Family wants to keep life support for girl brain dead after tonsil surgery #5

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I was thinking about this: If 6 different physicians told me I had cancer and the evidence is indisputable, I have several choices. I can believe them and seek treatment. I can give up and just watch myself wither away. I can choose not to believe them and seek 100 more opinions.

If I choose to ignore medical advice of all the experts, do I then have a right to sue them because I didn't believe them? Or I was stupid? Or they didn't hold my hand and make me see the light and drive me to the specialists?

Eta: This is my attempt to draw somewhat of a parallel. Hope it made sense.
The difference is you have choices.

My issue is...you decide not to have cancer surgery and the doctor & hospital decide you're going to have a specific treatment anyway.

Or let's say your child only has a 10% chance of a cure with treatment and the remainder of the child's life will be spent suffering through painful treatment in the hospital that may extend life only 6 months-to a year....without treatment your child has a good quality of life for a month then death within two months. Who gets to decide?...
 
Honestly I think she just needed more time to come to grips with what happened. I think the hospital strong armed her and she dug her heels in and gathered support...the hospital IMO made a huge mistake hiring the PR dude too.
I think time and compassion was the key. This child isn't going to last very long.

I appreciate your honest answer. TY!

I have no doubt that she needed more time to come to grips with the awful finality of it all. God bless her.

Nevertheless, after numerous qualified medical experts conducted tests that all arrived at the same conclusion of brain death, I don't see it as the hospital "strong-arming" her. I see it as medical experts attempting to inform her as to the tragic, irreversible reality of the situation.

At some point, one must recognize that the digging in of the heels is not going to alter reality, no matter how much one wishes or hopes or prays for an alternate reality.
 
Loved ones SHOULD have rights.

As patients who enter hospitals for elective surgery, we have the responsibility to tell our medical caregivers who can make decisions about our care should we be unable to. We have the responsibility to make those wishes known in writing. The medical caregivers have the burden of informing us about the potential complications and listing alternative courses of treatment. If we still decide to pursue surgery, we acknowledge in writing that we have so been informed and have consented to proceed despite very real risks. If the patient is our child, we absorb those responsibilities on his or her behalf.

If death occurs there aren't any more medical decisions to be made. Only funeral arrangements.
 
Honestly I think she just needed more time to come to grips with what happened. I think the hospital strong armed her and she dug her heels in and gathered support...the hospital IMO made a huge mistake hiring the PR dude too.
I think time and compassion was the key. This child isn't going to last very long.

I definitely agree with compassion and understanding. I think hers is a grief reaction. But I don't know that more time would help, and I can't say for sure what the hospital did/did not do. There's a reasonable accommodation time for families to come to grips, but if the family can't afford to pay the bills for weeks and weeks of time to accept the reality (and honestly, do we want to ask them to pay for that?) and the hospital is losing hundreds of thousands waiting for reality to sink in, I'm not sure we can just wait for time to heal. And in this situation, NW has said she won't ever believe it until Jahi's heart stops.

For a personal story, when my grandfather died we had to make a choice to stop extraordinary measures. Just before he seriously deteriorated, he told my father he was ready to die and was tired of suffering. When my family made the choice, my grandmother was incredibly upset. We talked long and hard to her about it and how this wasn't what he wanted, he had told us in his own words, etc. She let my father make the decision, and to this day she maintains he wasn't ready to die. But he was. He really truly was. But she was his wife and she couldn't accept that. We ultimately decided we had to do what he would have wanted, but five years later, she hasn't accepted that. I honestly believe if it was up to her, he would still be on life support. We're saddened that she can't accept it but know we did the right thing for him.

This case is even beyond that because she is deceased. But my point was, sometimes the people closest can't make the decision that might be for the best.
 
I had surgery last spring and had a discussion with the surgeon about my options, prognosis etc.(about 90 min.) when I went for my pre-op PET scan, scope etc. I was asked for my living will if I had one and who could make decisions for me if I was incapacitated. I had a LW with a DNR, no hydration and no feeding tube and my attorney was designated and not a family member. If I hadn't already had one they provided the forms for you to fill out and bring back when admitted.
Now even if I hadn't asked questions of my surgeon or paid attention to consent forms the living will conversation would have been a wake up call to me . MOO
 
I was thinking about this: If 6 different physicians told me I had cancer and the evidence is indisputable, I have several choices. I can believe them and seek treatment. I can give up and just watch myself wither away. I can choose not to believe them and seek 100 more opinions.

If I choose to ignore medical advice of all the experts, do I then have a right to sue them because I didn't believe them? Or I was stupid? Or they didn't hold my hand and make me see the light and drive me to the specialists?

Eta: This is my attempt to draw somewhat of a parallel. Hope it made sense.

