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 percent 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 center 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.