Family wants to keep life support for girl brain dead after tonsil surgery #3

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In 2008, the New England Journal of Medicine printed an article that frankly argued that “brain death” is a sham. The article, co-authored by Dr. Robert D. Truog, a professor of medical ethics and anesthesia (pediatrics) in the Departments of Anesthesia and Social Medicine at Harvard Medical School, said the scientific literature does not support the criteria for ‘brain death’ and ‘cardiac death’ as being real death. “Although it may be ethical to remove vital organs from these patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead,” the article said.

So open has the “brain death” secret become in medical circles that some are urging that such criteria simply be dropped. Dr. Neil Lazar, director of the medical-surgical intensive care unit at Toronto General Hospital, Dr. Maxwell J. Smith of the University of Toronto, and David Rodriguez-Arias of Universidad del Pais Vasco in Spain, admitted at a major conference that the pretense should be ended and that organs should be allowed to be removed from “dying” or “severely injured” patients. This more “honest” approach, they said, would avoid the problems created by purely ideological definitions of death that are known to be mere pretexts to expand the organ donor pool.

http://www.lifesitenews.com/mobile/news/one-in-five-brain-dead-patients-still-alive-claims-lawsuit


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For New York State, updated in 2011

http://www.health.ny.gov/profession...rator/letters/2011/brain_death_guidelines.htm


Definition

New York State regulation defines brain death as the irreversible loss of all function of the brain, including the brain stem. See 10 N.Y.C.R.R. § 400.16. The three essential findings in brain death are coma, absence of brain stem reflexes, and apnea. An evaluation for brain death should be considered in patients who have suffered a massive, irreversible brain injury of identifiable cause. A patient properly determined to be brain dead is legally and clinically dead.

The diagnosis of brain death is primarily clinical. No other tests are required if the full clinical examination, including an assessment of brain stem reflexes and an apnea test, is conclusively performed. In the absence of either complete clinical findings consistent with brain death or ancillary tests demonstrating brain death, brain death cannot be diagnosed.
 
Can I request the link again for the judge's original ruling that ordered an independent physician to examine Jahi? I'm looking for the actual ruling itself, not news stories mentioning it.

TIA
 
Seems to me there is no consensus as to when life begins or ends....

That being the case, I would hope those that love you get a say;)


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Linda7NJ said:
In 2008, the New England Journal of Medicine printed an article that frankly argued that “brain death” is a sham. The article, co-authored by Dr. Robert D. Truog, a professor of medical ethics and anesthesia (pediatrics) in the Departments of Anesthesia and Social Medicine at Harvard Medical School, said the scientific literature does not support the criteria for ‘brain death’ and ‘cardiac death’ as being real death. “Although it may be ethical to remove vital organs from these patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead,” the article said.

So open has the “brain death” secret become in medical circles that some are urging that such criteria simply be dropped. Dr. Neil Lazar, director of the medical-surgical intensive care unit at Toronto General Hospital, Dr. Maxwell J. Smith of the University of Toronto, and David Rodriguez-Arias of Universidad del Pais Vasco in Spain, admitted at a major conference that the pretense should be ended and that organs should be allowed to be removed from “dying” or “severely injured” patients. This more “honest” approach, they said, would avoid the problems created by purely ideological definitions of death that are known to be mere pretexts to expand the organ donor pool.

http://www.lifesitenews.com/mobile/news/one-in-five-brain-dead-patients-still-alive-claims-lawsuit


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Click to expand...

Thanks for that link. Until this case, I wasn't aware that the legal definition of clinical death had changed. Terri Schaivo's family is now weighing in and confirms what I've suspected. It is all about money, not what is best for Jahi (my bold emphasis):

"Together with our team of experts, Terri's Network believes Jahi's case is representative of a very deep problem within the U.S. healthcare system -- particularly those issues surrounding the deaths of patients within the confines of hospital corporations, which have a vested financial interest in discontinuing life," the Terri Schiavo Life & Hope Network said in a prepared statement.

