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Teen Forced Into Chemotherapy Now in Remission

A Connecticut teenager forced by the Supreme Court to accept cancer treatments is in remission. Continue reading →

A Connecticut teenager removed from her family for her own safety after refusing to undergo cancer treatment last year is now in remission, according to her doctors.

The 17-year-old, known as Cassandra C, was taken into state custody in January and forced to undergo chemotherapy for Hodgkin's lymphoma after refusing treatment in favor of unproven alternative medicines. According to an NBC News story, "Court documents show DCF [Connecticut's Department of Children and Families] took custody of her when she ran away from home after two days of chemotherapy and missed medical appointments."

Her family fought to retain custody of her, and the case went to the Connecticut's Supreme Court which ruled that Cassandra and her parents could not refuse medical treatments.

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At the time of the Supreme Court decision, NBC News noted that "Doctors at the Connecticut Children's Medical Center in Hartford say the treatment would give Cassandra an 85 percent chance of survival. Without treatment, the doctors said there was a near certainty of death within two years."

The fact that Cassandra was a minor when diagnosed likely saved her life; had she been 18 and legally an adult the courts could not have compelled her to seek medical treatment.

Cassandra's case was watched closely by medical ethicists and civil liberties organizations such as the American Civil Liberties Union, which filed an amicus brief on behalf of Cassandra's family. As NBC News noted, "Assistant Public Defender Joshua Michtom, who is representing Cassandra, said the case marks the first time the state Supreme Court has considered the ‘mature minor doctrine' recognized by several other states. The doctrine generally allows court hearings for minors 16 and 17 years old to prove that they are mature enough to make medical decisions for themselves."

Though there are cases of parents who refuse to take their minor children to doctors because of religious reasons or health beliefs, this case was different. Cassandra and her family apparently did not object to all medical treatment, nor on religious grounds, but because she he did not want to "put poison into her body." Instead Cassandra sought alternative, unproven treatments with fewer side effects - and no scientific evidence of effectiveness.

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Chemotherapy involves the use of potent drugs to kill cancer cells or at least slow their rate of reproduction, but it can also kill off healthy cells. Though the treatment is often effective, it can have painful and significant side effects including fatigue, hair loss, and constipation. It is not an easy regimen to adhere to, but a full course is essential for success, and that's one reason why Cassandra's missed appointments concerned her doctors and led to actions by Connecticut authorities.

Cassandra recently posted on Facebook: "It's true, I am in remission; and it would mean the world to me, to be able to come home to get the remainder of this nightmare over with."

June 28, 2012 --

Today the Supreme Court upheld the 2010 health care law in a dramatic victory for President Barack Obama. The lead up to today's decision has prompted debate between opponents and supporters of the Patient Protection and Affordable Care Act two years ago. Take a look at how we got to the health care system we have in place today.

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Prior to the 20th century, nothing even close to what could be called a health care system existed in the United States. Although the Civil War had led to some medical breakthroughs in terms of surgical techniques and pain management, medical knowledge, techniques and treatment availability at the time left little hope that patients would actually recover from severe ailments. As NPR's Alex Blumberg and Adam Davidson point out, medical treatments may have been downright medieval at the time, consisting of potions. But at least it was cheap. "In 1900, the average American spent $5 a year on health care ($100 in today's money)," they note in their report.

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In 1912, Theodore Roosevelt was the first presidential candidate to get behind the idea of a national health insurance plan. Roosevelt ultimately didn't win election that year. Proponents of government-provided health care tried to press the issue through state initiatives, only to see their efforts fail in 16 states. Roosevelt's plan may have certainly been ahead of its time, particularly since there weren't that many services that doctors could actually provide patients during that era.

At the same time, however, developments within the medical community changed the face of the industry. The horrors of World War I led to advances in the areas of wound care, sanitation, pain management and more, according to an article published in the Journal of the Royal Society of Medicine. Hospitals in the United States began to widely adopt the practice of using antiseptics to sanitize their facilities, preventing the possibility of medical personnel or patients becoming exposed to infection. That decade also saw the introduction of the first employer group insurance contracts (though not specifically for health insurance) as well as the first physician service and industrial health plans.

In 1928, Alexander Fleming made one of the most important discoveries in the history of medicine: penicillin, a life-saving drug used to treat countless millions. It would be decades, however, before penicillin would be mass-produced. Fleming's discovery was the signature achievement in an era that saw medical treatment become more effective, and, as a result, expensive. The Great Depression also fueled concerns about affordability of medical treatment as millions of Americans suddenly found themselves out of work. In 1929, Baylor Hospital provided the first group health insurance plan in the United States through an agreement with Dallas-area teachers. The plan was the forerunner of Blue Cross. The effort wasn't just meant to be in the best interests of patients, but also the hospitals. Patient facilities saw more empty beds as fewer patients during the Great Depression could afford treatment without participating in these collective prepaid health insurance plans.

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As part of his push to create a social safety net for Americans during the Great Depression, President Franklin D. Roosevelt advocated the passage of national health insurance. Roosevelt pushed ahead with efforts to pass Social Security first, a bill which intentionally omitted any mention of medical care to ensure its passage. Harry Truman attempted to carry on Roosevelt's legacy in 1945 by calling on Congress to create such a program. His efforts failed, partly due to criticism by the American Medical Association (AMA), who called the plan "socialized medicine." In this photo taken in 1937, First Lady Eleanor Roosevelt examines a chart of enrollment of health care insurance plans.

Like its predecessor, World War II would lead to new medical advancements, including the widespread adoption of antibiotics and the use of ultrasound. The war would also have a similar effect in terms of the spread of employer-sponsored health plans. Because the nation was in a state of emergency and had a legally mandated wage freeze as a result, employers had to attract workers to assist the war effort by providing them with benefits, including health insurance. Tax laws passed between 1943 and 1945 also gave breaks to employers who provided insurance to their employees, which gave businesses all the more incentive to offer coverage. Following the war, employer-sponsored health insurance became common. In 1951, around 77 million Americans had some kind of coverage, according to an insurance industry trade group. That era also saw one of the most celebrated medical achievements in history: Jonas Salk's polio vaccine.

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Although health insurance was widely available to employed Americans in the mid-20th century, the unemployed and the elderly were often excluded from these plans. President John F. Kennedy campaigned on the issue of insuring these groups. President Lyndon B. Johnson succeeded where Kennedy left off, securing the passage of a bill through Congress creating Medicare and Medicaid. At the bill-signing ceremony, shown here, Johnson presented former president Truman with the nation's first Medicare card. Within the medical industry itself, an increasing number of doctors began specializing in certain fields of medicine rather than acting as general physicians. By 1960, more than two-thirds of doctors reported themselves as full-time specialists, rather than general practitioners.

Starting with Richard Nixon in 1970, presidents have offered successive plans for covering the nation's uninsured, but they have have stalled for different reasons. In 1974, Nixon put forward a plan to cover all Americans through private insurance, only to have the Watergate scandal force him out of office. An economic crisis prevented Jimmy Carter from pushing forward with a national health plan. Congress late in Reagan's second term attempted to expand Medicare, only to have the law repealed the following year. Bill Clinton had a 1,300-page health care reform bill that was never even taken up for a vote in Congress. Since Nixon's presidency, health care costs have continued to rise, often outpacing inflation. This increase is due to a number of factors, including the increased use of new medical technologies for diagnosis and treatment. The Patient Protection and Affordable Care Act signed by President Barack Obama was intended to cover the 30 million Americans who live without health insurance, according to the bill's authors. It has been the most far-reaching piece of health care legislation since Johnson's signed the legislation creating the Medicare and Medicaid health care programs.

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