Just days after Oshin Kiszko returned home after court ordered chemotherapy his parents are facing a new battle.
Angela Kiszko and Adrian Strachan are back in court after refusing to allow Oshin to undergo radiotherapy – a treatment they say will give him “horrific, long-term side effects” but some doctors say may give him the best chance at a cure.
Oshin Kiszko, 6, was diagnosed with a malignant brain tumour in December. His parents went public with their decision to oppose the treatment recommended by doctors due to the side effects but earlier this year a court ordered Oshin to receive chemotherapy.
With his family by his side he has been received oral chemotherapy and just five days ago he went home.
Oshin, while in hospital. Via Go Fund Me.
But the family are now facing the prospect of him returning to hospital as they fight for their right to refuse radiotherapy for their son.
Yesterday Family Court Chief Judge Stephen Thackray considered eight hours of evidence on whether Oshin should also be given radiation as desired by his medical team at the Princess Margaret Hospital in Perth.
Justice Thackray heard evidence from a doctor who said that while Oshin's cancer had shown signs of receding, it was a partial response and not sufficient for chemotherapy to be effective on its own.
"In my opinion, it [radiation] is the only viable curative strategy," the doctor said.
"If our aim is to cure, that's what it's going to take, I'm afraid."
He said if high-dose radiation commenced immediately Oshin was estimated to have a 30-40 per cent chance of the five-year survival. Without radiotherapy, he had perhaps six months to live.
Oshin Kiszko with his family. Via Facebook.
The barrister representing Oshin's parents, Andrew Skerritt, told the court his clients were willing to go ahead with more chemotherapy but they still opposed radiation due to the long-term side effects, including reduced cognitive ability.
The doctor from PMH said medicine was not “black and white” and treatment decisions required an assessment of "quality of life versus life per se".
"It does boil down to some value judgements," the doctor said.
"We will not cure Oshin without radiation."
The doctor outlined the long-term side effects of radiotherapy in young children, including stunted growth, hearing problems and cognitive deficits.
He said in his opinion, Oshin would live up to a year with palliative chemotherapy.
"I would expect it would slow it down to some extent," he said.
"The odds are stacked against Oshin, yes."
The court heard there were differing medical opinions about the best treatment for Oshin, but at least one reputable expert agreed the parents' actions were reasonable.
Oshin has recently retuned home. Via Go Fund Me
Last month Angela Kiszko, Oshin’s mother told 60 Minutes the thought of putting her son through chemotherapy and radiotherapy made her sick.
"I read what he needed to go through, I read the care plan, all the side effects and I literally just wanted to vomit. And I felt I would not put myself through this, how can I possibly put my son through this?" Kiszko said.
In his initial judgement when he ordered the chemotherapy Justice Thackray said the evidence suggested Oshin’s parents had “tried to approach this matter on the basis of what is in the best interests of their child”.
But the prospect of a long-term cure is the matter “that most heavily must weigh in the decision”.
“One other matter that I think ought to be given weight is that the uncontested medical evidence is that the great majority of other parents faced with a similar decision would opt for the intervention that the hospital proposes,” he said.
Yesterday Justice Thackray described it as an “exceedingly difficult matter” and “a matter of life and death” as he delayed his decision.
With the presence of a time factor – the radiotherapy has to commence by next Monday - the judge promised to make the matter an urgent priority
Oshin's mother Angela Kiszko told WA Today outside court she respected the judge’s decision to take more time.
"I am feeling overwhelmed and very emotional but I am respectful of the judges decision to take some time to come to this very important and ethical decision about Oshin," she said.
If the judge sides against Oshin's parents the six-year-old will begin radiotherapy treatment on Monday. Via Facebook.
According to WA Today the judge has three options.
He could dismiss the Princess Margaret Hospital( PMH) case meaning Oshin will have a palliative care regime with some limited chemotherapy, he could order the PMH-prescribed regime of high-dose radiotherapy or he could order two extra rounds of intensive chemotherapy as an effort to shrink the tumour enough to buy Oshin some extra time.
Justice Thackray will hand down his decision later this week. If he sides against Oshin's parents the six-year-old will begin radiotherapy treatment on Monday.
“This is dressed up as a medical issue but it is in fact an ethical one," he said.
Oshin's friends have started a GoFundMe page to assist the family.