Family wants to keep life support for girl brain dead after tonsil surgery #9

[MyBelle]

"New Jersey is one of the few states that allows a family to reject a doctor’s diagnosis of brain death."

http://sanfrancisco.cbslocal.com/20...i-mcmath-after-lawyer-said-girl-is-improving/

MyBelle, did you catch that distinction? A FAMILY can reject the diagnosis of brain death. THE FAMILY can override the hospitals decision that the child ' is dead.'

A HOSPITAL can also reject a diagnosis of brain death. I'm not sure why you want to totally ignore that fact.

JMO

 

[nrdsb4]

There is not one set of medical ethics on which all medical professionals agree. Medical ethics tend to reflect a general, NOT absolute, consensus on various matters. There is no medical ethics law which states absolutes by which all must practice. There are many areas of controversy with regard to medical ethics.

As to the assertion that no hospital would admit a patient who had been declared brain dead, or that a hospital who would accept a patient with that diagnosis must be disputing it, that is not true. My hospital accepted a brain dead patient from an outlying rural hospital. The patient had presented with symptoms of stroke. The hospital did not follow standards of care and gave anticoagulants before results of the CT scan were known. The patient was actually experiencing a hemorrhagic stroke; the anticoagulants exacerbated the bleeding and the patient ultimately suffered a brain herniation. He was declared brain dead following all accepted medical standards. The family did not accept this diagnosis. Additionally, and understandably, they had lost confidence in this facility after their loved one's condition deteriorated. That patient was transferred to my facility and put in my unit. Someone in administration made the decision to accept this patient for reasons not explained to me. I can certainly speculate, but I don't know for sure exactly how the decision was reached. I took care of this patient in the ICU for approximately a week. The family never did accept the brain death diagnosis. Eventually the patient was transferred out of ICU and moved to a floor which accepted vent patients. This man was in his 60's and had underlying heart issues. He eventually suffered a cardiac arrest on that floor and was not successfully resuscitated.

 

[MyBelle]

There is not one set of medical ethics on which all medical professionals agree. Medical ethics tend to reflect a general, NOT absolute, consensus on various matters. There is no medical ethics law which states absolutes by which all must practice. There are many areas of controversy with regard to medical ethics.

As to the assertion that no hospital would admit a patient who had been declared brain dead, or that a hospital who would accept a patient with that diagnosis must be disputing it, that is not true. My hospital accepted a brain dead patient from an outlying rural hospital. The patient had presented with symptoms of stroke. The hospital did not follow standards of care and gave anticoagulants before results of the CT scan were known. The patient was actually experiencing a hemorrhagic stroke; the anticoagulants exacerbated the bleeding and the patient ultimately suffered a brain herniation. He was declared brain dead following all accepted medical standards. The family did not accept this diagnosis. Additionally, and understandably, they had lost confidence in this facility after their loved one's condition deteriorated. That patient was transferred to my facility and put in my unit. Someone in administration made the decision to accept this patient for reasons not explained to me. I can certainly speculate, but I don't know for sure exactly how the decision was reached. I took care of this patient in the ICU for approximately a week. The family never did accept the brain death diagnosis. Eventually the patient was transferred out of ICU and moved to a floor which accepted vent patients. This man was in his 60's and had underlying heart issues. He eventually suffered a cardiac arrest on that floor and was not successfully resuscitated.

BBM. I disagree. All hospitals and physicians are licensed and must adhere to the same Code of Ethics. The Oakland Children's Hospital said it was unethical to perform medical procedures on a dead person. If it is unethical in Oakland, it is unethical in New Jersey. It is more than obvious to me that in the case you describe, a physician or hospital did NOT accept the diagnosis and that is why it accepted the patient. The very same thing may be what has happened in Jahi's case.

JMO
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?

