Justina Pelletier ruling begs look at new standards for Somatic Disorder

Justina Pelletier

Snip from the Facebook page ‘A Miracle for Justina’.

Massachusetts Judge Joseph P. Johnston (Juvenile Court Dept.) ruled on the case of Justina Pelletier on Tuesday, granting custody to the problems-plagued Massachusetts Department of Children and Families.

The judge did specify the custody is “subject to the parties’ right to a review and redetermination…six months from the adjudication on December 20, 2013.” Judge Johnston’s ruling begs a close look at new standards for Somatic Disorder.

The judge’s disposition order for Justina’s case is posted on the Boston Globe website.

If you read the arguments the judge presented, a question arises. Is 15 year old Justina suffering from a mental disorder, or is she suffering mental stress because of a physical illness? The judge upheld the finding the Connecticut teen “suffers from a persistent and severe Somatic Symptom Disorder [SSD].”

What the judge and media haven’t included in their accounts involves an expansion of the criteria for that disorder. The standards changed in 2013, and now an SSD diagnosis “does not require that the somatic symptoms are medically unexplained.” The new standards also warrant a very close look when compared to the old standards:

“…Criteria instead emphasize the degree to which a patient’s thoughts, feelings and behaviors about their somatic symptoms are disproportionate or excessive. The new narrative text for SSD notes that some patients with physical conditions such as heart disease or cancer will indeed experience disproportionate and excessive thoughts, feelings and behaviors related to their illness, and that these individuals may qualify for a diagnosis of SSD.”

Thus, if you have a fatal illness, and you obsess over your potential death to a point where it interrupts your “normal” routine, you could be diagnosed with SSD.

The judge also asserted the Massachusetts court was informed by the Connecticut Dept. of Children and Families that “it recently ‘substantiated the parents for neglect’ of Justina and that return of custody of Justina to her parents was not in her best interest.” Conflicting with that assertion is the fact that the Connecticut DCF “declined to take any steps to assume responsibility of Justina’s case.”

Not a single mention of a diagnosis of mitochondrial disorder was included in the judge’s opinion. Media and Justina’s parents have said she has been diagnosed by doctors at Tufts Medical Center, a facility considered top-notch, with mitochondrial disorder.

Nor did the judge elaborate on what separation from a family does to a teen.

Nor did the judge acknowledge the complexities of mitochondrial disorder. There is a long article about mitochondrial disorders at the National Center for Biotechnology Information, the U.S. National Library of Medicine.

The judge’s argument also suggests Massachusetts wants to be rid of the issue and is eager to hand it over to Connecticut where DCF apparently wants nothing to do with the case.

There is a remarkable bias against the parents in the judge’s order. He seemed taken aback by her parents’ anger at Boston doctors and state bureaucrats. I’d posit that this is completely normal and not at all unusual when a child has a complex illness that is both rare and hard to understand. It didn’t help that Boston authorities placed Justina in a psych ward.

Massachusetts’ DCF was the subject of a recent study that found 95 children died over a decade while their families were being monitored by the agency. That record deserves a judgment of some sort.

Justina is old enough to speak for herself. She should decide where she will live and her decision, with input from her parents, should be the determinant in a case many of us believe never should have been brought in the first place.

That a court can issue an opinion so cloudy, so biased, should concern every parent in the country, especially considering the 95 dead children Mass. DCF let down and the fact they now have quite possibly violated the rights of a teen whose family simply wants her to return home.

If Justina is not getting proper medical care for the mitochondrial disorder, her health will continue to deteriorate. Meanwhile the judge should rethink his buying into the diagnosis of SSD. It’s not as clearcut as he appears to believe.

The judge may have dispensed law in Justina Pelletier’s case.  However, he completely abandoned justice and Justina in the process.

(Opinion by Kay B. Day/March 26, 2014)

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About Kay Day

Kay B. Day is a freelance writer who has published in national and international magazines and websites. The author of 3 books, her work is anthologized in textbooks and collections. She has won awards for poetry, nonfiction and fiction. Day is a member of the American Society of Journalists and Authors and the Authors Guild.
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