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<p>She would still be on the vent-she is absolutely 100% vent dependent. But whichever kind of breathing tube she has needs to be replaced because they are not intended for long term use. Usually by now she would have been trached. But you are right about the rest. She needs a PEG tube for transfer for her nutrition.</p>
<p>Many of you may remember Christopher Reeve’s setup. He was on a ventilator which entered his body through a trach.</p>
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<p>Aren’t hospitals legally bound not to release dead bodies except to “appropriate” places? (funeral homes, crematoriums, or towards a research facility should the patient have so designated) I mean, I can’t take grandma’s body home or have her shipped to my beach house, can I?</p>
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Not sure I follow. Insurance companies don’t pay instantaneously. They may authorize a continued inpatient stay, but they review and process the claims after they are submitted. If they deny the claim, the hospital (or the doctor submitting the claim) has to go through an appeals process. Been there, done that. The insurer doesnt file suit to “stop paying”. They just deny the claim. The burden is then on the facility or provider to go through the appeals process.</p>
<p>Probably these medical fees will be part of the ultimate settlement down the road. What I’m saying is that the insurer is sitting tight and doing nothing at this time. Depending on the situation, the company could decide to contest or not contest, but it isn’t going to do anything now because the outcome isn’t yet certain. Someone could step in and decide to pay on the family’s behalf. Heaven only knows.</p>
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Apologies, I misspoke. That is correct. The issue is a permanent tube. My bad. Sorry for trying to do 2 things at once.</p>
<p>As for the insurance and the stay, the stay is to prevent the discontinuation of the life support. It isnt reversing the drs determination that she is deceased.</p>
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That’s exactly right.</p>
<p>But again, what the court decrees and what the insurance provider has to do are not necessarily one and the same. As Hunt said, the insurer is governed by its policies. </p>
<p>That said, the mom works for Home Depot, and if she is insured by them (do not know- she could have insurance under her husband) but if she is under HD’s policy, HD is self insured, and their HR Dept can probably direct the carrier who manages their plan to pay for some or all of the ongoing hospital stay. That would be good PR.</p>
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They aren’t one and the same, but the insurance company’s situation is as yet unknown. For that and other reasons, they will act retroactively, not now.</p>
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I’m sorry, but as a flat statement of fact this assertion is clearly wrong. Doctors perform procedures on “dead bodies” all the time - keeping brain dead patients alive in order to transplant their organs, using cadavers to train physicians, etc. It isn’t the fact that the girl has been pronounced brain dead that makes it “unethical” per se, it’s the fact that her parents don’t believe she’s dead and want to take her someplace else. That’s why I call BS on using “ethics” as an excuse. It’s tautological. “If we don’t want to do it it’s unethical. If it’s unethical, we’re justified in refusing to do it.”</p>
<p>As to whether the insurance will pay for it, or any doctor is available to perform the necessary trach, those are all issues of speculation (although I suspect Zoosermom is right as to the insurance question.) Everyone is entitled to their opinion, but I’m addressing the situation as presented to the court. The hospital has been inconsistent with its statements, but as far as I can see the current position is that they won’t allow the operation to be performed at Children’s, period, unless ordered to do so by the court.</p>
<p>Perhaps Home Depot has already told the family that it will pay for it.</p>
<p>It seems to me that it would be unethical for a surgeon who believes the person is dead to perform this surgery. A surgeon who doesn’t believe that could perform the surgery ethically–like this Dr. Byrne, maybe.</p>
<p>kluge,putting a feeding tube in a dead person is totally different than harvesting organs for transplant or using a cadaver to train physicians in my opinion.</p>
<p>Perhaps Home Depot has already told the family that it will pay for it.</p>
<p>Not a chance. That doesn’t happen.</p>
<p>Actually, now that I think about it, it makes perfect sense that if the hospital takes the stance that they will not allow the procedure unless ordered by the court, they are then protected by the court order (to which they would comply if someone was found who would do it and who qualifies for privileges).</p>
<p>As for the insurance issue, I think we are talking about different aspects of the same process. The insurance verification coordinator at the hospital would get authorization for continued covered days from the insu provider. But again, this does NOT guarantee that all the charges will be paid. If some Dr was going to perform this procedure, they’d also contact the provider to verify coverage (they’d be stupid not to, unless they planned to do it pro bono). In some states , providers cant be sued for pro bono work. So maybe it would be smart to do it pro bono. However, they’d run the risk of looking like a media hound.</p>
