Family wants to keep life support for girl brain dead after tonsil surgery #8

[Nore]

Hi, I've said this before. People rely on Gods plan. They must accept the fact
that God does answer all prayers. Sometimes he says NO and this is one of those times. I had to accept it. The hardest thing I have done in my life, but I did it. I would not drag my son through any squabbles. I held him when he died. I feel his Dad and I did what was best. Both of our children now have peace in Gods' arms. Thiis family needs to wake up. So do the people enabling them. Blessed peace for Jahi. lease: :seeya:

 

[Donjeta]

In one of the court documents (please don't ask me to locate it), the hospital lawyers wrote that the nurses and other staff at CHO were quite distressed by the task of having to care for a dead person. It probably helps the current caretakers with the cognitive dissonance if everyone got in the Life and Hope Award spirit and convinced each other that they're battling a valiant battle to save her life and prepare her for the miracle that is her due, and if she's not really brain dead then they're not really going against anything the Pope said about brain dead people either. (if she is in a Catholic facility)

"This is a very tragic case but in the face of death, the Church proclaims that Jesus Christ has won the victory over death," the National Catholic Bioethics Center said Tuesday on its website. "And [Jahi's mother] has the obligation to comfort those who mourn with the sure and certain hope of the resurrection of the dead. We offer our prayers for all who have been so profoundly affected by this tragic event."

I believe this is misquoted. The original text had "she" in place of [Jahi's mother] and imo it refers to the Catholic Church.

 

[Minette]

K_Z, I am not convinced she is actually in a Catholic facility, per se. I am also not convinced that they actually found an ENT willing to perform a tracheotomy--wasn't that being requested so that they wouldn't have to use the ventilator? And isn't she *still* on a ventilator (using room air, which as I understand it is not the norm for life support)?

I've said this before, many threads back, and I am aware that it is a can of worms that might not need re-opening, but to me, one of the horrifying things about the continued maintenance of a body which has been issued a death certificate is that as a person no longer *legally* living, Jahi is not legally entitled to many of the protections under the law that a living child (even one in a coma, PVS, etc.) would enjoy.

Perhaps it is just that I have spent too much time on WebSleuths. but I can envision a whole host of horrible things that could happen to poor precious Jahi's body now that she now longer has the legal protection of being considered a living person. Medical experimentation being the least of these, btw.

That's one reason I'm glad (and very conflicted to be glad, I might mention) that NW is there at Jahi's side instead of being present to mother her living children, because I imagine (I hope?!) that she would not consent to anything truly offensive being done to her daughter's body with her knowledge and consent. (Although it could be argued, and I WOULD argue that having her body being forcibly maintained in a breathing state given her absence of brain function is offensive, and I do think it is, given that I honestly believe that her soul left her body when her brain died.)

OK, OK, incoming shrapnel, go!

 

[nrdsb4]

K_Z, I am not convinced she is actually in a Catholic facility, per se. I am also not convinced that they actually found an ENT willing to perform a tracheotomy--wasn't that being requested so that they wouldn't have to use the ventilator? And isn't she *still* on a ventilator (using room air, which as I understand it is not the norm for life support)?

BBM
No. The trach is a necessity for long term mechanical ventilation. One cannot have an ET tube or other temporary airway in place indefinitely as they can erode the tissues and cause other complications. These tubes can be dislodged. A brain dead patient cannot breathe on their own-they must have a ventilator to breathe for them. Having a tracheostomy placed does not change the fact that they have no respiratory drive.

I'm sure K_Z will explain it more eloquently than I, but the purpose of the trach was not to get her off the vent. She will need the vent as long as her family wants to keep her heart beating.

 

[al66pine]

Snipped for focus and BBM:

It's been reported in several sources that Jahi's body is being cared for in a Catholic facility....And both Dr. Paul Byrne and Kansas, MO area Bishop Robert Finn worked together on the plan to transfer Jai....
.... confusing that any "real", licensed, and regulated health care facility would engage in accepting someone brain dead for perpetual care. That is quite different than caring for a brain dead loved on in a private home situation.
.... I wonder about how the ethical concerns or conflicts of the bedside staff in that facility are being handled....
It would seem that everyone, and especially caregivers, in contact with NW and her family would have to be talking from the same script, using the same language, promoting her (false) hope, encouraging her impressions that Jahi is "alive". That seems a little fairytale-ish to me.... surreal.

Not that I want to know now where Jahi is, but I wonder if eventually her location will eventually become known.
Perhaps a private home w care provided by persons without medical licenses?