 

[nrdsb4]

BBM. I disagree. All hospitals and physicians are licensed and must adhere to the same Code of Ethics. The Oakland Children's Hospital said it was unethical to perform medical procedures on a dead person. If it is unethical in Oakland, it is unethical in New Jersey. It is more than obvious to me that in the case you describe, a physician or hospital did NOT accept the diagnosis and that is why it accepted the patient. The very same thing may be what has happened in Jahi's case.

JMO
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page?

Absolutely not true. Our hospital never disputed the brain death diagnosis. It was stated from the outset that the patient was brain dead and we were to accept him into our unit. There were many who were not happy about it, but we were not given a choice.

Also NOT true that medical ethics are always accepted unanimously by all professionals. Some medical professionals might feel that keeping a feeding tube in a patient like Terri Schiavo is unethical, while other perfectly logical and caring individuals would find it unethical to remove it. In the case of Jahi, someone clearly disagreed that it was unethical to put a trach into a patient declared brain dead.

 

[MyBelle]

Absolutely not true. Our hospital never disputed the brain death diagnosis. It was stated from the outset that the patient was brain dead and we were to accept him into our unit. There were many who were not happy about it, but we were not given a choice.

Also NOT true that medical ethics are always accepted unanimously by all professionals. Some medical professionals might feel that keeping a feeding tube in a patient like Terri Schiavo is unethical, while other perfectly logical and caring individuals would find it unethical to remove it. In the case of Jahi, someone clearly disagreed that it was unethical to put a trach into a patient declared brain dead.

I do not believe your hospital or any of its physicians knowingly admitted a brain-dead person from another facility. No physician would say it was unethical to keep a feeding tube IN Terri Schiavo and none did. She was not brain dead.

Please post a link to support your claim a hospital or physician is not required to adhere to a code of ethics. Thank you.

JMO

 

[nrdsb4]

I do not believe your hospital or any of its physicians knowingly admitted a brain-dead person from another facility. No physician would say it was unethical to keep a feeding tube IN Terri Schiavo and none did. She was not brain dead.

Please post a link to support your claim a hospital or physician is not required to adhere to a code of ethics. Thank you.

JMO

Who said hospitals and doctors don't have to consider ethics? Medical ethics are of course important and all are expected to consider the ethical implications of actions. Often these are clear and not really subject to debate. Other times there is considerable angst when ethics committees consider situations. There would be no such thing as debate, controversy, or angst if medical ethics were as absolute as law.

Quite frankly, your belief about the circumstances of the situation I described is completely irrelevant and not based on the facts involved. You have shown yourself to be fallible just like everyone else. Whether or not you believe a hospital accepted a patient who was clearly brain dead has ZERO to do with its veracity. You could believe with all your heart and soul that the earth is flat, but that does not change the facts.

There are several legitimate reasons this situation could have come to pass:

The family disputed the medical facts and refused to agree to cease treatment. The hospital, in spite of its legal right to cease treatment, nevertheless decided to hold off in order to give family members time to come to terms with their grief.

Due to the circumstances surrounding the tragic demise of this man, it became uncomfortable for both staff and family to interact on a daily basis, and the decision to transfer was made.

A receiving facility agreed that due to the prognosis of the patient and the circumstances involved, it would agree to accept the brain dead patient on compassionate grounds, assuming that the patient would soon suffer cardiac death, and the family could find closure in a caring environment with which the family did not associate negligence.

The accepting facility breaches no ethical boundaries by accepting this patient under these circumstances. The facility is not assuring the family that a cure may be achieved, the facility is merely providing supportive care, the facility is not performing operations on the patient, and the facility is doing no harm to either patient or family by providing a place for the patient to die with family at bedside.

Another hospital might well have refused the patient, citing ethical concerns. This illustrates the nature of ethics; there is not ALWAYS a cut and dried answer to every situation and caring, intelligent professionals can view ethical situations differently. If this were not the case, there would be no need for ethics committees at every facility and there would never be room for debate within these committees. There would simply be an indisputable ETHICS bible which would dictate all interventions in any given scenario.

