Yes. The only medically indicated procedures for a cadaver (which is what Jahi is at this point) are autopsy and/or organ and tissue donation. Anything else is pointless.
The doctors have had some issues, yes, but why should they perform a tracheotomy on a dead person? I can understand why hospitals refuse to perform medical procedures on dead people.
I live in the Bay Area, so I’ve been aware of this case a little longer than most of you. One odd thing is that it made the local news the day Jahi died, before taking the body off the respirator became an issue. I was puzzled at the time since it didn’t seem newsworthy to me - why did the public need to be informed that a thirteen year old girl had died of complications from a tonsillectomy? The public fight over keeping the body on “life support” hadn’t started yet. Looking back on it, I see that the family started a PR campaign as soon as they were told Jahi was brain dead.
Well, this past evening, I had the misfortune to view Huckabee’s show (my parents like it). One of the guests was Terry Schiavo’s brother. My considered opinion of the brother: Lying Sack of Dung. Oh, yes; he tried to appear as a concerned person, concerned about protecting a hospitalized person from having the government yank the right to make end of life decisions from the hospitalized person’s family. You know what the LSOD failed to mention? Right! He failed to mention that he was involved in trying to get the government do that very thing so that his sister’s immediate family member would, in fact, have that right removed from him.
Jahi McMath’s parents are in denial. Yes, it’s sad that their daughter is dead so young. But wishing she weren’t won’t bring her back.
On a related note: Finley Boyle, a 3-year old girl, is now brain dead after a dental procedure. Her parents, the mom being a nurse herself, seem to grasp the concept that brain dead is dead.
But how do they keep her from rotting, being dead and all?
They give her oxygen, they give her nutrients, and her heart is still beating to move those around the body. The heart will beat as long as it gets oxygen and nutrients and isn’t damaged - the electricity that causes its muscles to contract comes from the heart cells, not the brain. Hearts that have been cut out of the body will beat for some time, until they run out of the sodium and potassium they need. You know that image of the Aztec sacrifice, with the priest ripping the heart out of the chest and holding it up, still beating? That can happen.
So the heart is pushing the blood and the blood is bringing oxygen and nutrients to the cells, and many of them can keep doing their cellular jobs without the brain. The kidneys and the organs in the brain like the pituitary and the hypothalamus cannot do it for very long. So to try to compensate for that, they give her hormones and drugs to keep the kidneys going, and they have to use warming blankets or warmed IV fluids to keep her body temperature up (since they hypothalamus isn’t working).
The blood pressure will start to drop, because while the heartbeat is controlled by the heart cells, the blood pressure is only partly controlled by the heart. The brain isn’t making the hormones that fine tune the blood pressure, so they give her drugs to do the job instead.
So at first, she won’t rot because her cells aren’t each individually dead. Even in a natural death, our cells die at different rates; if I looked at a skin cell an hour after you had died, that skin cell would probably still be alive. This is why we can take some of your skin off and graft it to another person. This is why organ donation works - the cells and organs don’t die immediately when the brain function ceases, as long as you can get oxygen and nutrients to them.
Eventually, she will get skin breakdown, which is the nursing way of saying she’s getting open sores. They will try to slow this down by turning her frequently, but slowing it town is all they can do. Once the skin begins to breakdown, infection will set in sooner or later, and they’ll try to give her a lot of antibiotics to fight these infections. Her lungs, bladder and kidney are likely to get infections, too, from there the tubes are running into and out of her body. More antibiotics.
Eventually, she’s likely to get some infection (“rot”) that the antibiotics can’t kill, or can’t kill fast enough, and the infection will spread to her bloodstream and possibly to her heart. The heart will stop beating, and may not start again, ventilator and nutrition or no.
Hospitals don’t decide that. Families do. ALL hospitals must wait and ask for permission, in EVERY case.
Only if the public is paying for it.
(I agree that the family should pull the plug.)
Not true in the case of brain death. A hospital is under zero legal obligation to provide medical care to a dead person, and a person who is brain dead is both medically and legally dead. Hospitals don’t pull the plug immediately for the sake for the surviving family members.
