<p>That tactic was suggested by only one of the 20 or so doctors quoted in the posted link about Brain death and uncooperative families. </p>
<p>The family in question in that article seems remarkably similar to Jahi’s. They assume they have the right to say when the ventilator is shut off. They quote another famous case involving a brain dead baby (and guilty parents!) but they didn’t know enough to be truly informed. But the doctor tells them he’s turning it off in another hour and he does. </p>
<p>In Jahi’s case, was the family just crazily insistent? Or was the hospital too lenient? I don’t understand how it got past the first 24-48 hours.</p>
<p>During that first few days the hospital was giving them more time and counseling, etc. Then they called the news stations. I believe it was on day 3. If I’m not mistaken the timeline is surgery and incident occurred on Dec 9, death declared on Dec 12, TV news on Dec 15, and lawyer hired on Dec 16th.</p>
<p>Arabrab, If you read the study’s methodology, the questionnaire asked anesthesiologists about adverse events surrounding tonsillectomies in kids, plus a number of cases culled from closed claims, aka malpractice suits. The denominator is not all tonsillectomies, but those with known perioperative adverse events. Of those adverse events cases, a large percentage led to death or to permanent injury.</p>
<p>I’m not sure about the numbers of that study. It said there were more than 700 responses to a survey and they counted 111 of them. Of THAT 111, there was a 77% incidence of death or neurologic injury. What exactly was the criteria and would Jahi have met that criteria? </p>
<p>The abstract I read indicated that these were the ones that met the diagnostic criteria for obstructive sleep apnea, so the way I read it was that those who met the sleep apnea criteria who had tonsillectomy w/wo adenoid removal had a 77% rate of death or permanent neurological impairment, but that some of those could have been prevented with better respiratory monitoring during the first days of recovery. Also, that the obese were more likely to be affected.</p>
<p>Maybe I’m misreading it. (I don’t have access to anything but the abstract.) I could see that it might be saying that if you do have complications from this surgery, they’re likely to be really, really bad.</p>
<p>Jahi was obese, and was having the surgery for apnea reasons according to a number of previous reports. This would seem to put her in a high risk group. </p>
<p>I wonder if this study was shared widely with pediatric ENTs, who would normally be the ones who obtained the surgical informed consent.</p>
<p>57% of the adverse cases had likely OSA, and these cases were more likely to have apnea cause their adverse event vs the non-OSA cases who were more likely to experience hemorrhage as their adverse event. Jahi’s planned overnight stay in the PICU was probably for respiratory monitoring due to her higher risk for postoperative apnea.</p>
<p>arabrab, looks like the study was looking at adverse events for tonsillectomies. They discovered that 77% of the adverse effects were serious: death or permanent brain damage. They further discovered that of the children they studied (who had adverse effects from tonsillectomies) 57% also had sleep apnea. The adverse effect that caused the sleep apnea kids to be included in the study was most likely post-operative sleep apnea, whereas the adverse event for the other kids was most likely bleeding.</p>
<p>But the huge majority of kids who have tonsillectomies don’t have adverse effects. They recover with no problem.</p>
<p>For the first time in my life, I saw someone on life support last night. We are going today to turn off the life support. We’re not family. He has no family. We had to wait for the hospital to determine that he had no family and give us the power to make the decision (he listed my dad as his emergency contact and on some other documents… I really don’t know all the details). Seeing someone on life support is a really surreal experience. I’ve seen someone in a coma (my dad) and it really is so different. You can just tell he’s gone. I don’t know how else to explain it. </p>
<p>I can’t imagine most people that come in contact with Jahi can trick themselves into thinking she’s still alive. I still can’t imagine what it’s like to lose a child but I can’t imagine what it’s like to just hold on to a corpse either. They have to know on some level that she’s gone.</p>
<p>We never disconnect but tell the family that “nature will take it’s course” and then add a 60ml dead space into the circuit.</p>
<p>He goes on to acknowledge that it’s dishonest, but nonetheless the most practical way to deal with this kind of situation.>>>>>>>></p>
<p>Yikes.<br>
I remember years and years ago reading the heartwrenching admission of a resident who gave a pain drenched cancer patient who was imminently terminal an overdose of morphine. It was hard to read, but clearly he really did it for the right reason, to ease that person’s pain and passing.</p>
<p>Romani, they took a picture of her in that condition. I agree, they have to know. Some of them definitely know. This is tragic, morbid, & unbelievable on every level.</p>
<p>After listening to her mom on the news I think she believes she is doing the right thing by her daughter. She believes that when her heart stops that it is over and she is willing to wait.</p>
<p>I cannot imagine how difficult this must be for her mom. One month ago she had a laughing smiling middle schooler who was worried about not waking up from getting her tonsils out. Mom says not to worry…and then this.</p>
<p>I have NO idea how I would truly behave in this situation…none. I can’t even begin to imagine.</p>
<p>It would be one thing if Jahi’s mom thought, as Motl Brody’s parents thought, that her child was terminal but not yet dead: it’s one thing to say, “I know my child is dying but I’m not going to smother him with a pillow,” as it were. I find it more troubling that she apparently believes that Jahi has a chance of recovery. But soon Jahi’s heart will stop beating, and then her family will get on with their grief.</p>
<p>The mother will comfort herself by thinking she did everything she could. Unfortunately, she’s also going to blame the hospital for “starving” her dead daughter.</p>
<p>I very much hope the other side of this story sees the light of day, eventually. The hospital is also being put through a painful ordeal and many, many little things are very troubling. The current deafening silence, for starters.</p>