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<p>Perhaps, but as cartera noted upthread, the family (and by extension, the media?) might have distrust in Children’s…full release of the Stanford Prof’s report will give the media something real to digest…</p>
<p>*
It’s bothersome to me that that is even a fleeting thought in the week after a death. Later, maybe.
*</p>
<p>She was declared brain dead Dec 11, almost four weeks ago.</p>
<p>ekitty</p>
<p>I understand that but this was weird on Dec 15th.</p>
<p>ek,She was declared brain dead on December 12th but remember, the family does not even think she is dead.</p>
<p>The Stanford neurologist’s report is floating around online. I’ve seen it-- I thought it was linked here. He details the tests that he did. The body failed all of them. She didn’t breathe when they disconnected the vent, her eyes didn’t respond to light, she didn’t respond to the test where they put cold water in the ear, she didn’t respond to a sharp poke, etc. And there was no blood flow to her brain.</p>
<p>The test left no reason for doubt.</p>
<p>Do we know for sure what the family thinks? 'Cause, I’m with jym. Skeptical.</p>
<p>[Trials</a> & Tribulations: Jahi’s Legacy](<a href=“http://sprocket-trials.blogspot.com/2014/01/jahis-legacy.html]Trials”>Trials & Tribulations: Jahi's Legacy)</p>
<p>This site contains a good video explanation of brain stem death and why the heart might continue to beat after brain death.</p>
<p>I’m skeptical too, actingmt. But the idea that they truly think she is not dead is what has been floated by the family and their lawyer.</p>
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The functioning of the body, including its ability to fight off infection, heal wounds, digest food, etc., after “brain death” is discussed in some length by a pediatric neurologist in this paper: [Dr</a>. Alan Shewmon on Brain Death](<a href=“http://ldysinger.stjohnsem.edu/@books/Shewmon/02_01_somatic_integr.htm]Dr”>http://ldysinger.stjohnsem.edu/@books/Shewmon/02_01_somatic_integr.htm)</p>
<p>I find the vehemence and emotion expressed by those who insist that the hospital (a) should have the right to turn off the ventilator despite the family’s expressed refusal to acquiesce in that and (b) should do so, to be interesting. I rarely associate depth of emotion and wildness of hypotheticals with a well reasoned position. The family and their lawyer have been subject to vituperation and character assassination.
Obviously, the perception of these posts is that a potential “payday” is more motivating for this “low information” family than the fact that they took their daughter into the hospital for a fairly routine operation and a few days later were fighting the hospital to keep them from turning off the ventilator to stop her heart beating, while reportedly lecturing to the family that the girl was “dead, dead, dead!” Perception, or projection? I don’t know what “types” are posting here, so I can’t say. And then there is the simply bizarre:
Really. </p>
<p>One of my sons is an EMT in Oakland. Frankly, after years of dealing with the sick, old and feeble - and their “low information” families - his ability to deal with people is not quite as stunted as you project. Although potentially directly affected by your “prediction”, I’m not going to lose any sleep over it.</p>
<p>To respond to what appear to be at least attempts to discuss this rationally, I have the following:
Every professional has clients or patients who refuse to follow your advice. Any professional bound by ethical constraints can’t just do what he/she wants anyway, but has to respond in a manner which respects the rights of the person to whom the professional has agreed to provide services, which can definitely mean you end up “devoting resources” to actions you think are pointless. As a lawyer, I’ve had to do this; I’m sure doctors face the same problem on a regular basis. (And I’m not just talking about doctors who make big bucks performing non-therapeutic cosmetic surgery, which is not “clinically” indicated either.) In this case, the “critical care team” which has transported the girl has demonstrated a high degree of professional ethics by refusing to exalt their own opinion over that of the family, and has served instead of dictated in the manner many here feel is appropriate.</p>
<p>One more thing:
This is not actually a problem. The girl is legally dead. Just like others who are legally dead the entire parade of horribles won’t happen. We actually deal with this problem periodically where people who have been declared legally dead show up years later. It’s dealt with.</p>
<p>I cannot imagine what is going on in the family’s minds. I am sure this has been extremely difficult for them. I wouldn’t wish this on anyone.</p>
<p>There is no way for any of us to know who was at fault (if anyone), or what is in the family’s minds. </p>
<p>What I do know is that this is just so very sad.</p>
<p>Sorry, kluge, tying up a hospital’s resources because a family doesn’t agree with the “advice” it’s being given seems very different than a non compliant client a lawyer might have. Much more is at stake with resources, cost,effect on other patients and their families , effect on staff in an already stressful environment,greater good,etc. in a case like this.</p>
<p>kelsmom, The one thing everyone here does seem to agree on is how sad this is. I don’t think there is any debate about that.</p>
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<p>It’s already out there. I saw it in one of jym’s links- his full handwritten report with all his notes. It was unequivocal.</p>
<p>Kluge - Dr. Alan Shewmon is one of those who is quite, shall we say, “unorthodox” within the neurology community. When you continue to quote him as a source, it’s like quoting Professor Michael Behe from Lehigh and using him as a source to argue against evolution and expecting people to be impressed.</p>
