Family wants to keep life support for girl brain dead after tonsil surgery #1

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  • #201
  • #202
Here's a question. Surely an institution of that caliber and renown has an ethics committee. I wonder if Jahi's case has been presented?
 
  • #203
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  • #205
Thanks Zuri and KZ, I didn't have the medical expertise to find the terminology for it or to back up what I believed and had seen and how Dr Byrne just hit the hinky meter with me.

Kinda like a preacher who has a commercial with a lady giving testimony of her "incurable tumor" that was killing her and this pastor "laid hands" on her and healed her instantly and she started dancing. I'm not knocking religion and faith at all but this pastor is an outright sham if he is getting incredibly sick people's hopes up like that and profiting from it and I despise that.

Ok so now the next question. Dr Byrne touts himself as this expert in this area. Is he a neurologist? Does his medical expertise equal or surpass the previous 6 doctors who has assessed Jahi? Does anyone know or have heard of him before, either good or bad?
 
  • #206
I wanted to bump this link, because it is such a good discussion by docs about brain death and resistant families. I think SophieRose linked it first up thread, and my thanks to her for finding it.

http://www.ccm-l.org/discussion1/Ethics/uncoop.html

I did post it several days ago and then deleted it because I thought posters might think the doctors were insensitive calling the brain dead on vents as corpses. I didn't. Anyway someone else posted the link again later.
 
  • #207
Thanks Zuri and KZ, I didn't have the medical expertise to find the terminology for it or to back up what I believed and had seen and how Dr Byrne just hit the hinky meter with me.

Kinda like a preacher who has a commercial with a lady giving testimony of her "incurable tumor" that was killing her and this pastor "laid hands" on her and healed her instantly and she started dancing. I'm not knocking religion and faith at all but this pastor is an outright sham if he is getting incredibly sick people's hopes up like that and profiting from it and I despise that.

Ok so now the next question. Dr Byrne touts himself as this expert in this area. Is he a neurologist? Does his medical expertise equal or surpass the previous 6 doctors who has assessed Jahi? Does anyone know or have heard of him before, either good or bad?

I don't know if Dr. Byrne is published in any recognized professional journals or has done clinical research. I think the 6 docs that have officially looked at Jahi and concurred would be given more weight. I bet there have been more than 6 docs that have looked at her brain scan, MRI, CAT scan, EEG, whatever was done and quietly concurred. JMO
 
  • #208
Here is a well written Q & A from another medical facility that addresses coma, vegetative state and brain death. It also gives the view from a medical perspective on patient care.

Although most of this has been discussed already, it's a good reference for everything in one place.

http://www.baylorhealth.com/SiteCol...nfo_DocumentsForms/SevereBrainInjury_rev7.pdf

The closing statement in their article reads:

In closing, although modern science has created
treatments unimaginable to the ancient healers,
their moral insights remain relevant today. The
biblical wisdom that there is, “a time to be born
and a time to die”, remains true. When we can
no longer meet the first goal of medicine by cure
or temporary remission, or return the patient to a
quality of life that the patient can enjoy, we believe
the most appropriate goal of medicine becomes
comfort, allowing the patient to pass away as
peacefully as possible, surrounded by a caring
family and community.
 
  • #209
I wanted to bump this link, because it is such a good discussion by docs about brain death and resistant families. I think SophieRose linked it first up thread, and my thanks to her for finding it.

http://www.ccm-l.org/discussion1/Ethics/uncoop.html

I linked it :blushing: because I am a supergeek when it comes to finding out about something that I am interested in and have an opinion on. I have literally spent hours, all night long a few nights reading all kinds of stuff about them. I get obsessed and will study and research and find the answers I need.

It was a fascinating discussion with lots of experienced voices from different areas and it gave a good insight to how similar cases of brain death and reluctant parents are dealt with.

I was particularly interested in this comment"

Tom Bleck: Here in Virginia, and in most states of which I am aware, the diagnosis of death by brain criteria is death, and no legal action can be taken to reverse the diagnosis or to prevent one from discontinuing support which is futile for the patient (and the only purpose of which is to maintain the organs for potential transplantation).

