But in this case, this young sweet child is dead. It is not that she is going to die soon, she had met the legal and medical definition of death as defined by the standard of care by which physicians are compelled to practice. I must respectfully reject your statement that she is going to die soon no matter what -- in fact she died on the 12th of December. I will not go into the harm that giving antibiotics that are unwarranted can bring to an individual or the population (resistant bacteria, etc) But it is fair to say that her heart is beating only as a function of a ventilator. It is not beating on its own per se. Her heart could be removed from her chest in this state with the lungs and still beat with the ventilator and extracorporeal circulation. That does not change the fact she is dead.
What many do not realize is that to be declared brain dead, it is the WHOLE brain that must be examined, not just parts. Part of brain death criteria is something called an apnea test. All the chemistries of the body are balanced, and the body is warmed and oxygenated at 100%, and then the ventilator is held (mechanical ventilation mode). If there is no breath for 10 minutes or if the pH falls to a certain threshold, then the brain stem is destroyed and the whole brain is dead.
Can the brain stem be harmed without the rest of the brain? Certainly, but this leaves EEG with waveform. What is certain is that 5 physicians have independently confirmed the death of this sweet young girl. I agree that the parents should have a say and rights for the living child. But in this case, unlike all the other cases that have been cited, there is no brain activity and this has been confirmed over and over and over again.
In the final analysis, some argue that if the parents want to take this body home on a ventilator and continue to ventilate the corpse, is that their right? I am not sure, but if a court says this is ok, then I would think the parents should be responsible for this decision and it would be their physical as well as financial burden. In other words, if they choose to act against the proven opinions and standards of medical care, then they are on their own for it. Solicit private donations, or pay for it themselves. But I will point out as a matter of law, in my state, I would have no option short of a court order as it is illegal to assault a corpse, and that is in fact what is occurring. As a nuerointensivist, I see brain injuries that are not whole brian death. The majority do not make full recovery. Rarely there is a great story like yours, but this tragic story is nothing like yours, as you still had some obvious brain activity. . In this case, the child is unequivocally dead, and it is then the responsibility of the medical community to help her parents understand this.
Thank you for taking the time to consider what I have said.
I do consider what you said, doctor. And, as I have said, I’m pretty sure that this is a hopeless case.
Now you need to put down the stethoscope and hear a human being.
The rights of the parents are being trampled. They have the right to get the best care for their child, as they see fit. Saying, “But she’s dead,” doesn’t make this any less their little girl. Even if she is dead, they have the right to decide to donate her organs or not and to decide how to dispose of her remains. “The body” belongs to them.
They have to know that everything was done to save their girl, even if it proves futile. They have hope in their hearts and that hope is a necessary part of the human condition.
They have to deal with the grief. And grief is one hell of a lot easier to live with if you really believe that every possibility was exhausted and the death was G-d’s will. (This is coping mechanism than many humans use to cope with the difficulties of life.)
These parents’ actions are not abnormal. They are normal and healthy reactions to an impossible situation. And yes, their wishes should be given tremendous weight.
After a few weeks, as the body shuts down due to ‘brain death’, all the doctors can come poke their fingers in the parents’ faces and say, “I told you so.” Until then, just do what’s necessary to help them get through it. Put in the damn trach and feeding tubes and let her be transferred if they don’t want to deal with it.
Now I do have some serious questions for you. According to this article:
1) As she’s only being kept alive with a vent, why are her kidneys and guts still working after 3 weeks when they should’ve begun to malfunction after a week?
2) Why is her immune system still functioning?
3) Why is her body temperature stable?
4) Why is her blood pressure level?
She had her heart attack on the 10th, but the doctors didn’t ‘declare’ her dead until the 12th. So the reality is that she’s been in this condition for three weeks and three days. Should she not being showing signs of organ failure by now?
Thank you for your posts...