(Hospitals don’t have to ask the family’s permission to stop a code, either. You may want the ER team to continue shocks and chest compressions on your loved one for 5 hours, but they won’t. They’ll stop after 30-45 minutes regardless of your wishes, because there is no obligation on the part of medical professionals to provide futile care to a dead person.)
Good point. I was confusing it with coma/persistent vegetative state. Thanks for making me think more about this. Brain dead means dead.
I doubt that hospital - or any hospital - is 100% efficient. I’m sure doctors do tests just to be sure. The minor inefficiency seems reasonable in return for the benefits of not looking like assholes. (I said looking like, not being.)
If harm could be done with the procedure, then they should refuse. No harm would be done.
In any case, the girl (or her body) is gone now.
They are when there is a court order, which was true in this case.
As for the money, the hospital could have saved a lot if they had done the requested procedures and gotten her out of there.
This seems to be a logic versus emotions case. Logically she is dead, and the parents should accept it, and hire a lawyer to check their options. Emotionally they can’t accept it. The hospital really shouldn’t have gone all Sheldon on them and instead talked them down.
My understanding is that hospitals often keep a deceased patient on life-support machinery for a while to give the family time to come to grips with what’s happened. This usually won’t last more than a day or two.
I hope this incident is a one-time thing - that there isn’t a movement to keep brain-dead patients on life-support machines. That could force hospitals to change their practices to be less compassionate - to yank dead patients off the machines as quickly as possible regardless of the emotional state of the family members.
We don’t know what happened in the conversations between the family and the hospital staff and administrators, so I don’t see any basis for saying that the hospital went “all Sheldon” on them. We do know that Children’s Hospital has a lot of experience dealing with these types of cases, and this is the only time a family has gone to court (and to the press) to prevent them from taking a dead body off of life support.
I suspect one reason the hospital didn’t immediately agree to transferring the body is that they don’t want to set a precedent. They don’t want to risk this happening every time someone dies in their facility.
They may also have been worried that when the family eventually (and inevitably) does take the girl off the machines, they will blame the hospital for the result. That is, the family could claim that the girl would have survived if the hospital hadn’t botched the transfer. The family’s lawyer has already hinted at this in a statement he made to the press yesterday (he said something to the effect that Jahi’s recovery will be more difficult due to the way she has been treated at Children’s Hospital). I think this is one reason the hospital was so reluctant to do the transfer at all - there are no standard practices for doing such a thing, which leaves them open for a legal claim (and more bad publicity).
They definitely do - and before an official determination of brain death can be made, the tests need to be repeated at least once. Here’s the American Academy of Neurology’s procedure for determining brain death.
What makes you think the hospital did? I suspect it’s the other way around - the parents freaked when the hospital staff continued to try to get them to accept the reality of their daughter’s death. To them it does not compute, just as it didn’t seem to compute to Raechellogram, and for the same reasons: she has a pulse. Her skin is warm. She’s breathing (with the help of a machine). How can she be dead?
This. For most families denial is a short-term coping mechanism. Keeping the dead body on life support for a day or two almost always buys enough time for the family members to move past the denial stage into acceptance of the tragedy, and so they suffer less trauma when the life support is finally discontinued. Fortunately it’s unusual for a family to be stuck in a prolonged denial stage, as this family is.
I don’t watch Fox News, but it happened to be on this morning in the automobile service department I was at this morning. I guess the show was called “Fox and Friends” or something like that. Anyway, they seemed to be treating the fact that the family was moving her body from the hospital as a “big win”. Was I incorrect in thinking they saw this as a “big win” ? And if correct, is the “big win” holding out for some divine intervention?
Since I’m not following the story on Fox, are they mentioning who is footing the bill for moving the body to another facility ?
It’s pretty clear that they’re going to end up with both of those things anyway, based on statements like this from their attorney (which may be among those you heard):
“They left her without nutrition, she has severe infections; she’s struggling,” Dolan told the Daily News on Monday. “These are things that are easily preventable, but when they wrote her off as dead, they stopped caring for her. We don’t know what the outcome is going to be.”
You misunderstand me. My argument is not about whether she is in fact brain dead - I believe I read that her brain has not gotten any blood for a week now. My argument is that the explanation that the hospital could not do a tracheotomy because it would be wasting resources is rather weak.