Case closed. No unethical behavior involved.

 

[nrdsb4]

As to Terri Schiavo, there absolutely were ethical dilemmas. Her husband asserted that his wife had emphatically stated to him her desire to refuse treatment if she found herself in the exact scenario that occurred. His insistence on feeding tubes and other intervention would be UNETHICAL if this were the case.

TS's family asserted just as vigorously that Terri would NOT have wanted to cease treatment in her current circumstances. In this instance, removing the tube would be highly unethical.

The courts simply had to decide who best knew her wishes. Once they ruled that her husband was more likely to have known her wishes, he was allowed to refuse treatment on her behalf, because to do otherwise would have been unethical, as all patients have the right to refuse treatment, even if said refusal were to result in death. Such decisions to remove life support from non brain dead patients occur every single day in hospitals all over the country.

 

[lawstudent]

1) Doctor's licenses are given out by states, and the requirements are not the same across the board. There is no set rule on what is medically ethical and no national enforcement body.

2) The case I posted did not involve brain death. In that case, the hospital thought it was unethical to *stop* care, not continue it. That is an ethics debate that is definitely still ongoing with regard to people who are not brain dead but are in a PSV and can vary by state law and the individual providers. I used it to illustrate that what is ethical varies, and so does what state will allow.

3) The CA hospital did not find it was unethical to provide care to a brain dead person flat out, but to do so long term when there was no reason to postpone the death. Another hospital could disagree as to whether or not there was reason to hold out, which normally is just a matter of family concerns (saying goodbye, coming to terms, etc.) Maybe some hospitals would give families a longer period to grieve. It's a matter of dignity, so it's a balancing act.

4) Families cannot overrule the diagnosis of brain death! They can prevent the declaration of legal death! There is a huge difference for a number of reasons - it's not just semantics! Family members have no medical degrees - they are not allowed to perform any diagnosis of medical conditions or to overrule declarations of death. They are allowed, due to religious beliefs, to claim that a brain dead person is not dead - not that their brain is alive, but that the rest of the body is. The chart will still say brain dead. They may believe the brain is alive, but that doesn't matter. Some people could have religious beliefs that recognize the brain is dead but still consider that person alive in the sense that their soul has not yet departed. That is probably the essence of religious-based claims. That prevents the physician from declaring time of death and releasing the body to the coroner. It doesn't overrule his declaration - he's not allowed to make it in the first place. And it doesn't overrule his diagnosis. If insurance companies have a limit on the amount of time they will pay for the hospitalization of a brain dead person, the family's beliefs wouldn't change anything. The person would still be brain dead for that purpose.

ETA: Thinking of the Terri Schiavo situation, I find the NJ statute a bit weird because it allows the family members to make that assertion, right? It would seem that it would be the beliefs of the patient, if that patient were an adult. I wonder what would happen if some family members said they believed someone was alive, and but she had a husband who said she had given up those religious beliefs and would want to die. Which family member controls? The statute is so vague that I bet it would be interpreted in line with the intention and commonly accepted legal ideas - if there was strong evidence the person would want life support terminated, it would probably be ordered regardless. Absent that, if the family has any shred of evidence that this was a belief system, it would be upheld. Brain death just makes it legal to remove life-saving measures without being accused of euthanasia. If a doctor didn't listen to the family and removed support, I wonder if he could be criminally charged or if it would just be a professional disciplinary or civil issue. Would it be a homicide? Does a brain dead person have the right to the life support as long as the family wants them to? What if the family member who objected to the life support ran in and turned it off? I think with the doctor it would just be malpractice. The reason life support removal is allowed is because the doctor isn't considered the cause of the death - the prior deterioration is at that point, and the doctor is just stopping the extreme measures.

