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

[jjenny]

The difference I see is the Koochin family accepted Jesse's impending death. Jahi's family believes she will recover.

Whether they accept it or not, it doesn't sound like the heart will go on for a long time. Jesse's heart stopped beating a month after he was declared brain dead.

 

[MyBelle]

If there is a death certificate in this case it would be unethical to do tube feeds or any type of surgical intervention. The judge has made a decision. The family asked for his (judge's) intervention and now they don't like the result. Her vent will be turned off at whatever time on the 30th that the judge said it would be. JMO. I do not believe any facility will take this case before then. But we shall see.

I think this will stretch out with multiple appeals that probably won't end until after this child's heart stops beating for good.

I'm curious why you believe such procedures such as a trach would be considered unethical.

 

[jjenny]

I think this will stretch out with multiple appeals that probably won't end until after this child's heart stops beating for good.

I'm curious why you believe such procedures such as a trach would be considered unethical.

Hospital is saying that it's not ethical to carry out surgeries on a legally dead person.

 

[SophieRose]

Remember Usher's son? It appears coverage was for a few months.

http://perezhilton.com/2012-07-15-u...oster-insurance-coverage#sthash.Leps3kwX.dpbs

"According to sources, Tameka's insurance company has yet to set a specific deadline, but have made it clear that they will only cover the cost of the enormous hospital bills for a few months."

http://www.tmz.com/2012/07/15/usher-stepson-tameka-foster-life-support/

According to our sources, Tameka can only keep Kyle on life-support as long as her insurance company agrees to pay ... otherwise she doesn't have the funds to cover the enormous hospital bills.

We're told the insurance company hasn't set a specific deadline, but they've made it clear ... they're only willing to shell out coverage for a couple months ... tops.

He was injured on July 8, 2012 and life support discontinued on July 21, 2012.

 

[MyBelle]

The hospital that discharged Jesse said:

In a statement issued Wednesday, Primary Children's says it has no intention of caring for brain-dead patients meeting Utah's legal definition of death in the future.

"It is understandable that the death of a child is difficult for parents," the statement said. "Nevertheless, our staff cannot continue to provide treatment for patients who have met the condition of brain death because it is unethical to do so. In fact, if a hospital tried to bill a payer for such services, it could be considered medical fraud."

The statement said any medical study that proposed keeping a person on a ventilator for an undetermined period of time after brain death would be rejected as unethical by every institution in the country.

http://archive.sltrib.com/printfriendly.php?id=2434474&itype=ngpsid

I'm baffled why it would be "unethical" because the person is brain dead yet hospitals do it for patients who are in irreversible comas and ask families to agree to a DNR order.

 

[Trino]

The hospital that discharged Jesse said:

In a statement issued Wednesday, Primary Children's says it has no intention of caring for brain-dead patients meeting Utah's legal definition of death in the future.

"It is understandable that the death of a child is difficult for parents," the statement said. "Nevertheless, our staff cannot continue to provide treatment for patients who have met the condition of brain death because it is unethical to do so. In fact, if a hospital tried to bill a payer for such services, it could be considered medical fraud."

The statement said any medical study that proposed keeping a person on a ventilator for an undetermined period of time after brain death would be rejected as unethical by every institution in the country.

http://archive.sltrib.com/printfriendly.php?id=2434474&itype=ngpsid

Thanks for your research. If the family is correct, I guess we'll soon see what unethical institutions there are out there.

 

[Softail]

The hospital that discharged Jesse said:

In a statement issued Wednesday, Primary Children's says it has no intention of caring for brain-dead patients meeting Utah's legal definition of death in the future.

"It is understandable that the death of a child is difficult for parents," the statement said. "Nevertheless, our staff cannot continue to provide treatment for patients who have met the condition of brain death because it is unethical to do so. In fact, if a hospital tried to bill a payer for such services, it could be considered medical fraud."

The statement said any medical study that proposed keeping a person on a ventilator for an undetermined period of time after brain death would be rejected as unethical by every institution in the country.

http://archive.sltrib.com/printfriendly.php?id=2434474&itype=ngpsid

That makes total sense to me.

In the case of my step kids' mom, she was dead and they kept her on the vent until the kids begged them to shut it off. Seeing her decomposing was too much. I really was angered that they had to see that. All of her organs had also shut down. I also questioned the doctors. She was indigent, no insurance. The state was paying to keep her going for 2 days too many.

 

[MyBelle]

Hospital is saying that it's not ethical to carry out surgeries on a legally dead person.

Isn't organ removal for transplantation considered a surgery? I think that's why this will be tied up in legal battles to come because the hospital seems to be applying a double standard.

 

[Cubby]

The difference I see is the Koochin family accepted Jesse's impending death. Jahi's family believes she will recover.

The difference I am seeing is the Koochin family, as well as another mentioned in the link donjeta posted, brought their child home and had hospice care help. Jahi's family is not expressing an interest in bringing her home...... I think they'd have a fighting chance to bring her home, but not to another facility.

 

[Donjeta]

I'm not. I think a lot of people want to force these people to accept and want to rub their noses in it, frankly. I think if it were my child, I'd not want to keep their corpse breathing. But I'm not in their shoes. They may have different beliefs, different feelings.

And if Jahi is dead then she's not experiencing anything happening to her body. The only ones who would suffer from wAtching her corpse breathe would be her family. A brain dead body would eventually shut down, probably rather quickly. So again, I ask, what is everyone's stake in this? Why the anger? Why the determination to have these people, whose shoes we are not in, feel exactly how we feel? Walk a mile.

Obviously her family always suffers the most, whether her ventilation continues or not, but I think that there might be some staff members who would find it stressful, anxiety inducing or traumatic to be caring for the dead for extended periods of time, possibly against their personal professional ethics.

