CA - Parents Of Toddler Declared Brain-Dead Convinced He’s Still Alive

SophieRose

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The parents have retained the same attorneys who represented Jahi McGrath and parents. Parents have until April 29. Toddler suffered an asthma attack.

http://sacramento.cbslocal.com/2016...eclared-brain-dead-convinced-hes-still-alive/

Doctors declared a 2-year-old Vacaville toddler brain-dead and a judge gave the parents one week to prove there’s still hope for their son.

snip

Israel’s parents said he didn’t get oxygen for 40 minutes, causing severe brain injuries. They transferred him to Kaiser Permanente in Roseville where doctors came to the same conclusion
 
This is a very strange story so far:
"Israel Stinson was healthy and happy one minute and hooked up to a ventilator the next. His mother said he suffered a minor asthma attack. She took him to UC Davis Medical Center and it was there he stopped breathing and doctors determined he was brain-dead."

If it was just a 'minor asthma attack' and he was in the hospital, why would he be oxygen deprived? Wouldn't they give him oxygen and keep him breathing?

I was in the hospital with a major asthma attack. But they hooked me up with tubes of oxygen and force fed it into my lungs. If he was having a 'MINOR' attack, wouldn't that be enough to keep him breathing?
 
http://sacramento.cbslocal.com/2016...ning-out-of-time-for-son-declared-brain-dead/

Alexandra Snyder with Life Legal defense was able to get a court order to continue life support for Israel, but that ends Friday.

snip

The family tried to get their son into the same hospital that accepted Jahi McMath. She’s the Oakland girl declared brain dead back in 2013.

Her family won a court battle to have her moved to a New Jersey hospital, she is still on life support.

Israel was denied, but the reason hasn’t been released.
 
This is a very strange story so far:
"Israel Stinson was healthy and happy one minute and hooked up to a ventilator the next. His mother said he suffered a minor asthma attack. She took him to UC Davis Medical Center and it was there he stopped breathing and doctors determined he was brain-dead."

If it was just a 'minor asthma attack' and he was in the hospital, why would he be oxygen deprived? Wouldn't they give him oxygen and keep him breathing?

I was in the hospital with a major asthma attack. But they hooked me up with tubes of oxygen and force fed it into my lungs. If he was having a 'MINOR' attack, wouldn't that be enough to keep him breathing?

Here's more from one of those lifesites.
https://www.lifesitenews.com/news/r...toddler-as-hospital-plans-to-remove-life-supp

Israel suffered an asthma attack April 1 and was taken to Sacramento’s Mercy General Hospital ER, where he was stabilized, but since Mercy lacked a pediatric care unit, he was transferred to UC Davis Medical Center.

After his admission to UC Davis, Israel had another attack, stopped breathing and went into cardiac arrest, resulting in his being resuscitated and placed on a ventilator. He was moved to the Kaiser facility April 12 at the family’s request amidst concerns for his care at UC Davis during the second attack.

Despite the family’s intent for Israel to receive ongoing care at Kaiser, less than 24 hours after his admission there the facility began testing Israel’s brain activity, without his parents’ full knowledge or consent, declaring him brain dead April 14.
 
Well, we knew this would start happening after Jahi.

It was happening long before Jahi's case. Which is why most states have laws that brain dead person is legally dead. Otherwise there are families that would want their brain dead relatives on life support even though these relatives would never recover. Which obviously costs a lot of money.
 
Sadly, I don’t think Israel Stinson will recover. I do believe that the Uniform Determination of Death criteria are correct and accurate, from a legal, moral, and ethical perspective. We don’t allow families to reject the diagnosis of death in irreversible cardiac arrest—that remains the purview of physicians (and first responders in defined circumstances). But religious objections to brain death continue to increase in cases of functionally decapitated people with ongoing somatic/ organ function.

I think we have to come to some kind of national consensus on this due to the vast and serious number of multidisciplinary issues involved. I understand that some people have religious objections to withdrawing care while machines are still providing organ support for their loved one.

I’m not opposed to transferring these patients out of an ICU acute care hospital setting into a long term care/ home care setting, provided that there are no no legal mandates (like forcing hospitals to provide tracheostomy and g-tube surgeries), releasing hospitals and licensed professionals from any medical malpractice or negligence claims after the diagnosis of brain death, and no public funds or health insurance funds are used to maintain the body of the brain dead person. At the very least, we have to stop the pretense that these patients will ever “recover”, and limit what interventions (such as CPR/ ACLS, ECMO, LVAD, etc) will be provided while they are still in an ICU.

