Hanna Jones

"I'm not a normal 13-year-old," "I'm a deep thinker. I've had to be, with my illness. It's hard at 13, to know I'm going to die, but I also know what's best for me."

Leukemia
As more and more space is occupied by these abnormal blood cells, there is less and less space for the normal cells and the sufferer becomes ill. Quite simply, the bad cells crowd out the good cells in the blood. Hannahs heart was about 10 per cent of its normal capacity. If she didnt receive treatment it could lead to complete heart failure.

I've been in hospital too much. I've had too much trauma associated with hospital"

Family
Father Andrew: We were as low as it's possible to get, but I just didn't feel able to influence her. My wife and I agreed that whatever Hannah wanted, we would support her. She's a clever girl - but she was just fed up with operations and spending most of her life in hospitals."
Grandfather also understood and was not surprised of her maturity.

In July of 2008, doctors gave Hannah 6 months to live and warned that she needed the heart transplant in order to live more, but even with this action she could only last ten years at most.

Hannah is clearly attached to her family and wishes to be cared for at home..

She wanted to spend the rest of her short life at home in the company of her mother and father, brother Oliver and sisters Lucy and Phoebe

She appears to understand the serious nature of her condition. She demonstrated awareness that she could die. She was able to express her views and she did not wish to go back into hospital for cardiac treatment.

At this time Hannah was able to continue attending school depending on her health and when she was unable to attend to class, she was tutored from home.

July 12th, 2009: Hannah suffered partial renal failure

Heart was too weak to cope with the treatment.

Hannah did change her mind and asked to be placed on the transplant list

Late July of 2009: she was for an operation at The Great Ormand Street Hospital for Children. It is believed that the organ can add 25 years to her life.

''Hannah's change of mind came because she has enjoyed her life so much over the last year that she wanted more of it" said her father.

KEY ETHICAL ISSUES

There are issues involving six ethical principles with their roots planted firmly in the Oath of Hippocrates;

AUTONOMY BENEFICENCE NON-MALIFICENCE PRESERVATION OF LIFE JUSTICE TRUTH TELLING

Right to life

among these are life, liberty, and the

pursuit of happiness(1776).

Everyone has the right to life, liberty and security of person(1984).

Every human being has the inherent right to life.

This right shall be protected by law. No one shall be arbitrarily deprived of his life(1966).

Right to die

RIGHT TO DIE asociated with the idea of ones body and ones life are ones own
But Do we own our own bodies or does the State?

If we do

If States do

Then, we have the right to choose our own time and manner of death

Then, are we just pieces of national property?

Should a person with a terminal illness or a life-prolonging treatment have the Right to die?

What sould happen if this person is a child?

What is laws opinion?

 When is a child old enough to understand and give consent to complex medical treatment? What happens if medical opinion goes against a young patient's decision?

For it
Priscilla Alderson, professor of childhood studies at the Institute of Education.
Treatment or even about whether to live or die, cannot be based on age.

Against it
Fiona Stewart, a pediatrician at Belfast City hospital.
Often children who have lived with illness do have quite an evidence-based view. Defend sometimes doctors should end up taking the court option.

IN THE UK
Gillick Competence Mental Capacity Act 2005 Mature Minor Doctrine UN Convention: Rights of the Child.
+ 16 are qualified to give consent. Problem: -16!

GILLICK COMPETENCE
Medical law to decide if a child with 16 years or less is enought mature to decide his/her own medical treaties, without the need for parental persission or knowledge.

 England, Wales, Australia, Canada and New Zealand. A health departmental circular explaining that contraceptives could be prescibed to under sixteens years girls without parental consent by doctors.

VICTORIA GILLICK Started a campaign against the policy. But she lost it.

 Consent rather than parental rights or .

The parental rights just texist if it is to safeguard the best interest of a minor.

 The House of Lords: an underage person who understand the consequences of his/her actions could be considered legally competent.

VICTORIA GILLICK

HANNAH JONES

Case of contraception.

Case of a cardiac surgery.

All parents should be informed of the medical treatment of childs.

Hospital arguing that that Hannah shoul be operated.

SIMILARITIES:
The most important thing is the interest and the welfare of the minor

UN Convention on the Rights of the Child

Children have the same inherent dignity and equal rights as adults, but at the same time recognizes that children are born dependent and have a right to protection and guidance.

Mental Capacity Act 2005

Act of the Parliament of the UK. Legal criteria for establishing that a person lacks capacity of decision.

Mature Minor Doctrine

Statutory common law policy accepting that a non-emancipated minor patient may possess the maturity to choose or reject a particular health care treatment.

1. Parental decision overruling childs consent

Re M Case
Parental decision
Her daughter had to undergo the heart transplant operation

Childs decision
Refusal of consent for the operation

High Court decision

Acceptance of the surgeons clinical judgment

2. Courts decision overruling parental consent

Marions case
( Secretary of the Department of Health and Community Services vs. JWB and SMB) Parental decision Operations with future implication for the best interest of Marion High Court decision No authorization for such major operation

Yasser Ahmed Swisi

Andrea Oa Liss Hidalgo Noemi Vanunu Silvana Zarzar Paula Lorrio Yvette Mbaya