Jahi McMath is Taken off Life Support Discussion

[MyBelle]

I think it is likely to be dropped. New Jersey is the *only* state that allows a religious exemption. 49 other states do not. Not exactly a supreme court case when a single state is out of line with all the others. And actually, NJ isn't really out of line... The state does define brain death as death. It simply has a rarely used religious exemption put in place, IIRC, due to the large Jewish population in the state.
New Jersey best place for brain-dead patients, expert says
"As far as I've been able to tell, no one knows if anyone has ever used it," he said. "You'd probably have to show you belong to a church that doesn't accept brain death or a religious group. But all that said, New Jersey...is the best destination."

The family never allowed a subsequent test for brain death. (They expressly asked the court to forbid the defendants from conducting one.). Had another standard brain death test showed activity, then that is *huge*. An EEG, meh, not so much .
Can brainwaves be detected in lime Jell-O?

The MRI shows horrific damage to the brain. It didn't show activity, just that some parts of the brain structure hadn't liquified. I don't think the family will want to go very far with the MRI... after all, if there is no structure to support auditory function, that undermines all their claims about her responding to vocal commands.

She may have regained some minimal function, IDK. But it's going to take more than a worthless EEG, an MRI that shows massive damage, and statements by doctors who never examined her and have spent the better part of their careers advocating a position that is well outside of the medical mainstream to convince me.

I would have been very interested in the results of another standard test for brain death, conducted by an independent, mainstream, neurologist. (preferably one that isn't retired and hasn't had his medical license revoked). As I said, it would be huge if another standard test for brain death showed activity. Unfortunately, the family chose not to allow it. Without the standard, medically accepted tests showing otherwise, she has remained legally dead.

The family's many statements outside court are certainly relevant in judging the veracity of their statements, both those pertaining to the events leading to her death and their subsequent claims of recovery. Especially considering they haven't allowed the hospital to release any documentation, and the emotional and financial incentive they have to see what they want to see (consciously or subconsciously).

Just like when there is a missing child, and the mother says she was just in the other room, then she says she was napping, then the child was playing outside, etc. When the story changes, that is a red flag that the person telling the story is lying. The truth doesn't change.

I feel for the mother. I've lost a child, a teenager just two years older than Jahi. And I don't blame her for not accepting her death. I would give anything to be able to delude myself that my son was still alive, in any capacity. I envy her delusion. But that doesn't, unfortunately, make it any less a delusion.

My sympaShe isn't delusional and a federal court will agree with her. A civil rights lawsuit was filed years ago. Dolon has already said he will proceed with it pro bono.

The legal "brain death" laws in both California and New Jersey replicate the federal Uniform Determination of Death Act. No brain stem activity is allowed and it must be irreversible. As the Rutgers testing proved, minimal activity in Jahi's brain was detected nine months after she had been declared dead.

I think it is likely to be dropped. New Jersey is the *only* state that allows a religious exemption. 49 other states do not. Not exactly a supreme court case when a single state is out of line with all the others. And actually, NJ isn't really out of line... The state does define brain death as death. It simply has a rarely used religious exemption put in place, IIRC, due to the large Jewish population in the state.
New Jersey best place for brain-dead patients, expert says
"As far as I've been able to tell, no one knows if anyone has ever used it," he said. "You'd probably have to show you belong to a church that doesn't accept brain death or a religious group. But all that said, New Jersey...is the best destination."

The family never allowed a subsequent test for brain death. (They expressly asked the court to forbid the defendants from conducting one.). Had another standard brain death test showed activity, then that is *huge*. An EEG, meh, not so much .
Can brainwaves be detected in lime Jell-O?

The MRI shows horrific damage to the brain. It didn't show activity, just that some parts of the brain structure hadn't liquified. I don't think the family will want to go very far with the MRI... after all, if there is no structure to support auditory function, that undermines all their claims about her responding to vocal commands.

She may have regained some minimal function, IDK. But it's going to take more than a worthless EEG, an MRI that shows massive damage, and statements by doctors who never examined her and have spent the better part of their careers advocating a position that is well outside of the medical mainstream to convince me.

I would have been very interested in the results of another standard test for brain death, conducted by an independent, mainstream, neurologist. (preferably one that isn't retired and hasn't had his medical license revoked). As I said, it would be huge if another standard test for brain death showed activity. Unfortunately, the family chose not to allow it. Without the standard, medically accepted tests showing otherwise, she has remained legally dead.

