Family wants to keep life support for girl brain dead after tonsil surgery #4

[otto]

Like most of the posters here and on news sites, I also would like to know the truth of what has happened from the beginning. It's beyond frustrating trying to figure out truth from fiction in almost every aspect of this case. However, I do have to say that it really, really bothers me that there are millions of hate filled comments floating around the internet regarding this innocent 13 year old girl. Regardless of how this happened and how it has progressed to this point ... none of it was her fault.

I agree that Jahi probably won't be able to recover from this; but, at this point, it is just flat out wrong for the doctors, nurses, attorneys, all the way down to online posters to constantly refer to her as "the body", "the deceased", "the corpse", etc. Whether she really is brain dead or not she is still an innocent 13 year old little girl named JAHI. Is it really too much to ask that everyone continue to refer to her as Jahi instead of the hurtful titles I posted above? We all know the only reason she is being referred to by those titles is to hurt her family. It's extremely shameful that it started with the doctors and staff of CHO. Shameful!!!

I do not intend to insult anyone with this post, nor is it directed at any particular person; but, after following this case for weeks I just really needed to say that. May God Bless this little girl's soul ... wherever that may be. lease:

I don't think that there is any mystery surrounding what happened. A 13 year old with several medical issues required surgery, on December 9, to assist with breathing. After that surgery, the child developed a known risk associated with the surgery and subsequently died on December 12. Because she was in a benevolent hospital, a ventilator was attached to the deceased child so her loved ones could say their good byes. The family requested that the ventilator remain turned on until after Christmas. A court order was then requested that the ventilator for the deceased patient be turned off, and that was ordered for December 30. An appeal was made where the lawyer claimed that there are facilities that care for deceased persons.

A person is deemed brain dead and deceased when that person is unable to breath, speak, move, the five sense will never function again, and so on. A CT scan today would probably reveal darkness.

 

[otto]

In my opinion, this situation has been treated with gross insensitivity on the part of the hospital. The family is in shock and needs LOVE and prayers. Had they been treated gently and given time vs. pressure, they could make good decisions.
Everyone needs to back off and direct prayers towards them.

God's love and wisdom surround them!

As always, my opinion only.

The family was provided pastoral care. The family chose to produce sweat shirts with the child's photo, contact media, arrange protests and create a media campaign. They may be in shock, but they still had everyone wearing the sweatshirts in no time.

The family may not appreciate that the hospital's job is done, but this child died on December 12. It's now January. At some point, every hospital will become heavy handed if there is interference with their facility.

 

[SilkySifaka]

I don't think that there is any mystery surrounding what happened. A 13 year old with several medical issues required surgery, on December 9, to assist with breathing. After that surgery, the child developed a known risk associated with the surgery and subsequently died on December 12. Because she was in a benevolent hospital, a ventilator was attached to the deceased child so her loved ones could say their good byes. The family requested that the ventilator remain turned on until after Christmas. A court order was then requested that the ventilator for the deceased patient be turned off, and that was ordered for December 30. An appeal was made where the lawyer claimed that there are facilities that care for deceased persons.

A person is deemed brain dead and deceased when that person is unable to breath, speak, move, the five sense will never function again, and so on. A CT scan today would probably reveal darkness.

I am shocked one hasn't been done, or the special MRI done rarely but more often now for locked in syndrome that discovered many who were "vegetative statese" can actually answer questions using images and are locked in.

That would make it a lot easier for the family to understand when they see a blank brain compared to an active one or a vegetative locked in one

 

[Donjeta]

According to Christopher Dolan, the family attorney for Jahi McMath, the process to move Jahi will involve several steps. He said there must be communication between Children’s Hospital and the receiving facility, the family must give the receiving facility paperwork of Jahi’s health care status and she must be transported in an ambulance that can switch her to a portable ventilator.

Dolan also said Alameda County Coroner’s Office will be involved

“The hospital will give Jahi to the coroner,” Dolan said. "The coroner will then, if we fill out certain paperwork, give Jahi to us. Then we are free to transport Jahi.”

