A judge has again blocked an Ohio hospital from forcing a 10-year-old Amish girl to resume chemotherapy after her parents decided to stop the treatments.

The order siding with the parents comes just a week after an appeals court sent the case back to the judge and told him to give more consideration to the request by Akron Children's Hospital.

The hospital wants a registered nurse to take over limited guardianship of Sarah Hershberger and decide whether she should continue treatments for leukemia. The hospital believes Sarah's leukemia is treatable and says she will die without chemotherapy.

Andy Hershberger, the girl's father, 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.

Judge John Lohn, in Medina County, said in his ruling Tuesday that not allowing the parents to make medical decisions for their daughter would take away their rights. He also said there is no guarantee that chemotherapy would be successful.

"They are good parents,'' he said. "They understand completely the grave situation their daughter is in and the consequences of their choice to refuse chemotherapy for Sarah at this time.''

Lohn said also that allowing for a guardian would go against the girl's wishes.

"Even if the treatments are successful, there is a very good chance Sarah will become infertile and have other serious health risks for the rest of her life,'' the judge said.

The hospital said it is disappointed with Lohn's ruling. Officials there have said they are morally and legally obligated to make sure the girl receives proper care.

"We believe this case is about children's rights and giving a 10-year-old girl an 85 per cent chance of survival with treatment,'' the hospital said in a statement Wednesday.

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.

The Ohio judge ruled in July that Sarah's parents had the right to make medical decisions for her, but the appeals court said Lohn failed to consider whether appointing a guardian would be in the girl's best interest and ordered him to re-consider the decision.

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

They opted to consult with a wellness centre and treat Sarah with natural medicines, such as herbs and vitamins, and see another doctor who is monitoring their daughter, Hershberger said.

Hershberger said they have not ruled out returning to Akron Children's Hospital if Sarah's health worsens. The hospital has said the girl's illness -- lymphoblastic lymphoma -- is an aggressive form of non-Hodgkin lymphoma.

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  • In this image released by PBS, a girl rides a foot push bike in a scene from "The Amish: American Experience," a film that offers a revealing look at the Amish community of about 250,000 centered primarily in rural Pennsylvania, Ohio and Indiana. The film premieres on PBS stations on Feb. 28 at 8 p.m. (AP Photo/PBS)

  • FILE - This April 30, 2008 file photo shows farmers talking among truckloads of corn and hay during an auction at Belleville Farmers Market & Livestock in Belleville, Pa. The harvest season is nearing its glorious end, and the culture, architecture and history of Pennsylvania's Amish country can be seen for free in Lancaster County, where many Amish settled, starting in the early 1700s. (AP Photo/Carolyn Kaster, file)

  • In this image released by PBS, a boy works in a barn in a scene from "The Amish: American Experience," a film that offers a revealing look at the Amish community of about 250,000 centered primarily in rural Pennsylvania, Ohio and Indiana. The film premieres on PBS stations on Feb. 28 at 8 p.m. (AP Photo/PBS)

  • An Amish man and girl plow a field Friday, Oct. 19, 2012, near Troy, Ohio. (AP Photo/Tony Dejak)

  • Three Amish men who did not want to give their names, get baseballs autographed by Baltimore Orioles manager Buck Showalter, left, during a baseball spring training workout Thursday, Feb. 23, 2012, in Sarasota, Fla. The men come to Sarasota with their families every year from their homes in Indiana to join a local Amish community and enjoy the warm weather for several weeks. (AP Photo/David Goldman)

  • FILE - This March 27, 2012 file photo shows an Amish buggy passing a bunch of daffodils along Route 44 in Madison Township near White Hall, Pa. The harvest season is nearing its glorious end, and the culture, architecture and history of Pennsylvania's Amish country can be seen for free in Lancaster County, where many Amish settled, starting in the early 1700s. (AP Photo/Bloomsburg Press Enterprise, Jimmy May, file)

  • FILE - This Oct. 4, 2006 file photo shows a man loading bales of hay near Nickel Mines, Pa. The harvest season is nearing its glorious end, and the culture, architecture and history of Pennsylvania's Amish country can be seen for free in Lancaster County, where many Amish settled, starting in the early 1700s. (AP Photo/Mel Evans, file)

  • Amish women leave the U.S. Federal Courthouse in Cleveland on Wednesday, Sept. 19, 2012. The jury finished their fourth day of deliberations without a verdict in the trial of 16 people accused of hate crimes in hair- and beard-cutting attacks against fellow Amish in Ohio. (AP Photo / Scott R. Galvin)

  • Amish women assists with a cattle drive Saturday, March 31, 2012 near Maysville, Ky. The cattle were moved nearly two miles over a highway to new pastures. (AP Photo/The Ledger Independent, Terry Prather.)

  • In this image released by PBS, two children play in the snow in a scene from "The Amish: American Experience," a film that offers a revealing look at the Amish community of about 250,000 centered primarily in rural Pennsylvania, Ohio and Indiana. The film premieres on PBS stations on Feb. 28 at 8 p.m. (AP Photo/PBS)

  • In this image released by PBS, a family walks to church in a scene from "The Amish: American Experience," a film that offers a revealing look at the Amish community of about 250,000 centered primarily in rural Pennsylvania, Ohio and Indiana. The film premieres on PBS stations on Feb. 28 at 8 p.m. (AP Photo/PBS)

  • An Amish man attends to his horse and buggy in the parking area of a shopping plaza in Middlefield, Ohio on Wednesday, Oct. 12, 2011. The Amish are constantly faced with the clash of their lifestyles and those of the modern world. Amish leaders in another community in Holmes County, Ohio faced a soul-searching question after hair-cutting attacks against several followers of their faith. Should they cooperate with authorities or follow the deeply held belief of forgiveness toward one another? In the end, they decided the only way to stop the attacks was to seek help from the outside. (AP Photo/Amy Sancetta)