The family's many statements outside court are certainly relevant in judging the veracity of their statements, both those pertaining to the events leading to her death and their subsequent claims of recovery. Especially considering they haven't allowed the hospital to release any documentation, and the emotional and financial incentive they have to see what they want to see (consciously or subconsciously).

Just like when there is a missing child, and the mother says she was just in the other room, then she says she was napping, then the child was playing outside, etc. When the story changes, that is a red flag that the person telling the story is lying. The truth doesn't change.

I feel for the mother. I've lost a child, a teenager just two years older than Jahi. And I don't blame her for not accepting her death. I would give anything to be able to delude myself that my son was still alive, in any capacity. I envy her delusion. But that doesn't, unfortunately, make it any less a delusion.

You have my deepest sympathy on the loss of a child. I replied but my reply has been erased. I have no doubt the federal law will prevail and there is no delusion.

 

[MyBelle]

You have my deepest sympathy on the loss of a child. I replied but my reply has been erased. I have no doubt the federal law will prevail and there is no delusion.[/QUOTE]

 

[MyBelle]

My deepest sympathy.

 

[Kindred]

If you have not ever read the court documents on this I do recommend giving them a read. The way the family continuously contradicts themselves would be hysterical if not given the disturbing fact that they kept this poor girls body on a ventilator for 4 1/2 years and paraded her out whenever they needed more money until finally, her organs shut down.

They claim she was alive this whole time and insist the first death certificate is wrong yet they filed a "wrongful death" claim in court in March of 2015. Also, they claim she has been healthy and improving in these past 4 1/2 years. If that's true how can the California hospital be held responsible for her death now if she was recovering and under the care/treatment of others across the country from them now?

They claimed in June 2017 filings that she did menstruate and has started puberty but the only evidence they claim to this is a home health caretakers notes from 2014 claiming they found blood spotting in her sanitary brief (which could also be caused by UTI by the way), but have refused to provide any more recent records or take statements from any medical staffers who were currently caring for her

They claimed that she was responsive, breathed on her own "over" the ventilator, and no longer fit the criteria for brain death, but refused to allow anyone to evaluate her saying that 1)she was only occasionally responsive in no predictable cycle so there was no way to ensure that she would be responsive at the time if an independent party tried to evaluate her. That if she was evaluated and didn't respond for them it still didn't prove that she wasn't as they claimed. And 2) that the apnea test, the part of the brain death determination to see if the patient could take breaths independently from the ventilator would kill her

They claim that their religious beliefs state that death occurs when the heart stops beating. They admit in the court documents that Jahi's heart stopped and it took over 2 hours before she was able to be resuscitated, but that time didn't apparently count? Also her mother refused to sign a DNR in NJ, insisting that if her heart did stop on the ventilator, that everything be done to get it going again despite her already questionable condition.

That last one has always been my biggest rub. It is definitely one thing to say that if during a medical procedure things go wrong to do all you can, but at some point you have to say enough. 2 hours. TWO HOURS she was considered a full code but they try to claim that that wasn't enough time for brain death to occur? I'm still trying to determine what religion they are exactly because according to my Catholic upbringing, she should have been let go after 30 minutes as it was clear what God's will was by that point.

Bless you, Jahi. I hope you can finally have some dignity and peace

 

[nrdsb4]

I think it is likely to be dropped. New Jersey is the *only* state that allows a religious exemption. 49 other states do not. Not exactly a supreme court case when a single state is out of line with all the others. And actually, NJ isn't really out of line... The state does define brain death as death. It simply has a rarely used religious exemption put in place, IIRC, due to the large Jewish population in the state.
New Jersey best place for brain-dead patients, expert says
"As far as I've been able to tell, no one knows if anyone has ever used it," he said. "You'd probably have to show you belong to a church that doesn't accept brain death or a religious group. But all that said, New Jersey...is the best destination."

The family never allowed a subsequent test for brain death. (They expressly asked the court to forbid the defendants from conducting one.). Had another standard brain death test showed activity, then that is *huge*. An EEG, meh, not so much .
Can brainwaves be detected in lime Jell-O?

The MRI shows horrific damage to the brain. It didn't show activity, just that some parts of the brain structure hadn't liquified. I don't think the family will want to go very far with the MRI... after all, if there is no structure to support auditory function, that undermines all their claims about her responding to vocal commands.

