When A 14-Year-Old Chooses To Die Because Of Religion, Can Anyone Stop Him? | KUOW News and Information

When A 14-Year-Old Chooses To Die Because Of Religion, Can Anyone Stop Him?

Nov 4, 2015

The first time I interviewed Dennis Lindberg, he was alone on a weekday evening. He had just turned 12, and he had set out Saltine crackers on a paper towel and poured me a glass of tap water.

He sat up straight on the couch and folded his hands in his lap. “What questions may I answer?” he asked. He was polite, tall for his age, with light blue eyes and acne scattered across his nose.

I was a reporter in Mount Vernon, Washington, and I was interviewing Dennis because he had written a moving essay that his teacher had shared with me. For two hours, I asked him painful questions about the first nine years of his life, which he had spent with his parents. They lived in Idaho, were often homeless and were addicted to meth. Dennis wrote of finding needles in the toilet.

At the end of the interview, he jumped from the couch and led me to an alcove in his bedroom where he kept letters from his parents. That intimate moment showed how much he missed his parents despite their flaws.

After that story was published in the Skagit Valley Herald in 2005, Dennis asked me to write about him again in five years. He wanted readers to know he had turned out OK.

A decade later, I am late to that promise, and the story that follows is not what Dennis had in mind.

No Blood: Nov. 28, 2007

Walking into the Skagit County courthouse on a rainy November morning in 2007, Judge John Meyer realized his case had hit the news.

TV vans idled outside and middle school students huddled inside, many in tears. These were friends of Dennis, a 14-year-old so committed to being a Jehovah’s Witness that he refused blood that could save his life.

Dennis had been diagnosed with cancer three weeks earlier. He had a 75 percent chance of living – but only if he accepted blood transfusions to get healthy enough to undergo chemotherapy.

When Dennis said he wouldn’t take blood, doctors and lawyers at Seattle Children’s Hospital agreed he could refuse transfusions, even though it meant he would die.

Meyer, a lanky man in his 60s, had been assigned the case the day before. As far as he could tell, this had never happened before in Washington state.

Doctors in Washington state must respect young teens’ medical decisions – but only if they believe they are mature enough to understand the consequences. It’s a judicial doctrine that has been in place since 1967 and that has expanded to allow trans teens to take hormones and girls to get abortions without telling their parents.

But does it mean teens can also choose to die? Dennis’s case highlighted how little guidance accompanies the mature minor doctrine in Washington state – there is no protocol for determining if a teenager is mature.

Nor does the doctrine demand that hospitals seek outside input, which means doctors decide if a minor is mature. In similar cases in other states, doctors have dodged this dilemma by saying the child wasn’t mature enough or by punting cases to the courts.

Related: What Happened When Other Teens Refused Life-Saving Care

Seattle Children’s ultimately did call the state at the eleventh hour when a hospital administrator got involved.

That put Meyer in a tough situation; it meant he alone would decide Dennis’s fate. At the time he said the mantle of his black cloak had never felt so heavy.

Funny And Confident
Dianna Mincin, left, and nephew Dennis Lindberg at a wedding for Jehovah's Witnesses in 2005 or 2006. Dennis moved in with Dianna when he was 9. He was baptized as a Jehovah's Witness when he was 13.
Credit Courtesy of Dianna Mincin

Dennis wasn’t born a Jehovah’s Witness.

He spent the first years of his life zigzagging the country with his parents. As a toddler, he wandered the halls of the motels they lived in, knocking on doors, looking for company. At 4, he ran around an apartment complex with older kids, lighting fires and jumping off Dumpsters.

The summer before fourth grade, a neighbor called his aunt Dianna Mincin in Mount Vernon and issued an ultimatum: If she didn’t pick up her nephew, she would call the state’s child protective services. Mincin wasn’t surprised; she had taken care of her nephew before. That day, Mincin got in her car and headed for Idaho.

