<p>This sad story has been front-page news here in the San Francisco Bay Area for the past several weeks. A 13-year-old girl began bleeding and went into cardiac arrest after what the hospital calls a complicated tonsillectomy. She was declared brain dead after being examined by at least 5 physicians and 2 or 3 EECs.</p>
<p>Her grief-stricken and guilt-ridden mother refused to accept brain death as final and appealed to the court to block the hospital’s decision to remove life support. The court ordered the hospital to keep her ventilator on until 5pm today, during which time the family has tried to find a long term care facility to take the girl.</p>
<p>Well, it’s a very sad story. Based on comments I’ve read on various news outlets, it seems there is a whole lot of confusion about brain death vs. coma or vegetative state.</p>
<p>Her family is in denial. If this child is in fact brain dead, what they are proposing is pretty horrific. I’m not clear on who is expected to pay for long term care of a mere shell as no insurance company can be compelled to finance care for a dead person.</p>
<p>This breaks my heart. My family and I have always been very open with one another about what we want and don’t want. To keep a body alive when everything else is gone is torturous to me. </p>
<p>It usually is the parent’s decision when a patient is in a persistent vegetative state or coma. However, the patient is legally dead. Caring for her dead body could run into the millions and the general public will be expected to pay for it. Therefore, judges are involved as they act in the interest of the public. Her parents are operating on magical thinking vs. reality. Brain death is NOT coma or vegetative state.</p>
<p>I think the decision to take or not take her off the ventilator should be the parents’, in which case they would also have to be the ones to pay, but it should be their decision.</p>
<p>Can someone explain the difference between vegetative state and brain death and how they would be able to determine whether it’s one or the other?</p>
<p>Please note the word “irreversibly.” A patient in a coma has the potential to improve. They have measurable brain activity. A brain dead person’s condition is irreversible. There is NO brain activity.</p>
<p>If this child has had a negative cerebral flow study, she is dead. She is NOT coming back to life, she will never respond to others, she is gone. It is highly unlikely these parents have the financial means to care for their dead daughter. As sad as it is, money is something that does run out, and it’s patently unfair to put public resources towards caring for a dead person vs. having those funds available to help the living.</p>
<p>If this were my daughter, I would be absolutely devastated. I really feel for the parents, but in a circumstance like this, they cannot be allowed to dictate what happens if the child is in fact brain dead.</p>
<p>They may not have the money, but I still feel they should at least have the option to decide what happens, provided all expense will be on them. Then, it’s their decision and not a burden to the public.</p>
<p>I understand the parents state of mind somewhat. The tonsillectomy was an elective procedure with a dreadful outcome. They are feeling guilty and crushing remorse. Still someone good at teaching needs to explain the meaning of brain death to them. Understandably, they are not in any frame of mind to trust doctors just now.</p>
<p>First, they are going to have to find a doctor to perform surgery on a dead body. That seems unlikely. Actually, the fact that this has gone on for as long as it has is appalling.</p>
<p>Very sad story and I guess I understand where the parents are coming from. They don’t want to let go of their daughter and are hoping against hope the doctors are wrong. I don’t think explaining the differences between being brain dead and being in a vegetative state will change how they are reacting.</p>
<p>The hospital claims the procedure was much more than a simple tonsillectomy. Evidently, surgery for sleep apnea was also included. But citing HIPPAA, the hospital can’t comment further.</p>
<p>There are times when parents are not allowed to determine treatments/outcomes for their children when the courts deem they are either unethical or not in the best interest of their children. For example, parents who refuse life saving treatment for their children based on religious beliefs can still be compelled by the courts to hand their children over for these medical treatments. It can be considered unethical to continue to provide life support to a brain dead person. If you have ever observed long term care of a ventilated patient, what you see can be completely appalling, a cruelty exacted on a person who has no say in what’s happening. Even with the best of care, the body deteriorates in horrific ways. Courts have determined that keeping dead patients alive on a ventilator is medically unethical. Belief that parents “should” be able to demand medically unethical treatment for their children is irrelevant as the courts do have the power to overrule them, just as they overrule parents who take stances which will result in the otherwise preventable death of their children.</p>
<p>I would agree with you in pretty much every case except this. I agree about parents not getting their kids treatments, etc. - I would never advocate any potentially unethical treatment for a live person. However, in a case like this, if she is truly dead and it’s just a body, I guess I don’t see the harm to the child (since she is not alive) to let the parents make the decision - it can’t really be cruelty to a person if the person is dead.</p>
<p>The body doesn’t really stay alive after the brain goes. </p>
<p>Every minute that is spent with that corpse by the staff could’ve been spent by the doctors and nurses helping people that are actually still alive. </p>
<p>It’s not “just” the corpse. It’s not like it’s left in the hospital untouched and it doesn’t ONLY affect this family.</p>
<p>That’s why I advocate letting them pay for the expenses. If they pay, I don’t see the harm to anyone - I just don’t see why it can’t be their decision - at this point it doesn’t seem to be harming anyone at all, considering they pay.</p>