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You know why the hospital is fighting so hard to pull the plug?
How much does a wrongful death lawsuit cost?
How much does a lifelong life support cost?
That’s why. v’dok.
He isn’t in a coma, he is dead.
Do you really trust a doctor from the same hospital that killed her during a simple tonsillectomy procedure to decide just how brain dead she is?
Also, the mother claims that her daughter is responsive. And I am much more trusting of the mother than of the doctor, who has a financial motive to want to get the girl off life support.
Having the same people who destroyed your daughter’s life take her off life support only rubs salt in the parent’s wound. At least have a different organization do it.
Dear hospital, don’t be so eager to finish off the job.
After spending way too much time in hospitals watching my parents die, with the staff asking us not to “waste” -o blood on my dad, and putting a DNR in place without permission etc, I don’t find any of this surprising. The part I am having trouble with is their comments. They know the public doesn’t understand and that PR is everything, and yet they make insensitive statements such as, “transporting a dead body . . .” and others. Their messed up value system is universal, but that level of insensitivity from the PR people makes me think they are a place to stay away from.
I don’t assume the doctors made a mistake. Supposedly there is more information regarding what went wrong that the parents are blocking (thru not signing a HIPA waiver) which is really annoying the hospital who is left unable to defend themselves. I wouldn’t assume the hospital didn’t err, but I will say with certainty that it is not so simple to understand from the outside.
And regarding responsiveness, if there is no blood flowing to the brain, that is more telling than the movement of limbs.
I do wonder, however, if anyone knows legitimate stories of people who were declared brain dead (not coma) and recovered.
Exactly, Syag. Forget about the value system.
If you’re the one who puts her in a coma, it’s incredibly insensitive to make a fuss about taking her off life support.
Not sure, exactly, how to read your comment. I didn’t mean to forget about the value system, I meant that their lack of value of a brain dead patient doesn’t surprise me and is universal in the healthcare field. Being insensitive at the risk of losing customers is not universal.
Also, nobody put her in a coma, she is brain dead. and becoming brain dead is not always something actively done, sometimes it happens even under excellent care. Having apnea puts a person’s heart at risk. She was also overweight. Maybe her heart was 100% healthy, but maybe it wasn’t The point is that we haven’t a clue about the medical situation, but we do know that the way they are presenting themselves is not in anyone’s best interest.
By the death penalty, no standard of proof is good enough for the liberals.
But all of a sudden, when it comes to sick people, one hospital, who has a financial incentive, is enough to force the family to kill their daughter.
PBA – it isn’t only that, the insurance companies don’t want to cover dead people so it isn’t just the costs involved, it’s being stuck with them.
PBA, also Zack Dunlap, who heard doctors discussing harvesting his organs.
You can google “Brain activity after brain death” which shows that deeper parts of the brain may be active even after a patient is declared “brain dead” (by a flat isoelectric line)
Citation: Kroeger D, Florea B, Amzica F (2013) Human Brain Activity Patterns beyond the Isoelectric Line of Extreme Deep Coma. PLoS ONE 8(9): e75257. doi:10.1371/journal.pone.0075257
There is no need to discuss brain death.
It is the law of the land, if you dont like it you can work to overturn it.
As the law of the land stands the kid is dead.
My point is the headline of the post is wrong, and misleading.
I’m not debating the actual point you made I think it is obvious and not even wrong.
Ubiquitous,
You say “He isn’t in a coma, he is dead”. Is that your p’sak? Because this site is marginally defined as Jewish, thus for you to make such a declaration, you would have to have a legitimate basis.
You also say, “It is the law of the land,” Specifically what law are you referring to? I have never heard or reads of a law that says a hospital must take someone off life support (at least in the US before all provisions of Obamacare are effective)
PBA
No it means we should all follow the same language to have a meaningful discussion.
Coma does not equal brain dead (nor vice versa) they express to different physiologic states, By any definition legal/ English or otherwise.
Nishtdaynagesheft,
while this site may be Jewish the child in question and the state of California are not so that is the basis of my statement (in this context).