Dennis adapted well to his new life in Mount Vernon, a farm city an hour north of Seattle. Mincin taught him to brush his teeth and encouraged him as he learned to read. She immersed him in the Jehovah’s Witness faith, connected him with mentors and brought him to the nearby Kingdom Hall. On Saturday mornings, Dennis donned a suit and tie and proselytized in the area.

At school, he started a friendship club for new kids. He was popular and considered the best football player in his class. He could be found biking and skateboarding in the evenings, chatting with retirees in the neighborhood.

In the sixth-grade musical, Dennis was Baloo, the bear from “The Jungle Book.” In one scene, he shimmied around the stage in a coconut-shell bra. He was funny and confident. He stole the show.

When Dennis asked if he could call Mincin “mom,” she gently said no. He had a mother, she said. When he asked to be baptized as a Jehovah’s Witness, she resisted. He was so needy, she told me later, so eager to please. She worried that he was seeking social, not spiritual, acceptance.

In seventh grade, Dennis convinced Mincin that he was ready.

And so, at 13, Dennis was baptized. The same day, he signed what Witnesses call a “blood card,” saying he would refuse blood. Around this time, Mincin became his legal guardian. His parents said they believed it was a temporary arrangement so that Dennis could cross the nearby border to Canada for a religious convention.

Six months later, Dennis found himself out of breath playing football. His doctor ordered tests and within a day sent him and Mincin to Seattle Children’s Hospital.

Mincin, in school to be a nurse, feared the worst when she saw the results of his blood tests. Before climbing into the family’s beige SUV, she photocopied Dennis's blood card. She had used her own card that summer after losing blood during hip surgery. She was recovering slowly and using a cane to walk.

At the hospital, tests revealed that Dennis had acute lymphoblastic leukemia, a type of bone marrow cancer. When told he would need a series of blood transfusions, Dennis fell silent.

Mincin spoke instead. Dennis would refuse blood, she said. A hospital social worker wrote that “the family was open and wonderful to work with.”   

“It was a lot for me as a single mother to have to confront,” Mincin told me later. “I had two daughters who were looking at me and how I was handling the situation. Their spiritual lives were at stake.”

Jehovah’s Witnesses became adamant about refusing blood around 1945, when blood banks were established in Chicago and San Francisco.

Elders at the Watch Tower Society in Brooklyn pointed to Genesis 9:4, which condemns cannibalism, and Leviticus 17:10, which says, “I will set my face against that soul who eats blood and will cut him off from among his people.”

Not that it’s been uniform. Some Witnesses say they would take fractions of blood but not whole blood or specific parts – plasma, platelets, red blood cells or white blood cells. Others accept organ transplants.

Doctors hear mixed messages as well. One pediatrician told me, “Their worst nightmare is that you’ll take them at their word, and you won’t transfuse their baby.”

Mincin assumed Children’s would ignore their wishes. So she was surprised when a hospital social worker told her that Dennis, having just turned 14, could be considered mature enough to make his own decisions.

Years later, Mincin recalled what went through her mind: “I knew I was helping him to actually die. It was awful. But the other option was more horrifying. To abandon Dennis in his strong conviction to uphold Bible principles as we understand them and allow transfusions to be forced upon him, would have killed him in so many other ways.”

Mincin had been a fighter her whole life, often picking up the pieces for her family. She saw the sad irony of her current situation: She had rescued her nephew, and here she was, now fighting for him to be allowed to die.

Then again, she told me, 14-year-old girls in Washington state can have an abortion without parental consent. Teens may volunteer themselves for medical experiments, check themselves into psychiatric wards and, if they’re parents themselves, make decisions for their babies.

So why couldn’t Dennis refuse blood?

In Washington state, even young teens can be considered mature. The policy at Children’s – one of the biggest and most cutting edge children’s hospitals in the nation – is to respect “the wishes of patients and families regarding medical care whenever clinically appropriate.”

A few years after Dennis died, I reached out to Dr. Douglas Diekema, a senior ethicist at Seattle Children’s.