 

[al66pine]

MyBelle stated several posts back:
"All hospitals and physicians are licensed andmust adhere to the same Code of Ethics." BBM

Respectfully, same ethics code, but not necessarily the same exact outcome in every case.*
IIUC, an AMA member may have -
-- one ethics obligation in CA (discontinue care of braindead patient, beyond what is req'ed if organs to be recovered), but
-- a different ethics obligation in NJ (continue care per family requests, based on pt's religious beliefs).

IIRC, every state's statutes, except NJ (& maybe one other?), say in effect 'BrainDeath = Death'
meaning med prof's, including AMA members, would pronounce dead, notify county coroner/ME, get sign death cert, etc.

Is BD=D a specific part of AMA ethics code or interp?
So maybe BD=D provision of state statute and AMA ethics code coincide...except NJ?
Individuals in NJ practicing their religious beliefs ask for continued 'treatment' for braindead fam members in NJ and,
per NJ state statute, AMA members may continue providing care & treatment, even if violating AMA ethics.
If BD=D is part of AMA ethics code, then the NJ may be an example where the law mandates unethical conduct.

IIUC, as AMA code of ethics states: "Ethical values and legal principles are usually closely related."
it recognizes that since statutes vary from one state to another, "In some cases, the law mandates unethical conduct."

JM2cts and I may be wrong. Hoping to get feedback or input on this line of interpretation.

----------------------------------------------------------------------------------------------------
* AMA Code of Ethics and state law

"Opinion 1.02 - The Relation of Law and Ethics The following statements are intended to clarify the relationship between law and ethics.
Ethical values and legal principles are usually closely related, but ethical obligations typically exceed legal duties. In some cases, the law mandates unethical conduct. In general, when physicians believe a law is unjust, they should work to change the law. In exceptional circumstances of unjust laws, ethical responsibilities should supersede legal obligations.
The fact that a physician charged with allegedly illegal conduct is acquitted or exonerated in civil or criminal proceedings does not necessarily mean that the physician acted ethically. (III)
Issued prior to April 1977; Updated June 1994." BBM

link from MyBelle post ~532 http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page

 

[katydid23]

a care facility is not necessarily a hospital. Your assumptions are not fact. I don't know of any Catholic hospital that admits dead people to their ICU unit.

JMO

Apparently there is one in NJ that does.

 

[MyBelle]

1) Doctor's licenses are given out by states, and the requirements are not the same across the board. There is no set rule on what is medically ethical and no national enforcement body.

2) The case I posted did not involve brain death. In that case, the hospital thought it was unethical to *stop* care, not continue it. That is an ethics debate that is definitely still ongoing with regard to people who are not brain dead but are in a PSV and can vary by state law and the individual providers. I used it to illustrate that what is ethical varies, and so does what state will allow.

3) The CA hospital did not find it was unethical to provide care to a brain dead person flat out, but to do so long term when there was no reason to postpone the death. Another hospital could disagree as to whether or not there was reason to hold out, which normally is just a matter of family concerns (saying goodbye, coming to terms, etc.) Maybe some hospitals would give families a longer period to grieve. It's a matter of dignity, so it's a balancing act.

4) Families cannot overrule the diagnosis of brain death! They can prevent the declaration of legal death! There is a huge difference for a number of reasons - it's not just semantics! Family members have no medical degrees - they are not allowed to perform any diagnosis of medical conditions or to overrule declarations of death. They are allowed, due to religious beliefs, to claim that a brain dead person is not dead - not that their brain is alive, but that the rest of the body is. The chart will still say brain dead. They may believe the brain is alive, but that doesn't matter. Some people could have religious beliefs that recognize the brain is dead but still consider that person alive in the sense that their soul has not yet departed. That is probably the essence of religious-based claims. That prevents the physician from declaring time of death and releasing the body to the coroner. It doesn't overrule his declaration - he's not allowed to make it in the first place. And it doesn't overrule his diagnosis. If insurance companies have a limit on the amount of time they will pay for the hospitalization of a brain dead person, the family's beliefs wouldn't change anything. The person would still be brain dead for that purpose.