Only then, when we stop the pretense of the potential for recovery, can we focus on truly caring for these families who are reluctant to let go of their loved one. I do believe in these instances, when we care for the body of the brain dead person, we are caring MORE for the family than the patient. But we, as a society, absolutely have to put limits on what kind of care can and should be provided in acute care hospitals for brain dead patients, and for how long. This absolutely cannot be dictated by families, IMO, for a plethora of very sound reasons.

The really sad thing is that these high profile cases, increasingly (IMO) are forcing the regulation of the care of the brain dead, and not in a good way. Clinicians and hospitals (IMO) are having less and less flexibility in these cases, as hospitals scramble to enact policies to protect themselves legally from families who reject brain death.

I’d like to see religious organizations step up and start home-like facilities to receive, fund, staff, and provide custodial care for individuals with brain death, so these families have a place to take their brain dead loved one. We could even allow unlicensed individuals to provide care in these facilities, increasing the potential population of caregivers, and statutorily exempt the facilities from traditional LTC oversight and inspections. Essentially, they would fall into a “home” category, instead of a “health care facility”. What a great opportunity for those who feel so passionately that this kind of ongoing care should be available—a great mission for many religious organizations, if they would just get together and organize. But I think it’s essential to make sure that this type of somatic support care for brain dead patients is funded voluntarily by charities, and not at all by insurance mandates, or using any public funds, or coercing care by acute care hospitals and mainstream medical professionals. That’s my wish list for these tragic cases!

These stories of brain dead children, with parents rejecting the diagnosis of death, do seem to be increasing in the U.S. Every one of the cases are heartbreaking, and soaked in grief. The issues in pediatrics are somewhat different than in adults or elderly adults. Basically, the issues in pediatrics break down into two categories: children born with syndromes or abnormalities incompatible with life, and children who become brain dead as a result of trauma or disease.

The main arguments of the families center around whether or not parents/ guardians have the (legal/ ethical/ moral) “right” to “consent or reject” a diagnosis of brain death, and preceding that, whether parents/ guardians have the “right” to consent to, or refuse, the tests conducted by physicians to establish the diagnosis of brain death (or as Attorney Ethicist Thaddeus Pope labels it—determination of death by neurologic criteria—DDNC.) In the case of newborns with complex congenital anomalies (such as the severe underdevelopment of lungs, or infants born missing brain tissue above the brain stem), the issues have to do with how aggressively any type of medical intervention is applied and maintained—medical futility. These cases are the foundation of the push for “Simon’s Law” in Missouri and Kansas. (Easily searched if you type it in a browser.)

From what I’ve read, there have been five cases in California in the recent months regarding brain death diagnosis rejected by families. Three are related to Jahi McMath, one is Israel Stinson, and one is Alan Sanchez, a teenager brain dead after a car accident, who passed away (irreversible cardiac arrest after brain death) a few days after court proceedings began.
http://medicalfutility.blogspot.com...:+MedicalFutilityBlog+(Medical+Futility+Blog)


Thaddeus Pope, JD/ PhD, is a professor and medical ethical scholar at Hamline University in St. Paul, MN, who studies “medical futility” in policy and law. He has a blog where he follows these cases, as well as updates on policy and legislation. He is in the process of writing a textbook chapter for Law, Religion, and Health in the U.S., due out later this year. He has made his draft chapter available free (you do have to download—11 pages, but it’s free, no registration required). It’s a good read, no matter which side of the arguments you support. If interested, one can subscribe to Thaddeus Pope’s Medical Futility Blog (easily searched)—he updates about once a week.

Abstract:
The determination of death by neurological criteria (DDNC or “brain death”) has been legally established as death in all U.S. jurisdictions and in most other developed countries. It is supported by a “durable worldwide consensus.” Moreover, the consequences of DDNC are clear. Once a patient is determined dead, clinicians typically discontinue physiological support. In short, DDNC is a “hard clinical endpoint” where technological interventions reach the limits of required or accepted medical practice

Despite this legal consensus, hospitals continue to grapple with a significant number of conflicts. Some families do not accept DDNC as death and want clinicians to continue physiological support. While some of these disputes are due to misunderstanding or diagnostic mistrust, many are religiously based. Today, only four U.S. states legally require hospitals to “accommodate” families with religious objections to DDNC. I argue that other states should enact similar accommodation requirements.

