BONUS: When God and medicine collide

Chris Spyrou (0:08)

Hey Chris Spyrou with you and welcome to this bonus episode of The Briefing.

What happens when religious beliefs clash with medicine? That question is back in the spotlight this week with the coronal inquest getting underway into the death of eight-year-old Queensland girl Elizabeth Struhs. She passed away in 2022 after her parents stopped giving her insulin because of their religious beliefs. Elizabeth's mum and dad were found guilty of her manslaughter, alongside her brother and 11 other members of a fringe religious group.

So in this deep dive, we're going back to a different case from earlier this year, which sparked a similar discussion about what happens when God and medical science are at odds. Here it is for you now.

If your doctor told you that you had a 5% chance of surviving an aggressive form of cancer without treatment, what would you do? You'd probably give some serious thought to that treatment, right? Well, what if you'd been following their advice since 2022 and had relapsed not once, but twice? Would that change your mind? That was the reality for a 15-year-old who wound up resenting her medical team at Melbourne's Royal Children's Hospital, and this year refused to undergo a bone marrow transplant to treat her leukemia. She effectively said it was her body, her choice, and she had the backing of her mum who also refused treatment, believing her daughter could be cured through God and not the hospital. So the RCH made an urgent application to the Supreme Court of Victoria to legally bypass their refusal last month, and it won. To help us unpack the legal and ethical complexities of this particular case and how we're seeing medicine and religion clash in Australian courtrooms more broadly, is Professor Cameron Stewart from Sydney Health Law at the University of Sydney. Cameron, welcome to The Briefing. Now, most people would assume that if a patient says no and their mum says no in the case of a minor, that's the end of a conversation. Legally, why is that not the case?

Cameron Stewart (2:04)

Well, legally, the situation is that people can refuse treatment, but only when they're an adult. Part of the civil liberties that we still have is that we have control over our own bodies. And generally speaking, we can refuse treatments, and we can refuse treatments even when they're necessary to sustain our lives. So it's possible for you to refuse a treatment like ventilation or even simple things like insulin medication. All of these are things that have been upheld by the courts. It's within your power as an adult to say, no, I prefer to die now. I don't want to be given treatment. And we can even get help to do that. So you can actually be given things like sedation and pain relief and other things that might make the refusal easier for you. There are some exceptions. So the exceptions would be in public health. If you're suffering from an infectious disease or a public health order on you, you can't refuse treatment then.

Mental health is another. So in most jurisdictions, it would be that you've got a mental illness and that you're a risk to someone or yourself. So that behavior could also trigger compulsory treatment regimes. And there's also classes of people that can't refuse and prisoners would be one of those. And children fall into that category. So the presumption for children is that children have to be given treatment that's in their best interests.

And even if the child's competent, if the court disagrees with the parents and the child's assessment about what's in the child's best interests, the court can overturn that.

Chris Spyrou (3:28)

In this specific case, this 15 year old Melbourne teenager, the judge ruled that she didn't have the required competence or she wasn't legally competent enough to refuse treatment. What was some of her reasons when reaching that conclusion?

Cameron Stewart (3:42)

It had to do with the child's approach to treatment and her emotional reactions to the prior treatment that she'd had. So this child had been treated for acutelymphoblastic leukemia before, and she had not had a great experience for her, and she'd lost a lot of contact with her friends, and she felt really dislocated, and she felt that she'd been treated badly by the staff, and that created a emotional reaction for her.

The court believed that that was one of the reasons for finding that she wasn't able to rationally go through the reasons for needing the treatment. This often happens to children. Often, there are reasons sometimes discounted in a way that we don't see for adults. Like if an adult had a reaction like that, wouldn't even be questioned.