She may have regained some minimal function, IDK. But it's going to take more than a worthless EEG, an MRI that shows massive damage, and statements by doctors who never examined her and have spent the better part of their careers advocating a position that is well outside of the medical mainstream to convince me.

I would have been very interested in the results of another standard test for brain death, conducted by an independent, mainstream, neurologist. (preferably one that isn't retired and hasn't had his medical license revoked). As I said, it would be huge if another standard test for brain death showed activity. Unfortunately, the family chose not to allow it. Without the standard, medically accepted tests showing otherwise, she has remained legally dead.

The family's many statements outside court are certainly relevant in judging the veracity of their statements, both those pertaining to the events leading to her death and their subsequent claims of recovery. Especially considering they haven't allowed the hospital to release any documentation, and the emotional and financial incentive they have to see what they want to see (consciously or subconsciously).

Just like when there is a missing child, and the mother says she was just in the other room, then she says she was napping, then the child was playing outside, etc. When the story changes, that is a red flag that the person telling the story is lying. The truth doesn't change.

I feel for the mother. I've lost a child, a teenager just two years older than Jahi. And I don't blame her for not accepting her death. I would give anything to be able to delude myself that my son was still alive, in any capacity. I envy her delusion. But that doesn't, unfortunately, make it any less a delusion.

Whew, I've been out of the loop for awhile. Left for a vacation in Europe, came home to some personal business, and just had a medical procedure that required some preparation and recovery. No need for me to even read back to earlier comments or respond to them as you have very concisely and accurately stated the situation as it now stands. And done it far better than I could have, especially as I still have some residual anesthesia onboard, lol.

I'm so sorry for your loss. I cannot imagine anything worse in the human experience than losing a child. In spite of all stuff the family in this case has pulled, I do nevertheless believe that the mother in this sad case has experienced the worst that life has to offer. It's a club that she never wanted to be a member of, that is for sure.

 

[MelmothTheLost]

There have been so many claims, amended claims and counterclaims in this case that I suspect I've lost track of what was at the start of this case. From memory, Jahi's apnoea was said to be the result of her obesity, with throat obstruction being caused by fat accumulated in her throat. However, I'm not clear now if the more extensive surgery she had was entirely down to that obesity or whether there were other factors requiring so much tissue removal. I must read back through the available materials.

That said, if all of her problems were ultimately down to obesity, they might have been better off putting her through some form of bariatric surgery to help her deal with her weight problem than carrying out the surgery they did. Maybe she and her parents were offered bariatric surgery and refused it. Who knows?

 

[watcher9]

Here's a new one.

'The parents of a 9-year-old who failed a brain activity test at a Texas hospital believe the little girl can still recover, so they are fighting hospital policy in order to keep her on a ventilator.'

Parents fight TX hospital to keep 9-year-old daughter on life support

ETA -Found another link with more info.

Family fights to keep 9-year-old girl on life support at Cook Children’s in Fort Worth

 

[jjenny]

Bariatric surgery for children? I find the idea controversial. And it's still a surgery with all associated risks.
On the other hand proper diet and exercise don't carry risks associated with surgery.

 

[K_Z]

Here's a new one.

'The parents of a 9-year-old who failed a brain activity test at a Texas hospital believe the little girl can still recover, so they are fighting hospital policy in order to keep her on a ventilator.'

Parents fight TX hospital to keep 9-year-old daughter on life support

ETA -Found another link with more info.

Family fights to keep 9-year-old girl on life support at Cook Children’s in Fort Worth

I've been following this case, Watcher9. Another extremely sad, wrenching case. Payton Summons has a very serious thoracic (chest) cancer that caused her cardiac arrest and oxygen deprivation-- probably a type of lymphoma that was not responding to therapy.

Unfortunately, there have been dozens upon dozens of these sad cases of children properly diagnosed as brain dead, using neurologic criteria, whose parents are in denial about what is medically occurring.

IMO, the media has done a grave disservice by focusing on the parent's denial and lawsuits, and conflating brain damage with brain death. Or, tossing in cases of improperly diagnosed (or improperly reported by parents and media) kids who "came back to life" or "recovered".