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2699983&download=yes
 
Thanks so much, K_Z, I was hoping we would hear from you. Everything you say makes sense.
 
Sadly, I don’t think Israel Stinson will recover. I do believe that the Uniform Determination of Death criteria are correct and accurate, from a legal, moral, and ethical perspective. We don’t allow families to reject the diagnosis of death in irreversible cardiac arrest—that remains the purview of physicians (and first responders in defined circumstances). But religious objections to brain death continue to increase in cases of functionally decapitated people with ongoing somatic/ organ function.

I think we have to come to some kind of national consensus on this due to the vast and serious number of multidisciplinary issues involved. I understand that some people have religious objections to withdrawing care while machines are still providing organ support for their loved one.

I’m not opposed to transferring these patients out of an ICU acute care hospital setting into a long term care/ home care setting, provided that there are no no legal mandates (like forcing hospitals to provide tracheostomy and g-tube surgeries), releasing hospitals and licensed professionals from any medical malpractice or negligence claims after the diagnosis of brain death, and no public funds or health insurance funds are used to maintain the body of the brain dead person. At the very least, we have to stop the pretense that these patients will ever “recover”, and limit what interventions (such as CPR/ ACLS, ECMO, LVAD, etc) will be provided while they are still in an ICU.

Only then, when we stop the pretense of the potential for recovery, can we focus on truly caring for these families who are reluctant to let go of their loved one. I do believe in these instances, when we care for the body of the brain dead person, we are caring MORE for the family than the patient. But we, as a society, absolutely have to put limits on what kind of care can and should be provided in acute care hospitals for brain dead patients, and for how long. This absolutely cannot be dictated by families, IMO, for a plethora of very sound reasons.

The really sad thing is that these high profile cases, increasingly (IMO) are forcing the regulation of the care of the brain dead, and not in a good way. Clinicians and hospitals (IMO) are having less and less flexibility in these cases, as hospitals scramble to enact policies to protect themselves legally from families who reject brain death.

I’d like to see religious organizations step up and start home-like facilities to receive, fund, staff, and provide custodial care for individuals with brain death, so these families have a place to take their brain dead loved one. We could even allow unlicensed individuals to provide care in these facilities, increasing the potential population of caregivers, and statutorily exempt the facilities from traditional LTC oversight and inspections. Essentially, they would fall into a “home” category, instead of a “health care facility”. What a great opportunity for those who feel so passionately that this kind of ongoing care should be available—a great mission for many religious organizations, if they would just get together and organize. But I think it’s essential to make sure that this type of somatic support care for brain dead patients is funded voluntarily by charities, and not at all by insurance mandates, or using any public funds, or coercing care by acute care hospitals and mainstream medical professionals. That’s my wish list for these tragic cases!

These stories of brain dead children, with parents rejecting the diagnosis of death, do seem to be increasing in the U.S. Every one of the cases are heartbreaking, and soaked in grief. The issues in pediatrics are somewhat different than in adults or elderly adults. Basically, the issues in pediatrics break down into two categories: children born with syndromes or abnormalities incompatible with life, and children who become brain dead as a result of trauma or disease.

The main arguments of the families center around whether or not parents/ guardians have the (legal/ ethical/ moral) “right” to “consent or reject” a diagnosis of brain death, and preceding that, whether parents/ guardians have the “right” to consent to, or refuse, the tests conducted by physicians to establish the diagnosis of brain death (or as Attorney Ethicist Thaddeus Pope labels it—determination of death by neurologic criteria—DDNC.) In the case of newborns with complex congenital anomalies (such as the severe underdevelopment of lungs, or infants born missing brain tissue above the brain stem), the issues have to do with how aggressively any type of medical intervention is applied and maintained—medical futility. These cases are the foundation of the push for “Simon’s Law” in Missouri and Kansas. (Easily searched if you type it in a browser.)

