Posted on 11/07/2008 12:13:12 PM PST by SJackson
Children's National Medical Center in Washington, D.C. took the family of a 12-year-old Orthodox Jewish boy on life support to court yesterday.
Motl Brody's family wants to keep their brain-dead son on mechanical assistance for religious reasons, but the hospital said its resources are being used to preserve a deceased body. The case is currently disputed in the D.C. Superior Court.
Mr. Brody, under care for brain cancer, was pronounced dead Tuesday night after tests showed no signs of brain activity. His family said their Orthodox Jewish faith does not define death as cessation of brain function alone. The hospital argued that Mr. Brody is dead, and no religious principle can deny that.
"This child has ceased to exist by every medical definition," Sophia Smith, one of Mr. Brody's physicians, wrote in court papers. "There is no activity in any portion of his brain, including the brain stem."
Kenneth H. Rosenau, an attorney for the hospital, told the Washington Post, "There is no religious principle at issue in this case, but a clash of life and death."
The hospital's lawyers noted that alternative care facilities had denied acceptance of the boy because he is brain-dead.
Jeffery Zuckerman, the Brody family's lawyer, is challenging the hospital's plans to take Mr. Brody off life support on the grounds that religious beliefs must be respected under federal law.
"Under Jewish law and their faith, there is no such thing as brain death," he told to the Washington Post. "Their religious beliefs are entitled to respect."
Some states like New York and New Jersey have provisions in their laws and regulations that make exceptions for Orthodox Jews in similar instances. Washington, D.C. does not.
Rabbi Moshe Bogomilsky of Congregation Yeshiva of in Crown Heights, New York agreed with the Brody family's wishes. "There are some that feel brain-dead is sufficient [to declare a person's death]," said. "But the authoritative [Orthodox Jewish] opinion is we follow the heartbeat to declare the difference between life and death."
"As long as the heart is beating, he's alive," he added. "It may not be the best situation, but if a person's alive, we can't do anything that would shorten a life for a person."
In situations where congregants have a choice of whether or not their loved one should go on life support, Rabbi Bogomilsky said he would "encourage them to go on life support."
While Orthodox Jews do not believe in brain death, other religions, like Catholicism, do.
"We do accept the total brain-dead criteria," Rev. Alfred Cioffi, S.T.D., Ph.D., of the National Catholic Bioethics Center, said. He noted that there are two definitions of death.
"The classical definition is the cessation of heartbeat and respiration. It typically doesn't require much equipment to detect that," he said. "The neurological definition requires an Electroencephalogram (EEG). If it's a flat line, there are no brain waves."
In cases of a coma or trauma to the head, it is possible to have partial brain death in the cerebral cortex. Catholics believe a person must have total brain death, however, to discontinue life support. In total brain death, even the brain stem, which controls involuntary activities like heartbeat, breathing and digestion, among others, ceases to function.
"As long as person has total brain death, we accept that person has died," Rev. Cioffi said. He noted, "Even a corpse requires dignity and proper handling but may be disconnected from vital support. A corpse may be sustained on vital support systems for organ donation because once there is death, there is disintegration."
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DC hospital suing to cease life support on youth November 7, 2008 — 12:17pm ET | By Dan Bowman http://www.fiercehealthcare.com/story/dc-hospital-suing-cease-life-support-youth/2008-11-07
At Children's Medical Center in Washington, D.C., a Brooklyn youth is at the center of a controversy about whether the hospital has a right to discontinue life support after ruling the boy brain dead this past Tuesday evening. The boy, 12-year-old Motl Brody, was diagnosed with a "severe form of brain cancer," and had been at the D.C. hospital for six months. After tests revealed no brain activity, doctors wanted to end life support; the boy's parents, Eluzer and Miriam Brody, disagree with that decision, citing that their religion (they are Orthodox Jews) "does not define death as cessation of brain function alone."
A D.C. Superior Court hearing is scheduled for Monday to determine whether the hospital will be able to take the boy off of life support. The law in D.C. states that doctors can declare a patient dead if there is no brain activity. "This child has ceased to exist by every medical definition," wrote Sophia Smith, one of the boy's doctors, in court papers. "Ethically, there is no appropriate treatment except removal of the ventilator and of the drugs."
The parents' attorney, Jeffrey Zuckerman, argues that ceasing life support would "infringe upon religious freedom."
"Under Jewish law and their faith, there is no such thing as brain death," he said. "Their religious beliefs are entitled to respect."
“Shouldn’t the decision be made by whoever is paying the bills?”