The organization said it has been overseeing the efforts of several groups to help get Jahi transferred out of Children's Hospital Oakland and brought "to a safe place."

http://www.cnn.com/2014/01/01/health/jahi-mcmath-girl-brain-dead/
 
Linda7NJ said:
In 2008, the New England Journal of Medicine printed an article that frankly argued that “brain death” is a sham. The article, co-authored by Dr. Robert D. Truog, a professor of medical ethics and anesthesia (pediatrics) in the Departments of Anesthesia and Social Medicine at Harvard Medical School, said the scientific literature does not support the criteria for ‘brain death’ and ‘cardiac death’ as being real death. “Although it may be ethical to remove vital organs from these patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead,” the article said.

So open has the “brain death” secret become in medical circles that some are urging that such criteria simply be dropped. Dr. Neil Lazar, director of the medical-surgical intensive care unit at Toronto General Hospital, Dr. Maxwell J. Smith of the University of Toronto, and David Rodriguez-Arias of Universidad del Pais Vasco in Spain, admitted at a major conference that the pretense should be ended and that organs should be allowed to be removed from “dying” or “severely injured” patients. This more “honest” approach, they said, would avoid the problems created by purely ideological definitions of death that are known to be mere pretexts to expand the organ donor pool.

http://www.lifesitenews.com/mobile/news/one-in-five-brain-dead-patients-still-alive-claims-lawsuit


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Click to expand...


Here's the article in case anyone is interested:

http://www.nejm.org/doi/full/10.1056/NEJMp0804474
 
MyBelle said:
<modsnip> I also don't know where you get the idea that the New York facility expects to reimbursed for Jahi's care or that they intended to create a 24/7 facility. They didn't say that in their letter and the news media haven't reported that fact.
Click to expand...

This is what the facility director stated:

""willing to open our outpatient facility to provide 24-hour care as an inpatient long-term facility for Jahi with the required and appropriate medical staff that she depends upon."

To provide 24 hour care in a "facility" it must be licensed to provide 24 hour care, under whatever options the state of New York allows. Licensed means it must meet CMS criteria, and those of the state of New York. That could be anything from an acute care hospital, a long term acute care facility, a rehab hospital, a nursing home, or some other classification according to New York laws.

I used the term "for reimbursement" to emphasize that she is not offering a personal home care scenario for a family member, as you had given as an example. She is offering care in a business that currently provides outpatient care, but she wants to change to 24 care for Jahi.

It is a huge difference in licensing. I think this woman has good intent, but has insufficient expertise to understand what is required.
 
Steft50 said:
It was mentioned on the previous thread that there was no legal reason the hospital couldn't do the trach and gastric tube surgery so I thought I would post this again....apparently with the first extension the court ruled that the hospital is not to do these, and that ruling was upheld yesterday.

http://www.mercurynews.com/breaking...cmath-hospital-fights-court-remove-brain-dead

"On Tuesday, Jahi family attorney Christopher Dolan filed a second brief with the appeals court, asking the judge to reverse earlier orders forbidding the hospital from giving Jahi a tracheotomy for breathing and inserting a gastric tube for feeding. However, a judge denied that request a short time later.

Hospital officials have refused to perform any medical procedure on Jahi since she was declared brain dead, saying it is unethical to do so. The hospital also will not allow an outside doctor to perform the procedures at Children's Hospital, according to spokesman Sam Singer."
Click to expand...

My take is that it has become a chicken and egg circular logic. The hospital claims it would be unethical so the Court ordered them not to do it but the Court didn't agree it was unethical, leaving the door open for an outside physician to do it but then the hospital said it would not allow any outside physician to do it.
 
Steft50 said:
For New York State, updated in 2011

http://www.health.ny.gov/profession...rator/letters/2011/brain_death_guidelines.htm


Definition

New York State regulation defines brain death as the irreversible loss of all function of the brain, including the brain stem. See 10 N.Y.C.R.R. § 400.16. The three essential findings in brain death are coma, absence of brain stem reflexes, and apnea. An evaluation for brain death should be considered in patients who have suffered a massive, irreversible brain injury of identifiable cause. A patient properly determined to be brain dead is legally and clinically dead.