Although Diekema wasn’t involved in Dennis’s care, he said he believed Dennis was too young to make such a grave decision. Brain research shows that most of our decision-making is driven by the emotional side of our brains. In teenagers, that’s even more pronounced, because teen decision-making relies more on mid-brain structures, or the socio-emotional part of the brain, than adult decision-making.

Diekema had a 14-year-old daughter and he knew that social life might trump physical life for teenagers. He also knew of teens who refused chemotherapy because they didn’t want to go bald – they would rather die than wear a wig.

“If you allow the adolescent to establish that they are a very mature person and they’ve listened to everything we’ve said, and they understood that they may die, you’ve missed the fact that the main factor that’s driving this decision is that they’re going to lose their hair,” he said.

Given Dennis’s rough start in life, Diekema said he wondered if Dennis was refusing blood to maintain his relationship with his aunt and his standing in a church community that provided him social support and nurture.

“He may not feel as obligated to make that same decision when he’s 30,” Diekema said.

'Dianna, Don't Do This' (Week 1)
Dennis with a guitar. He was visited by many friends, most of them Jehovah's Witnesses, during his three weeks in hospital.
Credit Courtesy of Dianna Mincin

Soon after Dennis was admitted to the hospital, friends at their Kingdom Hall started a blog on Caringbridge, a site for patients and their families. Mincin, always open about her family, embraced the blog.

The Caringbridge site inspired nearly a thousand comments, many from supportive Jehovah’s Witnesses. It also had another effect, one Mincin had not predicted: It gave Dennis’s parents and grandmother from Florida a better view into Dennis’s hospital room.

Dennis’s parents were still struggling to get on their feet. They had spoken with Dennis several times since he was admitted to the hospital, but Mincin had asked them not to talk about his treatment. She said it would aggravate his enlarged heart.

Olga Lindberg, Mincin’s mother, ran a cleaning business in St. Petersburg, Florida. For her, the Caringbridge site was terrifying.

“Dianna, don’t do this,” Lindberg said she shrieked into the phone. She had a thick, German accent.

“Little Dennis is your brother’s only son. If you let him die, you die along with him, because I will no longer have a daughter.”

Until then Lindberg, a Baptist, had tolerated her daughter’s adopted faith. Now she thought of her daughter as a murderer.

One afternoon, Lindberg said, she called the oncology ward to speak with Dennis. The nurse who answered the phone told her that Jehovah’s Witnesses sat with Dennis day and night. The nurse said she had heard a Witness tell Dennis that accepting blood would make him unclean.

“Mrs. Lindberg,” the nurse said, “I’m telling you this because I’m a grandmother, and what they’re doing to your grandson is unforgivable.”

Ethics Report: Nov. 9

Three days after Dennis arrived at the hospital, a Children’s medical ethicist came to his room. It is Children’s practice to call in a medical ethicist in complicated cases.

Dr. David Woodrum, also a veteran pediatrician, met with Dennis alone and told him that he would be given blood if a synthetic alternative failed. Dennis, serious and polite, said blood would compromise his faith.

In his report, Woodrum wrote that Dennis was mature but that he seemed flexible. When a doctor said she would give blood if alternatives failed, Woodrum wrote, “Dennis and family did not voice refusal but instead stayed silent.”

“Up until a certain point, people had the idea he could be convinced to accept a blood transfusion,” Woodrum told me later. “This was a horrible experience for the clinical team.”

During his tenure at Seattle Children’s and the University of Washington, Woodrum had numerous patients whose parents said they would refuse blood for their children. But those had been babies, protected by the courts because they don’t have a voice; teenagers are different. Short of restraining Dennis, there was little doctors and nurses could do if he refused blood, he said.

Diekema agreed that he wouldn’t restrain a teen. But he said he would have pushed harder than his colleagues.

“I would have brought the blood into his room, and I would have hung it, and I would have hooked it up,” Diekema said he told the care team after Dennis died.

“If he had allowed me to do that, I would have just done it,” he said. “I would have told him that I’m sorry, and I would have apologized to him, and I would have told him that, ‘I know this disrespects what you want, but I can’t let you die.’ And if he had accepted that, I would have done it.”

