|By Michael Vitez, The Philadelphia Inquirer|
|McClatchy-Tribune Information Services|
The McMath family went to court in December to oppose the removal of ventilator and feeding tube even after three physicians determined there was no brain function and a coroner issued a death certificate.
A month later, the body of the little girl -- organs still working -- was taken to an undisclosed medical facility, where the heart still beats. A manicure and pedicure are given every Friday.
It has been a decade since the case of
Brain death is not a settled matter, he said. "The McMath family saw signs of hope, and they should be given the opportunity to provide their daughter hope. That's the bigger picture here. Who ultimately is going to make decisions for our loved ones? Is it going to be strangers -- hospitals and ethics committees? Or is it family members?"
Two medical ethicists, a neurologist and a lawyer specializing in end-of-life issues all expressed dismay at the award, saying that it ignores reality, will confuse the public, and attempts to turn back what has been accepted by every state and even
"Patient autonomy is important and so is family decision-making, but they come to an end when death comes," said
"One bright line that I don't think we can cross without causing havoc in our society is the line between life and death," he added. "And the line is set by medicine -- not by families, not by lawyers, not by theologians. It's doctors who say that person is dead. They are the experts."
Hurtig said he understands the shock and pain of grieving parents, but that doesn't alter the facts. "Every professional in this field accepts that when brain death is defined properly by the rules, it's death," he said.
"There were complications after surgery," she said, tears welling in her eyes. "She bled severely and went into cardiac arrest in front of me. It was traumatic and I will never be the same."
Two doctors at the hospital and a pediatric neurologist from
The parents sued to prevent removal of life support; a judge urged the parties to work out an agreement. The hospital allowed the family to remove the body with machines still working.
"I don't feel that anybody with a heartbeat and blood flowing through their veins, being treated in a medical facility, deserves a death certificate," said Winkfield, 34, who has worked at
She declined, as she has in the past, to say where Jahi was taken or who is paying the bills. Caplan, the bioethhicist, said he was certain that no insurance company would continue to pay for medical care once a person had been declared legally dead.
The award to the McMath family was presented by the Terri Schiavo Life and
The award recognizes families that overcome incredible resistance in fighting for loved ones.
But the Schiavo and McMath cases are different in essential ways. Schiavo suffered a heart attack in 1990, and was left with severe brain injury due to a lack of blood and oxygen, similar to what happened with
In Schiavo's case, however, the brain damage was not as severe, and some brain activity remained. Her body could breath on its own and respond to stimuli. As Caplan put it in lay terms, "the thermostat's still on," and with nutrition and hydration the body can be maintained for years. Schiavo lived in such a persistent vegetative state for 15 years.
In cases of brain death, like McMath's, the brain has no function at all -- no brainwaves. Even with a ventilator and feeding tube, the body will break down after suffering brain death. Neither Caplan nor Hurtig would predict how long a brain dead body can continue to function. They said there is no precedent for it.
There is no organized effort to remove such laws or to revisit the issue of whether brain death is death, Pope said, though he noted that a small minority of bioethicists and physicians question the rules by which brain death is determined and whether those rules should be changed.
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