The law I refer to is California H&S Code 7180-81 which adopted Uniform Determination of Death Act of 1982
Ubiquitin–hilchos retzicha apply to bnei noach also. I would think it would be obvious that if the Torah says he’s alive (for the sake of argument) then he really is alive, regardless of what people think or what the law says.
PBA
I’m sorry I don’t follow, The girl is NOT in a coma she is brain dead which legally/medically equals dead.
Your headline says the girl is in “a coma” this is simply factually incorrect.
“while this site may be Jewish “
And that is precisely where PBA is discussing the issue.
“California H&S Code 7180-81”
This law says that you must remove the child from life support?
And besides, have you examined the child yourself to make the determination?
nishtgedayget
This discussion isnt about the halachic status of “brain death” (As PBA made clear) it is in the context of this child vis a vis the hospital. (Please see th OP) In that context the child is dead, not in a coma as Popas’s state mistakinlgy and misleadingly states.
“This law says that you must remove the child from life support?”
No, what on earth are you talking about?
“And besides, have you examined the child yourself to make the determination?”
Again what are you talking about? I rarely determine for myself if person is dead or alive why would this case be an exception? Did you examine the child yourself? People are declared dead (whether via brain death or cardiac), countless times daily across the world, how on earth is my examining the child relevant?
Ubiquitin, would you have called Steven Thorpe brain dead or comatose?
DY great question!
I haven’t read up on that case in about a year now. As I recall the circumstance regarding what testing was done were never clear in the press( I don’t recall even seeing mention of it in mainstream press, let alone medical journals.) Ditto for case with boy in houston.
I will do search later and give you a more concrete answer.
If the doctors tested brain stem reflexes and did apnic test then he was brain dead, if not then he was “merely” in a coma despite any reporter confusing the terms as Popa did in his OP and which I am trying to correct
According to the article I read, four doctors declared him brain dead. They were wrong. I do not believe the hospital in this case especially, where as popa pointed out, they have a tremendous bias. Had the title been “brain dead” it might be wrong.
The OP was talking about removing the child from machines, not whether she was alive or not.
Hence saying “It is the law of the land, if you dont like it you can work to overturn it.” refers to removing from life support.
And PBA was discussing the case on YWN CR, hence it would be flavored by the hashkafos oof the site participants. hence, if PBA does not consider the California law as truly defining death, why should he call it so.
And it is clear that brain dead is not the same as a coma by some of the comments here. No comments are written by someone in a coma, but a number are written by individuals who appear brain dead.
Does being rude help make your point?
DY,
I only found it in dailymail and repeated in huffington post in both cases the story is extremly vague and self contradictory in terms of what exactly was said to the family. Did you see it elsewhere?
Nishtgedeygiy
This shouldnt be complicated He should call it what it is “coma” means one thing “brain dead” means another (regardless of whether you personally view it as “death.”
PBA was NOT making a halachic pronouncment, (please see his second comment on this thread) nor to the best of my knowledge is the family of the child. so discussion regarding the halachic definition of death is completly irrelevant as PBA pointed out. He is discussing the hospitals choices, and the choices they face are regarding a “brain dead” (whether you view her as alive/undead/dead/resurrected or whatever)
Your last paragraph proves you have absolutely no clue what “brain dead” means
Whats worse is you dont seem to know the aleoh bais of the subject at hand. You asked for a law, it was cited. Instead of a thank you you misconstrued (out of ignorance or malice) the discussion at hand. It isnt regarding whether the hospital “must remove someone from life support” (where on earth did you even get that bizzare notion) it is whether they may.
And according to the laws as currently written in every single state including California, this child is dead, there is no medical/legal reason to provide “life support” to a corpse.
(Again as to whether there is halachic reason to provide life support to what is legally/medically defined as a cadaver, is a great discussion but one for another day (or another thread)as it isn’t relevant to the discussion at hand which is limited to the options facing the child’s family and the hospital outlined in the OP neither of whom are invoking halacha)
Ubiquitin, I saw it in dailymail.
Those poor parents, nebech. They take a child to have tonsils out, and this is what they are now facing???? Horrible.
