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Children who are dying of cancer do not, and should not have, the right to reject potentially life-saving medical treatment. Child-welfare authorities in Hamilton were right to ask for a court order forcing an 11-year-old boy to receive chemotherapy. And the court was right to give the order.

The boy is entitled to his own feelings about the most appropriate course of treatment. He has certainly earned them. Diagnosed at age 7, he has a generally curable form of cancer, acute lymphoblastic leukemia. Chemotherapy has caused him to vomit, feel bloated and have pain in his spine and difficulty walking. He had been cancer-free for a year after an earlier round of treatment. When the disease returned in January, he tried a round of chemotherapy again. He now wishes to try natural remedies such as vitamins, even though doctors say he will die without chemotherapy.

An adult would have the right to choose the natural remedies. The right to refuse medical treatment is fundamental. But that is because adults have the capacity to understand what is at stake. It would be perverse to put children's rights on such a pedestal that an 11-year-old could be exposed to harm, even death, over something he cannot understand.

The common-law concept of the "mature minor" with the right to make some decisions affecting his own body emphasizes the first word: mature. It strains credulity to think that any 11-year-old has enough understanding of life to be able to weigh what he is giving up in making a decision to forgo potentially life-saving treatment. It would also be difficult to understand the medical course of treatment and the prognosis, if treated. There may be other matters as well that the child cannot think through. In this case, the child has fetal alcohol syndrome and, his father says, has a mild intellectual delay. He also has serious behavioural problems for which he takes medication. So his judgment is probably below the level of a typical 11-year-old.

Usually it is the role of parents to help ensure that 11-year-olds are given every chance to live. But the father of this 11-year-old (he was 4 when his mother died from a brain tumour) says he wishes to respect his son's wishes. The father says his son would like to be at home with his family, "and play with his sister and just try to have fun and live as long as he could live." The father may feel he is trying to protect the boy's happiness and dignity; but the parental role is to make vital decisions for which the child lacks capacity.

This case is different from those involving teenage children of Jehovah's Witnesses who reject medically necessary blood transfusions. In those, the children are heavily influenced by the beliefs of their religious community, and may feel that to maintain the love and respect of their parents they need to abide by their beliefs. Judges have questioned to what extent 15- and 16-year-olds have a fully free will in these cases.

The 11-year-old in Hamilton may know his own body, and may not wish to suffer any more. The father may respect his son's wishes. But loath as a democratic society should be to intervene in family matters, it is right to assert the value it puts on children's lives by insisting that children can't make life-and-death decisions.