Florida parents who refused chemo for child denied custody

A judge in Florida has denied a couple custody of their four-year-old son, who has leukemia, because there is "imminent risk of neglect" if he stays with his parents, who skipped a chemotherapy session for the child in order to leave the state to seek alternative treatments.

Tampa, Florida, (CNA) - A judge in Florida has denied a couple custody of their four-year-old son, who has leukemia, because there is "imminent risk of neglect" if he stays with his parents, who skipped a chemotherapy session for the child in order to leave the state to seek alternative treatments.

A judge ruled Sept. 9 that the Tampa Bay-area parents, Joshua McAdams and Taylor Bland-Ball, will be required to undergo a psychological evaluation with a parenting index after which point they may be able to be reunified with their son Noah, who is currently with his grandparents, the Tampa Bay Times reports.

Kevin Miller, assistant professor of theology at Franciscan University of Steubenville, stressed that the Catholic Church takes parental rights very seriously, but these rights should not be misused.

"When it is not fairly clear that parental rights are being abused, it seems to me, the state should generally be deferential to parents," Miller told CNA.

But this case, he said, raises serious questions about whether the parents are misusing their authority and rights.

Florida law allows the state to provide medical treatment to children even if the parents object, CBS News reports.

"There was no alternative with a remote chance of success...They were choosing between life and death for their child," Judge Palermo said as quoted by Fox13.

If the parents do not comply with the evaluation, the out-of-home placement could become permanent. They have 30 days to appeal the judge's decision, the Times reports.

Doctors at Johns Hopkins All Children's Hospital in St. Petersburg diagnosed Noah with acute lymphoblastic leukemia in April 2019.

After two rounds of treatment, on April 22, 2019, the Hillsborough County Sheriff's Office issued a Missing Endangered Child alert after the parents did not show up for Noah's third treatment, stating that "the parents failed to bring in the child to a medically necessary hospital procedure."

McAdams, Bland-Ball, and Noah were located in Kentucky a week later; they had fled to Ohio to seek alternative treatments. Authorities placed Noah in the custody of his maternal grandparents in early May 2019.

The child's mother argues that rather than denying him lifesaving treatment, she and her husband were simply seeking a second opinion, believing that chemotherapy had harmful side effects. On a GoFundMe page, Bland-Ball says that they were unhappy with the treatment they received at the hospital in St. Petersburg, and also that Noah's condition has not improved.

Bland-Ball had sought to use "rosemary, Vitamin B Complex, including B17, completely alkaline diet, Rosemary, a liver/kidney/gallbladder/blood herbal extract, daily colloidal silver, high dose vitamin c, collagen, Reishi mushroom tea and grapefruit peel and breastmilk" as alternative treatments for Noah's leukemia.

She has also posted on Facebook seeking cannabis treatments for Noah, and her attorney has confirmed that Noah also has received CBD and THC oil treatments. Medical marijuana is legal in Florida.

Bland-Ball also moved Noah's PICC line, which she had no formal training on how to do other than watching instructional YouTube videos, the judge said.

Among the reasons the judge cited for his decision were evidence the parents dumped a car and cell phones while fleeing Florida, and the judge stated that he was convinced that the parents would flee Florida again if given the chance.

The judge also cited McAdams' "proclivity for aggression" towards family members. McAdams in August 2016 was arrested on a charge of misdemeanor domestic battery by Brooksville police, the Tampa Bay Times reported.

McAdams reportedly threw a plastic toy bucket at Bland-Ball but accidentally hit Noah, cutting his face. McAdams then shoved Bland-Ball into a wall "multiple times," causing a head contusion, the Times reported.

He spent three days in jail, records show, and the case was dropped in March 2017; McAdams later attended counseling. The Times reports that Bland-Ball also filed for a protective injunction against McAdams, according to court records, but it was later dismissed.

'Appropriate social measures'

The Catechism of the Catholic Church teaches, "In creating man and woman, God instituted the human family and endowed it with its fundamental constitution. Its members are persons equal in dignity. For the common good of its members and of society, the family necessarily has manifold responsibilities, rights, and duties."

According to Miller, those rights include the right of parents to make decisions about how to promote the welfare - physical, psychological, intellectual, spiritual - of their children.

He also emphasized that "the family is a community of love in a way that no other community is capable of being," and thus respect for family rights serves the good of both family members and of society more broadly.

The Catechism also teaches: "The family must be helped and defended by appropriate social measures. Where families cannot fulfill their responsibilities, other social bodies have the duty of helping them and of supporting the institution of the family. Following the principle of subsidiarity, larger communities should take care not to usurp the family's prerogatives or interfere in its life."

But, Miller told CNA, some actions that parents might claim to be exercises of parental rights might actually be abuses of those rights. In case of gross abuses, he said, putting children in serious danger, it can be appropriate for the state, as part of its natural purpose of looking after the common good of its members, to step in and stop those abuses; this is obviously the case when, for example, parents subject their children to certain kinds of violence.

Parents overruled

Of course, Miller said, it is possible for the state to overstep its authority.