Like K_Z said, seems - well, unusual - that a prominent figure within a religion would be so vocal and active in participating in actions outside that religious doctrine.
Ditto a physician, re medical science.

Seems clear no private med ins or fed or st gov't program would pay for 'services' Jahi wd receive, although some ppl have donated for 'services.'

Have 'Jahi supporters' marshalled enough resources to pay licensed/registered medical care providers for 'services' and for a registered licensed care facility, for equipment and supplies, for months or years?
Or are the 'care providers' unlicensed and have no fear wrt license status?

If the facility and med providers are in fact licensed, wouldn't their actions wrt Jahi subject them to possible license suspension, revocation, or other disciplinary action by their state boards?

JM2cts and I could be wrong.

 

[Minette]

BBM
No. The trach is a necessity for long term mechanical ventilation. One cannot have an ET tube or other temporary airway in place indefinitely as they can erode the tissues and cause other complications. These tubes can be dislodged. A brain dead patient cannot breathe on their own-they must have a ventilator to breathe for them. Having a tracheostomy placed does not change the fact that they have no respiratory drive.

I'm sure K_Z will explain it more eloquently than I, but the purpose of the trach was not to get her off the vent. She will need the vent as long as her family wants to keep her heart beating.

Thank you, nrdsb4, I did not know that! I mean, I did know that Jahi has no respiratory drive, being brain dead, but I did not know why a tracheotomy was necessary to maintain the bodily functions, so thanks!

 

[K_Z]

BBM
No. The trach is a necessity for long term mechanical ventilation. One cannot have an ET tube or other temporary airway in place indefinitely as they can erode the tissues and cause other complications. These tubes can be dislodged. A brain dead patient cannot breathe on their own-they must have a ventilator to breathe for them. Having a tracheostomy placed does not change the fact that they have no respiratory drive.

I'm sure K_Z will explain it more eloquently than I, but the purpose of the trach was not to get her off the vent. She will need the vent as long as her family wants to keep her heart beating.

nrdsb4, I think you did a very fine job explaining that! :seeya:

 

[lawstudent]

My understanding is that the Catholic Church allows the withdrawal of life support in these situations, but not becuase it considers the person dead. I don't think they have a strict definition of death. If you remove life support, the person dies naturally, so it is okay - you don't need to take extreme measures to keep someone alive. With Terri Schiavo, the issue was more that they weren't giving her food and water, which was less extreme, but even that I think was a debatable issue. You aren't allowed to purposely kill someone, but you can sit by and allow them to die of natural causes without committing a sin. That seems to be obscured now because people think it's so wrong not to seek out medical care for someone in modern times, since we can do so much and pay for it. But for most of the Catholic Church's history, if you got sick, you died - no one was forced to get medical care for their kids. Euthanizing someone with drug would 100% be against Catholicism because it's intentional and not natural.

So I think there is a choice in Catholicism - keeping someone on life support is not wrong, but neither is taking them off. Maybe they have some facility that serve the purpose and they feel bad. But I don't see this as a Catholic stance in terms of being pro-life - they just don't see anything wrong with keeping someone on life support, and I don't think brain dead = dead for them. It's like how women with ectopic pregnancies can have the surgery that will terminate the fetus, and that is okay, but they can't purposely abort a child to save their lives - it has to be a secondary effect. But if they decide they want to proceed with the pregnancy of a non-viable child who is threatening their life and could have necessitated a hysterectomy, that is fine.

 

[nrdsb4]

So I think there is a choice in Catholicism - keeping someone on life support is not wrong, but neither is taking them off. Maybe they have some facility that serve the purpose and they feel bad. But I don't see this as a Catholic stance in terms of being pro-life -they just don't see anything wrong with keeping someone on life support, and I don't think brain dead = dead for them. It's like how women with ectopic pregnancies can have the surgery that will terminate the fetus, and that is okay, but they can't purposely abort a child to save their lives - it has to be a secondary effect. But if they decide they want to proceed with the pregnancy of a non-viable child who is threatening their life and could have necessitated a hysterectomy, that is fine.

BBM

That is NOT what the Catholic National Bioethics Center states.

