CA - Parents Of Toddler Declared Brain-Dead Convinced He’s Still Alive

[scmom]

The 9th Circuit did not set a new cutoff date on life support in its order, but set up a schedule for additional paperwork from Fonseca and Kaiser that could extend through Wednesday. The court said Fonseca could provide an update on her efforts to move Israel to another location.

http://abcnews.go.com/US/wireStory/court-grants-additional-time-life-support-toddler-39260674

 

[Doghairrules]

One can't evaluate movements in a patient known to be definitively brain dead (no blood flow to the brain, and meets all other diagnostic criteria) without taking ALL the diagnostic information into account. If the child is brain dead (and I believe this child has had numerous imaging and diagnostic studies), then these kind of movements are spinal reflex arc movements-- no matter how heart wrenching or persuasive they may be to watch.

Watch the video from Brazil I linked above-- that man had the vent removed, and produced that classic Lazarus sign. He was unquestionably brain dead. If one googles "brain death and spinal reflex arc movements, there will be thousands of articles, videos, and explanations. I just did this and got 20,200 results returned.

Brain dead patients can have a lot of involuntary somatic shivering movements, limb movements, etc in response to touch, ventilator manipulations, being turned in bed, etc. It is very disconcerting for family to see this. It makes them think medical professionals are lying to them. It is our duty to explain what they are seeing, and give them the ENTIRE picture of what's going on, including diagnostic imaging and other studies. To compassionately teach.

The child Israel is beautiful, with not a mark on him except for the medical equipment. It's particularly and miserably hard for grieving parents to believe that what has happened inside his head is so catastrophic, when his heart beats, he is warm, and he is so beautiful. He cannot recover, at all. To accept that, for some, is to descend into a pit of madness and grief, from which they may not emerge. I get it. It's thoroughly, completely devastating. But no less true.

The courts are not helping in these situations, IMO. They only prolong false hope, encourage more litigation, foster confusion in the parents and the public, and delay the inevitable. These decisions, IMO, don't belong in courts.

I agree. He is beautiful and does look like he is sleeping. I can imagine how hard this is for the family to accept.

 

[MelmothTheLost]

They think that by Monday they'll be able to find a facility in another country to take him, and make international travel arrangements to transport a dead child to another country?

I wonder what "getting their passports ready" means. Are they making emergency applications for passports or just digging them out?

I'm sorry if this sounds harsh, but I really hope every country they approach sends them away with a flea in their ear over the idea that a certified dead person could be transferred abroad for medical treatment. This family, like Jahi McMaths, seriously need bringing to their senses.

 

[watcher9]

I keep wondering why the NJ facility accepted Jahi but now has refused this little toddler?
Was it a case of futility to believe they could revive a brain dead body? Or, a lesson learned by accepting a brain dead body it would cause a endless money pit for them? Or, both?

 

[MelmothTheLost]

I keep wondering why the NJ facility accepted Jahi but now has refused this little toddler?
Was it a case of futility to believe they could revive a brain dead body? Or, a lesson learned by accepting a brain dead body it would cause a endless money pit for them? Or, both?

I imagine they accepted Jahi's body as an act of compassion, in order to give her parents a little more time to come to terms with the reality of her death. Now they've realised that all they've done is to enable the family's delusions, they are mightily hacked off and don't intend to be caught in the sticky threads of yet another legal spider's web.

 

[BetteDavisEyes]

I wonder what "getting their passports ready" means. Are they making emergency applications for passports or just digging them out?

I'm sorry if this sounds harsh, but I really hope every country they approach sends them away with a flea in their ear over the idea that a certified dead person could be transferred abroad for medical treatment. This family, like Jahi McMaths, seriously need bringing to their senses.

An international legal nightmare looms.

 

[MzOpinion8d]

From the SacBee link:


They think that by Monday they'll be able to find a facility in another country to take him, and make international travel arrangements to transport a dead child to another country?

Read more here: http://www.sacbee.com/news/local/health-and-medicine/article78857447.html#storylink=cpy
​

Someone I know was injured in Mexico and had to return home on a medical flight, and it was $39,000 from PV to Iowa, which is only about a 4.5 hour flight.

 

[BetteDavisEyes]

Would the youngster need a passport? If the toddler doesn't currently have the document, what are the chances that a passport would be issued to a brain-dead individual?

 

[scmom]

Would the youngster need a passport? If the toddler doesn't currently have the document, what are the chances that a passport would be issued to a brain-dead individual?

Seems they would need a passport but I don't know how they would get one since it looks like the child must be present for the application.
https://travel.state.gov/content/passports/en/passports/under-16.html


travel.state.gov > Passports & International Travel > Your Passports > Children Under 16

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Children Under 16

Quick Facts
Who Needs One:

Every child regardless of age traveling overseas must have a valid passport.
Valid For:

5 years
Submission Method:

Passport applications for children under age 16, who have or have not had a passport in the past, must be submitted in person at a passport agency or authorized passport application acceptance facility. The child must be present. Both parents or guardians should appear with the child. If both parents/guardians cannot be present, see parental consent for additional document requirements.