I totally understand this, if your religious/ ethical beliefs contradict w/ what doctors at a hospital are telling you, I think you have the right to decline or refuse treatment, but if you have accepted treatment, you don't call the shots (that's not the same as saying you have no control).
 
IMO I don't believe many people would want to keep their brain dead loved ones around....and if a select few did...most brain dead people wouldn't last very long anyway...it really is a non issue in reality, IMO

I linked a Japanese study and there were some brain dead that did last quite a while. We do have modern technology that can keep a heart and other organs functioning. Each "body" would be different and what treatments are given would be a factor in how long it could be artificially maintained.

If there are ways to pay for this treatment, there will be those running to get a piece of the pie, just like in any other business. Ethical or not.
 
The difference is you have choices.

My issue is...you decide not to have cancer surgery and the doctor & hospital decide you're going to have a specific treatment anyway.

Or let's say your child only has a 10% chance of a cure with treatment and the remainder of the child's life will be spent suffering through painful treatment in the hospital that may extend life only 6 months-to a year....without treatment your child has a good quality of life for a month then death within two months. Who gets to decide?...

I totally get that you think the parent should decide. So when is it enough?

Did you read the report of what is happening to her right now? She is and has been decomposing ....
 
bleeding is a complication of surgery (which she had and immediately I might add) and it of course would be in the informed consent

brain death is not a complication of surgery.. it is an outcome of excessive bleeding.

I also further add that in my 27 odd years of doing icu/cvicu nursing I have never seen the likes of this case.

Once we had a ptca patient (angioplasty) pull out his catheter even though his leg was fully restrained and he was on the monitor and it took him a total of 1 min to code and 2 minutes to bleed out (ptca patients on large heparin boluses and drips are always in the unit at least 24 hours post procedure)<---- measure a minute. we were there in seconds and did our best

as for elective surgery.. this was not emergent unless I am missing something so it was most likely elective. <meaning what the attorney is terming routine

as for her weight um.. that is not an issue really and truly. I worked in one icu where we did gastric bypass surgeries and I won't get into it but trust me when I say that everything is calculated on body weight ESPECIALLY in pediatrics.
 
The difference is you have choices.

My issue is...you decide not to have cancer surgery and the doctor & hospital decide you're going to have a specific treatment anyway.

Or let's say your child only has a 10% chance of a cure with treatment and the remainder of the child's life will be spent suffering through painful treatment in the hospital that may extend life only 6 months-to a year....without treatment your child has a good quality of life for a month then death within two months. Who gets to decide?...

You decide!

It's your right to decide . . . based on the choices the care providers give you (until PPACA death panels)
 
The difference is you have choices.

My issue is...you decide not to have cancer surgery and the doctor & hospital decide you're going to have a specific treatment anyway.

Or let's say your child only has a 10% chance of a cure with treatment and the remainder of the child's life will be spent suffering through painful treatment in the hospital that may extend life only 6 months-to a year....without treatment your child has a good quality of life for a month then death within two months. Who gets to decide?...

The facts of the matter in this case: Jahi was declared brain dead by a team of medical experts. Brain death is irreversible, ergo, brain death equals death, based on medicolegal findings.

IMO, comparing brain death to cancer treatments (or any other medical treatment on living patients, for that matter) is akin to comparing apples to oranges.

Brain death is death. There is NO treatment for it.
 
The difference is you have choices.

My issue is...you decide not to have cancer surgery and the doctor & hospital decide you're going to have a specific treatment anyway.

Or let's say your child only has a 10% chance of a cure with treatment and the remainder of the child's life will be spent suffering through painful treatment in the hospital that may extend life only 6 months-to a year....without treatment your child has a good quality of life for a month then death within two months. Who gets to decide?...

I had a relative who's son had terminal cancer where the hospital told them they had reached the end of treatment options. I know it's completely different than the Jahi situation but on some level it feels the same. They had to go out of state for another hospital willing to do the radiation treatment they wanted done and he didn't survive long afterward. In the end it was their choice but the doctors also had the right to say they there was nothing else they could do.

It seems to me the issue with Jahi's care after brain death is how to discharge a legally dead patient. By law, hospitals have a legal responsibility make sure a patient is cared for after discharge. That's how they get stuck with indigent patients when no long term facility can be found. The laws against hospitals dumping patients is probably the same that kept Jahi's mother from just going in and taking her out before the federal mediation.
 
I had a relative who's son had terminal cancer where the hospital told them they had reached the end of treatment options. I know it's completely different than the Jahi situation but on some level it feels the same. They had to go out of state for another hospital willing to do the radiation treatment they wanted done and he didn't survive long afterward. In the end it was their choice but the doctors also had the right to say they there was nothing else they could do.