From what I’ve read, there have been five cases in California in the recent months regarding brain death diagnosis rejected by families. Three are related to Jahi McMath, one is Israel Stinson, and one is Alan Sanchez, a teenager brain dead after a car accident, who passed away (irreversible cardiac arrest after brain death) a few days after court proceedings began.
http://medicalfutility.blogspot.com...:+MedicalFutilityBlog+(Medical+Futility+Blog)


Thaddeus Pope, JD/ PhD, is a professor and medical ethical scholar at Hamline University in St. Paul, MN, who studies “medical futility” in policy and law. He has a blog where he follows these cases, as well as updates on policy and legislation. He is in the process of writing a textbook chapter for Law, Religion, and Health in the U.S., due out later this year. He has made his draft chapter available free (you do have to download—11 pages, but it’s free, no registration required). It’s a good read, no matter which side of the arguments you support. If interested, one can subscribe to Thaddeus Pope’s Medical Futility Blog (easily searched)—he updates about once a week.



http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2699983&download=yes

But if you have to care for and watch these patients suffer with tube feedings, weight gain, infections, breathing difficulties and every other medical problem you can ever think of, no one would ever do that to someone they claim to love. They are doing it to make themselves feel better about whatever they regret or feel guilty for. Very sad and horrible. RN '87
 
I recall watching a show recently that showed proof that Brain dead, is not necessarily "Dead". So I am not so sure things are cut and dry any longer. I also recall one where a supposedly Brain Dead person came back to recover..So I don't trust the medical criteria 100 percent. JMO.
 
I recall watching a show recently that showed proof that Brain dead, is not necessarily "Dead". So I am not so sure things are cut and dry any longer. I also recall one where a supposedly Brain Dead person came back to recover..So I don't trust the medical criteria 100 percent. JMO.

Be wary of reports like these. Often these reports have confused coma or persistent vegetative state with actual brain death. Neither of these conditions meet the legal criteria for brain death, so when someone "recovers" from these conditions, they have not recovered from brain death. I have read about a few cases where someone "recovered" from brain death and in a couple of them, the family had misunderstood the actual diagnosis. Their loved ones were severely brain injured/damaged, were in a coma as a result of temporary brain inflammation, or had been in a persistent vegetative state, none of which constitute brain death. In a couple of others, the brain death tests were commenced a)before brain swelling had subsided and/or b)while drugs which depress the CNS are still on board. Patients in either of these situations are ineligible for brain death diagnostic tests.

Be careful what you believe from these types of reports. Upon further investigation, they usually turn out to be false.
 
But if you have to care for and watch these patients suffer with tube feedings, weight gain, infections, breathing difficulties and every other medical problem you can ever think of, no one would ever do that to someone they claim to love. They are doing it to make themselves feel better about whatever they regret or feel guilty for. Very sad and horrible. RN '87


I agree, Wendy. It’s easy to say that these families are in denial, or that they feel intense guilt—and some of that is true, but there isn’t much any caregivers can do to break thru that. It does seem cruel to care for the body in perpetuity, but the burden and the pain belongs to the caregivers and families—I don’t believe the patient has any sensations of life or pain or discomfort once brain dead.

IMO, families who refuse to “accept” the diagnosis of brain death, require a completely different approach than those that profess to have a religious objection to the diagnosis of brain death. And IMO, there are some families who were not particularly religious before the diagnosis of brain death, that then suddenly profess a “religious” objection, because they think it will afford them more deference from the courts and caregivers. There isn’t much we can do for those families, because in my experience, the more factual and objective information they receive, the harder they cling to their newfound religious convictions. The religious objection laws were conceived and designed to protect those who have sincerely held beliefs (such as devout Judaism) that they lived prior to the diagnosis of brain death. In this country, we reject any kind of “religious tests” to determine whether or not someone holds their professed beliefs “sincerely”, so many people have figured out all they have to do is say is they “believe” in something specific, and the courts and everyone else have to take that as legitimate. Beliefs of convenience, IMO. (But that’s not politically correct to say out loud, right?!)

The bigger issue, as I see it, is that there are far too many people who believe that brain death is like a “coma”. These people give all sorts of examples of people who were incorrectly diagnosed as brain dead, who “came back to life”, or woke up, etc. In fact, there is not a single person, ever, anywhere in the world, who has been correctly diagnosed brain dead (especially with MRI and blood flow studies) who has ever “woken up” or recovered to any degree. What is clear is that the younger the patient, the healthier the body is at time of brain death (cessation of neurological function and perfusion), the stronger the heart, and the more prompt the resuscitation efforts—the more likely someone can be resuscitated to a prolonged beating heart/ brain dead status supported by machines and pharmacology. That means kids and young adults.