Bearing Witness

Mincin worried that Dennis’s sweet demeanor was giving doctors the impression that he wasn’t steadfast. Even some Witnesses seemed soft on refusing blood.

She had noticed a man from their congregation, one of Dennis’s mentors, coaching Dennis on how to graciously accept a blood transfusion, should it come to that.

Another elder told her to prepare for Dennis to be transfused. Visualize Dennis receiving blood, he said, the bag of blood hanging by his bed, the line going into his arm.

The thought made her nauseous.

“(Elders) told me to comfort Dennis and that there was nothing the hospital could do because he was a minor,” Mincin told me by email. “I had to prove to them, because Dennis wanted me to, that he was a mature minor.”

She said she decided to read Dennis a Bible passage on fierce resistance.

She said that when she finished, he turned to her and said, “I understand, Aunt Dianna.” His hands had grown cold, his breath turned short, but he said he would fight a transfusion with all his remaining strength.

Growing Weaker (Week 2)

Two weeks after Dennis was admitted, Dr. Douglas Hawkins took over as Dennis’s doctor. Hawkins, then in his mid-40s, is currently the associate division chief of hematology/oncology at Children’s.

His patient was gaunt, and his heart had weakened from anemia. The synthetic blood had failed. Dr. Hawkins insisted that Dennis needed a packed red blood cell transfusion within two days.

Hawkins told Dennis that he was in a difficult position. He wanted to honor his patient’s wish but said that he would die without a transfusion. Hawkins said he would confer with Children’s in-house lawyers later that day.

Mincin believed the hospital would force a transfusion. But the next morning, Hawkins delivered the news to Dennis: Dennis could make his own medical decisions.

Dennis cried and said he felt respected. He said he wanted to spend his remaining time at Children’s as a hospice patient.

That day, Mincin started a blog entry with one word: “Victory!”

But the next day, the day before Thanksgiving, a Children’s administrator directed the hospital social worker to call the Department of Social and Health Services, the state agency in charge of child welfare.

“Administration asked social worker to make a CPS referral to cover all bases and to cover the aunt,” a state caseworker wrote.

At the same time, Hawkins, unaware the state had been called, met with five senior oncologists to discuss Dennis’s case. The doctors unanimously agreed that Dennis had the right to die. They believed that if a 14-year-old could so clearly express his position, then he deserved to have that position respected.

“We owe respect to a 14-year-old,” Hawkins would later tell Judge Meyer.

“In the past I have favored parents, and I’ve always regretted it,” Hawkins told the judge. “I believe we give parents rights because they speak for their child, but at some point that right transfers – we all agree that happens at 18, I guess – but it seems that we owe them some respect before 18.”

If the judge ordered a blood transfusion, Hawkins said, he would want “specific instructions about what to do.”

“Dennis has said if we were to compel a blood transfusion, he would do everything possible to fight us,” Hawkins said.

“Right now I don’t think he’s conscious enough to do that. He doesn’t have enough energy to do that. But as we gave him blood, he would recover and regain strength, and you would have to tell me – would you want me to put him in restraints or to sedate him? I would have to do this repeatedly. That for me is very difficult to do with a 14-year-old.”

Week 3: Thanksgiving

Hawkins would not speak with me for this story.

His notes are clinical but also heartbreaking as the doctor summarizes his conversations with Dennis, urging him to change his mind, while documenting the boy’s physical decline.

Woodrum, the ethicist, summed up those notes in medical terms: “Day after day after day, the hematocrit” – volume of red blood cells – “would go from 14 to 13 to 10." It got to 5.4. Normal for a teen boy is 45. 

On Thanksgiving Day, Hawkins tried again.

He asked everyone to leave Dennis’s room. It was the first and only time he would speak with Dennis alone.

“I wanted to make sure that there was no one in the room who could potentially be influencing him,” Hawkins testified. “We talked for about 15 minutes alone. I told him that without blood transfusions he would die.

“He said, ‘I understand that. I do not want to be treated if the requirement is that I would have to take a blood transfusion.’”