I just don't understand how this represents a victory for the family in getting new instructions how to manage in arranging a transfer.

The new conditions sound to me like the almost same exact conditions that were stated by CHO in their letter on Dec. 29:

1) the new facility is aware of Jahi's status, 2) suitable transport is arranged, and 3) the coroner permits the move.

JMO but these things would all have had to been rather self-evident from the beginning for everybody concerned.


http://www.nbcbayarea.com/news/loca...Letter-to-McMath-Family-Lawyer-237897191.html

1. Children’s will be pleased to communicate directly with a physician at any facility that is considering accepting Jahi’s body to make sure Children’s understands the requirements set by that facility for accepting the body and to ensure that the facility understands the current condition of the dead body and what is being done to maintain it under Judge Grillo’s temporary restraining order. Of course, the family’s representatives can observe that communication.

2. Children’s needs to be assured that there is a lawful transportation plan to any facility to which transfer is proposed.

3. If the proposed facility is out-of-state, Children’s needs written assurances from the Coroner that their office will allow the transfer.

 

[Softail]

How is this supposed to work- I doubt the coroner is going to put a portable vent in/be the transport guy, etc etc...

and, how many transfers does he think that tube placement will take at this point. And, there is no facility...

What I find interesting in that statement is that they obviously agreed that she will go to the coroner first. :waitasec: Isn't that admitting she is dead? From that point the coroner will release her to the family. I am curious as to what this paperwork is. Since when does a coroner release a deceased person to a family. To do what with her? :waitasec: It's all so absurd to me. IMO...

 

[SilkySifaka]

The family was provided pastoral care. The family chose to produce sweat shirts with the child's photo, contact media, arrange protests and create a media campaign. They may be in shock, but they still had everyone wearing the sweatshirts in no time.

The family may not appreciate that the hospital's job is done, but this child died on December 12. It's now January. At some point, every hospital will become heavy handed if there is interference with their facility.

No the hospitals job is not done, they have a duty of care to the family members they interacted with. A duty to get them the best help, the most caring and empathetic doctors to help them deal.

THey keep people on ventilators for organ removal. That mean they are dead or alive? they are doing surgery on the dead body. Which i fully agree with but i can see why the mom feels putting in a feeding tube is not much different morally.

It doesn't MATTER what the family is saying/doing in terms of the hospitals responsibility to treat patien AND families with care and empathy. So they got sweathshirts with Jahi's pic on them or called out the hospital. It is CLEAR imo that there is some mental illness going on that needs treatment and in fact the hospital should be moving heaven and earth to get the mom treatment, if not from them then from someone they can trust. NOT putting their backs up because a mom can understandably not believe her baby is dead. imop

In fact the hospitals current reaction to the family and refusing to call Jahi by name etc. would ensure that I picked up a lawyer on my way to the hospital for any care of a family member. If they are willing to lose all empathy for family in this case, what will they do with their duty of care ijn another case. I would want an attorney at bedside documenting everything with an eye to a lawsuit if they step away from the boundaries of good care.

 

[SilkySifaka]

What I find interesting in that statement is that they obviously agreed that she will go to the coroner first. :waitasec: Isn't that admitting she is dead? From that point the coroner will release her to the family. I am curious as to what this paperwork is. Since when does a coroner release a deceased person to a family. To do what with her? :waitasec: It's all so absurd to me. IMO...

As I mentioned upthread, you can know someone is dead but not accept it any form. Its called grief.

 

[Donjeta]

Thanks donjeta. I do have a problem with one small part of what he says. Worrying about the moral distress that "the family" is putting on the providers. They are the doctors and have the moral duty to care for the patients family as well as the patient. Given Jahi cannot be helped, the family is still part of the group being cared for or should be. As i said in another post, it is not the mentally ill's job to worry about the doctors, it is the doctors to worry about the mentally ill. This is a tragedy all the way around but I assume the hospital is providing counseling to the doctors involved...and i would hope they are providing through another hospital to the family, as I doubt they would trust CHO's docs. But they should have made an arrangement to offer help with another institution.

