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Monday, October 31, 2005

After Court Battles Over a Cure, Saddest Case Nears an End

Oct. 31, 2005, 5:52PM
A judge intends to rule on whether a cancer-stricken girl should return to her parents

By TODD ACKERMANCopyright 2005 Houston Chronicle

CORPUS CHRISTI - A judge is expected to rule today whether to return to her parents a cancer-stricken teenager seized by the state because they would not follow doctors' advice that she undergo radiation therapy.

The ruling should resolve whether Katie Wernecke tries her parents' alternative plan — intravenous Vitamin C therapy — or continues to live with Houston foster parents and receive treatment at the University of Texas M.D. Anderson Cancer Center.

"We're not going to dillydally another nine months, we're not going to dillydally another week," state District Judge Jack Hunter said Friday. "Every hour we spend in this courtroom is one less hour she'll have to live."

Hunter, a former M.D. Anderson patient, on Friday gave state lawyers the weekend to come up with new evidence on why he shouldn't return the child to her parents.

Since erupting into a battle in June, the case has attracted national attention, pitting those who believe parents should be able to choose their child's medical treatment against those who believe parents' unconventional choices can endanger innocent lives and thus require state intervention.

In Wernecke's case, the prolonged fight has caused both sides to accuse the other of endangering the now 13-year-old child. Her chances of being cured, once put at 85-90 percent, are down to 20-25 percent, according to M.D. Anderson doctors.

Wernecke was diagnosed in January with Hodgkin's disease, a cancer of the lymph nodes that oncologists consider very curable.

Treatment involves chemotherapy, radiation or both, depending on how advanced the cancer is. Katie's parents were elated when chemotherapy appeared to destroy the tumor, but balked at follow-up radiation therapy, fearing its long-term toxicity. Her doctors said radiation was necessary because her cancer was advanced.

"Radiation's effects on a child are a lot different than they'd be on me," said Edward Wernecke, 53, Katie's father. "It could shape her whole future — make her sterile, stunt her growth, cause her to get breast cancer in her 20s. The effects would be with her the rest of her life."

In a video shown on television at the time, Katie Wernecke also expressed her opposition to radiation.

But when her doctors told Child Protective Services that the Werneckes were refusing to follow the recommended treatment, authorities intervened. Mother Michele Wernecke fled with Katie, but after an Amber Alert was issued, the girl was found at a relative's ranch west of the family's Corpus Christi-area home. CPS took custody and Katie was placed in a foster home in Houston and taken to M.D. Anderson, where doctors promised to consider all options.

Soon thereafter, doctors said, Katie's cancer reappeared and doctors recommended chemotherapy and radiation.

But despite a judge's order that Katie receive the treatment, little has been done in the months since. For a time, Katie resisted treatment by pulling catheters from her arm and disobeying doctors' orders.

In addition, the matter has been frequently tied up in court. The Werneckes and CPS have fought over whether Katie resisted treatment at her parents' urging, whether the judge should step down because he visited Katie without court officials present and whether an M.D. Anderson regimen represented experimental treatment to which the parents had not given consent.

The delays prompted CPS spokesman Aaron Reed to call the Wernecke case "the most frustrated and saddest case" he's experienced at the agency.

"To go from a 85 to 90 percent chance of a cure to where she is now is heartbreaking," Reed said. "If her parents had just gone ahead with the prescribed treatment all along, Katie most likely would be in good health now, doing the things normal kids do at her age."

Earlier this month, the Texas Supreme Court ruled that Edward Wernecke can have supervised contact with Katie, ending four months during which only Michelle Wernecke was allowed such visits. The ruling prompted the judge at the time, Carl Lewis, to remove himself from the case and led to the appointment of Hunter.

Just two days after taking over, Hunter heard the Werneckes request to take Katie to Kansas for the Vitamin C therapy and M.D. Anderson oncologist Dr. Robert Wells' telephone testimony that the therapy has "a long and sordid history in oncology" and that any delay it could cause in her conventional treatment could lead to her death. He added that "she may die anyway."

Wells' quote was alluded to numerous times at Friday's hearing: by the Wernecke's lawyer, who said it showed "what the state's doing isn't working;" and by a state-appointed lawyer for Katie, who said she's decided "she wants to live" and is now open to radiation.

It also was quoted by Hunter, who suggested it brought a new dimension to the debate and pledged to move things forward if it requires holding a hearing every day.

"I don't care who's at fault," said Hunter, whose hairy-cell leukemia was successfully treated at M.D. Anderson. "If it's true she may die anyway, she may need to spend quality time with her family."
todd.ackerman@chron.com