 

[MyBelle]

Obviously her family always suffers the most, whether her ventilation continues or not, but I think that there might be some staff members who would find it stressful, anxiety inducing or traumatic to be caring for the dead for extended periods of time, possibly against their personal professional ethics.

I think you are absolutely right. After I signed the DNA for my dad, the hospital removed the nursing team that had cared for him and replaced them with nurses who had not. The reason given was that it was standard because it was too stressful and that the nurses were very attached to him emotionally.

 

[BeginnersLuck]

Isn't organ removal for transplantation considered a surgery? I think that's why this will be tied up in legal battles to come because the hospital seems to be applying a double standard.

The hospital has told the family that the procedures can be performed, if they find a physician that will do the procedures. I really doubt that a judge can order a physician to perform a procedure that the physician finds unethical and medically unnecessary.

 

[Donjeta]

I'm baffled why it would be "unethical" because the person is brain dead yet hospitals do it for patients who are in irreversible comas and ask families to agree to a DNR order.

Isn't organ removal for transplantation considered a surgery? I think that's why this will be tied up in legal battles to come because the hospital seems to be applying a double standard.

Medicine is usually for the living because they are the ones who can benefit. The medical appropriateness of surgical procedures tends to be evaluated in terms of, and, in a world of limited resources, prioritized based on expected risks and expected benefits. There is always an element of uncertainty with living patients, you don't know for sure if the outcome is going to be good or bad, but if the patient is already dead, we know with 100% certainty that any further surgery does not change his outcome in any way. It will be just a waste of hospital resources that could have been more ethically used to benefit another, living patient, and if there are legal issues the police and the courts might be annoyed if the surgery makes the medical examiner's job harder, eg. clouds the evidence in a medical malpractice case.

I think that if one's an organ donor it should be considered a last gift to help someone else. It does not benefit the brain dead donor (unless he found the thought comforting prior to his brain death) but if it could benefit the recipient there is ethical justification (IMO, anyway - if you ask Dr Byrne he would disagree). But I think that even the surgery to remove organs for transplantation could be considered unethical if you knew before starting that the donor's organs probably wouldn't be usable.

Some people think performing any surgery on corpses is disrespectful of the dead or defiling the body but personal beliefs and faiths may differ in that respect.

A coma patient is not yet clinically dead so his legal status differs from that of a brain dead patient, and as a living person his outcome could possibly be changed by medical procedures, either in a good way or a bad way. If his state is considered hopeless and a DNR order has been made I think most doctors tend to think twice before recommending e.g. surgery. It's imo ethical to consider all treatments in terms of whether they are required to avoid further suffering, in the name of common humane decency, or whether you're just unnecessarily meddling in a case that is hopeless anyway, no matter what you do.

 

[momrids6]

for our medical members, or anyone who knows, etc., what affect, if any, would eating a hamburger have on the sutures/bleeding?

 

[otto]

for our medical members, or anyone who knows, etc., what affect, if any, would eating a hamburger have on the sutures/bleeding?

Was someone eating a hamburger after the surgery?

 

[gngr~snap]

for our medical members, what affect, if any, would eating a hamburger have on the sutures/bleeding?

Usually after a tonsillectomy clear liquids are begun and slowly advanced to full liquid then soft diet.
I'm not sure that eating say, a hamburger would do a great deal of harm, but general anesthesia slows the digestive system to a crawl. If she didn't have good bowel sounds allowing her to eat regular food would be ill advised.
I would think it would cause vomiting which, imo could cause suture and bleeding problems.

I don't know how often sutures are used now. I thought tonsils were removed with cauterizing laser and not scapels, but I have no ENT experience so idk. From working in peds ,I know sutures didn't stay very well in the mouth due to moisture. For split lips and tounges etc. Surely they have better material to suture with now!
If cautery was used a burger could cause irritation and bleeding to begin.
All moo
Sent from my SGH-T679 using Tapatalk 2

 

[Tulessa]

for our medical members, or anyone who knows, etc., what affect, if any, would eating a hamburger have on the sutures/bleeding?

I've never had this type of surgery, but I would think, that the results of some one eating a hamburger, would be horrible?

 

[momrids6]

I don't know how often sutures are used now. I thought tonsils were removed with cauterizing laser and not scapels,


If cautery was used a burger could cause irritation and bleeding to begin.
All moo
Sent from my SGH-T679 using Tapatalk 2

rsbm; I meant the sites that were cauterized- obviously, I am not a med pro

 

[SeekingJana]

for our medical members, or anyone who knows, etc., what affect, if any, would eating a hamburger have on the sutures/bleeding?

Because this was an extensive surgery of the palate ( back of throat) in addition to removal of tonsils and nasal resection, I would expect packing to be in place for the first few hours post- operatively.

IMO, solid food such as a hamburger could dislodge the packing, which would probably mean dislodging the clot behind the packing. Thus, bleeding of an unknown amount could restart. Hypothetical based upon my experience with ENT post- operative nursing care.

One thing I've wondered and have not seen addressed here is whether or not Jahi might have taken Aspirin or an aspirin- containing OTC med. regularly for her throat pain, etc. She could have had an altered coagulation state prior to surgery that went undetected. I don't know, of course, but if I had been on her team, I would have brought this possibility up and had her blood tested for ASA.

 

[otto]

I've never had this type of surgery, but I would think, that the results of some one eating a hamburger, would be horrible?

Removal of wisdom teeth requires all sorts of special care and liquid food for a couple of days to minimize the possibility of bleeding and infection. I don't think that a surgeon would recommend a hamburger after adnoid and tonsil surgeries.