An appeals court has sided again with an Ohio hospital that wants to force a 10-year-old Amish girl to resume chemotherapy after her parents decided to stop the treatments.

The court ruled that an attorney who's also a registered nurse should be granted limited guardianship over the girl, Sarah Hershberger, and the power to make medical decisions for her.

Doctors at Akron Children's Hospital believe Sarah's leukemia is treatable but says she will die without chemotherapy. The hospital went to court after the family decided to stop chemotherapy and treat Sarah with natural medicines, such as herbs and vitamins.

The appeals court ruling, issued last week, overturns a judge's decision that said that keeping the parents from making medical decisions for their daughter would take away their rights.

"While we respect the wishes of the parents and believe them to be honest and sincere, we are unwilling to adhere to the wishes of the parents," the appeals court judges wrote.

The beliefs and convictions of the parents can't outweigh the rights of the state to protect the child, the court said. It also ordered that the guardian should be appointed right away.

The appeals court noted that a county probate court investigator found that Sarah is not in remission and will die without chemotherapy.

The ruling said that while adults can refuse medical treatment regardless of the consequences, children do not have those same rights because of their vulnerability and inability to make critical decisions in a mature manner.

While state laws give parents a great deal of freedom when it comes to choosing medical treatment for their children, that's not always true when the decision could be a matter of life or death. Courts most often will draw the line when doctors think the child's life is in danger and there's a good chance that the treatments being suggested will work, according to several medical ethicists.

Andy Hershberger, the girl's father, has said the family agreed to begin two years of treatments for Sarah last spring but stopped a second round of chemotherapy in June because it was making her extremely sick.

Sarah begged her parents to stop the chemotherapy and they agreed after a great deal of prayer, Hershberger said. The family, members of an insular Amish community, shuns many facets of modern life and is deeply religious. They live on a farm and operate a produce stand near the village of Spencer in Medina County, about 35 miles southwest of Cleveland.

Hospital officials have said that they are morally and legally obligated to make sure the girl receives proper care. They said the girl's illness, lymphoblastic lymphoma, is an aggressive form of non-Hodgkin lymphoma, but there is a high survival rate with treatment.