"Jahi’s family has always been rather vague about what religion they practice that rejects the notion of brain death. "
Yes, that’s one of the aspects of the case the media has chosen not to examine too closely or at all.
Somewhat ironically, the Gospel reading in my church today was Mark 5:21-43, the story of Jairus’s daughter and the woman who was healed. Any of the churches that are using the common lectionary with ours will have had the same scripture. In brief: Jairus was one of the leaders of the synagogue. His daughter was on the verge of death. Jairus came to the spot by the Sea of Galilee where Jesus was teaching, and “besought Jesus greatly” to come to his home. There was an intercalation in the story, about Jesus’s healing a woman who had suffered from hemorrhaging for twelve years. Then a group of people arrived from Jairus’s house to tell him his daughter had died. When Jesus went to the house and observed the weeping of the crowd outside, He said to them that the girl was not dead, but sleeping. “And they laughed him to scorn.” But Jesus went into the house, took the girl’s hand, and said, “Talitha cumi,” (“Girl, arise.”) And she did. Jairus’s daughter was 12.
My personal belief is that Jahi’s spirit had already left when she was declared brain dead. I would not have looked for the miracle that her mother was no doubt hoping for, in this case.
However, neither would I criticize the mother for trying to do everything that she could to preserve her daughter’s life, as she perceived it. The reported situation that Jahi did not want to have the operation, but her family persuaded her to go ahead with it (if true), could only add to the mother’s burden, and I feel great compassion for her.
There are obviously multiple complexities in this case. Black lives matter. Absolutely. And every bit as much as the lives of any other people. But I don’t think the family could be faulted for not trusting that this view was held by everyone involved. I think it likely that everyone involved does share the view that black lives matter. Yet I understand the distrust.
There are some religious belief systems that include the resurrection of the body. These groups do not approve of cremation, nor of organ donation. If the family was asked about donating Jahi’s organs, when she seemed alive to them, I think they would regard this as somewhat ghoulish, even if they did not belong to one of those specific religious groups.
Jahi’s heart was strong. It could have saved the life of someone who may otherwise have died. Jahi had been declared brain dead. I am glad to live in a country where despite the possible ethical arguments in favor of taking Jahi’s heart, the lack of consent by the family was an absolute bar to doing that.
Other points have been raised in this thread, including the issue of the mother’s comparative neglect of her other children while attending to Jahi. There have been enough instances in my family of early parental death (with 5 children, 11 and under in one case; and with 5 children, roughly 13 and under in another) and enough instances of children being sent to live with relatives for various reasons that I don’t think the needs of the other children make it wrong for the mother to attend to the daughter she thought was still alive.
It seems to me that Jahi’s heart kept beating a good deal longer than the physicians had predicted (if what I have read about the case is correct).
When it comes to the cost of Jahi’s maintenance, distributed among us all, I can only say that I am compelled by the government to pay a lot more for many purposes that I would jettison faster than this one.
It has been mentioned that Jahi’s family could collect more if Jahi was “alive” when her case came to court than if it was recognized that she had died years ago. Yet this does correspondingly create an incentive for the hospital personnel to assert that she was dead. I believe them that Jahi was dead. But again, this is a circumstance where I would not fault the family for a lack of trust.
Finally, I would like to thank Massmomm for her compassionate post, #37.
Did anyone say Jani’s life didn’t matter? You can’t bring race into this. I think everyone involved was quite accommodating. Four doctors independently confirmed it so. Any death is difficult and death of a child much more so. Parents come to terms with it n any way they can if ever. But keeping a dead body isn’t really helping anyone. Far from it.
The parents reportedly said they thought that if Jahi was a “little white girl” there would have been more attention to her when she was hemorrhaging seriously. I am just saying that I can understand why African Americans would be uncertain that their child was getting the full attention that she deserved, when she was hemorrhaging.
It seems to me that a lot of people in the US, including some comparatively wealthy white people, do not get the full attention that they deserve, medically. But it would be reasonable for Jahi’s family to be distrustful.
