A 12-year-old boy from North Holland with cancer has the right to refuse chemotherapy, a Dutch court ruled on Friday.

The NOS reports that David, who was operated on for a brain tumour last year, does not have to have further follow-up chemotherapy.

He had undergone six weeks of daily radiation treatment last year, after the tumour had been successfully removed, but said he wanted to have alternative therapies instead of chemotherapy due to its side effects.

The boy’s parents are divorced, and while his mother believes in alternative therapies, his father went to court to try to persuade judges to rule that David should have further medical care against his will.

Self-determination

The boy had been under the care of social workers since last year, when his mother refused to cooperate with treatment, according to media reports.

But a judge in Alkmaar ruled on Friday that David has the right to decide on his care, even if this reduces his chances of survival.

‘He is especially concerned about the side effects of chemotherapy and the deterioration of his quality of life,’ said a judge.

‘Major medical procedures require his consent, taking into consideration his right to self-determination…David has apparently made his decision in terms of his quality of life now.’

50% survival chance

Court documents had suggested that with the follow-up chemotherapy, the boy’s chances of survival were 75% to 80%, but without it, they would be 50%.

David’s father believes the boy gives contradictory signals, wanting to end it all but making plans for the future, reports the Volkskrant. A psychiatrist had told the court, however, that David is not depressed, has a strong will to live but can also contemplate death.

Martine de Vries, a paediatrician from Leiden University’s teaching hospital, LUMC, told broadcaster NOS that the verdict confirmed that a child of 12 ‘has a very important voice in deciding such treatment’ and that even divorced parents need ‘to keep the child’s interests in mind’.

The judge added in court that it can be ‘hard for parents’ to let a child make such a decision. In Netherlands, children from the age of 12 are also seen as old enough to seek to end their own lives through the 2002 euthanasia law, under certain conditions of unbearable suffering with no prospect of improvement.