We could have an entire forum dedicated to court battles from loved ones who fight in the courts to deny the brain death criteria/ diagnosis, and removal from "life" support (ventilators and other organ support). I think we would all be better served if the media would focus more on education-- documentaries, articles, etc, on what brain death "is" and "is not". These cases continue to mislead the general public, and stoke mistrust of health care professionals.

Thaddeus Pope, law professor at Mitchell Hamline School of Law in Minnesota, has seen a rise in what he calls brain-death “conflicts.” After Jahi’s case, two families rejected a brain-death diagnosis at San Francisco General Hospital, citing her case, he said.

“There is what you could call the Jahi McMath shadow effect,” Pope said. “It’s casting a shadow; it has had some impact. I don’t know how to quantify it, but based on my discussion with physicians at a number of hospitals, it does seem there’s an uptick.”

“I worry that the more these cases begin to appear, the more pressure will come from other parents who say I don’t accept brain death, either,” said Arthur Caplan, the founding director of the Division of Medical Ethics at New York University School of Medicine. “It becomes important for the medical field to be responsive to these cases. Not heartless or cruel but nonetheless try to explain what the concept is, how it’s tested.”

More families now challenging doctors’ brain-death diagnoses

A brief, partial listing of just a few cases in the news in the past couple years-- other than Jahi McMath-- (and I can remember several others that I can't find their names):

Israel Stinson
Mirranda Lawson
Azayla Anderson
Charlie Gard
Alex Pierce
Areen Chakrabarti
Ashya King
Alfie Evans
Isaac Lopez
Taquisha McKitty
Simon Crosier
Jayden Auyeung
Motl Brody
Rumpa Bannerjee
Teresa Hamilton
Anihita Meshkin

 

[K_Z]

I wanted to add that I think allowing parents and families a period of time after a brain death diagnosis to make decisions is wise and compassionate. These families are in a soul crushing crisis.

But that time (in ICU's and acute care hospitals, once brain death is determined) should not be open ended, or unreasonably extended with court battles. (And who will define what is reasonable and unreasonable?!)

I feel like we are approaching a critical situation with these cases where we will have to have a "national" guideline for how long that period of time will be, as each hospital now has their own policies and procedures.

These are deeply wrenching cases-- there is no greater crisis than the loss of a child. The families are very sympathetic cases, the stories deeply personal, and capture headlines and general public interest. But as in many situations, the media typically only covers one side of the story-- the families report of the situation. Media almost never present the hospital or medical providers in a positive light, or provide legally and medically accurate information. Whatever the families say is what is printed as "truth", and the hospital is gagged because of patient privacy laws.

I think the eventual court decision to allow Jahi's parents to remove her from the hospital with the ETT was correct-- but I disagree with New Jersey providing public funds to maintain her in a home situation.

I'm fine with families taking their brain dead diagnosed loved ones home with a trach or ETT-- as in, the hospital not insisting on discontinuing these when a family has indicated they want to take their loved one away. I'm fine with nursing homes admitting these patients for custodial care if that is what the families want, and if a nursing home is willing to provide staff and funds to do it.

I just think that acute care/ ICU/ hospital time should be definitively limited for how long the hospitals will continue to staff, hold the ICU bed, maintain (and pay for-- very expensive) the brain dead patient. I think the families should locate private resources and funds to transport and maintain their brain dead loved one outside the hospital. (Churches/ faith based organizations, non-profits, supported home care, etc.)

I don't think these brain dead patients should be re-admitted again to acute care hospitals, either.

 

[Doghairrules]

Here's a new one.

'The parents of a 9-year-old who failed a brain activity test at a Texas hospital believe the little girl can still recover, so they are fighting hospital policy in order to keep her on a ventilator.'

Parents fight TX hospital to keep 9-year-old daughter on life support

ETA -Found another link with more info.

Family fights to keep 9-year-old girl on life support at Cook Children’s in Fort Worth

Good lord.

 

[MelmothTheLost]

Bariatric surgery for children? I find the idea controversial. And it's still a surgery with all associated risks.

And yet it's increasingly being used on teens, though not so far (AFAIK) on younger children.

On the other hand proper diet and exercise don't carry risks associated with surgery.[/QUOTE]

Bariatric surgery for teens is very much seen as the last resort, to be used only when everything else has been tried and failed. Unfortunately for teens to have reached the sort of super obesity where surgery is the only option, they have grown up with eating habits which prove impossible to break or improve.

The way things are going, bariatric surgery on preteens may just be a matter of time.

