popular forms of alternative treatment among cancer patients. But even its practitioners caution against depending on it as a cancer cure.

Senior physician He Qiu Ling of the TCM group Eu Yan Sang said she informs cancer patients of the limitations of Chinese medicine in treating the disease.

'We can help with reducing side effects like vomiting and the management of pain, but I tell them that if they want to get rid of a tumour, they should opt for surgery or chemotherapy,' said Ms He.

Osteopath David Tio of the Centre for Complementary and Alternative Medicine, which offers treatments like naturopathy, also said patients are advised of the limitations of complementary treatments. But at the end of the day, 'it is up to patients who they want to see', he said.

That was the experience of full-time investor Lee Yong Yee, 46. His wife, who died of ovarian cancer about four years ago, needed five rounds of chemotherapy but decided to stop after the second cycle as she wanted to try alternative cures.

Mr Lee reluctantly agreed to it as 'I didn't want her to lose hope'. They spent about US$50,000 (S$63,600) on treatments like purified ginseng injections, extracts of certain exotic living things, coffee enema, acupuncture and special massages.

Her spirits improved because she no longer suffered the side effects associated with chemotherapy and radiotherapy, but the cancer continued to spread, and even accelerated.

She died about a month after stopping conventional treatment, he said. 'With further chemotherapy, I sincerely believe she would have lasted a few more months,' said Mr Lee, who added that she still suffered a painful death.

Dr Lim Siew Eng, a senior consultant at the department of haematology-oncology of the National University Cancer Institute, Singapore, said that 'complementary and alternative medicine may be appealing as it is perceived to be more 'natural and holistic'. But the therapies we recommend have been proven to be effective against cancer and is the best way we know to treat the disease'.

MCYS steps in to get cancer treatment for boy
By Melissa Pang, The Straits Times, 10 Jul 2012

IN A rare move, a hospital has turned to the State to ensure a three-year-old boy suffering from leukaemia gets chemotherapy treatment.

The boy's parents believe in the 'natural therapy' advocated by an alternative health and well-being centre in Arizona in the United States.

The mother, in particular, was against chemotherapy as she felt the centre's philosophy would help him.

The couple - who are divorced - had spent time at Our Place International.

Its founder Ray Kent, 82, promotes 'self-healing' through fasting, exposure to sunshine and a diet of fruit and vegetables.

A court order was taken to place the child at a safe place - KK Women's and Children's Hospital (KKH) in this case - until a decision was made on the type of treatment he would receive.

The boy is now receiving chemotherapy at the hospital after the Ministry of Community Development, Youth and Sports (MCYS) stepped into the picture.

Neither the child nor his parents can be named.

The mother, a 31-year-old business owner, said that in 2010, when the boy was two years old, the family stayed at Mr Kent's ranch where the toddler enjoyed 'optimal health'.

The boy was diagnosed with acute leukaemia at KKH in early May this year. His doctor told his parents he had an 80 per cent chance of recovery and the sooner he began chemotherapy, the better. Aware of their belief in natural therapy, the doctor told them that the authorities would be told if they refused to let him be treated. He gave them a few days to think it over.

The boy's 31-year-old father told The Straits Times yesterday that although he had spent time at Our Place International, he was 'unsure of its effect on major illnesses like cancer'.

Unable to come to a decision, the father, who is a manager, agreed to the doctor bringing the case up to MCYS, which can act under the Children and Young Persons Act to allow a doctor to treat the child.

The first court hearing on May 11 involved only a mention of the case. At the second on May 18, the parents were told to choose from three doctors for a second medical opinion. If they could not decide, the Child Protection Service would decide for them.

The boy became really ill before the third hearing. The father then relented to the treatment, although the mother was still against it. But she agreed in the end. She said she signed the consent form 'most unwillingly'.

'I refused to give consent because I really feel the brutal treatment would kill him,' she told The Straits Times.

The father said the boy, who is now under his care, has to be on intensive chemotherapy treatment for the next eight months.