It seems to me the issue with Jahi's care after brain death is how to discharge a legally dead patient. By law, hospitals have a legal responsibility make sure a patient is cared for after discharge. That's how they get stuck with indigent patients when no long term facility can be found. The laws against hospitals dumping patients is probably the same that kept Jahi's mother from just going in and taking her out before the federal mediation.

:Welcome1: Glad you decided to join us...:seeya:
 
from post 1078 ref'onmg to fruity's wqad link
SBM

Med folks - help, please?

Does four units of blood necessarily equal four transfusions?

Is it possible to give a patient 4 ____ (liters? pints?) of blood in a single transfusion? YES. They would transfuse blood until they had established a normal blood pressure and pulse and the bleed was under control
Or 2 __ in 2 transfusions?
Or 2__ in one transfusion and 1 ___ in another transfusion?
Is it likelly there were 4 separate transfusions, as Uncle O said? I believe the Uncle is confusing units of blood with individual transfusions. If she had required 4 separate transfusions post-op, it was in response to 4 different episodes of severe bleeding the staff didn't respond to adequately.

Does his stmt re pumping blood from lungs, stomach make sense? Yes she was bleeding out and had swallowed and aspirated (breathed in) blood

My first point:
Is possible/likely Uncle O accurately describing what happened? No. To a medical person it wouldn't be considered accurate but he gives a good laymans description of what he was told happened.

My second point:
AFAIK Uncle O was not even present in PICU room to witness this himself, so at best, it is hearsay.

JM2cts and I may be wrong. :seeya:

Respectfully answered in red :seeya:
 
Brain and cardiac death are considered equal in terms of defining death. They are both irreversible. So, no there would be no consent form to sign. Your original post was concerning removal of life support and physicians having that option over the parents.

There is no life support in Jahi case, because there is no life. Jahi's heart failed and her brain died. They were able to restart her heart beating and attach a vent to keep oxygen flowing and blood circulating. So there is a vent attached to a deceased body. It is not "life" support.
Rbbm. I saw a suggestion recently that it shouldn't be called "life support" in the case of deceased (brain dead) people. PVS and coma, sure. But for dead people it needs another term. A few were suggested: mechanical ventilation, mechanical support, mechanical breathing etc.

I would support this.
 
Oh the things I run across when I am trying to find information :floorlaugh:

http://www.alcor.org/Library/html/legalstatus.html

The link above in on cryonics and discusses some issues when a person is deceased and their remains are "cared" for in nontraditional manners.

It sites some statutes and I thought it was interesting to see the way attorneys can attempt to maneuver around the system.

Dolan has mentioned different facilities in different states throughout this time period and I do wonder if it's not more about wanting to transport Jahi to these states because of their statutes, than actually having facilities there that may be willing to take and care for her body.
 
Goodnight all. May Jahi finally rest in peace.

:seeya:
 
I definitely agree with compassion and understanding. I think hers is a grief reaction. But I don't know that more time would help, and I can't say for sure what the hospital did/did not do. There's a reasonable accommodation time for families to come to grips, but if the family can't afford to pay the bills for weeks and weeks of time to accept the reality (and honestly, do we want to ask them to pay for that?) and the hospital is losing hundreds of thousands waiting for reality to sink in, I'm not sure we can just wait for time to heal. And in this situation, NW has said she won't ever believe it until Jahi's heart stops.



For a personal story, when my grandfather died we had to make a choice to stop extraordinary measures. Just before he seriously deteriorated, he told my father he was ready to die and was tired of suffering. When my family made the choice, my grandmother was incredibly upset. We talked long and hard to her about it and how this wasn't what he wanted, he had told us in his own words, etc. She let my father make the decision, and to this day she maintains he wasn't ready to die. But he was. He really truly was. But she was his wife and she couldn't accept that. We ultimately decided we had to do what he would have wanted, but five years later, she hasn't accepted that. I honestly believe if it was up to her, he would still be on life support. We're saddened that she can't accept it but know we did the right thing for him.



This case is even beyond that because she is deceased. But my point was, sometimes the people closest can't make the decision that might be for the best.


It's not just a grief reaction IMO. There are a whole host of other issues IMO.

These are the very same doctors she handed her living breathing daughter to. They said she would be better after this surgery.

She no longer trusts them.
<modsnip>

I'm not saying that's the case here...

I understand her reluctance to trust.

I think just about everyone on this thread, myself included would let our brain dead loved one go.
However, I would be a fool not to have an independent neurologist of my choosing to confirm the hospitals findings.

Anyone that thinks doctors are perfect, never make mistakes, can't be criminals, don't lie, incapable of committing crimes for profit, not looking after their own best interests is very naive. All IMO.

Again...I'm not saying that's the case here. But it does happen. All too often.





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