Wednesday, December 18, 2013

Jahi McMath - Who Gets to Decide when to End Life Support when a Person is Dead?

On December 9, 13-year-old Jahi McMath underwent surgery at Children’s Hospital Oakland to remove her tonsils. It was supposed to have been a routine procedure intended to cure a sleep apnea problem.  But after the surgery, she coughed up blood and went into cardiac arrest.  On December 12, Jahi was declared brain dead. (CNN)

But this sad case has gotten even sadder.  Jahi's mother, Nailah Winkfield, will not consent to removing life support technology.  She says: "I just feel my daughter is trapped inside of her body, just screaming to get out of there."  "I will not let them pull the plug on my child."  Ms. Winkfield even started a Facebook page called "Keep Jahi Mcmath on life support."

Furthermore, the family has served the hospital with a "cease and desist letter" that says the hospital does not have the family’s consent to remove life support without permission. The letter from attorney Christopher Dolan said that "no action" should be taken regarding the life and death of Jahi McMath until there can be a "judicial termination."

I have not seen Dolan's letter.  But families almost always lose these sorts of cases.  California law is uncertain in lots of situations, like dialysis for a vegetative patient.  But it does permit healthcare providers to unilaterally stop treatment for a dead patient.  Yes, some short-term  accommodation is appropriate.  But ultimately, family consent is not required.

11 comments:

Carol Cross said...

I think this particular case is kind of a "red herring" that diverts attention from the real problem of withholding end of life care from patients when "medical futility" is invoked. WHO DOES get to decide when a patient is brain dead or when a patient is better off dead than alive --when the patient's death is the result of some kind of error made in the hospital? .

Obviously, some kind of mistake or error was made in this hospital by some person or persons and does the hospital want to bury the error OR investigate the error? I thought I heard someone speculate that they could not find "the cause of death" unless this little girl was removed from life support.

Certainly, this hospital owes this grieving family some short- time accommodation until the Court decides that the decision to pull the plug is fair and neutral and not made for reasons of fiscal expediency and/or protection of the hospital and the physician from malpractice. That is, what if this child is not "brain dead" but "brain injured" and it is malpractice?



I think their attorney is protecting his clients in the only way possible and the judge will know this.

Carol Cross said...

I think this particular case is kind of a "red herring" that diverts attention from the real problem of withholding end of life care from patients when "medical futility" is invoked. WHO DOES get to decide when a patient is brain dead or when a patient is better off dead than alive --when the patient's death is the result of some kind of error made in the hospital? .

Obviously, some kind of mistake or error was made in this hospital by some person or persons and does the hospital want to bury the error OR investigate the error? I thought I heard someone speculate that they could not find "the cause of death" unless this little girl was removed from life support.

Certainly, this hospital owes this grieving family some short- time accommodation until the Court decides that the decision to pull the plug is fair and neutral and not made for reasons of fiscal expediency and/or protection of the hospital and the physician from malpractice. That is, what if this child is not "brain dead" but "brain injured" and it is malpractice?

I think their attorney is protecting his clients in the only way possible and the judge will know this.

Patrik Hutzel said...

What a sad and tragic case... Unfortunately, while these cases are relatively rare, I have witnessed and I have been involved in similar cases in Intensive Care regularly. These situations tend to stir a lot of emotions and angst for all parties involved, whether it be for the Intensive Care team and/or the Families of brain dead Patients. Whilst for the Intensive Care team "brain dead" is diagnosed, for a Family who is on the brink of losing a Family member, it will never be clear cut and to accept the death, especially of a child is heartbraeking...
Patrik Hutzel
Critical Care Nurse

Anonymous said...

What a sad and tragic case... Unfortunately, while these cases are relatively rare, I have witnessed and I have been involved in similar cases in Intensive Care regularly. These situations tend to stir a lot of emotions and angst for all parties involved, whether it be for the Intensive Care team and/or the Families of brain dead Patients. Whilst for the Intensive Care team "brain dead" is diagnosed, for a Family who is on the brink of losing a Family member, it will never be clear cut and to accept the death, especially of a child is heartbraeking...
Patrik Hutzel
Critical Care Nurse

Anonymous said...

We don't know what happened except for what the family recounts. I would like to hear from the ICU before I made any decisions on who was at fault, if anyone. Usually these patients are sent back to surgery if there is heavy bleeding. I didn't see that mentioned by the family.....but then they also are refusing to let the hospital explain the events.....so again, we are getting this story from lay people. I have worked ICU and OR. Even if the hospital was at fault, that is the staff that failed to report her bleeding until it was too late, those nurses should be disciplined, but it is ridiculous to claim the hospital needs to keep a brain dead corpse on a ventilator because its staff members were negligent. The girl is still dead. The family should stop listening to those crazy pastors and stop believing a miracle will happen. Religious arrogance has no place in medicine.

Kao said...

Carol, the hospital has kept her on a ventilator for three weeks. We don't know what really happened because the family is not letting the hospital comment. we have only heard their account. Even if it was the fault of ICU nurses not reporting the bleeding until it was too late, that still is not a reason to keep a brain dead corpse on a ventilator indefinitely. Two doctors declare a patient brain dead after extensive testing. Insinuating the hospital is trying to declare her brain dead to avoid a lawsuit is ridiculous.

Anonymous said...

My prayers go out to this family. This is a VERY tragic situation and I don't fault them for wanting to hang on to hope. I pray that they will accept that she is with God and allow her to rest in peace.

Carol Cross said...

Why would the attorney be assisting this family to fight the removal of the ventilator if the matter is so settled in the law?

Can't you see that the use of words like a "dead corpse" (redundant?) is very offensive to those who love this girl -- especially to the Mother who can still feel the warmth of her daughter's body and the beating of her heart?

Carol Cross said...

Why would the attorney be assisting this family to fight the removal of the ventilator if the matter is so settled in the law?

Can't you see that the use of words like a "dead corpse" (redundant?) is very offensive to those who love this girl -- especially to the Mother who can still feel the warmth of her daughter's body and the beating of her heart?

Carol Cross said...

Why would the attorney be assisting this family to fight the removal of the ventilator if the matter is so settled in the law?

Can't you see that the use of words like a "dead corpse" (redundant?) is very offensive to those who love this girl -- especially to the Mother who can still feel the warmth of her daughter's body and the beating of her heart?

Venetia Rose said...

It’s such a trauma for the entire family to see their loved ones who are brain dead and who require life support . How long can you see Jahi Mc Math be on life support? There would have been an error on the part of the medical team which was the main reason on how Jahi developed cardiac arrest.Consult a medical malpractice lawyer who will guide you on the medical laws and issues and try to sort out this issue first. There are many medical malpractice lawyers http://www.sommersandroth.com/areas-of-law-practice/medical-malpractice/ in Toronto who will be able to help you out.