 

[K_Z]

I flew airevac for the USAF for many years, and all passengers, including preemie babies being moved to another hospital in another country, need a passport. That can be done administratively when the need arises.

However, Israel does not need a passport. He is not legally a living person. He has a death certificate that is incomplete for only disposition of the body. As such, an international move of Israel would fall under the laws governing movement of a deceased corpse, and the documents needed to cross borders for that purpose. A local medical examiner/ coroner can assist in obtaining the necessary documents if they want to move Israel internationally. Technically, remains are considered as "shipping cargo".

If they can find an airevac company that will continue the ventilator and do an international move, I think that could *maybe* be arranged with the accepting country. Typically, international movement of bodies requires embalming and being casketed. (Rules to limit spread of communicable diseases, sanitary conditions, etc.) They would have to apply for some kind of variance to move Israel on a vent with IV's, etc. Jonee and Nate and their daughter, if they accompany Israel, would have to have passports. Emergency passports can be obtained, but are VERY expensive, and still take a few days. Doubtful their one year old has a passport, and I suspect Jonee and Nate do not already have them, either. Their lifestyle as reported in the news doesn't indicate that they have had international travel in the past few years. Jonee is only 23, so if she has an adult passport, she would have had to get it in the past 5 years. (PP are good for 10 years as adults; 5 years for kids under 18.)

When I flew AE in the Pacific, we occasionally moved a beneficiary who was in the final stages of dying. Many times the family wanted the beneficiary moved back in the U.S. as a living person because it was infinitely cheaper and easier than "shipping" a body back. For somewhat the same set of reasons (laws involving bodies shipped across borders), no one is ever actually "pronounced" dead inflight if they were alive when the plane took off. They may die, but if past the Z point, the plane continues to destination and they are pronounced dead in the new country. Interestingly, a person CAN be legally born inflight. The birth certificate lists longitude and latitude, and the "souls on board" count is adjusted to add one. If a person dies enroute, the souls on board count stays the same-- the deceased person is not subtracted. Just some medical air evac trivia!

Here's some civilian transport examples (the military uses different rules than civilian aircraft moves):

http://www.us-funerals.com/funeral-articles/when-death-occurs-away-from-home.html#.V0HQkpErIfI

https://www.aacargo.com/learn/humanremains.html

http://www.funeralplan.com/askexperts/country.html

The first requirement comes from the airlines, and that would be the requirement for the remains to be embalmed. I do not know of any airline that will ship an unembalmed body. Also, the airlines require that the body be shipped in an approved container or "air-tray." Additionally, each foreign country has different rules and regulations regarding the shipping of human remains. Some of the more common requirements would be for the following documents to accompany the body: death certificate, embalming report, passport, burial permit, and a letter from the physician stating that the deceased did not die from a communicable disease.

Some countries require that the remains be shipped in a sealed casket along with the air-tray. A company that specializes in foreign shipments that could give you all the specifics is Bergen Funeral Service.

http://www.cgihouston.org/page/display/68/20

http://www.citizensinformation.ie/e..._body_to_ireland_for_burial_or_cremation.html

 

[K_Z]

Someone I know was injured in Mexico and had to return home on a medical flight, and it was $39,000 from PV to Iowa, which is only about a 4.5 hour flight.

That's about right. General rule of thumb for domestic medical evacuation flights is $10,000/ hour of flight. International is considerably higher.

 

[K_Z]

An international legal nightmare looms.

As far as the nightmare goes, I actually don't think so. I sincerely doubt that they will be able to put together an international "plan" to move Israel to another country on a vent with a private AE company doing the move. I think the answers to many international movement questions on the part of the receiving country will be a firm "no", because Israel is legally dead in the country of origin.

 

[K_Z]

Here is a link to an "emergency" passport service. An adult passport needed within about 48-72 hours (including shipping both ways) is $468, plus the $170 fee to the State Department. Or about $638 per person (child is same price).

https://www.apviexpress.com/order/step1/#new

http://www.apviexpress.com/emergenc...1-Uid0tZwXCHQGb9n30Do7ngma4RLUEG4BhoCSFjw_wcB

*Expedited* service via the State Department (without using a service) usually takes weeks, even at a walk in center. The only real way to get a new passport for an emergency trip, within a few days, is to use a service that will walk the paperwork thru, babysit the process, and use high priced overnight delivery services.