The diagnosis of brain death is primarily clinical. No other tests are required if the full clinical examination, including an assessment of brain stem reflexes and an apnea test, is conclusively performed. In the absence of either complete clinical findings consistent with brain death or ancillary tests demonstrating brain death, brain death cannot be diagnosed.
Click to expand...

If she's dead in California, then she's dead in New York, too.
 
Herat said:
This is what the facility director stated:

""willing to open our outpatient facility to provide 24-hour care as an inpatient long-term facility for Jahi with the required and appropriate medical staff that she depends upon."

To provide 24 hour care in a "facility" it must be licensed to provide 24 hour care, under whatever options the state of New York allows. Licensed means it must meet CMS criteria, and those of the state of New York. That could be anything from an acute care hospital, a long term acute care facility, a rehab hospital, a nursing home, or some other classification according to New York laws.

I used the term "for reimbursement" to emphasize that she is not offering a personal home care scenario for a family member, as you had given as an example. She is offering care in a business that currently provides outpatient care, but she wants to change to 24 care for Jahi.

It is a huge difference in licensing. I think this woman has good intent, but has insufficient expertise to understand what is required.
Click to expand...

I don't know that the organization doe not have the expertise to care for a 'corpse' which OCH insists she is. I think the Schiavo Foundation has sufficient expertise to know requirements.

I do not agree that "facility for Jahi" means the organization must obtain any additional licensing it does not already have. Nor should it matter to Children's hospital, which insists Jahi is a corpse.

Just my opinion.
 
Herat said:
If she's dead in California, then she's dead in New York, too.
Click to expand...

That was my take on it too, although I freely admit I didn't read the whole page just the definition.
 
With all this talk about organ harvesting and the implications wrt declarations of brain death, I just feel compelled to say two things:

There has been no mention that I've seen of the Childrens or the parents taking any steps wrt organ donation in this case; and

if the findings of the Childrens' docs weren't independent enough, the Stanford doc has confirmed that she is, indeed, brain dead. With still no mention of organ donation from anyone on either side.

jmo
 
Herat said:
If she's dead in California, then she's dead in New York, too.
Click to expand...

I think New York will require a signed death certificate and I haven't seen one issued by California. What I have seen is that the Cali Dept of Health has opened an investigation into the Hospital. I doubt any death certificate will be issued until after this investigation is complete.

Anita Gore, spokeswoman for the state Department of Public Health, on Tuesday told NBC Bay Area the investigation was launched two weeks ago and could not get into the details of the investigation.

http://www.nbcbayarea.com/news/loca...Investigating-Jahi-McMath-Case-238319021.html
 
MyBelle said:
I don't know that the organization doe not have the expertise to care for a 'corpse' which OCH insists she is. I think the Schiavo Foundation has sufficient expertise to know requirements.

I do not agree that "facility for Jahi" means the organization must obtain any additional licensing it does not already have. Nor should it matter to Children's hospital, which insists Jahi is a corpse.

Just my opinion.
Click to expand...

If the director claims she is running a "24 hour care facility", then she must have a license.

If she is going to take care of Jahi as a corpse in her garage, then maybe not.

It is up to the State of New York to determine what can and cannot happen.

CHO is being very careful to try to abide by whatever rules pertain to this situation.
 
http://www.lifesitenews.com/news/archive/ldn/1990/22/9022504

I must admit I am concerned after reading articles like the one above, suggesting that the apnea test itself can cause brain damage and possibly brain death. (I do realize the article above is from a pro-life site which is probably biased, but it is interesting food for thought nonetheless).

My question is this: Does anyone know in Jahi's case (or in general) if the apnea test is/was performed before or after the EEG and other diagnostic tests? If it were me and my loved one, I am thinking I would definitely want the EEG and possibly ALL other diagnostic tests to be performed before the apnea test. Maybe I am just paranoid! :scared:
 
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