That being said, a family that cannot accept the diagnosis of death by cerebral criteria is, in my experience anyway, unlikely to accede to organ donation within a useable (for the organs) period of time. My own feeling, and practice, has been to put the patient out of the ICU in a regular bed (may require a special dispensation for the ventilator in some hospitals), and allow the family to stay with the corpse for as long as they wish. Without fluids or vasopressors the blood pressure is almost never maintained for more than a day or two. We don't draw blood, do chest films, or anything else except occasional suctioning to decrease the family's distress from the sound of rattling secretions. I know there are many people who think it is wrong to keep ventilating a corpse, but as long as resources are not being diverted from the living and potentially salvagable, I don't see this as a major ethical problem.



The first BBM speaks of the fact that legally most people have no recourse to keep a brain dead person on life support and that the hospital makes the determination and acts accordingly within days, despite the family's reluctance or downright refusal.

The 2nd BBM is interesting because this is the course I would have chose had I been in charge. The family wanted her on the vent, then ok but the inevitable WILL happen and they will HAVE to deal with it. In the mean time they have moved to a private area, out of ICU, not being given special treatment or allowed to interfere with other patients or cause a disruption. This is what should have been done in my opinion. Let nature take its course and provide minimal assistance while that takes place and the family will deal with it hopefully.
 
  • #210
And Swampmama, I think your instincts are absolutely correct.
 
  • #211
I skimmed through a little bit of Dr. Byrne's writings and couldn't take anymore. I didn't see him posting links to facts that backed up his claims. He seems to be trying to mix faith and science.

He's using scare tactics. The guy sounds like a quack.
 
  • #212
Dr. Paul A. Byrne is a Board Certified Neonatologist and Pediatrician.

One article I read said that their attorney was going to court this past afternoon to see about getting Byrne to do a brain death analysis. Wonder where that went? They did get that stay for time til the 30th in the afternoon court session so they have several more days to present something.
 
  • #213
I linked it :blushing: because I am a supergeek when it comes to finding out about something that I am interested in and have an opinion on. I have literally spent hours, all night long a few nights reading all kinds of stuff about them. I get obsessed and will study and research and find the answers I need.

It was a fascinating discussion with lots of experienced voices from different areas and it gave a good insight to how similar cases of brain death and reluctant parents are dealt with.

I was particularly interested in this comment"

Tom Bleck: Here in Virginia, and in most states of which I am aware, the diagnosis of death by brain criteria is death, and no legal action can be taken to reverse the diagnosis or to prevent one from discontinuing support which is futile for the patient (and the only purpose of which is to maintain the organs for potential transplantation).

That being said, a family that cannot accept the diagnosis of death by cerebral criteria is, in my experience anyway, unlikely to accede to organ donation within a useable (for the organs) period of time. My own feeling, and practice, has been to put the patient out of the ICU in a regular bed (may require a special dispensation for the ventilator in some hospitals), and allow the family to stay with the corpse for as long as they wish. Without fluids or vasopressors the blood pressure is almost never maintained for more than a day or two. We don't draw blood, do chest films, or anything else except occasional suctioning to decrease the family's distress from the sound of rattling secretions. I know there are many people who think it is wrong to keep ventilating a corpse, but as long as resources are not being diverted from the living and potentially salvagable, I don't see this as a major ethical problem.



The first BBM speaks of the fact that legally most people have no recourse to keep a brain dead person on life support and that the hospital makes the determination and acts accordingly within days, despite the family's reluctance or downright refusal.

The 2nd BBM is interesting because this is the course I would have chose had I been in charge. The family wanted her on the vent, then ok but the inevitable WILL happen and they will HAVE to deal with it. In the mean time they have moved to a private area, out of ICU, not being given special treatment or allowed to interfere with other patients or cause a disruption. This is what should have been done in my opinion. Let nature take its course and provide minimal assistance while that takes place and the family will deal with it hopefully.

What Tom Bleck said about brain dead patients in Virginia is true in many other states, including PA, NC, DE where I have worked.
The longer Jahi remains on the vent, the greater chance for nosocomial infections like MRSA. I hope the doc from Stanford will concur and the judge in his own way can give the family "permission" to let her go. JMV
 
  • #214
Dr. Paul A. Byrne is a Board Certified Neonatologist and Pediatrician.