Dennis wore boxer shorts, a white T-shirt and socks – gifts from Witnesses in his first week at the hospital. His skin had yellowed from anemia, and he could barely sit or use his bedpan.

His hand tingled and his nostrils felt dry. His heart swelled. They could turn this around, Hawkins said. Dennis still had a 70-percent chance of survival with treatment.

Heart-shaped balloons were tied to Dennis’s bed, drooping for want of helium. Mincin had bought them, believing they might inspire Dennis to produce red blood cells. 

That afternoon, about 30 Witnesses from congregations in the Pacific Northwest visited Dennis. When they left, Mincin read him passages about strong characters from the Bible.

Like Jesus, Mincin said. Jesus was willing to sacrifice his life for his beliefs.

'I Should Follow My Faith'
Big Dennis Lindberg, Dennis's dad, and Olga Lindberg, his grandmother. They wanted Dennis to accept blood transfusions.
Credit Courtesy of Olga Lindberg

Lindberg kept calling.

Not Mincin anymore – her daughter wasn’t taking her calls – but to anyone else who might be able to give her a voice.

She remembered Teresa Vaughn, Dennis’s fifth- and sixth-grade teacher. Vaughn had been reading the Caringbridge site and was also worried. Dennis was one of her favorite students.

Lindberg spoke with Vaughn, who said she would visit Dennis and report back. On the Saturday after Thanksgiving, Vaughn drove down to the hospital.

When she walked into the hospital room, Dennis was curled in a fetal position on his bed. Anxiety had kept him awake the two previous nights, and the nurses had given him drugs to sleep.

Ten Witnesses were in the room. Vaughn asked them to leave.

“Do you know these people?” she asked Dennis. He shook his head, no. They were there to support him, he said.

She looked around the curtain and saw the head of the Mount Vernon Kingdom Hall seated quietly on the other side. Vaughn glared at him. “Could you give us some privacy?” she said.

Alone with his teacher, Dennis said that if he were to die, he might be among the 144,000 believers and nonbelievers chosen to spend eternity in heaven with Jehovah. He believed that only the meek and those who followed God’s direction would endure, and he thought he stood a good chance.

“Dennis, you are a child,” Vaughn recalled telling him. “You do have an old soul, and 10 years from now, you can be pissed at me, but you have a lot more living to do.” She lowered her voice and nodded toward the Witnesses outside his room. “If they told you to take a blood transfusion, would you?”

Vaughn thought Dennis looked confident, almost smug.

“I know that you and a lot of other people want me to have the treatment,” he said, “but more people think I should follow my faith.”

A Witness entered to say Dennis needed rest. On her way out, Vaughn pulled Mincin aside in the hallway. “You can’t let him die,” she said.

“It’s not up to me,” Vaughn recalled Mincin saying. “This is Dennis’s decision.”

On the drive home, Vaughn cried. She was baffled the hospital hadn’t intervened. She wondered if Mincin would stand to watch one of her daughters die. It was a thought others had shared privately – would a mother defend her child’s right to die?

Big Dennis And Rachel

Olga Lindberg called her son, “Big Dennis” Lindberg, and Dennis’s mother, Rachel Wherry, in Idaho. Get to Seattle now, she said. Olga Lindberg believed that doctors might force treatment if they knew Dennis’s biological parents opposed his decision.

Wherry was short and raven-haired – Dennis had described her to me years before as fragile – and his father was a lumbering man whose voice was so gravelly it was sometimes hard to understand him. When I knew Dennis, he often showed me his father’s photo, which he kept in a worn leather wallet.

Big Dennis Lindberg started randomly calling agencies in Washington for guidance. The next morning, he got through to DSHS, and within hours, he and Rachel were on a plane to Seattle. The state paid the bill.

By then, high-level administrators at the Department of Social and Health Services had made up their minds to go to court.

They wanted to find out whether Mincin was Dennis’s legal guardian. They also appeared concerned that Dennis hadn’t received a psychological evaluation. “Psychology had declined as they do not have the tools for such an assessment,” a state caseworker wrote.