DY
You do know that is roughly the equivalent of the New york post? do you believe everything you read in tabloid type magazines especially when it doesnt seem to be ANYWHERE else, the story as (sort of) reported by the dailymail is astounding why wouldn’t it be posted elsewhere?
reread the article with a critical eye worthy of the asstounding claim it makes. It doesnt actually quote doctors, and aside from the headline makes no mention of brain death or any Doctor actually saying such a determination was made. The article is full of hearsay reported by the family memebrs repeating what nameless doctors had told them. The only medical opinions mentioned say quite THE OPPOSITE of what the headline says:
Long story short I dont know what I would have called him since their simply isnt enough information available on the case
FWIW, the story was also reported on BBC news. Of course the hospital isn’t going to say, “Oops, we goofed. It’s a good thing the family insisted on another opinion, otherwise Steven would be dead”.
The only comment on this thread that didn’t turn my stomach was from oomis.
Nebach. Horrible.
Halachic discussions don’t apply in this case.
And for the rest of you, please keep in mind that behind all the discussion, there’s a tragedy.
As the law of the land stands the kid is dead.
Is this also the law in the Land of Israel? given that this Saturday shall be exactly 8 [secular] years to the day that Ariel Sharon is in a coma effectively brain dead, and yet he is still being maintained in his vegetative state.
Maybe Medinat Yisroel is far more sympathetic to human life than the state of California.
Halachic discussions don’t apply in this case.
I strongly disagree. We are supposed to view everything through the prism of Halachah.
147 – I don’t know if you did that on purpose or not but you just equated coma, vegetative state and brain dead which are three very different states. A person in a coma is NOT brain dead, and a person in a coma is not being maintained in a vegetative state.
That’s (loosely) like saying he can’t speak because he is mute so he is being medicated for his laryngitis until he gets his strength back.
147
I’m pretty sure it is the law in Israel too. (As I recall it was passed with in 2008 with Degel abstaining though per Rav Elyashiv’s instructions not bringing down the government) However Sharon is not brain dead. There is no such thing as “effectively brain dead” Sharon is in a coma he is not brain dead. the girl about whom this topic is reffering is brain dead she is not in a coma (though of course you can view both as alive that is not my point)
DY
I agree with your point however the girl and hospital about who popa are reffering both don’t agree.
At any rate even if you consider a brain dead individual to be “alive” They are still brain dead, they arent in a coma just becuase you dont recognise brain death as death. Rabbi Bleich who strongly disagrees with the notion of brain death being “dead” still discusses brain death. That is my sole point. This girl is not in a coma she is brain dead
ubiquitin- she is only braindead according to the scans we do right now. It’s possible that there is some brain function that current testing does not detect. That doesn’t mean there isn’t any. I believe that if the heart is still beating it means there must be some level of brain function supporting that. If I remember correctly, if a spinal cord is severed the heart stops pumping almost instantaneously. I hope for the family’s sake that this turns out to be a big mistake and she wakes up in good shape and proves all the doctors wrong. No one even dreams that this can happen to their child from such a simple surgery.
Gamanit,
Brain death isnt determined by scans. It is (theoretically) possible there is some brain function that is irrelevant. I have news for you btw “regular” death isnt determined by scans either it is done by listening and feeling for breaths/heartbeat. No scans whatsoever are required nor routinely done
You do not remember correctly. A heart can pump on its own modified for younger audiences even with a spinal cord injury if on a ventilator (provided blood loss is prevented)
DaasY, I stand corrected.
Gamanit: The Mishnah (I think in Ohalos) says that a decapitated person is considered dead instantly. There is a Machlokes between contemporary Poskim whether that is a Din (if somene have no head/brain, they are dead even though the brain still reacts for another 30-45 seconds) or whether that’s just because they’ll bleed out and their heart will necessarily stop pumping in a few seconds. They did an experiment in Israel to prove something to R’ Shlomo Zalman with a sheep where they tied off the major veins and such then decapitated it. The heart continued beating for a day or two.
ubiquitin- an article I read said that Ariel Sharon was considered brain dead until scans proved otherwise. Apparently you can’t listen and feel for brain function as you can breathing and pulse. Sam2- I never heard about that. I did not think the heart can last that long without the brain, but even in the case you brought it stopped after two days. It’s over a week since this girl was ruled brain dead, and her heart is still beating. I do not see how she can be considered dead in the eyes of the law.