We simply HAVE to do better at educating the public about what brain death IS, and what it ISN’T.

Brain death is not "persistent vegetative state."

It's not a coma.

The person is not "asleep."

Brain death is exactly the same thing as a decapitated body that is still hooked up to machines to keep it warm and pink.

We need a national discussion, and a national campaign of education, IMO. A discussion that is completely disassociated with all discussions of organ donation—because so many of those who disagree with “brain death” also believe that brain death diagnosis is a vast medical and legal conspiracy to harvest organs from poor and disadvantaged groups of people, to give to rich people.
 
https://www.lifesitenews.com/news/j...ieve-from-hospital-removing-toddlers-life-sup

On Thursday, a federal court gave Life Legal Defense Foundation (LLDF) a restraining order enjoining Kaiser Permanente Medical Center in Sacramento from withdrawing two-year-old Israel Stinson’s life support through the weekend.

The Pacific Justice Institute worked with LLDF on the order, giving Israel’s family a reprieve until the next hearing on Monday afternoon.
 
Comment says that
This is Israel responding to his mother tickling him.

[video=youtube;BhgGSjbb08Y]https://www.youtube.com/watch?v=BhgGSjbb08Y[/video]
 
For those of us who don't understand this, how can Israel move his tongue if he is brain dead?

Not being snippy, but if I was his mother, it would be impossible for me to accept the brain dead diagnosis after seeing this video.

K_Z would you please explain what is going on? TIA?
 
One can't evaluate movements in a patient known to be definitively brain dead (no blood flow to the brain, and meets all other diagnostic criteria) without taking ALL the diagnostic information into account. If the child is brain dead (and I believe this child has had numerous imaging and diagnostic studies), then these kind of movements are spinal reflex arc movements-- no matter how heart wrenching or persuasive they may be to watch.

Watch the video from Brazil I linked above-- that man had the vent removed, and produced that classic Lazarus sign. He was unquestionably brain dead. If one googles "brain death and spinal reflex arc movements, there will be thousands of articles, videos, and explanations. I just did this and got 20,200 results returned.

Brain dead patients can have a lot of involuntary somatic shivering movements, limb movements, etc in response to touch, ventilator manipulations, being turned in bed, etc. It is very disconcerting for family to see this. It makes them think medical professionals are lying to them. It is our duty to explain what they are seeing, and give them the ENTIRE picture of what's going on, including diagnostic imaging and other studies. To compassionately teach.

The child Israel is beautiful, with not a mark on him except for the medical equipment. It's particularly and miserably hard for grieving parents to believe that what has happened inside his head is so catastrophic, when his heart beats, he is warm, and he is so beautiful. He cannot recover, at all. To accept that, for some, is to descend into a pit of madness and grief, from which they may not emerge. I get it. It's thoroughly, completely devastating. But no less true.

The courts are not helping in these situations, IMO. They only prolong false hope, encourage more litigation, foster confusion in the parents and the public, and delay the inevitable. These decisions, IMO, don't belong in courts.
 
For those of us who don't understand this, how can Israel move his tongue if he is brain dead?

Not being snippy, but if I was his mother, it would be impossible for me to accept the brain dead diagnosis after seeing this video.

K_Z would you please explain what is going on? TIA?

I watched the video several times. I didn't see any tongue movements, or mouth movements at all. His lower lip is pouched up and taped in what we call "fish lips" position, to prevent the oral endotracheal tube from eroding his mouth or lip edges. When they panned to the monitor, there is no respiratory effort over the vent.
 
These cases are always hard.

I am an adult and I have a "Living Will" that I have shared and have given to my mother (1st), Eldest sister (2nd), Youngest sister (3rd) and Eldest Niece (4th and she is an adult) and if I ever end up in this type of situation, they know and are legally able to make the decisions I have made clear to them for me.

What makes these cases hard, is that they are children. They don't get those choices. I am not going to judge the parents... I just can't. My heart literally aches for them. Prayers and blessings to this precious baby, Israel. Prayers and blessings to his parents, who... again, I can't judge them.

These cases make my heart hurt... because I don't see a right or wrong.
 

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