That could be true but that could apply to many less privileged people white or black. Not every little white girl is treated princess. Anyway, that’s no reason to insist she is alive. They can insist with better care she could be living. How do you jump from that to she is alive? Sometimes, we should call nonsense nonsense however tragic the circumstances may be. Life is no picnic.
“There are obviously multiple complexities in this case.”
There are. Only a few of which were explored by the media. Including, once again - exactly what religion is it that Jahi’s family practiced? Or can any of us cite our unspecified “Christian” beliefs to demand unlimited taxpayer funding for something that is unsupported by medical consensus, the law or logic?
My post in #41 is long, but here is the second paragraph: My personal belief is that Jahi’s spirit had already left when she was declared brain dead. I would not have looked for the miracle that her mother was no doubt hoping for, in this case.
It is my best guess that the mother insisted that Jahi was alive, because she thought Jahi was alive, when she (the mother) saw the involuntary “Lazarus sign” movements and took them for responsiveness. (I am none too fond of the medical designation of this as “Lazarus sign,” incidentally.)
The general public is not very well informed about conditions from which patients do or do not recover. There are cases of people coming out of comas after a very long time (years). This may offer false hope to people whose loved ones’ conditions are not similar to that.
For that matter, I do not know how the nervous system regulates the heartbeat, and whether any part of the brain is involved. Perhaps that could be explained by people with medical knowledge.
Re #45: To the best of my knowledge the decision to keep the ventilator running was supported by the law (in New Jersey), otherwise it would not have been possible.
"To the best of my knowledge the decision to keep the ventilator running was supported by the law (in New Jersey), otherwise it would not have been possible. "
The law in New Jersey was specifically written to allow for the beliefs of their local Orthodox Jewish community. Again, anyone have any idea which Christian religion shares this belief about brain death? Or why it would be appropriate for the taxpayers of a state in which the family never lived or paid taxes should pay millions of dollars to support those unspecified religious beliefs of someone who had never lived in their state, never paid taxes in their state and stood to benefit financially from this action? Jahi and her family were from California, where Jahi died.
@QuantMech said:
It would take one heck of a conspiracy to convince numerous CHO doctors (none of whom had been involved in her care, as is required) to lie about something as critical as this-risking criminal prosecution, loss of their licenses and livelihoods, their reputations, and down the line, money and property- to call a live child dead in order to make CHO less financially culpable. I find this so incredibly highly unlikely and I personally don’t believe that family distrust should be driving judicial action.
Apart from that, Paul Fisher was not associated with CHO in any fashion. He is a specialist in pediatric neurology at Stanford. He, as I’ve already pointed out, had ZERO incentive to fake test results that would result in a living child being called dead and subsequently having court mandated cessation of ventilator support.
@QuantMech said:
Not sure about that; could be. Nevertheless, it was certainly not unprecedented, particularly given her age.
Here is my problem with this:
Ever since Jahi’s case proceeded the way it did, more people are attempting to fight the concept of brain death. Most, if not all, expect society to shoulder the cost of this post brain dead maintenance. It is incredibly expensive. We know that currently, MANY people who are living cannot access good medical care. It seems patently unfair that this should be the case, that viable people suffer and may die, yet someone who has no brain function whatsoever receives vast resources which do no good other than enabling parental delusions.
Here is what USUALLY happens in cases like Jahi’s:
Child suffers brain injury. Doctors do tests in accordance with law and medical standards and determine that brain death has occurred. They inform the family.
Family says they reject the diagnosis. Hospital informs them that they have x number of days to gather family and then the mechanical support will be withdrawn.
Family concedes and after goodbyes are said, support is withdrawn.
OR
Family rejects the diagnosis and attempts to get judicial relief.
Judge reviews medical diagnoses and sees that the child has met the legal standard of death and gives the Hospital the go ahead to remove mechanical support, which takes place in short order.
In this case, we have a judge who ignored legal precedent and massive reams of medical evidence from experts in the field, succumbed to the parents’ demand for yet another expert to come in and evaluate the child, and ordered this exam. This is where Paul Fisher comes in. The parents had agreed to accept his evaluation, but they did not after he confirmed the CHO doctors’ results.