Gamanit: Her heart is still beating because she is on a respirator. If the plug was pulled, it would stop. The headless sheep could have also lived indefinitely if we had artificially kept its lungs pumping and heart beating.
(I am not agreeing that brain death should be considered death; just explaining the Tzad.)
Gammit
I’m sorry but you read wrong you absolutly can feel/look for brain function that is EXACTLY how the determination of brain death is made. Cranial nerves are assessed by checking for pupil constriction to light (2 & 3), doll’s eye reflex and/or calorics (8,3,4 &6) corneal reflex (5&7) and fiannly apnea test.
Absolutely no other scans are required (nor routinely done)under US law and I’m fairly certain Israeli law as well.
The heart can last without a brain as Sam2 pointed out. That experiment was interrupted since it successfully proved the very point you are now denying. (the sheep gave birth to a live sheep 2 days after its head had been severed)
However please note this isnt a discussion about brain death. That has been debated ad nauseum though I am more than happy to discuss it further on another thread.
My only point is this girl, tragic as it may be, is by both legal standards and medical standards dead and not simply “in a coma”
(I suppose she can be described as “appearing to be unconscious” just as Lenin can.)
sam2 – but the respirator is not beating the heart. It is merely pumping air into the lungs. I have seen people on respirators die when their hearts stop so it is obviously not pumping the heart, I would understand that to mean it is allowing a pumping heart to continue pumping.
Syag (and gamanit)
the heart as an internal pacemaker as long as it has a steady supply of oxygen, glucose and the correct balance of electrolytes it can pump indefinitely (in theory) without a brain. Thus evn if the brain is not connected (as in the sheep experiment) or not functioning (like in the poor case of this girl) as long as oxygen is supplied via a ventilator the heart can continue pumping.
In contrast however breathing requires a steady signal from the brainstem for each breath.
Syag Lchochma- exactly what I was going to say… There is nothing forcing the heart to keep pumping.
ubiquitin – thanks for the response. it is true, tho that that cannot go on indefinitely, correct? As I said, people do go into cardiac arrest while on ventilators all the time. In a way, the oxygen is still feeding an already pumping heart. I know comas can last for years (and years) but I don’t know (in real life, not tabloid) of any case of a person declared brain dead who lived more than a week and a half. How long is it possible to go on that way (medically, not in regard to this girl)? I don’t think it is correct that it can be indefinitely.
Syag: Healthy, low-stress hearts last for plenty of people well into their 90s. Why would this be any different?
ubiquitin-
During the two-hour fMRI scan conducted three days ago, researchers tested Sharon’s response to various stimuli: family pictures, a recording of his son’s voice, and human touch. They said they were surprised to discover significant activity in relevant parts of his brain in response to all tests. “These results point to mental processing of sensory information,” Soroka reported. Sharon was transferred to Soroka from Sheba Medical Center for the purpose of the neurological tests.
Looks like to rule out brain death in Sharon they did use scans. Not just checking pupil dilation.
Also, the mother claims that when she whispers Jahi’s name in her ear she responds. The doctors claim it’s just random muscle reflexes that coincidentally occurred at the same time. If Jahi indeed does respond to her name then she is not brain dead.
Syag in theory it can
However generally there will be other issues that arise, most commonly infection leading to sepsis and septic shock.
In actuality I dont know of the longest case of hand. There is generally little desire to keep patient that way OTherwise the issue becomes who should pay? The hospital and insurance comapnies wont pay for the ventilation of what is legally a cadaver. The family never wants to. unless there is a compelling reason to do so, for example pregnant women have been kept on “life support” for months while brain dead for the benfit of the fetus. (this is what prompted the sheep experiment in Israel where a pregnant headless sheep gave birth while on “life support”)
I understand that there are other health issues and that there are payment issues, but there are places (or perhaps were) where people were allowed to stay on support until they died on their own. In those days gone by, i still don’t know that many who remained for years had been declared brain dead. In the cases of pregnant mothers kept alive, do you specifically remember them not being comatose? The case presently going on in Texas, IIRC, is not dealing with brain death.
Sam2- she first fell into a coma after going into cardiac arrest. I’d assume this is not a normal healthy heart.
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