Boy has cancer, mum goes for healing
Mother heads to alternative healing centre in the US, son undergoing chemo
By Melissa Pang, The Straits Times, 10 Jul 2012

THE mother who did not want her cancer-striken three-year-old son to undergo chemotherapy is now back at the Arizona alternative health centre whose beliefs she subscribes to.

She went back at the end of May and will be returning next month.

She told The Straits Times yesterday that she is now undergoing the centre's healing programme and gets updates on her son's condition through text messages and e-mail from her ex-husband. 'It took me a long time to realise that for my son to begin his healing, it must begin with me,' she said.

A Juvenile Court had granted her supervised visitation rights to the boy during the nine months he has to undergo intensive chemotheraphy treatment.

He is now under the care of her ex-husband. The toddler is one month into the treatment.

Over the phone yesterday from Arizona, the 31-year-old mother said she learnt about the centre, called Our Place International, through its current general manager, Ms Poh Siok Khoon, a Singaporean who conducted a cooking class in Singapore in 2009.

All in, the mother and son spent seven months atthe centre in 2010, when he was about two years old.

'We sunbathed naked every morning, had organic blueberry smoothies for breakfast, sumptuous salads for lunch and fruit for dinner,' she said.

'His skin and hair glowed, his eyes sparkled. He was happy and played in the garden every day. I knew without a doubt that it was an indication of optimal health.'

She also became a firm believer in the strict diet of fruit and vegetables, fasting, sun-bathing and self-healing that the centre's founder, Mr Ray Kent, advocated.

She said: 'Our health was at its peak when we were in Arizona.'

She added that she had brought her son to the Arizona centre because both her family as well as her ex-husband's had a history of heart attack, diabetes and cancer. Convinced of the need for prevention, she put him on a vegan diet.

If he did fall sick at all, all she needed to do was put him on a juice fast, and 'the symptoms would clear in two to three days', she said.

She claimed the boy's health had begun deteriorating after her divorce. When they were granted joint custody, she became unable to control the child's diet as strictly as before.

In April this year, the boy's paternal grandmother took him to hospital after he vomited blood clots. He was diagnosed with leukaemia a few days later.

The mother said she was vehemently against chemotherapy because she believed it would only 'suppress the symptoms, not cure the cancer'.

She added: 'I just wanted to provide a healing environment for him. I know he'll not get better in hospital.'

The boy's father said he felt healthier during his time at Our Place when he visited in 2010.

But he was uncertain how it could help his cancer-stricken sonand was unsure about chemotherapy's usefulness. But he said his confidence in Our Place was shaken when Mr Kent, 82, and Ms Poh declined to come to Singapore to see if his son could be 'healed', even though he had offered to pay for their expenses.

The father said: 'The last thing I wanted was for our son to go to the United States, only to be told it was too late for him to be 'healed'. I called a lot of alternative medicine practitioners, some of whom advised me to agree to the chemotherapy.'

When the boy's condition deteriorated, he agreed to chemotherapy and convinced his ex-wife to consent to it too.

Dr Wong Seng Weng, an oncologist and the medical director of The Cancer Centre here, said it is not uncommon for cancer patients and their families to refuse conventional treatment.

Being told they have a life-threatening condition such as cancer can trigger strong reactions of anger and denial, he said.

'There exist many myths and horror stories about cancer, and fantastic stories about patients who avoided the pain of chemotherapy, yet enjoyed spectacular results from alternative treatments,' he said.

'When offered an easier way out, there is a tendency to grab at it,' he said.

Paediatric oncologist Anselm Lee of Parkway Cancer Centre, agreed. He said: 'Parents, sometimes blinded by anger and denial, would opt for less-painful unconventional treatments. When this happens, they might miss the golden opportunity to treat the cancer when it is still at an acute stage.'

The boy is getting used to chemotherapy now, his father said yesterday.

'He was really unhappy during the first month, and his face is very swollen because of certain medication,' he said.

'But he's a lot livelier and happier now.'

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