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  1. Opinion

Editorial: State wisely puts a child's life first

Only in extraordinary instances should the government overrule a parent's wishes for the medical care of their child. But the state appropriately assumed that responsibility in the case of a Tampa mother and father who want to treat their 3-year-old son's leukemia with medical marijuana, not chemotherapy as the doctors have recommended. A judge sided with the state Wednesday, and the overriding priority should be on providing Noah McAdams with the treatment he needs. Given the implications to parental rights and governmental authority, this case also should be playing out in public view.

Joshua McAdams and Taylor Bland-Ball appeared in a Tampa courtroom this week to fight the state's efforts to require chemotherapy for Noah, who was diagnosed last month with acute lymphoblastic leukemia — a cancer of the blood and bone marrow. Doctors at Johns Hopkins All Children's Hospital in St. Petersburg recommended chemotherapy. McAdams and Bland-Ball eventually agreed but later refused additional chemotherapy in hopes of trying natural remedies.

The couple failed to show up to a medical appointment in late April, prompting child protective investigators in Hillsborough County to get a court order to take Noah into custody. Last week, police found McAdams, 28, and Bland-Ball, 22, at a Kentucky motel and took Noah to a hospital. The parents, who are under investigation on suspicion of child neglect, said they were en-route to Cincinnati to consult a doctor there. The Florida Department of Children and Families filed a motion for authority to treat Noah according to recommendations from oncologists. Hillsborough Circuit Judge Caroline Tesche Arkin ruled Wednesday that the boy should finish his first phase of chemotherapy. Another Hillsborough judge last week placed Noah in the custody of his maternal grandparents for the duration of the legal fight.

The case highlights the tug-of-war that can ensue between parents and the state's child protective system over medically necessary treatments. In contrast to straightforward examples of abuse and neglect, these cases can hinge on value judgments and differences of opinion over treatment options. The parents maintain they sought care for Noah, and that natural remedies were more appropriate, at least for now. The state disagrees; an expert at Moffitt Cancer Center in Tampa who is uninvolved in the case told the Tampa Bay Times that only a full chemotherapy regimen could be effective.

Documents in the case are not available because of medical privacy laws. And it's not entirely clear what's happening in the courtroom, as Arkin granted a request from Noah's guardian ad litem Tuesday to close the hearing to the news media, citing the boy's privacy interest.

Noah's privacy already has been effectively waived. The bigger issue here is establishing the legitimacy of the state's position. DCF hardly has a perfect track record as a child safety net. In this case, however, the agency has raised the alarm about a potential tragedy in the making and appropriately intervened. The thoroughness of its investigation and the soundness of its treatment plan should withstand professional and public scrutiny. DCF is seeking extraordinary authority, and it should be accountable to the public for that consideration from the very start.

The public also deserves to see firsthand and in real-time how the court has balanced these competing interests and set the bar for state intervention. The parents' attorney wanted the media present, which would have produced a deeper and more balanced record of the proceeding. It also would have underscored to DCF the level of public scrutiny that would follow its handling of this case. Noah's story tugs on medicine, emotion and the law, but by all outward signs DCF's request is appropriate and a judge has agreed for now. Those involved in Noah's fate need to demonstrate that his interests come first, and they need to do it in public.

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