ETA: Thinking of the Terri Schiavo situation, I find the NJ statute a bit weird because it allows the family members to make that assertion, right? It would seem that it would be the beliefs of the patient, if that patient were an adult. I wonder what would happen if some family members said they believed someone was alive, and but she had a husband who said she had given up those religious beliefs and would want to die. Which family member controls? The statute is so vague that I bet it would be interpreted in line with the intention and commonly accepted legal ideas - if there was strong evidence the person would want life support terminated, it would probably be ordered regardless. Absent that, if the family has any shred of evidence that this was a belief system, it would be upheld. Brain death just makes it legal to remove life-saving measures without being accused of euthanasia. If a doctor didn't listen to the family and removed support, I wonder if he could be criminally charged or if it would just be a professional disciplinary or civil issue. Would it be a homicide? Does a brain dead person have the right to the life support as long as the family wants them to? What if the family member who objected to the life support ran in and turned it off? I think with the doctor it would just be malpractice. The reason life support removal is allowed is because the doctor isn't considered the cause of the death - the prior deterioration is at that point, and the doctor is just stopping the extreme measures.

BBM. You are posting an incredible amount of misinformation as fact. All teaching hospitals must be accredited. The American Medical Association has the Code of Ethics. States do not set the standard of medical ethics, they handle licensing.

As to your question about removal of life support, my own family was faced with this and we had a choice take her home or to a hospice. She had no living will so all her children had to be in agreement. Leaving her in the hospital was not an option. Brain-dead patients do not recover. It is not curable just as terminally ill cancer patients do not recover. Their body continues to deteriorate.

No hospital would admit an already diagnosed brain-dead patient because it is considered unethical to perform medical procedures on deceased patients. That is why permission of the family is required before a hospital can proceed with organ donation. Ethics have to do with maintaining dignity and respect for the patient. How would you like it if a bunch of med students gathered around your dead loved one's body so they could "practice" a surgical procedure repeatedly.

Saint Peter's University Hospital is fully accredited by The Joint Commission and was the tenth hospital in the nation to be designated as a Magnet hospital for nursing excellence by the American Nurses Credentialing Center in 1998. In 2010, we became one of only six hospitals in the world to have achieved this honor for a fourth consecutive term. As the “gold standard” of nursing care, the Magnet Award is the highest honor given by the American Nurses Credentialing Center. And, Saint Peter's Intensive Care Unit is one of only ten intensive care units out of 6,000 in the country to receive the Beacon Award for Excellence in Critical Care three times.

http://www.saintpetershcs.com/saintpetersuh/

http://www.jointcommission.org/general_public.aspx

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page

http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3285

 

[K_Z]

There is not one set of medical ethics on which all medical professionals agree. Medical ethics tend to reflect a general, NOT absolute, consensus on various matters. There is no medical ethics law which states absolutes by which all must practice. There are many areas of controversy with regard to medical ethics.

Respectfully snipped.

How very true this statement is!

Consider the tragic case of Marlise Munoz in Texas last year, which is (IMO) much more relevant and applicable than the Justina Pelletier case cited a few times above. A large majority of health providers in this country felt that maintaining a brain dead 14 week pregnant patient, against her expressed wishes and her husband's wishes, was highly unethical on a number of levels. But obviously, there were administrators and health professionals in the Texas hospital who must have felt it was unethical not to try to gestate a 14 week fetus to term in a brain dead host.

 

[MyBelle]

Respectfully snipped.

How very true this statement is!

Consider the tragic case of Marlise Munoz in Texas last year, which is (IMO) much more relevant and applicable than the Justina Pelletier case cited a few times above. A large majority of health providers in this country felt that maintaining a brain dead 14 week pregnant patient, against her expressed wishes and her husband's wishes, was highly unethical on a number of levels. But obviously, there were administrators and health professionals in the Texas hospital who must have felt it was unethical not to try to gestate a 14 week fetus to term in a brain dead host.

