<p>So, Pizzagiurl and Cardinal Fang, you believe that the family should be prohibited from taking their daughter out of the hospital, come hell or high water, unless she’s not breathing anymore? That’s what I’m talking about: the degree of coercion that is appropriate to make people do what we think is best. </p>
<p>As to the payment for the use of the facility, I’ve made it clear that I think our current policies routinely waste a thousand times what this instance would cost, with regard to the elderly - who are also going to die soon, regardless, and no ones says a word. I’ve proposed that Medicare reimbursement for medical intervention for the aged should taper off after a certain age, so that the cost of full-court press medical treatment for the extremely old would be borne more by the aged (and their heirs) rather than the taxpayers if the family insists on it. As it stands the default is to take extreme (and costly) steps to keep even hopelessly senile, bedridden old people breathing unless they voluntarily agree to pull the plug. Would you agree with that proposal?</p>
<p>Kluge, many of us agree that something needs to be done about end of life care. It’s the people who scream Death Panels you need to be talking to.</p>
<p>Didn’t the “death panel” happen on Dec 12th? There is a coroner’s certificate issued in this case. They disagree. They have had 5 or 6 second opinions including independent exams ordered by the court. The old people are at least alive. But, it’s a different issue entirely.</p>
<p>Who has disagreed? Two of the hospital’s doctors and a pediatric neurologist from Stanford who examined her all agreed she was brain dead. Are you implying that determining someone has died is a death panel?</p>
That’s where we disagree. The definition of “brain dead” as meaning “dead” is a policy decision. It’s not self-evident (as is complete body death, which follows from a cessation of blood circulation) It’s just a convenient (and defensible) “bright line” rule. The McMath family believes that their daughter is “still alive” and there are people who aren’t crackpots who agree with them. I believe that society has the right to say that medical treatment for her is not required. Where I have difficulty is saying that it is not allowed. </p>
<p>And the issue raised by Cardinal Fang, is cost. And that’s exactly the same issue, whether it’s a brain dead 13 year old or a senile, bedridden 90 year old. Who should pay to keep their heart beating? How much?</p>
<p>No Emily, the family disagrees. It doesn’t matter who tells them their daughter is no longer living. They are willfully refusing to accept this information. I’m not implying anything. That’s happening.</p>
<p>And, Kluge - I’m confused by the distinction between required and allowed since they certainly can’t pay for it. We know that, as well. So nothing changes.</p>
<p>Who are these people who agree she is still alive? And if there are so many of them, where is a doctor who will perform the necessary procedures so she can be moved?</p>
<p>Emily - I simply meant the court issued a coroner’s certificate with that date. I guess it was a sloppy attempt at humor which never works here. Oops.
My apologies.</p>
<p>Boy, this thread moves fast! As mentioned, very young children may need, or be recommended, advanced dental care if they have soft enamel. This can be hereditary or due to medical syndromes. Children also fall and can injure their mouths/teeth requiring care. This happened to our youngest at age 3. All of our boys have had regular early dental care, as did my husband and myself. We took him to a reputable pediatric dentist who gave him a root canal under nitrous oxide as the tooth had died. In retrospect we wish we’d just had the tooth pulled, he was three. Yes, we regret the decision. Parenting isn’t perfection, but the best, most educated decision at the time. The need for care was not a result of neglect or poor hygiene habits as was the immediate thought of some.</p>
<p>The hospital’s handling has been poor in my opinion too. No comment would have been better than some of the things that were said. If they are in an “unthinkable” position, then someone who should have been thinking wasn’t. I represented hospitals when I practiced law and it was our job to make sure hospitals are never in “unthinkable” situations. Every time they recommended that someone be taken off life support, they should have considered what happens if the answer is “no.”>>>>>>>>>>>>>>></p>
<p>Very interesting. What does an institution do next when the answer is no? Sure, it often takes families many hours to accept the situation. In the case of very young patients, families often choose to counteract their devastation by donating organs. I wonder how many different people from different disciplines have counseled this poor mother that there is no hope and she still will not back down. Can she sincerely not accept this or is she just the most stubborn person ever born? What an absolute horror. They cite their religion as the reason. What does their minister tell them?</p>
<p>kluge, The elderly issue is completely different than this. Jahi is clinically brain dead. Your example of an elderly senile 90 year old is not equivalent, that person is not dead. From first hand experience, my 91 year old MIL with late stage Alzheimer’s took over a year from entrance into hospice to finally die. Her family did nothing to artificially prolong her life. Her body just would not give out. We let nature take its course ,quite different than taking extraordinary measures with the elderly. I visited my MIL for the last 3 years of her life in a memory unit- lots of sad issues , hard to see,but no one was being artificially maintained.</p>
<p>From first hand experience with having dealt with both my parents in ICU, I can’t imagine a hospital having to maintain a dead body in their unit to give a family weeks (or even as much as 10 days as you noted) to get a grip and make arrangements. That is absurd and a major disruption to other families and staff members, let alone the cost factor.</p>
<p>Blue Iguana -This is very true! My youngest D had a big hole in a tooth at age 5. She brushed regularly and never drank juice. Still hates fruit to this day. However, what I didn’t do was look inside of her mouth. Never thought about it until one day I saw a giant hole. It never hurt a bit. Very strange. I fail.</p>
<p>My BIL wanted my SIL to abort their 4th child because tests showed that the baby might have Downs. My SIL refused and the baby was born normal. My nephew knows about this and he’s angry at his dad.>>>>>>></p>
<p>God, poor kid. Why on earth didn’t these parents keep this totally private. Only the two of them should have ever known any of it. Let alone the poor child. Ugh. People are so incredibly stupid sometimes.</p>
<p>Val - I asked the big kiddo, our future MD, what she thought about this situation. She said that one of her professors talked from his experience - most come to grips with the reality relatively quickly, some take longer to grieve and accept the fact, and only a tiny handful dig their heels in and insist on continued “treatment” (like what Nrdbs described in one of her posts), which usually does not last this long since a dead body starts to go south quickly, then the situation resolves naturally when the heart stops. This is an extraordinary situation, mostly because the girl’s body is young and has enough nutrients stored to sustain the artificial existence for so long without feeding.</p>
<p>Sadly, the mom actually commented on this saying she was glad her daughter was heavy because she still looked good after 24 days without food. I know. It’s awful.</p>
<p>with the International Brain Research Foundation, a nonprofit group that specializes in treating coma patients and claims to have helped hundreds of people deemed brain dead awaken from comas>>>>>>>>>>>>>></p>
<p>If this is true, why do we not know about it? They should have won the Nobel Prize for medicine. No one, therefore, should EVER be withdrawn from life support if this is true.
To the physicians here, have you ever heard of this? Read it in medical journals?
I’m guessing not.</p>