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Justina Pelletier: A breakthrough, and a path forward

The saga of 15-year-old Justina Pelletier, which began with a girl’s tough-to-diagnose medical condition and devolved into a national fight over parents’ rights and medical treatment, got a much-needed breakthrough this week. Massachusetts’ Department of Children and Families, which has had legal custody of Justina since a court ruling in March, announced a plan to move the girl to a behavioral education provider in Connecticut, near her home. DCF also outlined a path for Justina’s parents to regain custody — pending a judge’s approval — by visiting Justina, participating in family therapy, following through with a medical treatment plan, and meeting with child welfare officials.

Any kind of cooperation, as opposed to recrimination, would represent a welcome change from the unfortunate way this case has played out so far. Justina’s saga began when officials at Boston Children’s Hospital questioned a tentative diagnosis, from a doctor at Tufts Medical Center, of a rare cell disorder, and instead accused her parents of medical child abuse. The case has dragged on, in part, because so many parties have declined to budge, compromise, or engage in civil dialogue. And that delay has allowed Justina’s situation to become a rallying cry for many unrelated people and advocacy groups, some of whom have deep knowledge and expertise in the issues involved — and some of whom don’t. The attention, in turn, made all sides more likely to dig in.

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In his ruling in March, granting custody to DCF, Massachusetts Juvenile Court Justice Joseph Johnston suggested some ways out of the stalemate. He was deeply critical of Justina’s parents, maintaining that they had made threats and invectives that discouraged a range of facilities and foster homes — including one close to Justina’s home — from accepting their daughter for treatment and care. Johnston also said he had expected authorities in Connecticut — either the state’s court system or its Department of Children and Families — to step in and accept responsibility for Justina’s well-being.

Massachusetts will still maintain that responsibility. But next week, Justina will move to the JRI Susan Wayne Center for Excellence, a therapeutic school in Thompson, Conn., that specializes in complex cases and family unification. DCF, which arranged the move, has taken another step that is likely to defuse tension: It is transferring Justina’s medical care from Children’s back to Tufts, which has devised a new plan for her behavior and medical health. John Polanowicz, Massachusetts’ Secretary of Health and Human Services, has met with Justina’s relatives and has said that the agency’s goal is to reunify Justina with her family. That’s most likely to happen through quiet work, adjustment, and accommodation — and at some remove from a heated public debate.

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