BBM. You are incorrect. The hospital maintained life support because they believed they were required to do so in accordance of state statute.

officials at John Peter Smith Hospital in Fort Worth had said state law required them to maintain life-sustaining treatment for a pregnant patient.

http://www.cnn.com/2014/01/26/health/texas-pregnant-brain-dead-woman/

 

[nrdsb4]

No hospital would admit an already diagnosed brain-dead patient because it is considered unethical to perform medical procedures on deceased patients.

You don't know what you are talking about in this particular instance. My hospital accepted a brain dead patient and performed no "medical procedures" on him. There is NOTHING unethical with providing minimally supportive care on a brain dead patient. It is done ALL THE TIME while families gather and/or until organs are procured (which requires more aggressive treatment to keep organs viable). We simply provided oral care and personal hygiene, turned him at intervals, etc., and kept the ventilator running (which are the same things CHO was ethically fine with doing in the short term) until the family agreed to turn it off or he died, as he was expected to do within a short amount of time.

Stating "beliefs" as though they are facts does not make you more credible. You ARE WRONG. You have not seen the medical record of the patient in question, while I was privy to it every day. Your statements are completely baseless.

 

[K_Z]

BBM.
No hospital would admit an already diagnosed brain-dead patient because it is considered unethical to perform medical procedures on deceased patients.

I strongly disagree with this statement, and will have to consider it an "opinion", because it is not grounded in fact. There are examples of brain dead patients being transferred or admitted to different facilities under certain circumstances. Two specific examples were given upthread-- 3 if you include the Jahi McMath case. I could dredge up others, but it isn't necessary.

The admission to a new facility under no circumstances means that the new facility rejects, or does not "agree" with the diagnosis of brain death at the previous facility. I'm not sure exactly where, or why that idea developed for you, but it's really not accurate.

An admission to a hospital is not a medical procedure. It's very likely the NJ hospital is just maintaining the body in the state it arrived. Someone else placed the trach and feeding tube, and that person/s apparently did not feel that there was an ethical dilemma about performing the procedures for a brain dead patient. The Oakland hospital docs did decline to perform NEW surgical procedures designed to prolong somatic support, and felt it was unethical. The courts allowed the family to seek placement in another facility as a remedy, which has happened. That doesn't mean the patient is no longer brain dead, if they are admitted to a new facility. There are definitely issues with the admission, but debating a diagnosis of brain death is probably not one of them. It would be ridiculously easy to re-confirm that diagnosis, if the new facility felt it was needed.

The "Code of Ethics" is not as plain and simple as some might wish it to be. And ethics, like everything else, change over time-- when patient TK became brain dead at age 4 in the 1980's, children under 5 could not be pronounced brain dead. Was he any LESS brain dead, or more ALIVE, because the law prohibited the diagnosis for children under age 5 at that point in time??

Consider the Hippocratic Oath-- "first, do no harm"-- and how difficult that is to interpret in these thorny ethical cases, such as Marlise Munoz. This is why ethical dilemmas are best tackled and debated by consensus, ahead of time, when possible. Like the Uniform Determination of Death Act.

In a consensus model of medical practice (which is what we have in this country), there will always be those who do not agree with the consensus model. Those are the outliers, and they each have their own personal reasons for declining to agree with the consensus model. And when one chooses to be an extreme outlier (such as Dr. Paul Byrne), one has to accept that they will always be in a position to have to defend their ideas, and that the mainstream will typically renew their objections to the outliers.

 

[nrdsb4]

I wonder if he could be criminally charged or if it would just be a professional disciplinary or civil issue. Would it be a homicide? Does a brain dead person have the right to the life support as long as the family wants them to?

No, they don't. In many (most) states, the hospital can and does turn off life support in the face of family resistance because their laws allow them to. It happens every day in some location. We just don't hear about it. What happened in Jahi's case was unusual in that the judge said she was legally dead but prevented them from turning off life support.