There are now credible reports of children in the US reaching their midteens having gone through Type 2 diabetes, through fatty liver disease to actual cirrhosis due entirely to the sugar in their diets. That's irreversible, end stage, liver damage for which the only treatment is a transplant. The numbers reaching that stage at that age are very small at present, but until a few years ago they didn't exist at all.

Bariatric surgery on pre-teens may in the end be a preferred option to a liver transplant.

 

[MelmothTheLost]

I wanted to add that I think allowing parents and families a period of time after a brain death diagnosis to make decisions is wise and compassionate. These families are in a soul crushing crisis.

Unfortunately our experience in the UK with the Charlie Gard and Alfie Evans cases has been that every time the parents were given time to spend a final few hours or days with their child, they chose to spend that time with lawyers and in court instead. They repeatedly abused the goodwill of GOSH and Alder Hey.

 

[K_Z]

I wouldn't characterize it as "common", but bariatric procedures, including gastric sleeve surgeries, are increasingly being considered and performed on pre-pubescent kids (as the studies below indicate--as young as 5).

The debatable/ controversial issues are about how serious the medically related obesity issues are in the child, versus the risks of the procedure. And, the moral issues of surgery on a child, versus letting a child move into adulthood as morbidly obese. The kids who undergo surgical procedures are not just "a little" overweight. These kids have many very serious health problems, in addition to being massively overweight. Jahi was unquestionably overweight, but to my eye, she was not nearly overweight "enough" to begin to meet criteria for bariatric surgery. Her complex ENT procedure was designed to improve her sleep apnea, and thereby prevent heart and circulatory problems. Sometimes patients lose some weight months after with UPPP procedures like Jahi had, but it's not typically a lot.

Behavior modification for weight loss (diet, exercise, lifestyle), and meds in kids, have only limited and modest success. (See below.)

It's a very, very difficult situation. Extremely difficult to treat.

Obesity: bariatric surgery in youth. - PubMed - NCBI

Bariatric surgery for obese children and adolescents: a review of the moral challenges

Effectiveness of weight management programs in children and adolescents.

Bariatric surgery for pediatric extreme obesity: now or later? - PubMed - NCBI

 

[K_Z]

Regarding the Payton Summons case, it appears the family is trying to bring her to New Jersey. NJ has become the desired location for a number of these cases, because of how their laws have crafted a religious exemption.

The family has revoked their permission for the hospital to comment on Payton's condition.

"We were informed in the last hour that the HIPAA [privacy law] authorization we previously received from this family has been revoked," hospital spokesperson Kim Brown said via email to NBC News on Tuesday evening.

Texas parents go to court to keep 9-year-old daughter on life support

Lawyers for a Fort Worth family that filed a restraining order to keep their child on life support at least two more weeks, have told Cook Children’s Medical Center it can no longer release information about 9-year-old Payton Summons.

Family Of Child On Life Support Revokes Cook Children's Ability To Update Public








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[MelmothTheLost]

Regarding the Payton Summons case, it appears the family is trying to bring her to New Jersey. NJ has become the desired location for a number of these cases, because of how their laws have crafted a religious exemption.

It'll be interesting to see how the voters of NJ react longer term to this, especially if public funds are used to "maintain" imported patients. I'm sure you'll have seen the same photos from Israel that I have of entire wards of brain dead patients permanently hooked up to machines who cannot be unhooked because Jewish law regards them as alive. If I were a NJ taxpayer and voter I'd be highly pissed off if I was being forced to pay for a similar situation developing.

 

[MelmothTheLost]

This case is in the news at present in the UK:

'Fizzy drinks were his downfall': Father of Britain's youngest weight-crisis victim issues stark warning to parents after his obese son, 13, died in his arms from blood clot 'linked to his size'

A grieving father whose obese son, 13, collapsed and died when a blood clot travelled from his leg to his chest is warning parents about the dangers of fizzy drinks.

Stephen Platt, 48, was holding Lewis Albon in his arms when he suffered a cardiac arrest. A postmortem concluded Lewis was obese, and that this was likely to have been a 'significant associated condition' in causing his death.

Mr Platt from Radcliffe, Greater Manchester, says fizzy drinks and a family condition that increases the likelihood of developing blood clots caused his son's tragic death. He is believed to be the UK's youngest victim of an obesity-related death.