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<p>I didn’t say your son’s ability to deal with people is “stunted” - where did you get that from? But go ahead, ask him. What is he supposed to do if he were to be called into that home and asked to resuscitate her? What, ethically and morally and legally, are the limitations on him? </p>
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<p>Professional ethics is more than just “serving instead of dictating.” I want my doctor to give me a CSection at 30 weeks because I’m just tired of being pregnant. Is he obligated to “serve” me in that regard? Is he violating medical ethics by telling me he won’t do it, and the hospital will back him up in that regard?</p>
<p>Some things explained about the physiological processes that go on after brain death:</p>
<p>[How</a> Long Will A Brain-Dead Person’s Body Keep Working?](<a href=“http://m.huffpost.com/us/entry/4537750]How”>How Long Will A Brain-Dead Person's Body Keep Working? | HuffPost Life)</p>
<p>kluge, I have a huge issue with tying up a hospital’s resources just to keep a dead girl on machines. </p>
<p>Call me heartless, I don’t care. This isn’t a gut reaction for me. I have been studying bioethics for going on five years now. These are issues I’ve thought through and written about before. </p>
<p>This child is dead. The resources being spent on her are pulling away from others either directly (the bed space and ventilator, etc) or indirectly by racking up bills that are putting greater burden on the hospital and, by extension, everyone else who uses the hospital (driving up costs). </p>
<p>Letting this dead girl stay on machines for going on a month is an incredibly dangerous precedent to set. Imagine if we let every grieving family let their loved ones stay on machines until they could cope and heal- there would NEVER be any bed space! </p>
<p>I wish the family the best and hope that they can let go and start the healing process- something that won’t happen with this scumball lawyer feeding them lies and false hope.</p>
<p>I was thinking that if this had been a vastly wealthy family with the same attitudes, how would this have played out? I suspect that somebody really, really rich would have been able to identify a facility that would take the girl, as well as professionals who would come in and do the necessary procedures–for a high price, of course. And they would probably have been able to do this much more quickly. Would they have met with the same resistance from the hospital if they had offered to pay for everything? And how would we feel about it? I think that I would still think it was a terrible, poorly informed decision by the family, and I certainly would still oppose it if it created risks for other people (i.e., if it made a needed ICU bed unavailable). I wouldn’t argue that the family had no right to make such a terrible decision–but I wouldn’t let them take a deduction for her as a dependent in 2014.</p>
<p>"
In this case, the “critical care team” which has transported the girl has demonstrated a high degree of professional ethics by refusing to exalt their own opinion over that of the family, and has served instead of dictated in the manner many here feel is appropriate"</p>
<p>So, kluge, in your opinion, any charlatan who administers whatever voodoo treatments to a patient just because the patient wants it behaves in a highly ethical manner?</p>
<p>So it sounds like there will be no “long term support” for this body, because it’s beginning to break down. Brain liquefying, skin breaking down, bowel breaking down. I hope the heart stops beating soon, so the parents can get off this treadmill.</p>
<p>How long is it possible to keep a brain dead individual “alive,” anyway? Could you really keep it going very long with no instructions even from the brain stem?</p>
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<p>For someone who is all over nuance, you are missing the difference between someone not following your advice and someone compelling you as a professional to provide your services.</p>
<p>If I have advanced cancer and my doctor tells me the treatment is such-and-such, I have every right to say - thank you but no thank you, I don’t want to go through this, I would rather just end the treatment and go home and die in peace. I don’t have to show up for chemo if I don’t want to. That IS my right.</p>
<p>However, I can’t say to the doctor - you know, I read on the internet that if you give me ABC treatment, it will cure me - so hook me up and administer it, even though it’s completely experimental and unproven. I can’t compel him to do something to me. You might think that’s “serving,” but that’s called - “losing one’s license.” </p>
<p>If you are representing a client and she asks you to do X or not do X in her case, there are limitations on what you can and cannot do, kluge, consistent with the practice of law, the guidelines in your state, the laws of your state, and your desire to not be disbarred. Why you seem not to understand that it’s the same for doctors, kluge, is beyond me. You don’t just “serve” your clients blindly and jump when they say how high. You wouldn’t be doing your job if you didn’t.</p>
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<p>You know, if you really want to turn medicine into a “patient dictates his care and treatment and doctor just meekly nods and carries out patient requests, regardless of what medical science indicates is the appropriate treatment,” then you’d best be willing to get rid of all malpractice. Because that is simply not tenable, to hold doctors responsible for bad outcomes while simultaneously not allowing them to exercise their professional judgment. You can’t have it both ways.</p>