One article I read said that their attorney was going to court this past afternoon to see about getting Byrne to do a brain death analysis. Wonder where that went? They did get that stay for time til the 30th in the afternoon court session so they have several more days to present something.

SR, does this mean that irregardless of what the Stanford doc tells the judge, there will be no decision until the 30th?
 
  • #215
SR, does this mean that irregardless of what the Stanford doc tells the judge, there will be no decision until the 30th?

All I know is that the family attorney Dolan is still saying he'll take it all the way to the California Supreme Court if he must.
 
  • #216
Well I don't know if I would say that taking a person off life support after 15 years is "premature." But Terri Schiavo wasn't brain dead, like this little girl. Brain damage and brain stem death are two different things. Do you believe a person can recover when their brain has totally flat lined and there is no function in the actual brain stem itself?

I think Terri's case is different (and her husband should have let her parents care for her). However, I think the hospital may have messed up here and why can't the family be allowed to take her home on life support? Or put her in a hospice? It's always about cost but it's unlikely this little girl will last too long. I get why the family feel the way they do. She is warm and her heart does beat so to them, she is alive. Frankly, I have a hard time with the concept that she's not, myself.

10 years ago my father in law had a stroke on Labor Day weekend; my mother in law had him on life support and even though he was declared brain dead, she had him on life support until the Friday before Thanksgiving because she could afford to do so. He went from ICU to a private room and she hired private duty nurses; it was her children who intervened and finally got her to understand that he was no longer alive or coming back to her.

I understand the mother wanting to do everything she can, believing that her daughter may come back from this. Once the decision is made to remove life support, there is no going back. I wonder how much financial concerns factor into this case. Losing a child is the worst thing in the world, we know this from personal experience; I have empathy for this mother, especially at what is to be a joyous time of year, she has to make the most devastating decision of her life.

As far as organ donation goes, the person will either have a donor card/statement or the family is asked at the time they are notified of death in the hospital if they want to donate the organs. I don't see this family doing that so prolonging and thus negating organ donor potential may well be a moot point.
 
  • #217
All I know is that the family attorney Dolan is still saying he'll take it all the way to the California Supreme Court if he must.

So basically, if the judge agrees with the 7 doctors and rules that life saving measures be withdrawn, the attorney will appeal, drawing this out for as long as Jahi's body hangs in there. So the lawyer wins, the family's grief is postponed, and poor Jahi is not allowed to go in peace. Smh. Sad.
 
  • #218
On Monday, a judge appointed Dr. Paul Fisher, chief of pediatric neurology at Stanford Children's Hospital, to evaluate McMath.

Fisher is expected to testify on the case in a closed hearing Tuesday, according to court documents.

Alameda Superior Court Judge Evelio Grillo also ruled that the hospital must hold off on any decisions regarding discontinuing life support until December 30.


http://edition.cnn.com/2013/12/23/health/jahi-mcmath-girl-brain-dead/
 
  • #219
So basically, if the judge agrees with the 7 doctors and rules that life saving measures be withdrawn, the attorney will appeal, drawing this out for as long as Jahi's body hangs in there. So the lawyer wins, the family's grief is postponed, and poor Jahi is not allowed to go in peace. Smh. Sad.

The lawyer didn't hire himself and he can't do anything the family doesn't support or agree to. Just sayin'

jmo
 
  • #220
http://www.dailymail.co.uk/news/art...nsil-surgery-stay-life-support-Christmas.html

The family's attorney also asked Judge Evelio Grillo to allow a third evaluation by Paul Byrne, a pediatric professor at the University of Toledo.

The hospital's attorney objected to Byrne, saying he is not a pediatric neurologist.

The judge is expected to take up the request to use Byrne, and another hearing was scheduled for Tuesday morning, Christmas Eve.

snip

Given the very public battle over Jahi's treatment, the judge pleaded with attorneys on both sides to continue speaking with each other and the family to help prepare for his eventual final order.
 
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