27Jan14 Follow-up to brain-dead cases
http://nyti.ms/1jLjPUC Doctors had cited a Texas law that prevents them from
withdrawing or withholding “life-sustaining treatment” from a pregnant patient.
http://america.aljazeera.com/opinions/2014/1/the-munoz-lessonhowthelawfailsusatthebeginningandendoflife.html
I'll start by posting an article about brain death -- focusing on two high-profile U.S. cases. Please read it and comment. In additional post(s) respond with stories from the news that are relevant to class.
http://www.nytimes.com/2014/01/10/health/the-science-behind-brain-death.html?_r=0
I think the cases of Jahi McMath and Marlise Muñoz are quite interesting due to there differences and a common tread linking them hope and the lack there of. In the case of Jahi McMath her parents have hope that their brain dead 13 year old can recover. Marlise Muñoz's husband and parents had no hope and had a court order remove her from life support even though her body was carrying a viable fetus. In the case of Jahi McMath their is the ethical question of should this false hope that their brain child be able to return to the land of the "living" remain? And what about Marlise Muñoz even though she did not wish life support would that decision remain the same if she had thought of carrying a child while brain dead? Would she wish it's birth? Unfortunately today the laws of man have dictated that one no longer living can be removed from life support regardless of pregnancy and we will never know.
ReplyDeleteAnother ethical question that could be addressed today is that of transplant wombs. This article addresses wombs removed from live donors should this be allowed? The following link address some of the concerns of doctor's what do you think? I personally think perhaps the wombs should come from dead or dying patients like more vital organs in the body the risk in these Swedish operations seem unnecessary.
http://www.usatoday.com/story/news/world/2014/01/13/womb-transplant/4456975/
It’s hard to say what exactly “brain dead” is, but I think Dr. James L. Bernat did a good job at describing it when he stated, “The way I’ve described this state is that a part of the organism is still alive, obviously, but the organism as a whole — the human being — is gone.” I think people have a difficult time accepting that concept. Even though the organ is still functioning, such as the heart continues beating, the person still may not be alive, or at least in the same state as they were before. As I’ve mentioned before with the other life support situation, I believe people are not prepared to have such life changing events occur to themselves or to loved ones, so it’s easy to be in denial and have false hope. Both situations are heartbreaking, I could never imagine myself being in any type a situation such as those. It's tough to say what I believe is best for each family because I'm not involved with the situation, but I think the hospital should respect and perform the wishes of Ernest and Lynne Machado because of the complications with keeping the mother on ventilation. I believe the other family may be feeling a false hope with their daughter, but I can only wish they realize what is best for their daughter.
ReplyDeletehttp://www.cnn.com/2014/01/22/health/flu-pregnant-miscarriage/index.html?hpt=he_c2
In cases involving a brain dead patient, I don't see a reason to continue life support. It's said that it is impossible for those with brain death to return back to life. For the case of Jahi McMath, I understand that the parents have a bit of hope for their daughter, especially since brain death is a hard concept to accept. However, they will have to make a decision eventually, because their daughter will not be returning back to life.
ReplyDeleteI understand the hospital's reasoning for keeping Marlise on life support for the hope of saving the baby, and I believe Marlise's husband understood the reason too. After some time, however, when the fetus wasn't improving and was showing signs of possible impairment, I agree with the husband's want for removing his wife off life support. Ultimately, I believe it had to be the husband's decision on what to do, especially since he was the father of the child. Initially, I believe the decision should be made by the patient before any accidents happen. However, because unusual tragic events can occur, the individual closest to the brain death patient should be granted permission on what decision to make.
I'm including a link to an article about ways a particular slaughterhouse was treating their product. I already feel strongly against eating meat, and therefore, I'm extremely against the poor treatment of animals. I believe that if you do choose to consume meat, there are less gruesome ways to come about your food.
http://abcnews.go.com/Health/wireStory/feds-suspend-nj-slaughterhouse-cruelty-alleged-22250393
I think that people diagnosed as brain dead should automatically forfeit all rights of end of life care to either spouse or parent/immediate family, because they have been pronounced in essence dead. The brain dead person cannot breath on their own and is non responsive to most if not all of the brain stem function tests. I feel like it is almost fankinstine like to keep a fetus in a dead woman's body especially if it is non viable in the case of Marlise Munoz. Doctor's have no idea how the fetus would have functioned or complications it would have. It's unfortunate for the parents of Jahi McMath that they are struggling to keep their daughter on life support, but that is their decision as her parents to keep her on the ventilator. Not the hospital or a state law. I can understand putting a set time restraint on the ventilator of a few months if the family so desires, but to permanently keep someone on life support is doesn't make sense to me. At a certain point there is no chance of them "waking up" again.
ReplyDeleteIn the cases of Muñoz and McMath, it’s very interesting to witness the perspectives of both families and how they dramatically differ. I sympathize with both of them; in that I can’t imagine the pain each patient’s loved ones are experiencing, and the difficulties that arise from that type of situation. I understand why Marlise’s family wishes to remove her from life support, but I also can see why Jahi’s mother wants to ensure that that never happens. Knowing, though, from a medical professional’s opinion that both patients are essentially dead themselves, it’s difficult to determine the actions that should follow. This very desperate state is one in which we see two sides of the coin: a patient’s family has accepted their wife and daughter’s fate, while another patient’s situation may be deemed one of denial and prolonged false hope. I can’t say I would make the ethical or “right” choice if I were placed into situations such as these; it would take a long time, I imagine, for me to come to the eventual acceptance that my loved one was never coming back to me.
