<p>Garland,
We dont know that he is or is not represented by the mom’s attorney, but he has been in front of the cameras, ind it would be most surprising if someone didn’t give him some guidance. Even if he is not represent by the mom’s attorney, they have a vested interest in how he comes across, because if he does not come across well, for whatever reason, it could, like it or not, affect the opinion or sympathies of the public. The mom is coming across like a genuinely grieving, caring, distraught parent who is living everyone’s works nightmare. She is getting almost everyone’s sympathies. If, heaven forbid, the bio dad comes across like one of those “money grubbers”, that could hurt their case. So they have every reason, whether he is or is not represented by this counsel, to try to not let him negatively affect things, were that a possibility. I did not see him in the news, so dont know how he came across.</p>
<p>Well, I can’t imagine the medical/legal decisions will be affected by Dad’s FB name. So I guess you’re right; if they’re in it for the money, Dad better tone it down.</p>
<p>(I don’t think, just to be clear, that they’re in it for the money–just horribly misguided and mis-advised, as I’ve repeatedly said.)</p>
<p>I’ve never been present in an OR during an arterial bleed.</p>
<p>I have taken care of patients who are bleeding from the femoral artery. It can bleed with tremendous force, and if not controlled immediately, can cause death pretty quickly. In my unit, I never experienced a fatal event due to an arterial bleed as we were always able to eventually get it under control with manual pressure and blood transfusions. I’m not that familiar with what kind of bleeding happened in Jahi’s case. I just assumed that that the bleeding had interfered with her respiratory efforts, which then caused a cardiac arrest and subsequent severe hypoxia of the brain before she was finally able to be intubated and her heart re-started. I haven’t read any official version of events.</p>
<p>Zoosermom- thank you for posting that. What grace that family has and what a loss for the world community to lose a wonderful person like Sanaz. So sad.</p>
<p>So not to digress (well, only a little), but what IS the appropriate “ask” for money when someone dies? After not having been to a funeral in 10 years, I have–in the past three weeks–attended a memorial service (more like a “celebration of life” party) for an old friend who committed suicide and one for my friend’s elderly mother who died on Christmas. In both cases, there was a donation area. For the friend, the family asked for donations to defray the costs of the party. It was hard to see what costs those might have been other than the modest rental cost for the venue (everyone brought food and drink). For my friend’s mom’s service, there were preprinted envelopes from the funeral home. It was unclear to me what the donations were intended to cover. I am honestly asking about the etiquette of all this here, since I really don’t know. And I am thankful that I don’t.</p>
<p>I find the debate here between two groups of people who agree that the child is dead and that she won’t come back to life to be interesting. </p>
<p>Some feel that because the parents are wrong in their ultimate belief everything they and anyone who has aided them do is not merely wrong but immoral. Statements such as:
Their lawyer has been called everything from “questionable” to an “ambulance chaser.” Those posters seem to feel that it is the responsibility of everyone around - their lawyer, the judge, the doctors and hospital - to force the family to get in line. The parents believe their daughter is not dead. They have used the tools available to them - publicity in the first instance, the help of a lawyer they were referred to and who agreed to help them later - and they have been, so far, successful in preventing the hospital from allowing their daughter’s heart to stop beating. That success seems to outrage the first group, with suggestions of sleazy financial motivations, “handlers” and the like. </p>
<p>On the other hand, some of us feel that the while the parent’s beliefs are not well founded they are not hurting anyone and they should be allowed to do whatever they want (as long as they don’t demand a public payment for it.) The arguments advanced for why it would be “unethical” to perform a tracheostomy on this particular person’s body when her parents want it done (and there is no financial or other ulterior motive for a doctor to perform that operation) border on the silly. The arguments that it would “harm” the girl based on the assertion that she’s already dead - even though it’s not unethical to do the same thing to a different dead body - strike me as particlarly strained. Yes, it’s different from a practice operation on a medical school cadaver. But the difference does not impact the ethics of doing it.</p>
<p>The hospital isn’t refusing to cooperate because there is a risk of harm to anyone. A dead person cannot be harmed; any argument to the contrary is vitiated by her parent’s agreement to the procedure. Similarly, you can’t argue the parents are being harmed - they’ve heard your argument that their daughter is dead. By refusing to allow a tracheostomy the only message the parents will get is that the Hospital would rather let their daughter die than allow her parents to try to save her. The hospital’s poorly-disguised lack of cooperation isn’t based on “ethics” - at least not on any type of ethics I’ve ever seen.</p>
