A 17-year-old, cancer-stricken Connecticut teen who has been fighting to stop her chemotherapy treatments says she fully understands that she will die without them.
In an interview with the Associated Press, the teen, known only as Cassandra C. in court papers obtained by PEOPLE, wrote in a text that she knows “death is the outcome of refusing chemo” but says she believes in “the quality of my life, not the quantity.”
Still, she must continue to receive the treatments she does not want. On Thursday, the Connecticut Supreme Court ruled that she must continue her state-ordered treatments, saying she is not mature enough to make that decision.
The court upheld a lower court ruling that supported a decision by the state to take her into custody so she would receive treatment for what doctors call an aggressive but treatable cancer, according to court records.
“She has not been deprived of her due process rights and we agree that Cassandra’s conduct proves she is not mature based on any standard,” Chief Justice Chase Rogers said at the Hartford hearing.
Cassandra, who was diagnosed with Hodgkin’s lymphoma in September, disagrees. “Being forced into the surgery and chemo has traumatized me,” she wrote in her text from her hospital room at the Connecticut Children’s Medical Center (CCMC) in Hartford, where she has been confined since December.
“I do believe I am mature enough to make the decision to refuse the chemo, but it shouldn’t be about maturity, it should be a given human right to decide what you want and don’t want for your own body.”
She says she does not want to have “such toxic harmful drugs” in her system and would like to explore alternative treatments. Her mother, Jackie Fortin, has said she supports her daughter’s decision.
In a statement released to PEOPLE, the Department of Children and Families (DCF), which has custody of Cassandra, thanked the court for its “prompt decision,” which will allow officials to “continue to provide the medical treatment that will save Cassandra s life. This is a curable illness, and we will continue to ensure that Cassandra receives the treatment she needs to become a healthy and happy adult.”
In a statement Monday, the department stressed that Cassandra needs the treatments to save her life. “When experts – such as the several physicians involved in this case – tell us with certainty that a child will die as a result of leaving a decision up to a parent, then the Department has a responsibility to take action.
“Even if the decision might result in criticism, we have an obligation to protect the life of the child when there is consensus among the medical experts that action is required.”
While Connecticut’s child welfare system is striving to work with families to voluntarily find solutions to family challenges, “unfortunately that can’t happen in every situation, especially when the life of a child is at stake,” the statement reads.
Still, Joshua Michtom, an assistant public defender in Hartford who is representing Cassandra, tells PEOPLE he is “disappointed” that they lost the court case yesterday. “For me, the takeaway about this case is not about chemo,” he says. “It’s much more a question of an individual’s ability to control her own body.”
He plans to fight the ruling. “Since it’s a child protection case, it’s still an open case, so there are still a lot of things to be dealt with in terms of getting a court to allow Cassandra to have a say in her treatment and in terms of improving her situation while she is undergoing treatment.”
Cassandra will be able to make her own medical decisions in September when she turns 18.
This past September, Cassandra was diagnosed with Hodgkin’s lymphoma, which medical experts say is highly curable with chemotherapy.
But after her mother skipped several oncology appointments and exams for her daughter, doctors at the CCMC in Hartford notified the DCF, according to court records.
When surgery failed to get rid of Cassandra’s cancer, she underwent two rounds of chemotherapy before asking that the treatments be stopped, according to court papers. She ran away from home to avoid further treatment, the papers state.
In December the DCF removed Cassandra from her mother’s home in Windsor Locks and admitted her to the CCMC, where she has been ordered to receive six months of chemotherapy, court records state.
The chemotherapy she is receiving in the hospital has left her “doing remarkably well,” Assistant Attorney General John Tucker told the court. “I would note that the child is mid-treatment here. To interrupt that treatment would be devastating, even more devastating than delaying the treatment in the initial instance.”
Since Cassandra is in custody of the DCF, she has limited contact with her mother, who is allowed to visit her twice a week, says Michtom.
Authorities took her cell phone away, say court records. Hospital staff pulled the land line out of her hospital room so that she could not communicate with her mother, according to court records.
“Right now, she’s in a hospital room she is not allowed to leave,” says Michtom. “She has less freedom of movement than kids I have represented who have been in juvenile detention. That just seems unnecessary, so we are hoping we can persuade a court to lessen the constraints on her even if she continues to be obliged to get treatment.”
Cassandra does not want to be kept in the hospital until June, he says. “For Cassandra, it’s more of an ongoing low level misery of being in a room and doing nothing and that just continues for her and is frustrating.”
Experts say consistent chemotherapy treatments can prevent Hodgkin’s lymphoma from becoming a more deadly disease.
“If she’s been in the middle of treatment and then stops and then the disease comes back, that’s harder because a lot of times what [cancer] cells that will then come back are now resistant to the chemotherapy,” Dr. Mitchell Smith, director of the lymphoid malignancy program at the Cleveland Clinic, told NBC News. Smith is not treating Cassandra.
Bioethicist Arthur Caplan, founding head of the division of bioethics at NYU Langone Medical Center, agrees with the court’s decision, saying that at 17, Cassandra is too young to make such a life-or-death decision.
“The primary goal in this case is to save a young life,” Caplan wrote in an essay to NBC News. “This is a disease where medicine can do that. Admittedly, the treatment sucks, but it works …Respecting choice is important,” Caplan wrote. “Not burying a young teenage girl who would have lived is far more important.”