From their web site:

The National Catholic Bioethics Center cannot address the accuracy of the facts of the case of Jahi McMath since we have not been a party to the case; however, this tragic situation provides an opportunity for the Center to make clear the teaching of the Catholic Church on the question of the determination of death using neurological criteria. Some media commentators have presented this situation as evidence of the opposition between faith and science since the mother professes to be a devout Christian and believes her daughter can be restored with God’s miraculous intervention. However, the determination of death by the rigorous application of the neurological criteria is considered legitimate by the Catholic Church, which accepts the findings of science in such a determination. The Catholic Church does not believe there can be any opposition between faith and science since both are gifts from God, the source of all truth.

http://www.ncbcenter.org/resources/jahi-mcmath-and-catholic-teaching-on-the-determination-of-death?

 

[nrdsb4]

Thank you, nrdsb4, I did not know that! I mean, I did know that Jahi has no respiratory drive, being brain dead, but I did not know why a tracheotomy was necessary to maintain the bodily functions, so thanks!

Think about Christopher Reeve. Obviously, he was not brain dead, but he WAS vent dependent. He didn't have the capacity to breathe completely on his own. So he had a vent-AND a trach-because an ET tube was neither practical nor safe as a long term solution. Remember that the tracheostomy provided an entry point for the tubes which the ventilator used to artificially push air into his lungs. This was incredibly superior to having a hard tube going into his mouth and down his throat and eventually into the airways. That's what Jahi has, even though she is not able to cognitively appreciate the difference.

 

[mck16]

Think about Christopher Reeve. Obviously, he was not brain dead, but he WAS vent dependent. He didn't have the capacity to breathe completely on his own. So he had a vent-AND a trach-because an ET tube was neither practical nor safe as a long term solution. Remember that the tracheostomy provided an entry point for the tubes which the ventilator used to artificially push air into his lungs. This was incredibly superior to having a hard tube going into his mouth and down his throat and eventually into the airways. That's what Jahi has, even though she is not able to cognitively appreciate the difference.

But, did he die naturally? ty

 

[Donjeta]

Pope John Paul II is addressing organ transplantation here, not prolonged mechanical support for the brain dead, but he certainly seems to recognize the neurological criteria of death as valid:
http://www.vatican.va/holy_father/j...nts/hf_jp-ii_spe_20000829_transplants_en.html

5. It is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardio-respiratory signs to the so-called "neurological" criterion. Specifically, this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). This is then considered the sign that the individual organism has lost its integrative capacity.

With regard to the parameters used today for ascertaining death - whether the "encephalic" signs or the more traditional cardio-respiratory signs - the Church does not make technical decisions. She limits herself to the Gospel duty of comparing the data offered by medical science with the Christian understanding of the unity of the person, bringing out the similarities and the possible conflicts capable of endangering respect for human dignity.

Here it can be said that the criterion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology. Therefore a health-worker professionally responsible for ascertaining death can use these criteria in each individual case as the basis for arriving at that degree of assurance in ethical judgement which moral teaching describes as "moral certainty". This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such certainty exists, and where informed consent has already been given by the donor or the donor's legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant.

 

[lawstudent]

Pope John Paul II is addressing organ transplantation here, not prolonged mechanical support for the brain dead, but he certainly seems to recognize the neurological criteria of death as valid:
http://www.vatican.va/holy_father/j...nts/hf_jp-ii_spe_20000829_transplants_en.html

5. It is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardio-respiratory signs to the so-called "neurological" criterion. Specifically, this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). This is then considered the sign that the individual organism has lost its integrative capacity.

With regard to the parameters used today for ascertaining death - whether the "encephalic" signs or the more traditional cardio-respiratory signs - the Church does not make technical decisions. She limits herself to the Gospel duty of comparing the data offered by medical science with the Christian understanding of the unity of the person, bringing out the similarities and the possible conflicts capable of endangering respect for human dignity.

Here it can be said that the criterion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology. Therefore a health-worker professionally responsible for ascertaining death can use these criteria in each individual case as the basis for arriving at that degree of assurance in ethical judgement which moral teaching describes as "moral certainty". This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such certainty exists, and where informed consent has already been given by the donor or the donor's legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant.

Yes, I think everything you said is correct. The Church doesn't get into the technical aspects of this sort of thing, but kind of looks at the general situation and compares it to established principles. I actually had never thought about the Church's position on organ donation - I actually would have thought they opposed it based on their principles, but they have probably come to accept brain death partly in order to support organ donation. I don't think they accept it 100%, though - as in, I don't think they would insist Jahi is dead. They would acknowledge that she could be. And the Catholic Bioethicists - is that connected to the Vatican? There are a lot of Catholic organizations that do not follow the Vatican's teachings on social issues.