Think about that as Obama takes RomneyCare and makes it national.
So an insurance company can decide when to pull the plug?
Or worse yet, nationalized healthcare?
I agree, as long as the financial resources are there. I wouldn't advocate payment of the bills by the state for what is probably a minority opinion.
One can understand the parents' point of view with the traditional Orthodox Jewish love of life, but to keep that body alive on machines for who knows how many years is much worse than dying now, IMHO. Nevertheless, the choice should belong to them.
Obviously utilization of resources is a major concern here. If he is taking up a bed that could be used by someone who can actually be saved, then they need to pull the plug no matter what.
However, if the family is not paying for every cent of his care then the hospital has a right to make the decision.
Insurance companies make that decision each and every day. Once a patient exhausts the insurance, the company stops paying the bills.
If the family wants to right the check to the hospital that is fine with me. But who ever is paying now has the right to stop forking over money.
It's not, there doesn't appear any medical hope for "recovery", some would have argued that with Schiavo.
The issues are clearer here, since you don't have a disagreement within the family.
The family opposes removal of life support, based on long standing beliefs, and are financially able to provide it. The state say no. Who decides. I say state rather than hospital since in some states this couldn't be done.
Probably.
Exhausted what limits?
Insurance companies DO try to deny care all the time -— because they’ve never made money paying a claim.
It doesn’t matter if they owe it or not. They will just lie and cheat to not pay.
Ariel Sharon has been kept alive for years.
My insurance policy has a Limit and after they pay out that limit they would stop paying for my care and treatment.
If there is a machine forcing his breathing and heart beat, wouldn’t that be understood by the rabbis and laws as “artificial?”
Artificial isn’t the issue, rather the removal of necessary sustenance. It’s my understanding nourishment, iv liquids and/or tube feeding are pretty clear, once started they can’t be stopped. Most medication, particularly those that impact patient comfort as well, even if they hasten death. You might get some disagreement on mechanical means, as is being used here, but the family’s position is sound. The issue isn’t the maintenance of life, rather it’s termination which isn’t our call.
I disagree with Jewish teachings about some areas of life … I feel that if the rabbis a millenium + ago had only seen an ultrasound image they would have ruled differently. And I believe G-d does rule differently.
The Orthodox/Reform disagreement over modern reinterpretation, not the place to get into that.
In all the articles I've read, the hospital acknowledges that there are no financial considerations, the bills are and will be paid. Also there are no ongoing utilization considerations, the facility is at about a 60% utilization rate.
These things have to be in writing, most importantly for those who want support continued, since that won't be the option the medical community advise. The issue isn't the quality of life, rather the fact that Judaism doesn't recognize that concept. Ultimately there's no basis to determine the worth of this boys life as being worth more or less than mine, it's simply not our call. Obviously other faiths would disagree, the Reform position would factor in the pain caused to the parents and would likely condone a different conclusion. As I noted earlier, I believe there are differing opinions on mechanical devices, like a ventilator. And extreme means may not have to be taken, but once taken can’t be discontinued. A position we all hope never to be in.
Yes, similar issue. But in Israel there'd be little controversy. Other than a Jewish doctor might refuse to disconnect support if asked by family members. But there are plenty of doctors.
The next of kin are the responsible parties for the decision, by law.
If the Orthodox faith defines death as no heart beat, then they have hope (the substance of things not seen).
God Bless.
So if a religion says that death is defined by the total decomposition of the body then a hospital should be forced to continue treatment of a rotting corpse?
My heart goes out to these parents. However, as painful as it would be, I will not prolong "non-life" for my children.
If that satisfies the Orthodox requirement for life, then so be it. (vastly different than your sophomoric counter-example)
The Hippocratic oath requires medical professionals to sustain life and do no harm, does this sound like they are attempting to sustain life in any definition other than the current secular version?
All too often we seem to be unable to grasp the depth of the tenacity of life. I certainly hope for a miracle, but often it is not to be. When to decide to remove sustenance or supporting techniques can only be left, in my opinion, to the counsel of the family and their faith.
Respect the wishes of the ones legally and morally responsible, do not attempt to force the situation, (especially if they are footing the bill, personally or via insurance). What is a life worth?
In other words, we should mind our own business and stop trying to force contrary beliefs on this family in this sad and grave matter.
God Bless
As an ICU nurse who has seen too many bodies being kept alive on machines far too long ...
its sad to see them literally rot before your eyes
in this case, it is a religious question thus I cannot question their faith. I can disagree, but I’m not the one making the decisions
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