Vancouver, Canada - She waged bitter legal battles in two provinces to avoid a blood transfusion, which her religion forbids. Now, a devout Jehovah's Witness teenager with bone cancer is returning home to Canada, triumphant that she found a U.S. hospital to both treat her disease and respect her desire to refuse blood.
The British Columbia girl, who cannot be named because she is a minor, flew to New York in May after losing court bids in B.C. and Ontario to stop doctors from giving her blood against her will. Jehovah's Witnesses do not believe in blood transfusions.
When the girl, who was diagnosed with bone cancer last December, told doctors in B.C. that she did not want a blood transfusion in the course of her cancer treatment, the state stepped in.
But now, as she prepares to return home to B.C., it is apparent her chemotherapy treatment in the United States was no different than in Canada. In the end, she did not receive a transfusion in the U.S. But she never received one in Canada either.
Why, then, did the emotional case land in court, adding stress and creating another expense to a family already in turmoil?
The girl's doctor in the United States blamed an inflexible Canadian health system.
Michael LaCorte said yesterday that his young patient felt she had no choice but to leave Canada because she lost trust in the health system.
"It's not an issue about science or something we're doing differently," Dr. LaCorte said.
"It's really about a trust with the family and an acknowledgment by physicians that we cannot allow a child to die."
Schneider Children's Hospital, where the girl was treated in the U.S., has a policy of not giving blood transfusions except in life-or-death scenarios. Had the girl's survival ever depended on a blood transfusion, the hospital would have given her one, Dr. LaCorte said.
At B.C. Children's Hospital, where the girl was treated in Canada, she did not receive a transfusion, either. However, last March the province got a court order to force the girl to have a transfusion in the event doctors believed she needed one. The girl fought back and tried to have the court order overturned, but a B.C. judge refused.
Dr. LaCorte said Canada's public health system is too rigid.
"I think [that] unfortunately the Canadian health system is a government system. And whenever you get a government and legal systems involved, things get a little muddied.
"Our philosophy is just to work with the families and they trust us to know that we're not going to do it unless we absolutely have to."
The girl's legal dilemma began soon after she was diagnosed with cancer last winter. She agreed to chemotherapy but explained to her oncologist that she was opposed to a transfusion because of her religion. Blood transfusions are common in cancer patients because one of the side effects of chemotherapy is that it suppresses the production of blood cells.
According to protocols in most hospitals, once a patient's blood levels drop to a certain point, a transfusion is ordered. At the Schneider Children's Hospital, however, doctors do not order a transfusion unless a patient's life is in jeopardy.
Dr. LaCorte said so-called bloodless treatment has gained currency among medical professionals and patients, and not just on religious grounds.
Blood transfusions carry the risk of acquiring diseases such as hepatitis, HIV and West Nile virus, he said.
The B.C. government, which obtained the court order last spring, defended its action. Kate Thompson, a spokeswoman for the Ministry of Children and Family Development, said she could not discuss the girl's case because the province signed a confidentiality agreement with the family when it permitted the trio to fly to New York.
However, she said, the ministry's job is to protect children and, in this case, it followed the advice of doctors.
Although the girl completed her treatment without a transfusion, it is unclear whether a case like this could arise again.
Paul Rogers, a pediatric oncologist at B.C. Children's Hospital, said doctors do practise restraint with transfusion when treating Jehovah's Witnesses.
"We give transfusions in life-threatening situations where we think that the patient, without the transfusion, might die," Dr. Rogers said. "We don't just give transfusions for the sake of giving transfusions."