NORWELL, Mass. -- The chemotherapy 16-year-old Billy Best was receiving for cancer left him nauseated, aching and fatigued, but not too tired to run.
After losing his hair and facing another five months of chemotherapy and radiation, Billy chose instead to leave his parents, trumpet, black Labrador and, doctors said, very good chances for survival.
He has Hodgkin's disease, a usually curable cancer of the lymphatic system.
The high school junior's determination to escape the painful treatments has put his family at the heart of a national debate over the rights of patients, particularly adolescents not traditionally afforded the full autonomy of adulthood, to refuse lifesaving medical care.
"I am not unhappy with my home life. The reason I left is because I could not stand going to the hospital every week," Billy wrote in a note he left for his parents when he ran away from home Oct. 26. "I feel like the medicine is killing me instead of helping me."
Billy has made several brief phone calls to his worried parents to reassure them of his safety, but he has told them that he is adamant about avoiding further chemotherapy after enduring 2 1/2 months of treatments.
While teen-agers deemed mature enough have been allowed to consent to medical services without their parents' approval, there is as yet no consensus about when they should be allowed to refuse treatment, said Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.
Legally, state courts have the power to order that minors receive medical treatment, although they rarely intervene when parents support a youth's refusal of care, Dr. Caplan said.
"I do think [youths] should be allowed to refuse, with some special provisions," Dr. Caplan said. "You need to examine how old the child is, how long the child has been in treatment, what the chance of success is and how well they understand the treatment."
At Billy Best's age, he said, "they shouldn't make him go through the treatment, but they should sure try hard to persuade him."
Reluctantly, William and Susan Best have let their son know that they won't force him to take the treatments if he returns.
They have also called off a national police search for Billy and asked him to pick a place to meet, with no strings attached.
"I'd like to just tackle him, put him in handcuffs, and bring him back. But he'd just run away again, either that or maybe hate us the rest of his life," said Mr. Best, a 47-year-old salesman who speaks softly and anxiously wipes his forehead as he talks about Billy.
The Bests hope that their son returns so he can be monitored for any spread of the cancer and perhaps be persuaded to resume the treatments, especially if his condition worsens.
A fundamentalist Christian, Billy had declared upon his diagnosis that his recovery should be left to God rather than chemotherapy, but a church pastor seemed to have dissuaded him.
Once the treatments began, he rarely complained. When his hair began to fall out, he simply shaved his head.
And although his body was weakening, he still wanted to play on the school soccer team.
An outgoing teen who schoolmates say exudes a friendly cheerfulness, Billy hid his growing frustration with the chemotherapy treatments as he quietly sold off belongings.
Only a few of his closest friends were aware he had cancer.
A few days after doctors told him that his treatments would be extended for an extra month, he boarded a southbound Greyhound bus and fled while his parents were at Wednesday night church services.
"He must have felt so trapped he felt he had no other way," said Mrs. Best.