International cases such as that of 11-month-old Charlie Gard in 2017 and toddler Alfie Evans last year have highlighted situations of the state determining treatment for a patient against the parent's wishes. In both cases, which took place in the UK, the state determined that the patients be removed from life support, despite the protest of the parents.

These cases are different from the Florida case, Miller said, because in both UK cases, the state was choosing death for the children in question, and in the Florida case, the state is prioritizing a treatment aimed at saving child's life.

"I think one clear difference is that in those [UK] cases, it was the state that - I don't think it's hyperbole to say - wanted them to die," Miller commented.

He noted that in the Gard case, the parents attempted to transfer to transfer the child to the United States to undergo an experimental treatment for his condition.

"In the one case, it was experimental treatment, but it was experimental treatment offered as part of a bone fide study by a bone fide doctor at a bone fide hospital here in the US. So in that case they were pursuing an approach that you could certainly call extraordinary rather than ordinary means of treatment, but there's nothing wrong with that. I think it's within the rights of the parents to decide whether to pursue that kind of a treatment or not."

He noted that in both of the UK cases, the question was not whether or not to pursue an alternate form of treatment, but rather whether or not to continue basic life-saving measures.

Miller said the only similarity he sees between the UK cases and the Florida case is the fact that the state overruled the wishes of the parents.

"This [Florida] case, in multiple respects, is almost like the opposite of what was going on in the Charlie Gard and Alfie Evans cases," Miller said.

"In terms of what the parents are trying to do, and in terms of what the state is trying to do...there's absolutely no inconsistency in siding with what the state is doing in this present case and siding with the parents in those earlier cases."

'An abuse of parental rights'

"I suspect that the parents are genuinely sincere in claiming that what they want to do is in their son's best interest - although the fact that the father, on one occasion, attempted an act of violence against the mother that ended up injuring their son is cause for concern," Miller said.

"Nevertheless - and putting aside that point about the father's history - it seems to me that what they want to do constitutes an abuse of parental rights."

According to Fox13, the judge said the particular type of chemotherapy being given to Noah has a 70-year track record with 90-95% success rate.

"Proper treatment, based on evidence established by a tremendous amount of research, is, sadly, very difficult for the child, his parents, and other family members. It takes several years. There are side effects, including serious ones, during this period. There is the possibility of other side effects appearing years later. The fact remains that in the vast majority of cases, treatment is lifesaving, and so confers benefits that far outweigh the burdens," Miller noted.

"In contrast, there is absolutely no evidence to support the parents' view that stopping standard treatment very early, and switching to the approach that they favor, will confer any benefit. Rather, it is certain that - barring a miracle - the child will come out of remission and die of leukemia."

Miller also pointed out a fact that has been circulated in news reports about the case: that at least one of the alternative treatments that Bland-Ball mentions, known commonly as Vitamin B17, has been found by the National Center for Biomedical Information to not only be likely ineffective for curing cancer, but also bringing with it the potential for cyanide poisoning.

"Again: We ought to be vigilant about the problem of abuse of state authority. This does happen -including in the area of health-care decision making. The phenomenon of 'medical kidnapping' is not purely fictitious," Miller cautioned.

"But in the case at hand, it is clear to me that it is the parents - not the state - who are abusing their rights."

'Measure of last resort'

Father Tad Pacholczyk, director of education at the National Catholic Bioethics Center, told CNA that removal of a child from parental custody ought to be a measure of "last resort," to be used only after a "shared understanding" between the parents and healthcare professionals cannot be achieved.

"Sometimes parents may be attracted to 'alternative' treatments they came across on the internet that have not [been] tested or verified, and it may be important to spend a great deal of time and energy explaining to such parents the clear preferability of using standard treatments that have been tested and verified as efficacious for many patients," Pacholczyk said.

Pacholczyk said parents should generally be permitted to make medical judgements on behalf of minor children, especially when weighing the burdens of particular treatments such as chemotherapy - or, as in the Charlie Gard case, whether to discontinue treatment altogether.

"The decision to discontinue such interventions ultimately lies with the patient - or in this case with the parents as the child's proxy," he said.

In making such judgements, he noted, parents need to be in close communication with healthcare professionals, and avail themselves of their medical expertise, prior to reaching any conclusions regarding the proposed treatment.

"In situations where there is a standard treatment available, one that works in a high percentage of cases...it may indeed be unreasonable, and even wrong, for parents to decline such a treatment if the burdens to their child associated with its use are fairly low," he said.

"In such cases, however, the first line of attack should be not to take away the custody of their child, but to work assiduously to convince the parents to use the most effective approach."

Echoing Miller, Pacholczyk said that the family is, broadly speaking, the best place for a child, and "custody should be taken away only in clear situations of manifest danger to the child or in other evident situations of abuse or gross neglect."

Judge Palermo in the Florida case emphasized that in his view, the state had "met its burden and found clear and convincing evidence for neglect."

"Being raised through substitute arrangements set up by the state is many times more detrimental to the well-being of children than remaining within their native family setting," he said.

"State and governmental agencies are almost invariably worse at caring for the needs of children than the child's own parents, even when those parents may not exercise perfect judgment or may lack ideal parenting skills."

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