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Time to take brain dead patients off life support
January 3, 2014 - Andrea Johnson
Two tragic cases of brain dead patients are in the news this week.
In one case, a mother is fighting desperately to force an Oakland, Calif., hospital to keep her 13-year-old daughter, who was declared brain dead following a tonsillectomy in early December, on life support. In another case, the husband of a brain dead pregnant woman wants a North Texas hospital to disconnect her from life support. The hospital has refused, citing a state law that requires them to provide life support to save the fetus of a pregnant woman.
Erick Munoz, husband of Marlise, said his 33-year-old wife would never want to be kept alive on life support. Marlise, who suffered a likely pulmonary embolism in November when she was 14 weeks pregnant, was a paramedic like her husband. She made her wishes on the subject well known, according to her husband, who doesn't seem to want to keep his wife on life support even if it might save their unborn child. None of the articles have said so explicitly, but I imagine the family is concerned about the prospect of the baby being born with severe disabilities. Surely, this is not an ideal situation for a pregnancy and chances are high that the fetus has already sustained brain damage if the mother was without oxygen for several minutes. If he or she is born prematurely, there is also an increased risk of disability. Medical bills are probably also extensive. The Munozes already have a one-year-old son at home whom Erick Munoz will now have to raise on his own. But doctors at John Peter Smith Hospital in Fort Worth, Texas have told the family that state law requires that they must leave Marlise on life support until her pregnancy has reached 24 weeks or until she has miscarried.
Meanwhile, at Children's Hospital, Oakland, Nailah Winkfield has been waging a bitter battle to force doctors to leave her teenage daughter on a ventilator. Doctors have said 13-year-old Jahi McMath is brain dead, has no hope of recovery, and they have refused to do tracheotomy surgery or insert a feeding tube or assist in any way in moving the girl to a long term care facility. According to news reports, the county has already issued the girl's death certificate.
A judge ruled today that Winkfield can remove the girl from the hospital as long as she assumes full responsibility for the girl's body, according to news reports. Winkfield, who seems to be in a state of denial, still seems to believe that the girl will recover. There is apparently a long term care facility in Long Island that might take the girl, but first the family needs to find a doctor willing to insert a trach and a feeding tube.
I think it's probably time to disconnect both Marlise Munoz and Jahi McMath, both of whom are dead, from life support. While it may be crass to consider money, it is also true that medical resources are finite. Jahi McMath is occupying a bed in the intensive care unit at Children's Hospital that another child probably needs. Everyone can sympathize with the pain of a mother who has lost a child and with her need for time to come to terms with the loss, but I'm not sure that anyone can afford to give her weeks and months, at the cost of millions of dollars, to come to terms with that loss and to accept that what the doctors are telling her is true. In the case of Munoz, I would support her husband if he wanted to keep his wife on life support long enough to save his child, but I can also sympathize with his position that his wife would not want this and he does not want it for her. Taking her off life support is a choice that he should legally be allowed to make.
Who do you think is right in these situations?
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