 

[lawstudent]

BBM. You are posting an incredible amount of misinformation as fact.

:banghead:

I'm not even stating many facts - I'm attempting to provide context in response to the facts you are linking together in a conclusory manner. We don't necessarily disagree on as much as you think we do. If I have misinformed anyone, I apologize.

The argument was that all doctors (and hospitals) are licensed. I addressed the license argument for that reason. Doctors retain their licenses largely because of compliance with the board's idea of their compliance with the ethical rules. Accredited hospitals are a different matter. It does not change the fact that whatever medical schools generally teach, and whatever rules are put out by generally respected associations, they don't have binding authority and can be interpreted in multiple ways. There's no code of exact rules for dealing with each medical situation. It's not as simple as "This hospital says this is ethical, so clearly it is and all hospitals do the same." In a perfect world, that's how it would work.

As to the cases of doctors turning off life support against the family's wishes, I know that is normally fine, but that's because the doctor isn't considered the legal cause of the death. If a doctor disobeyed a family's wishes in NJ, and just didn't declare death until cardiorespiratory function had ceased, would he have done anything wrong? The statute just prevents declaring death based on cessation of brain function. If the doctor performed an organ donation operation on a brain dead person without declaring death, obviously killing the patient, that would make him the cause. But other than in that situation, it seems like a doctor could choose to pull life support regardless. If there was a court order against it, the hospital would be liable for the violation, but that seems to be about it. I don't see why the NJ statute is being interpreted as so powerful.

 

[nrdsb4]

There's no code of exact rules for dealing with each medical situation. It's not as simple as "This hospital says this is ethical, so clearly it is and all hospitals do the same." In a perfect world, that's how it would work.

I'm not really sure that in the "perfect world," that is how it would work. There should always be a method of debating these issues. Many ethical dilemmas are not cut and dried, and it's possible for two intelligent, caring, educated individuals to have differing opinions on certain issues. What can happen with ethics committees is that they cannot come to absolute agreement on a given situation. Sometimes it is necessary to compromise, which means that there is no clear "right" answer and all must work towards a solution which considers multiple factors, multiple issues, multiple consequences, and the greatest good and least harm for the majority of people involved. It's just NOT always a matter of indisputable 1 + 1 = 2. If it were, there really would be no need for ethics committees. All you would have to do would be to refer to "the" manual and no discussion needed, no dissent tolerated.

 

[ArianeEmory]

Not a lawyer or a doctor, but I'll just say that "a hospital admitted her so she's not brain dead" seems extremely specious, especially since multiple doctors declared her brain dead AND the family has an enormous amount of incentive to shout it from the rooftops if their miracle has occurred. They have no incentive to keep it private, and they have all kinds of incentive (financial, spiritual, moral high ground, rewarding their donators, etc) to advertise it. And we know Uncle Omari is hardly a master of circumspection. If this was happening, he'd be running the cable news circuit again.

This central argument on which you've pivoted pages and pages of debate is very thin. But thanks for getting the thread active, I guess.

 

[Steft50]

My thoughts turned to this case last week while I was watching one of those reality ER shows, many of which were filmed in the late 90's early 2000's. One of the ER cases they followed was a young man who had an accident and after a short while he was found to be brain dead. I felt for the poor parents who just couldn't accept that, they kept telling the doctors to do something to get the blood into his brain, to put a tube in or something. Through the whole conversation the doctors just kept telling them that there was nothing they could do because he was dead. They said that over and over, to every argument the parents put up the reply was always he's gone, he's dead, he's not coming back. It reminded me of what this family said how the hospital kept pounding in that she is dead over and over again. The doctor on this show commented later on to the camera that its' something they don't like to do but something they have found over their years of practicing is that answer, telling families that over and over is often the only way family finally gets it, finally accepts it. Watching this whole thing happen let me further understand what others considered callous was simply practiced responses that all to often are needed.