Neuroblastoma diagnosed in under-2 year olds has a cure rate of about 90% with the right treatment. Neuroblastoma diagnosed in any child over 2 years of age has a cure rate of about 10% in the long term.
It is very rare for an older child with Neuroblastoma to live a long healthy life as most of the time it will return at some point. Hamish was already unfortunately in the wrong age bracket despite the excellent results seen in Neuroblastoma treatment under the age of 2, with the odds greatly stacked against him.
Stage 4 is terminal. Neuroblastoma behaves in a fairly predictable way when it is terminal - it spreads to any organ in the body it likes, and quickly grows bigger. It causes pain, pressure within organs / bones where there is little space to accommodate extra tumour growths. It grows under the skin, in the mouth and throat etc. New lumps can appear within hours if you watch. All these new tumour lumps are painful, and they can ulcerate because they expand too quickly for the overlying skin to accommodate.
A child with stage 4 neuroblastoma would not have been a thin and tired little child saying that he has an ouchie somewhere inside his body. You would most likely be able to see the tumours that are causing the pain. It would be almost constant suffering.
The child may still have some respite if the pain medication is at a correct dose - there may be periods of childish joy playing with toys / watching tv/ interacting with others, but most of the days of Stage 4 neuroblastoma will be spent in a degree of pain. And it will steadily increase because without treatment, neuroblastoma doesn’t hover at a stable state.
I don’t know if these moments of joy in between all the suffering are sufficient to make me think that the child still has a decent quality of life. I don’t believe at this stage that the quality of life can be considered human. Parents looking after a child in this stage of illness may go through the motions very well and appear to be in control of all aspects of looking after the child - feeding, medication, washing, toileting, turning, changing, comforting. However there will also be feelings of helplessness and guilt very often, for seeing their child to go through the indignity and discomfort.
This mother has been brave and unselfish. She put her child first, and did a very kind and humane thing, probably one of the very few remaining good things she would have been able to do for her child at that time.
even if she hadn’t a diagnosis of cancer herself, and even if 40 years had not passed since, I would still believe that she has not done anything wrong. I know exactly which way I would vote as a juror in cases like this.