<p>It’s based on the same mindset the first group of posters here have exhibited: The belief that well informed, smart people have a right to coerce people who we think are wrong and make them not do things we think they shouldn’t do - even if they’re not actually harming anyone by doing it.</p>
<p>This is interesting to me. I’m the guy who posts harsh comments about gun owners, global warming deniers, etc. I’m pretty rough on those folks. But even I’m not ready to march them to the wall and tell them they have to go along with my opinion on the matter, or else. Yet that’s essentially what the first group of posters appear to think should be done. “You think your daughter’s still alive? You’re wrong. We know better. The doctors who agree with you are all quacks. You should be denied every means of keeping us from pulling the plug. You can’t seek public support through publicity. You can’t fundraise. You can’t have a lawyer. You can’t go to court. And even if you succeed in delaying things, we’ll prevent you from taking your daughter out of here in anything but a body bag.” </p>
<p>I think the girl’s dead. I think her parents are wrong. I think that even if they succeed their daughter will stop breathing in a few weeks or months. But I don’t think they should be criticized for trying based on what they sincerely believe. I don’t think their lawyer should be criticized for giving them access to the legal tools needed to do what they’ve done so far. I don’t think the judge should be criticized for making rulings that at worst cost some money but otherwise cause no harm, while allowing the family to try to do what they can. I understand why the hospital doesn’t want to do it. But I don’t think that hiding behind purported “medical ethics” as a justification for refusing to allow the parents and any willing doctors or medical facilities from doing whatever they think is best is anything but dishonest and craven.</p>
<p>Its likely there are 2 separate issues for this grieving family. The first and foremost, at the present, is the management of Jahi. The second issue, likely to be addressed at a later date, are the damages (legally speaking). And knowing that, the plaintiffs should , IMO, do their best not to inadvertently do/say something that defense counsel can throw in their face in front of a jury to try to make them look less sympathetic and try to mitigate the size of the award (if they win). </p>
<p>That said, given the publicity, its likely, IMO, that a settlement will be reached out of court.</p>
<p>[Teen</a> girl is brain dead after tonsil surgery | Home - Home](<a href=“http://www.krcrtv.com/teen-brain-dead-after-tonsil-surgery/-/14285892/23523864/-/ab1vnoz/-/index.html]Teen”>http://www.krcrtv.com/teen-brain-dead-after-tonsil-surgery/-/14285892/23523864/-/ab1vnoz/-/index.html)</p>
<p>Listen closely to her Mom’s comments towards the end of the video. Other than not wanting to let go, could the Mom be fighting the hospital as her way of “pay back”. Now please, I’m not trying to portray her in a bad light. She’s been through hell. But, could the real reason for continuing on with her fight to keep the ventilator going be some sort of revenge towards the hospital? Pay attention to when she says–“My daughter is a bed space and they need to get her out of there so they can put another child in there and kill them too.”</p>
<p>Kluge,
First, minor point. The word "handlers is taken out of context. What was said was "(or “handlers” or “managers” in other scenarios)</p>
<p>As for the trach issue. The doctors are likely the ones saying its unethical to do this procedure. Even if there is disagreement as to whether it is or is not ethical, should one compel any doctor to perform a procedure he/she is uncomfortable doing? Pages back PG used the analogy of a patient asking to have their arm or leg cut off. Just because it is requested, does it mean a doctor should be compelled to do it? And especially in such delicate and highly publicized cases as this one, its understandable that many physicians, even if they didn’t agree that it was “unethical” , might not want to touch it with a 10 foot pole.</p>
<p>I couldn’t put to words part of what was disturbing me about this case, aside from the obvious tragedy. Kluges post #526 expresses it perfectly.</p>
<p>Is it any different from the cases where physicians turn to the courts to compel a family to permit treatment for a dying child that the family is opposed to for religious reasons?</p>
<p>"On the other hand, some of us feel that the while the parent’s beliefs are not well founded they are not hurting anyone and they should be allowed to do whatever they want (as long as they don’t demand a public payment for it.) "</p>
<p>So if my kid is (heaven forbid) in a car accident, is pronounced dead at the scene or in an ambulance, I should be allowed still to insist that he or she put on a ventilator upon arrival? Why or why not? Is there a difference between the death occurring at the scene or in the hospital?</p>