The state resolved to ask a judge to order blood transfusions and assess Dennis’s case when he was healthy enough to testify.

'Everyone Is Torn'
Judge John Meyer of Skagit County Superior Court said the mantle of his cloak had never felt so heavy as when he had to decide Dennis's fate.
Credit Seattle Post-Intelligencer/Paul Joseph Brown

It was the Tuesday after Thanksgiving, and Judge Meyer was working against time at the Skagit County courthouse.

Hawkins, speaking by phone from the hospital, told the judge that Dennis would likely die that night or the next day.

“Everyone is torn by this case because we all want Dennis to live,” Hawkins told Meyer. “If you polled nurses and physicians in training, some of them might feel that we should compel a blood transfusion.

“We can’t perform medical care by consensus or democracy,” Hawkins continued. “In the way that we design medical care, the decision rests with the attending physician. That, in this case, is me.”

Dennis’s court-appointed attorney, Jacob D’Annunzio, was in disbelief.

“They knew three weeks ago this would be a potential outcome,” D’Annunzio said at the hearing. “It’s at the Eleventh Hour that the hospital administration says, ‘We don’t want to be liable, so let’s call a judge.’ The decision was already made – by doctors and by Dennis.” 

The Eleventh Hour

Rachel Wherry, Dennis's mother, and father, Big Dennis Lindberg, were flown to Seattle by Washington state. They asked Judge Meyer to order blood transfusions for their son.
Credit Seattle Post-Intelligencer/Paul Joseph Brown

On Wednesday morning, Meyer stepped into his small courtroom.

Dennis’s parents stood before him. Vaughn was several rows behind them. Mincin called into the courtroom from the hospital.

The judge started slowly, pausing between words with the cadence of a minister. Dennis, Meyer said, would not be able to resist the first transfusion.

“However, over a period of time, as more transfusions were given, and as Dennis got stronger, he would start fighting,” he said, paraphrasing Dennis’s doctor. “At that point, we would have to put him in restraints, and we would have to probably sedate him.”

The judge noted that he was the father of two and grandfather of four. This was not the ruling he would want for them, he said.

Vaughn wanted to scream. That was precisely the problem, she thought. No one was treating Dennis as their own.

The courtroom grew silent as the judge concluded, “It is time to do what Dennis has decided, to place this in God’s hands.

“The motion to require an unconsented blood transfusion is denied.”

For a brief moment, the courtroom was quiet. Then Dennis’s mom started to wail. It was a cry so piercing that it could be heard outside the courthouse.

At the hospital, Mincin hung up the phone. She walked into Dennis’s room and stood by his bed.

“You won,” she said. “Nobody is going to come. Nobody is going to do anything.”

She thought Dennis couldn’t hear her. But he opened his eyes and a tear spilled out.

“I knew he understood what I was saying,” Mincin said.

Seven hours later, at 6 p.m., on Nov. 28, Dennis died.

Life After Dennis
Dianna Mincin and her daughters climbed Sauk Mountain in northern Washington state to scatter Dennis's ashes.
Credit Courtesy of Dianna Mincin

Within hours, Mincin signed a form to donate Dennis’s blue eyes. She spoke with someone at a funeral home about having him cremated. At Dennis’s request, she and her daughters would climb Sauk Mountain to scatter his ashes.

Olga Lindberg flew in from Florida. She organized a memorial service for her grandson. She did not invite Mincin. One hundred fifty people came, many of them students wearing pink in honor of Dennis’s favorite color. Dennis’s mother was puffy-faced from crying. She sang “Amazing Grace.” 

Mincin held a service in a private location, with Jehovah’s Witnesses standing at entrances with guest lists.

When Olga Lindberg returned to St. Petersburg, she staked a handmade sign in the lawn outside her condo: “No Jehovah’s Witnesses allowed on my property or I put a restraining order on you.”

In 2010, three years after his son’s death, Big Dennis Lindberg died of liver failure. Olga Lindberg later told me that his doctors said he spent his last days screaming his son’s name. After Big Dennis Lindberg died, Wherry moved to Phoenix, Arizona, to live with her father.

