<p>I can understand the mother’s feelings of guilt although I do not think she is at all guilty.</p>
<p>I think many of us, when signing medical releases, have a tendency to ignore the warnings. It’s only natural. No one wants to think they or their child will be the one in a thousand who suffers catastrophic complications from what seems on the face of it to be a routine surgery. Unfortunately someone has to be that one in a thousand, and when the surgery is more complicated, like in this case, the odds get worse.</p>
<p>My assumption is that the parents and their doctors carefully weighed the pros and cons of surgery in this girl’s case. In my experience medical professionals, aware of the risks, don’t make these recommendations lightly.</p>
<p>I remember when my active, healthy 15 tear old had her tonsils and adenoids out. All I could think of as I smiled reassuringly as they wheeled her into surgery was, “What if something goes wrong? How will I ever live with myself, knowing I made this decision for her?”</p>
<p>When we first visited the ENT surgeon and he told us he would not do the surgery without a signed agreement that for 10 days post-op we would not travel further that 15 minutes from a hospital at which he had privileges I thought he was being overly cautious. As he reiterated the risks of post-op complications I realized that he’d already detailed these risks but that I’d sort of glossed over them, assuming that they were overstated.</p>
<p>Yet health care personnel do this routinely when a brain-dead patient’s body needs to be kept in the best possible condition to enable the patient to donate organs.</p>
<p>Here’s a thoughtful article from an anesthesiologist who is sometimes involved in surgeries to remove organs that are to be donated. Why would an anesthesiologist be needed? This doctor will tell you.</p>
<p>Of course, it’s hard but continued denial is not going to make it any easier. The situation can only get a whole lot worse before it gets any better. It’s very sad and getting sadder. It’s also appalling.</p>
<p>It’s not “continued denial,” in my opinion. It is more likely a “slow acceptance.” Think about all the stages of grief that people experience under normal circumstances. Then try to imagine this.</p>
<p>Well, we can’t read minds so I have no opinion on that. </p>
<p>Based on what they are saying on a ton of talk shows and through their attorney, acceptance is not in the plan. They want to transport a dead girl to a nursing home run by a hairdresser. I understand the desire to be sympathetic to a grieving family. But, really. This is too much.</p>
<p>actingmt, of course “acceptance is not in the plan” when the family believes there is hope. I am not saying they should have it–if it were my relative I would have taken the overwhelming advice of the medical experts a long time ago–but I don’t know why you seem so personally outraged by this. You don’t seem sympathetic at all.</p>
It is also his opportunity to get the family’s version of what happened to the public. He likely looked the mother in the eye and asked her if she was willing for him to ANYTHING to keep her child breathing. She likely said yes. He can take the heat. It’s his job.</p>
<p>Just like the stages of grief, I think those of us who learned about this case very early on are at a different point than people who are still stunned that a girl died getting her tonsils out. When this thread appeared this case had already been going on for weeks and the confusion about the facts and changing perspectives on the situation is evident if you read through all of the posts on this thread or in various news reports. No-one is unsympathetic to a family losing a child. No-one.</p>
<p>It is not being on a high horse to state that I have taken care of a patient in an ICU with a diagnosis of brain death when you have not any more than it would be a high horse for you to state you have worked in close contact with a certain type of law firm and I have not. You stated that no treatment is mandated and that is incorrect. By definition, if a patient is on a vent and mandated to be on a vent, there is a standard of care that is REQUIRED and it most definitely involves treatment.</p>
<p>True, but it is usually mercifully quick. In those cases, the main priority is keeping the organs viable. It is still very intensive, usually a 1:1 nursing ratio with additional personnel involved, but in this case it has been long term in comparison. Additionally, measures are taken to preserve range of motion in the extremities as well as nutrition and personal hygiene. The main difference here is that they are preparing the patient for transfer to long term care, therefore the care is much more holistic and involved.</p>
<p>You don’t know anything about my life experience. I bet you didn’t know that I got my LPN in high school, because there were two programs at that time that allowed that a,ong with dual enrollment and was in charge of a floor at night in a long-term care facility at 19, including several brain dead patients - although they were elderly. I always expected to get my RN because I was so close already, but my family fell apart and college was out of the picture for me. I needed to make money so I took a more lucrative job, but I do have some experience that might surprise you. But, again, we aren’t arguing the merits. I agree with you. We are arguing what was actually ordered by the court and my position was and is that the actual care issue didnt factor into the judicial order.</p>
Sadly, when these situations become a media circus, they bring out the wingnuts. Even Jahi’s family said they had to come up with a secret password to keep out people who falsely claimed to be relatives, who told stories of brain dead family members returning to a completely norman state, to wanting to come up and touch Jahi, and one came up to watch the mother sleep. Creepy. If they can turn down the volume of the fringe people with their own agendas or idiosyncratic belief systems, maybe this family can properly grieve and heal.</p>
<p>Were those individuals declared “brain dead” that were at that long term facility, zoos? That might set a precedent in NY, perhaps why a facility there might consider accepting Jahi. But while memory fails me, I would be surprised that the medical technology almost 30 years ago was sophisticated enough to keep a brain dead individual going for very long.</p>
<p>jym626, lots of people equate comatose or persistent vegetative state with brain death. 30 years ago, they did not have the technology to either completely differentiate the two nor sustain a truly brain dead individual as long as this child has been sustained.</p>
<p>As someone quoted above, it is highly unlikely that a long term care facility truly has the capacity to sustain a genuinely brain dead individual. Even someone as incapacitated as Terri Schiavo was had enough brain function that she was able to breathe on her own and sustain her blood pressure without mechanical help or intensive drug therapy.</p>
<p>Agreed, nrdsb4. That’s why I asked if they were truly declared brain dead but were in a long term facility. If such is the case, as I said it could set a precedent. But if a person doesn’t have brain stem function to allow for some basic autonomic function, it’s surprising.</p>
<p>The above is deceptive. Jahi’s mother stated something to the effect that “I can see my daughter breathing” etc. Jahi is not breathing. A machine is literally pushing oxygen into her lungs. They took her off the vent as part of the brain death assessment. She failed to breathe on her own. At all. Jahi is not breathing.</p>
<p>Really, in light of the advice the parents are getting from various sources, the question is not “why don’t they believe she is dead,” but “why wouldn’t they believe she is alive?”</p>