JMO dont attack me

I agree that taking the family into account in care decisions is important but not sure that it is necessarily even beneficial for the mental health of the families to have their brain dead family members lingering on in a state of limbo forever, taking up an ICU bed while people fill up their heads with promises of extremely expensive false hopes. There are other ways of supporting grieving families, and while I believe that most intensive care unit staff members are lovely people, understanding and experienced in meeting grieving families professionally and supportively, they are not for the most part mental health professionals.

The court records state that CHO has offered a lot of counseling resources for the family benefit, as well they should have. Whether the family trusts them I can't say for sure but I think it is possible they do, they have made some statements that there is a lot of staff in CHO that have been very supportive and empathetic.

 

[Donjeta]

I am shocked one hasn't been done, or the special MRI done rarely but more often now for locked in syndrome that discovered many who were "vegetative statese" can actually answer questions using images and are locked in.

That would make it a lot easier for the family to understand when they see a blank brain compared to an active one or a vegetative locked in one

It is my understanding that this child has had several scans done, all showing signs associated with brain death. The most recent one was (afaik) when the Stanford neurologist did his exam just before Christmas and it showed no cerebral blood flow.

 

[Elley Mae]

Actually, I don't think they're finished yet. The last tweet was "no further settlement discussions this weekend." Perhaps they will continue Monday? And the TRO expires Tuesday at 5pm.

So, we wait... again.

For some reason I think this "wait time" will be quieter.

 

[SilkySifaka]

It is my understanding that this child has had several scans done, all showing signs associated with brain death. The most recent one was (afaik) when the Stanford neurologist did his exam just before Christmas and it showed no cerebral brain flow.

actual brain death should show a blank unlit brain though. I am talking about a specific scan that not all hospitals can even do, including some big ones, it takes a special MRI machine and is used only to show that someone in a vegetative state is actually alive, thinking and awake. It is very new, over the last couple of years and extremely expensive but its ripe for this sort of case. Traditional scans won't be of use as the family doesn't trust them but this scan would show once and for all that her brain is dead while if god forbid she actually is locked in would mean a quick correction of course by the hospital. Does anyone know the name of the scan and if CHO has a machine for it?

Edit found it. It is called an fMRI and as the article says will rewrite medical textbooks. It gives me the shivers how many vegetative people were probably awake and conscious an no one knew and still don't know

A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.

It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

His doctor says the discovery means medical textbooks will need rewriting. .... "I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful."

http://www.bbc.co.uk/news/health-20268044

 

[Elley Mae]

Your thoughts are not alone with concern for the other siblings.

I lost my mother when I was young and my father was in deep grief. I remember tip toeing around, trying my best to be as good of a girl as possible. It hurt me so much to see him in pain that I never went through the grief process myself and raised myself basically. I was very scared and confused. There was no counseling. So, when I see a loss in a family, I always try and share my experience in hopes that other adults with be encouraged to get counseling for children.

We are in a much different era now, with good access to grief counseling. Parents can't be forced unless there is intervention to see that their children get this much needed care. There situation is much different than mine because of all the media. They may have problems trusting doctors and hospitals from things they have overheard. I have wondered who is meeting their need over the last weeks.

I have thought about these siblings who also seem to have been lost in all of this and hope that someone will be looking out for them as well as making sure that Jahi's body is properly cared for.

bbm, They may have problems finding a doctor after this.

 

[Elley Mae]

I just don't understand how this represents a victory for the family in getting new instructions how to manage in arranging a transfer.

The new conditions sound to me like the almost same exact conditions that were stated by CHO in their letter on Dec. 29:

1) the new facility is aware of Jahi's status, 2) suitable transport is arranged, and 3) the coroner permits the move.

JMO but these things would all have had to been rather self-evident from the beginning for everybody concerned.


http://www.nbcbayarea.com/news/loca...Letter-to-McMath-Family-Lawyer-237897191.html

1. Children’s will be pleased to communicate directly with a physician at any facility that is considering accepting Jahi’s body to make sure Children’s understands the requirements set by that facility for accepting the body and to ensure that the facility understands the current condition of the dead body and what is being done to maintain it under Judge Grillo’s temporary restraining order. Of course, the family’s representatives can observe that communication.