Ordinarily, the judge would have said “sorry for your loss, but the case is clear, and the hospital may withdraw support.” But he didn’t. Again and again he caved to the demands of this family. Later, he even decided to wash his hands of it entirely and ordered that a jury of medically uneducated persons would be more able to determine whether or not this child was brain dead than medical doctors. It’s outrageous and has now opened the door of precedent so that scientists’ and physicians’ vast education and expertise is treated as inferior to the “feelings” of lay persons.
This isn’t about one girl and one family. It has serious repercussions that we are already seeing as I write this.
I have this gruesome image in my head of vast warehouses of brain dead persons being kept “alive” by ventilators in order to accommodate religious beliefs, denial, or other motives (such as cases where it’s financially expedient to be called disabled and alive vs. dead).
People hesitate to bring certain other considerations up because they do not wish to make the suffering of the family greater than it already is, but there is also a legitimate discussion to be had about the ethics of this choice assuming Jahi wasn’t completely “dead” by one definition. There is an argument to be made that it is unspeakably cruel to keep a person trapped in a body with no ability to move, communicate, perceive certain things or experience what most would consider any quality of life alive. If there was any “Jahi” remaining in there, nobody was speaking for her and no examination was made of whether she would want to “live” such a life.
Oh good heavens! I am not suggesting that there was a conspiracy by the medical personnel to declare Jahi dead! Others have remarked (here and elsewhere), rather callously in my view, that the family would collect more in malpractice if Jahi was legally alive than if she was legally dead. The flip side of this is that correspondingly, the malpractice payments are larger for the hospital/doctors if Jahi was legally alive than if she was legally dead. I think it would tend to make the family mistrustful. That is all I mean about that. Throw in the probable element of mistrust that is race-connected, and I totally understand the family’s mistrust.
I don’t see the nightmare scenario that Nrdsb4 mentioned in #49 as likely to come to pass.
Perhaps one’s view on this issue is affect to some extent by whether one has loved ones who were the victims of medical errors (not necessarily malpractice, but clearly errors).
@QuantMech, I wasn’t saying you said a conspiracy happened-Jahi’s family would have to believe this, which is why I specifically said “family distrust should not be driving judicial action.”
Well, what exactly do you think will happen if courts reject the notion of brain death, which is certainly a possibility, given current culture, influence of “pro life” organizations, anti-science rhetoric that is becoming more and more common, and other factors that influenced this case? These people will be entitled to care. My nightmare scenario is not that far fetched.
We already have “rehab facilities” similar to what I already described, filled with patients who are not legally brain dead, but might as well be, for all the quality of life they have. They are rehab facilities for vent dependent comatose/persistent vegetative state patients.
In my opinion, in issues of life and death, we are all equal, and our individual philosophies ought equally to be honored whether we can claim a long tradition of others with the same religious or philosophical views, or not. We should honor people’s wishes and beliefs, and not defer to the “vast education and experience” of physicians (or scientists).
With regard to costs, as I have understood it, Jahi was in an apartment in New Jersey for most of the past four and a half years, and not in a hospital (where the costs would have been utterly astronomical).
Don’t your health insurance policies have lifetime caps? Doesn’t Medicaid? (My policy does, I don’t know in general.)
With respect to diagnosing medical conditions and keeping people with no brain function whatsoever alive artificially at great expense, I could not disagree more. Currently law supports my philosophy, but current anti science/anti-intellectual climate puts that into jeopardy.
According to posts of Jahi’s grandmother on their facebook page, she was on Medicaid for years in New Jersey, and in and out of the hospital for a large block of time, part of it in ICU, with several surgeries, since March or April IIRC.
These kinds of hospitalizations would be common with brain dead/vent dependent individuals, as their conditions can be quite fragile and complications are common.
“Others have remarked (here and elsewhere), rather callously in my view, that the family would collect more in malpractice if Jahi was legally alive than if she was legally dead. The flip side of this is that correspondingly, the malpractice payments are larger for the hospital/doctors if Jahi was legally alive than if she was legally dead. I think it would tend to make the family mistrustful”
Of course it’s reasonable for a family to be mistrustful of the hospital that they feel killed their child. If that were the entire story, most people would side with the family’s mistrust as being perfectly justified. But that’s not exactly what happened here.