Grieving father's warning after his obese son, 13, collapsed and died in his arms | Daily Mail Online

While this boy's obesity was not the only factor in his death, clearly it was a major one.

 

[katydid23]

I love my children and grandchildren more than anything in the world. They are my life.

But I cannot imagine a worse nightmare than having to sit for years, watching my child, motionless, essentially lifeless, hooked to machines, and slowly deteriorating , before my tear filled eyes.

 

[YESorNO]

California Brain-Death Standard Debated at 9th Circuit

January 14, 2019

"(CN) – Magnified by a 2016 case in which doctors removed an infant from life support over the parents’ objections, a fight over California’s longstanding standard on brain death sharpened Monday at the Ninth Circuit.

The attorney for Jonee Fonseca, whose child Israel Stinson was deemed brain dead by doctors at several hospitals before being taken off a ventilator, argued the state cleared the way for doctors to end Israel’s life support based on a faulty 1982 law. Matthew McReynolds says the California Uniform Determination of Death Act – called “CUDDA” in Monday’s proceedings – gives doctors the ability to act as “both judge and executioner” and needs to be scrapped by the courts.

“If not now, then when? I don’t know how much more concrete we have to get than the death of this child,” McReynolds asked the three-judge Ninth Circuit panel....

The Ninth Circuit hearing is the latest in a legal challenge that has drawn comparisons to Jahi McMath, a 13-year-old girl who was declared brain dead in California in 2013. McMath’s family refuted the doctors’ determination, citing religious beliefs, and moved the teenager to New Jersey. After over four years of being on life support, McMath died in June 2018....."

California Brain-Death Standard Debated at 9th Circuit
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[YESorNO]

What does 'dead' mean?

Date: January 4, 2019

Source: The Hastings Center

Summary: Marking the 50-year legacy of a landmark Harvard report on brain death, a new special report examines lingering questions about the definition of death, implications for organ transplantation, and lessons from the case of Jahi McMath.
Should death be defined in strictly biological terms -- as the body's failure to maintain integrated functioning of respiration, blood circulation, and neurological activity? Should death be declared on the basis of severe neurological injury even when biological functions remain intact? Or is it essentially a social construct that should be defined in different ways?...
While the legal determination of death in all 50 states includes death by neurological criteria -- the irreversible cessation of all functions of the entire brain -- the concept of brain death remains contested, most recently by the case of Jahi McMath, who was declared dead by neurological criteria but continued to have unexpected biological development. In the new special report, leading experts in medicine, bioethics, and other fields discuss and debate areas of continuing and new controversy, including:...."

What does 'dead' mean?
---

Lessons from the Case of Jahi McMath

"Abstract
Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; in fact, there has never been a case of a person correctly diagnosed as brain‐dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright‐line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions.

Consensus and controversy fifty years after the Harvard report: the case of Jahi McMath

The experience of Jahi McMath was, first and foremost, a terrible tragedy for her and her family. A healthy girl underwent elective surgery and was left with a profound brain injury that led to the diagnosis of brain death. But beyond this sad story, the case has also raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead?...."

https://onlinelibrary.wiley.com/doi/10.1002/hast.961
---

The Case of Jahi McMath: A Neurologist's View

"Abstract
From the start, I followed the case of Jahi McMath with great interest. In December 2013, she clearly fulfilled the diagnostic criteria for brain death. As a neurologist with a special interest in chronic brain death, I was not surprised that, after she was flown to New Jersey, where she became statutorily resurrected and was treated as a comatose patient, Jahi's condition quickly improved. In 2014, her family reported that she sometimes responded to simple motor commands. I shared the general skepticism regarding these reports, assuming that the family was in denial and was misinterpreting spinal myoclonus (a rapid, involuntary twitch generated by the spinal cord) as volitional. The family had noticed that when Jahi's heart rate was above eighty beats per minute, she was more likely to respond, as though the heart rate reflected some sort of inner level of arousal. So they began to make video recordings. I have been privileged to be entrusted with copies of these recordings, forty‐eight of which proved suitable for assessing alleged responsiveness. All have been certified by a forensic video expert as unaltered.

The first thing that struck me was that the great majority of the alleged responses were not spinal myoclonus. In fact, they did not resemble any type of spontaneous, involuntary movement described in patients paralyzed from high spinal cord lesions...."

https://onlinelibrary.wiley.com/doi/10.1002/hast.962
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