<p>And can you imagine the precedent that would set if Home Depot did pay for all this after she has been declared dead.</p>
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<p>Fine, you win, kluge. It’s unethical for a doctor to perform a medical procedure on a brain-dead person when he knows such a medical procedure is fruitless and fuels unrealistic fantasies in the minds of her loved ones that recovery is possible. Is that better? </p>
<p>You know, we wouldn’t do this to a dog. We wouldn’t keep a dead dog like this. We’d cry, and let them pass on to a hopefully more comfortable life. There’s a reason we say Rest in Peace.</p>
<p>I visited the Facebook page of the New Beginnings facility which has allegedly offered to take over Jahi’s care. I did notice that when people question the ability of the center to provide the proper care for this patient that their comments are often deleted. Comments like this one:</p>
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<p>I simply cannot imagine the hospital releasing this patient, dead or not, to a facility such as New Beginnings if they are as ill equipped to care for her as they seem. </p>
<p>Regardless of whether or not certain lay people consider it not to be unethical to operate on dead bodies, the general consensus in the medical community is that doing anything other than letting this child go is unethical. It is a general consensus that fruitless treatments and surgeries on legally dead patients is unethical. It would be a general consensus that performing treatments on brain dead patients would be giving false hope to the parents, which goes against the “do no harm” tenants most medical professionals embrace. Allocating precious resources to dead patients rather than providing them for a population which still finds quality health care a difficult commodity to obtain and who could actually benefit from them goes against the do no harm philosophy as well. One might disagree that it is unethical, but many of the people expected to actually carry out interventions on legally dead patients most certainly do, and their position is completely valid and should be fairly easy to comprehend even if disagreed with.</p>
<p>I also visit a nursing forum and there is a very long thread about this incident, and I don’t believe I saw even one post which advocated continued treatment on a brain dead patient. This forum is usually very contentious, so this is very notable. People who actually work with patients and who have a good understanding of what it takes to be declared brain dead, who understand the implications of continued treatment, etc. seem to be unanimous in their disgust with what is going on, particularly the misinformation which continues to be spouted as fact in the media and other sources. I should probably bookmark that thread because nothing approaching unanimity will likely ever appear there again.</p>
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I think you are right. What I’m saying is that the insurance company really doesn’t want to pick up its head and get caught in the crossfire. Plenty of time for it to protect its interests later when the situation isn’t so hot. Also, while unlikely, it is still possible that a donor could come through; and more likely that medical costs will be part of some later settlement.</p>
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<p>As usual, PG states it succinctly and so much better than I ever could.</p>
<p>Kluge, the analogy you draw with organ transplantation and medical training is flawed. Medical ethics seek to balance benefits and burdens. For either of the cases you cite there is a clear benefit. For the proposed procedure on the child’s body, there is no benefit, except perhaps the hypothetical benefit to the family of allowing them to continue their clearly false belief that their tragically dead child can somehow be resurrected.</p>
<p>Medical ethics also seeks to balance other values, such as the right to patient self-determination and the fiduciary duty to conserve scare resources to maximize benefits to all. Again, in this case, a dead child is by definition unable to receive benefits or experience harms. ICU resources are exquisitely titrated to be maintained at close to the maximum level–they are just too expensive to sit idle for long. The capacity of this hospital’s (or this community’s) pediatric ICU beds has not, as far as I know, been made public, but even if there is not a shortage today is it a wise thing to set a precedent of using those resources to maintain dead persons when we have no way of knowing whether live persons may need them tomorrow?</p>
<p>Finally, I will say that the court is setting a very chilling precedent for those of us who are committed to human and civil rights. If courts can compel treatment in cases where no benefit to the (former) patient is possible we should all be very very concerned.</p>
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Agree that this will probably be subrogated. If an insu co pays out, they will want to be reimbursed if the cost should be covered by a third party. </p>
<p>What I am saying is that the insu co may not up front deny the continued LOS, but they may likely deny some or all of the claim when it is submitted for payment.</p>
<p>(LOS = length of stay)</p>