- After the doctors associated Oakland Children's Hospital in CA (where Jahi's surgery was performed) ruled she was brain dead, Jahi's family hired an attorney to sue the hospital. The attorney petitioned the court to have an independent expert examine Jahi. The court agreed and appointed an independent expert to examine Jahi. The independent expert was not associated in any way with Oakland Children's hospital and after his examination, he agreed that Jahi was dead.
- Jahi's family and attorney did not accept the opinion of the independent expert they requested and continued to sue the hospital to provide care for the body. The hospital refused and eventually Jahi's family and attorney agreed with the hospital that they would "take custody of the body" and instead they transferred Jahi across the country to St Peter's Hospital in NJ.
- The medical records from St Peter's include a note from a doctor there that the administration admitted Jahi without consulting medical personnel. Many doctors at St Peter's clearly agreed with the declaration that Jahi was dead, going to the extent of ostracizing a doctor who performed a medical procedure on Jahi.
- After approximately eight more months at St Peter's, Jahi's body was discharged from St Peter's with the diagnosis "brain death."
- The family then "rented" (that term is in quotes because the landlord has since sued Jahi's family for not paying rent for their stay) an apartment where NJ Medicaid provided 24/7 nursing care at a cost of approximately $150,000 per week. This continued for almost three years, until this past week.
- The $150,000 figure was from a court filing in their suit against Oakland Children's Hospital and is included in their calculation of damages, even though the family was not actually paying or responsible for that amount - the NJ taxpayers were.
So no, there apparently is no upper limit to what NJ taxpayers will pay for this and no, it’s not callous to examine what financial motives the family had after multiple sympathetic independent doctors confirmed that Jahi was brain dead.
Hell no we shouldn’t. Children shouldn’t be forced to suffer because their parents reject science and meds.
romanigypsyeyes, It’s one thing to for the state to ensure that children get proper medical care–which helps them to survive and be healthy, and quite a different thing for physicians to insist that people be pulled off respirators against the family’s wishes.
I am not anti-science. I am quite pro-science. At the same time, as a scientist, I know that we don’t know all there is to know about the hydrogen molecule (two electrons, two protons, that’s it). It is laughable to me to think that physicians actually know very much about how the brain functions, or about consciousness. With fMRI it was apparently possible once to detect “responsiveness” in a piece of salmon picked up at a market.
As I said earlier, I think that Jahi’s spirit had left her body by the time the physicians declared her brain-dead. While I think that “vast ignorance” is a better description of the current state of understanding of living things than “vast knowledge,” I do agree that physicians have sufficient knowledge of the bad effects when there is no blood supply to the brain to be correct in their declaration in this case.
Jahi went into cardiac arrest, as I understand it. The physicians brought her heart back, but could not bring her back? After two hours of no blood supply to the brain? Why would they do that? I don’t assume that her heart restarted on its own.
Issues of life and death are very thorny. I don’t have the answers. I personally have a very deep distrust of anyone who thinks he/she has the answers.
romanigypsyeyes, How did you stand on the British government’s prohibiting the parents of Alfie Evans (a British toddler) to leave the country with him (while he was unquestionably alive), to seek treatment for him in Rome? It is a moot point now, since he is dead. But I stand with Pope Francis, who wrote, “I renew my appeal that the suffering of his parents may be heard and that their desire to seek new forms of treatment may be granted.” (You can check this out on the CNN web site.)
When you get to the question of what kind of life is worth living, you find some people who adopt the philosophy of Peter Singer, the Princeton philosopher, who apparently believes that it is permissible to kill infants with severe birth defects (after they have been born), and who, while not supporting involuntary euthanasia, supports “non-voluntary” euthanasia (per Wikipedia). Personally, I find this abhorrent.
She wasn’t in a vegetative state. She was DEAD. Medical definition of dead is brain dead not heart dead. Don’t you pull supports from a dead body?