ReplyDeleteThe following article does not pertain to the topic being discussed, but would be very interesting to address in this class. It discusses whether or not families who relied on prayer versus medical treatments to heal their loved ones should be held responsible for their death, and put on trial as a result.
http://www.nbcnews.com/id/23885944/ns/health/#.UuczGxAo7IU
oth of these cases deal with similar situations of brain-dead individuals that were handled in very different ways. In the case of Marlise Munoz, her family wanted her to be taken off of life support but the hospital refused to do so because she was deep into her pregnancy. In the case of Jahi McMath, the hospital removed life support against the family’s wishes. Although I understand the necessity of removing an expensive and burdensome treatment, I think it should be up to the families to choose whether or not a person continues life support. If the hospital makes the decision for the families, the families may never be able to reconcile the death of the individual and will never come to terms with his or her passing. For Marlise, I understand the argument of not wanting the fetus, which was most likely harmed when Marlise was unconscious for an hour, to come into the world motherless. For Jahi, I understand how her parents would want to cling to the hope that maybe one day their young daughter would recover.
ReplyDeleteThe first article I found was about how Marlise’s husband named his unborn child. The article goes through his reasoning for this, and I found it extremely interesting that a person will cling to the hope of recovery even when it is not viable.
http://m.rapidcityjournal.com/news/national/brain-dead-pregnant-woman-s-husband-names-fetus/article_c1f2367d-b51c-55b6-bf0d-6043032b5cc3.html?mobile_touch=true
The second article is about a family whose son was forced into a vegetative state due to a head on car crash. This family chose to take their son, who is in a most likely irreversible vegetative state, home and help him lead as normal a life as possible. I think this article shows how people are willing to do anything for their loved ones, even if the conditions that the injured person will live in are less than ideal.
http://news.yahoo.com/family-promise-gave-life-man-31-coma-152453050.html
The cases of Jahi McMath and Marlise Muñoz are very unfortunate situations for families to be put in. In the case of McMath, the brain death is that of a 13 year old girl. In the Munoz case, it is the brain death of a pregnant woman. Overall, I think that the hospitals should respect the wishes of the families involved. For McMath, the family did not want her to be removed from life support, I can see where her family is coming from in being hopeful that she can recover from this brain death but it may just be a way of preventing the inevitable. First, the definition of “brain death” should be fully evaluated by these families and the risks of keeping McMath on the ventilator for extended periods of time should be divulged. In the Munoz case, I think that if her husband wanted her to be off of life support that the hospital should respect his wishes. The pros and cons of keeping the baby alive obviously have been weighed out and to not keep the baby seems to be a better choice. The baby would have been born defective and without a mother so not keeping Munoz alive in order to keep the baby alive is a good choice. In both cases however, the issue of when is taking someone off of life support too soon seems to be a commonality.
ReplyDeleteI found an interesting article about individuals who were considered “brain dead “and gained consciousness a few days later; looking at a different outcome. Also the article looks at the problems with the brain-death standard. This is one of the things I always think about in these brain-death cases. The brain is fully capable of repairing itself and what if it can but just needs more time?
http://news.yahoo.com/brain-dead-doctors-said-yes-patients-proved-otherwise-221600587.html
While I agree with laws that help protect pregnancies, however, you can't generalize every case. You have to take each case by a case by case bases so that the best decision can be made. In this Munoz case, the wife was already dead so I don't think she should have been put on life support. Also, I think the hospital should respect the wishes of the family, even though there is a law that is protecting the hospital, respecting the families wishes should come before the law.
ReplyDeleteIn the other case, I think the hospital did the right thing by respecting the families wishes, even though I don't agree with they decided. I can see why the family would want to keep their child on life support because you never want to give up on your child, however, if you read the definition of brain dead it states that the person cannot breathe on his or her own. If somebody can't breathe on their own they are the dead, that is just my take on it. Keeping someone alive that can't breathe on their own is something I disagree with strongly, however this is America and everybody has a right to their own opinion.
The other article I found is about a former Dallas Cowboys football player has dementia and he is slowly dying. Recently in the NFL there was a settlement of 765 million dollars was reached that would provide players with compensation for head injuries that happened in the past. Rayfield Wright was one of the 4,500 former NFL players that sued the NFL. This article is relevant to the class because we are talking about brain injuries and all these former NFL players revived brain injuries from playing football.
http://www.nytimes.com/2014/01/27/sports/football/for-a-cowboys-star-with-dementia-time-is-running-out.html?rref=health&module=Ribbon&version=origin®ion=Header&ac
Both cases are unfortunate cases to hear about. For the McMath family I definitely believe that the hospital should respect the family's wishes and still keep the ventilator on their child. As far as the Munoz family, I'm going to have to play devil's advocate. If someone is unable to make a decision of their own, I believe that the people closest to them should make a decision for them, within reason. In the Munoz case, I definitely believe that the ventilator should still be attached to Marlise, simply to make sure that the fetus is okay, even if it is going against the family's wishes.
ReplyDeleteThe article that I have attached talks about how patients with brain injuries are surviving, but patients with that need an organ are becoming out of luck due to a shortage of organ donors.
These two cases, that of Jahi McMath and Marlise Munoz, are very troubling and unfortunate. However, they are also quite different. McMath is brain-dead and there is nothing more they can really do for her. Munoz was also brain-dead, however in her case we are not merely dealing with Munoz, but also with her unborn child. That child has to be taken into consideration as well. If he or she is not dead and can grow to the point of being able to be born then it may have been necessary from a moral standpoint to sustain the mother's body for the sake of that child, who is an individual all their own and has a right to life like any other individual.
ReplyDeleteI found an article that discusses how the number of "brain deaths" are decreasing in Canada possibly from improved care. However, there has also been decreased organ donations.
http://www.medicalnewstoday.com/articles/268013.php