<p>If there is a dying patient who codes, resuscitation efforts are unsuccessful and the patient is pronounced dead, do the parents / next of kin get to override and tell the doctor to keep working on resuscitating? Why is that?</p>
<p>I don’t know if the hospital has ever said anything along the lines that performing a tracheostomy would be unethical, simply that it is not their policy to perform surgical procedures on dead people. We on this thread are interpreting this as a matter of medical ethics. Regardless, the hospital cannot compel a surgeon to perform surgery on a patient declared legally dead. I imagine there certainly are many surgeons who would consider it medically unethical to perform this surgery for several reasons, even in spite of the fact that kluge would find it perfectly fine and dandy to do it. Just because one might disagree with a person’s ethical framework does not mean it is insincere. </p>
<p>Surgeons refuse to do surgeries every single day for numerous reasons, even if said surgery could prolong a person’s life. They are well within their rights. </p>
<p>The “hospital” doesn’t operate on humans, surgeons do. Hospitals have policies and procedures which all medical personnel with privileges to practice there must adhere to. And there is a general framework of “medical ethics” which many but certainly not all medical professionals integrate as part of their professional belief system and which guides their professional practice. As the question “is this medically unethical?” and there is no one defined answer, but you will find a lot of consensus about various ethical scenarios.</p>
<p>"Their lawyer has been called everything from “questionable” to an “ambulance chaser.” Those posters seem to feel that it is the responsibility of everyone around - their lawyer, the judge, the doctors and hospital - to force the family to get in line. The parents believe their daughter is not dead. "</p>
<p>But that’s not a factual belief, kluge. </p>
<p>Suppose instead that the family believed that she was possessed by demons, and that she needed to have an operation in which a surgeon cut her open so that the demons could fly out and she would come back to life. They believe this sincerely. </p>
<p>A) Would it be ethical for a surgeon to do this? </p>
<p>B) should a surgeon (who knows this is nonsense) but who has the skills be compelled to do this?</p>
<p>The idea that it’s ok if it’s not costing public money doesn’t work. That’s because it’s increasing health care costs overall. And I can’t imagine insurance is covering these costs.</p>
<p>This may seem gauche to discuss but the decision to keep the machines working on this poor, dead child, is an example of how screwed up is the American health care system. There are people who can’t get care because their states didn’t expand Medicaid but then you have hundreds of thousands of dollars spent in this situation.</p>
<p>And then there’s the reality that people who could have been helped with the poor child’s organs won’t be, since they won’t be healthy enough to go to people who need them.</p>
<p>“It’s based on the same mindset the first group of posters here have exhibited: The belief that well informed, smart people have a right to coerce people who we think are wrong and make them not do things we think they shouldn’t do - even if they’re not actually harming anyone by doing it.”</p>
<p>Uncle Bernie died in his sleep at home. Do I have the right to keep Uncle Bernie propped up at home so we can still feel his comforting presence? After all, it’s not hurting Uncle Bernie, and if he smells after a while, well, that doesn’t affect anyone other than me. So, can I keep Uncle Bernie’s body at home? Does the state have the right to compel me to ensure his body is handled somehow? (Buried, cremated, etc). And why can’t I bury UB in my front yard? It doesn’t hurt anyone, does it?</p>
<p>Look the family doesn’t have a place to move the girl to yet. Why is this an issue already? Are they making this an issue to sensationalize?</p>
<p>^^^Reports are that they do, or at least it is in the works if you believe the family and said facility. Have you not followed the thread tonight?</p>
<p>In your last example, PG, yes, there are health laws that prohibit keeping uncle Bernie on the front couch. And dogs might dig him up from the flower bed, even if his dying wish was to be fertilizer for the roses. In Jahi’s case, the are seeking the legal system to navigate what appears to be a gray area. Is there case law that would address this? I have to find the hospital petition again to see. HEre, btw , is the family’s petition, requesting theat the cours compel the hospital/drs to perform the trach <a href=“http://media.nbcbayarea.com/documents/JahiDeclaration.pdf[/url]”>http://media.nbcbayarea.com/documents/JahiDeclaration.pdf</a> The letter from the NY facility is attached.</p>
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<p>I agree. The system is completely messed up…but hopefully will begin to get better with the changes taking place.</p>
<p>kluge, thank you for your well-articulated post.</p>