Here's another:

https://www.passportsandvisas.com/p...d-uZ0PuQ-jJ1wJIwffvCOFHxj2jrIm1dz0xoCabbw_wcB

Jonee and Nate have raised $19,411 on an online fundraising site. That's not much money to fund any kind of domestic or international move, unless they can get airevac transportation deeply discounted, or donated free, or covered by some of the "life" nonprofits. What they are proposing to do with Israel (move him somewhere and then maintain in long term care) is breathtakingly expensive, in the short term, as well as funding long term care.

Home care/ hospice would be the most affordable, realistic, and the most expedited way to get him out of the Kaiser hospital. But then they would lose the leverage that his current hospitalization provides to help move him to another facility.

After the Jahi McMath case, I think what we're seeing is an increasing reluctance for facilities in NJ to accept brain dead transfers from out of state. I will be interested to see if NJ moves to change their state laws for the "brain death" exception to apply only to people IN the state when they become brain dead. I have a hunch things will be moving in that direction politically, to prevent NJ from becoming a "brain death" destination for long term care that is funded by the citizens of NJ. Jahi McMath's home care is currently being funded by NJ taxpayers via medicaid, according to news articles.

 

[K_Z]

From Professor Pope's website:

In the Aden Hailu case in Nevada, the hospital kept a dead body in its ICU for seven months. Seven months! This was the result of numerous stays from the trial and supreme court pending the outcome of litigation.

In contrast, in the ongoing the Israel Stinson case, the 9th Circuit has not granted a stay pending the outcome of the appeal there. Instead, the court stayed the dissolution of the district court TRO for less than a week. It has asked for more briefing on the emergency motion.

http://medicalfutility.blogspot.com/2016/05/ninth-circuit-cautious-about-brain.html

http://thaddeuspope.com/images/Document.pdf

Basically, plaintiffs have until 5 pm tomorrow to file supplements to the court for their motion for emergency stay. I think plaintiff attorneys will keep trying, so we'll see new filings in 24 hours or so.

 

[K_Z]

And yet another similar case-- Mirranda Grace Lawson, in VA. 2 year old choked on popcorn, and arrested. Parents fighting to prevent brain death tests from being conducted. So incredibly sad-- so many cases lately. We could have a whole WS forum of brain death cases.

http://www.nx2.com/a/mp/this-toddle...ter-choking-on-something-everybody-eats-58468

http://wtvr.com/2016/05/21/lawson-family-fights-to-keep-mirranda-grace-on-life-support-at-vcu/

 

[MelmothTheLost]

And yet another similar case-- Mirranda Grace Lawson, in VA. 2 year old choked on popcorn, and arrested. Parents fighting to prevent brain death tests from being conducted.

Frankly this is insane. Parents should not be permitted to interfere with necessary testing to determine whether a patient is dead or not.

 

[MelmothTheLost]

As far as the nightmare goes, I actually don't think so. I sincerely doubt that they will be able to put together an international "plan" to move Israel to another country on a vent with a private AE company doing the move. I think the answers to many international movement questions on the part of the receiving country will be a firm "no", because Israel is legally dead in the country of origin.

I suppose it's possible that a country which does not recognise brain death might accept him on the basis that, from their point of view, he can't be dead while his heart and lungs appear to be working, albeit only with external support. I understand that neither Judaism nor Islam recognise brain death, so in theory Israel or a strongly Muslim country might be willing to accept him.

This case which came before the British courts last year:

http://thaddeuspope.com/images/NHS_v_W_W_2015_FAM.pdf

might be partly relevant.

The Saudi parents of a dying child sought to prevent a hospital from switching off the external support machines. The father wanted to take the child back to Saudi Arabia where as long as the heart and lungs were being supported the child could not be taken off support.

Sensibly, the British court was having none of it.

 

[SophieRose]

I suppose it's possible that a country which does not recognise brain death might accept him on the basis that, from their point of view, he can't be dead while his heart and lungs appear to be working, albeit only with external support. I understand that neither Judaism nor Islam recognise brain death, so in theory Israel or a strongly Muslim country might be willing to accept him.

This case which came before the British courts last year:

http://thaddeuspope.com/images/NHS_v_W_W_2015_FAM.pdf

might be partly relevant.

The Saudi parents of a dying child sought to prevent a hospital from switching off the external support machines. The father wanted to take the child back to Saudi Arabia where as long as the heart and lungs were being supported the child could not be taken off support.

Sensibly, the British court was having none of it.

Maybe Germany. Headline: Thousands of brain dead American refugees seeking asylum in Germany.

 

[perfectingpink]

If you search "Israel Stinson" on Facebook, there is an update as to what the family has said has already happened. (I am sorry I cannot link to the page but it comes up as the first post.)

 

[SophieRose]

If you search "Israel Stinson" on Facebook, there is an update as to what the family has said has already happened. (I am sorry I cannot link to the page but it comes up as the first post.)

Do they say if they have found a place to go for Israel?