I last saw Mincin in Mount Vernon in 2011. We had emailed and talked by phone for months. In one email she told me that she had had trouble breathing after Dennis died and would sometimes hyperventilate. 

I asked her how Dennis’s death affected her faith, and she said it was strengthened initially.

“Now that the years are passing, I feel like everybody has forgotten the courageous stand he took,” she said.

“Intellectually, I know that is not true. But, somehow, I want his name written down somewhere in our literature. I want him remembered. It's as though life goes by and he never existed. Not to me, but to others. It's hard to move on.”

Her daughters had grown up and left home. “The loneliness is almost unbearable sometimes,” she wrote in an email.

Mincin has since left Washington state and is now a pediatric nurse.

It’s true that Dennis’s death didn’t have much impact on how a case like his would be handled.

His refusal of blood has not been mentioned in Jehovah’s Witness literature. His death did not prompt a formal review of the mature minor doctrine at Seattle Children’s, according to Diekema, although the doctors discussed the case at length among themselves.   

Nor were laws enacted to make sure this wouldn’t happen again, although Dennis’s sixth-grade girlfriend Morgan Curry tried. She persuaded her local representative to propose a bill she believed would have helped Dennis.

Morgan, then 15, testified in Olympia.

“HB1759 requires doctors and hospitals to immediately notify CPS when a minor’s refusal of medical care creates a substantial risk of death,” she said, reading from a statement. “It requires CPS to investigate promptly, and it requires a guardian ad litem to be appointed.”

The bill didn’t pass.  

As for me, I’ve spent years unraveling the events that lead to Dennis’s death.

I petitioned the court to unseal Dennis’s records, but my request was rejected. I ended up getting the records through Mincin, who gave me the right to view them. She also gave me a more complete set of Dennis’s medical records.

When I asked Children’s if another teen would be allowed to refuse life-saving care, the hospital emailed its policy: 

Seattle Children’s respects the wishes of patients and families regarding medical care whenever clinically appropriate. However, when factors, including a patient’s religious beliefs, lead to the denial of necessary medical care, Seattle Children’s priority is to operate in the best interest of the child.

In an emergency situation, Seattle Children’s policy is to provide medically necessary emergency medical and surgical treatment to minors, unless there is a court order directing the contrary. In non-emergent cases where the medical team, patient and legal guardian(s) have time to develop a care plan, the patient’s medical team consults with a wide range of experts, which can include Seattle Children’s Ethics Committee, Seattle Children’s legal team and Child Protective Services.

For patients who are Jehovah’s Witnesses, physicians also collaborate with patients and their families to review any reasonably available non-blood medical alternatives, however, alternative treatments are not always available. If the recommended treatment is deemed medically necessary for the child’s welfare, Child Protective Services can present the case in court, where the final decision on treatment is made.

Diekema, the ethicist, told me he hoped there wouldn’t be another case like this one. 

“A life was extinguished,” he told me when we met at the Starbucks at Children’s. For him that was the bottom line: A kid died when he didn’t have to.

Diekema quoted a U.S. Supreme Court decision from 1944, a case that involved Jehovah’s Witness children: “Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children.”

I read the full decision late in my reporting. What struck me was the dissent by Justice Frank Murphy, an Irish Catholic who wrote of the trials Jehovah’s Witnesses have faced throughout history.

“Theirs is a militant and unpopular faith, pursued with a fanatical zeal,” Murphy wrote. “They have suffered brutal beatings; their property has been destroyed; they have been harassed at every turn by the resurrection and enforcement of little used ordinances and statutes.

“Religious freedom is too sacred a right to be restricted or prohibited in any degree without convincing proof that a legitimate interest of the state is in grave danger.”

Ultimately, those close to Dennis, both those who let him choose to die and those who fought for him to live, remain haunted. They become angry when they talk about him. Some cry, others have nightmares. Sometimes I think Dennis may be the only one in all of this who has found peace.