2. Children’s needs to be assured that there is a lawful transportation plan to any facility to which transfer is proposed.

3. If the proposed facility is out-of-state, Children’s needs written assurances from the Coroner that their office will allow the transfer.

Exactly, nothing has changed. The only change is the language that is being spoken.

 

[Elley Mae]

There are some commenters on Twitter who say Jahi is alive because hospitals don't keep dead people on ventilators.
Good grief, this whole case is about the hospital trying not to.

My thought from the beginning of the demand for the vent and feeding tube has been that once in place then the argument begins that what hospital would put tubes in a dead person.

 

[Donjeta]

actual brain death should show a blank unlit brain though. I am talking about a specific scan that not all hospitals can even do, including some big ones, it takes a special MRI machine and is used only to show that someone in a vegetative state is actually alive, thinking and awake. It is very new, over the last couple of years and extremely expensive but its ripe for this sort of case. Traditional scans won't be of use as the family doesn't trust them but this scan would show once and for all that her brain is dead while if god forbid she actually is locked in would mean a quick correction of course by the hospital. Does anyone know the name of the scan and if CHO has a machine for it?

Some methods that show brain areas alighting with brain activation are functional MRI (fMRI) or PET scans but IMO it is very possible that it would be pointless. Everybody else already knows what the result would be and if a family can ignore several neurological brain death examinations showing brain death, CTs showing brain damage, EEGs showing no activity, and a radionucliotide SPECT showing once and for all that her brain is dead and does not get any perfusion because they see her and she seems alive to them they can ignore other scans that show the same thing.

People with the locked-in syndrome have brain perfusion and EEG activity, Jahi does not.

 

[SilkySifaka]

My thought from the beginning of the demand for the vent and feeding tube has been that once in place then the argument begins that what hospital would put tubes in a dead person.

They put tubes in dead people all the time. Just think organ transplant donors.

 

[SilkySifaka]

Some methods that show brain areas alighting with brain activation are functional MRI (fMRI) or PET scans but IMO it is very possible that it would be pointless. Everybody else already knows what the result would be and if a family can ignore several neurological brain death examinations showing brain death, CTs showing brain damage, EEGs showing no activity, and a radionucliotide SPECT showing once and for all that her brain is dead and does not get any perfusion because they see her and she seems alive to them they can ignore other scans that show the same thing.

People with the locked-in syndrome have brain perfusion and EEG activity, Jahi does not.

True but the fmri shows them actually being able to answer questions directed to them and no one knows they are locked in until the fmri is doen which few hospitals have. Thats why people have been considered vegetative for decades. Imagine if they had the fmri when Terri's case was being considered. For all we know she was alive and conscious when discussion of removing life support was done. It is only the last couple of years the technology is there to weed out the locked in's.

I think mom might be more able to accept it if she sees her daughter can't answer questions or respond to the fmri.

 

[Elley Mae]

K_Z, I hope that these children are checked on whether Jahi is brought home or not. It's hard enough losing a sibling at such a young age. To have to witness this craziness for the past three weeks (and counting), well, I really worry about them. School goes back into session very soon, and this has been all over the news, so classmates may ask questions in that "zero filter" way that kids have.

What a tragic mess

Going to street view at( 52th street and dover)on maps there is a sign at the corner of the building that reads.

community physician's parking
children's hospital foundation
branches

It is a gated (secure) entrance.

 

[popsicle]

Catholic News Agency ‏@cnalive 31m
Catholic bioethicist advises caution in Jahi McMath case http://ow.ly/sg2hk #Catholic #JahiMcMath #bioethics #ethics

 

[Elley Mae]

They put tubes in dead people all the time. Just think organ transplant donors.

If I am not mistaken the tubes are in donors before they die. And iirc there is no donating going on in this situation. jmo