But, did he die naturally? ty

Yes, but of infection from bedsores as a result of his condition. I think that's considered a natural death. Had he been disconnected from his breathing apparatus, he would have died naturally.

 

[nrdsb4]

But, did he die naturally? ty

How is that relevant to the point I was making?

 

[nrdsb4]

Think about Christopher Reeve. Obviously, he was not brain dead, but he WAS vent dependent. He didn't have the capacity to breathe completely on his own. So he had a vent-AND a trach-because an ET tube was neither practical nor safe as a long term solution. Remember that the tracheostomy provided an entry point for the tubes which the ventilator used to artificially push air into his lungs. This was incredibly superior to having a hard tube going into his mouth and down his throat and eventually into the airways. That's what Jahi has, even though she is not able to cognitively appreciate the difference.

Rereading my post makes it seem as though I was saying Jahi has an ET tube going down her throat. She does not; she has a tracheostomy.

 

[nrdsb4]

And the Catholic Bioethicists - is that connected to the Vatican? There are a lot of Catholic organizations that do not follow the Vatican's teachings on social issues.

http://www.ncbcenter.org/page.aspx?pid=1178

I am not sure exactly what you mean by "connected to the Vatican," but according to their web site, they have had several "Papal Patrons" who support their mission, most recently Pope Benedict XVI in 2013.

http://www.ncbcenter.org/Document.Doc?id=498

 

[K_Z]

A very good article for understanding the Catholic Church view on neurological death. Dr. Byrne is specifically singled out as holding and promoting ideas contrary to the Catholic church teachings and philosophy. Important to note that Dr. Byrne's philosophies are at odds with the last 2 popes, as well.

22 Page teaching and discussion on the National Catholic Bioethics Center website "open access" page, under "Publications" tab.

http://www.ncbcenter.org/page.aspx?pid=1364

Neurological Criteria for Determination of Death

http://www.ncbcenter.org/document.doc?id=588

Dr. Byrne claims that those who have been judged dead by neurological criteria are  still alive and that the excision of their vital organs is tantamount to murder. By taking  such a position, Dr. Byrne is at odds with the current teaching of the magisterium of  the Catholic Church. 

Because of such reports, and because of deeper philosophical and medical  opinions, some Catholics adamantly refuse to accept the legitimacy of neurologi- cal criteria for determining death. Because such negative judgments can be very  unsettling to the consciences of the faithful and may lead them to reject the appeal  of Pope John Paul II to be organ donors—or recipients—it is important to determine  just what it is the Church teaches.

In the last ten years, two essays appeared in Catholic World Report by certain  authors who later contributed to Finis Vitae, including Dr. Byrne; both essays have  created confusion in the minds of the Catholic faithful. 

(snipped)

According to current Church teaching, a Catholic may accept the neurological criteria for determining death and may make moral choices based on those criteria  so long as the neurological tests are rigorously performed. 

 

[mck16]

How is that relevant to the point I was making?

You know what? I don't know. I am sure I had a reason for asking, but I can't remember. Sorry.

 

[lawstudent]

http://www.ncbcenter.org/page.aspx?pid=1178

I am not sure exactly what you mean by "connected to the Vatican," but according to their web site, they have had several "Papal Patrons" who support their mission, most recently Pope Benedict XVI in 2013.

http://www.ncbcenter.org/Document.Doc?id=498

I just mean that there are organizations that identify as Catholic but have major issues with the 'official' doctrine. Like with any religious there are offshoots and varying interpretations, but it gets a bit more dicey with Catholicism due to the central authority of the pope. Many want to "modernize" the Church, but one thing I have to hand to it is consistency.

 

[SeekingJana]

You know what? I don't know. I am sure I had a reason for asking, but I can't remember. Sorry.

Just because he was my favorite actor... Yes, Christopher Reeve died of natural causes- He had sepsis from a decubitus ulcer and experienced cardiac arrest from an antibiotic given to treat the sepsis.

He had a tracheostomy for the duration of his paralysis, since endotracheal tubes are a temporary method of airway ventilation. He had a C-2 spinal fracture, known as " hangman's fracture" due to the location- usually fatal but there was a doctor present at his equestrian event who saved his life on the scene. His spinal cord was severed as high up as is possible, hence the paralysis of diaphragm and respiratory muscles, so I am relatively certain that he would have received a trach. ( vs. ETT) very early into the acute phase of his injury.

He advanced the cause of those with spinal cord injuries greatly through his public appearances and his foundation.