Legal battles between families and hospitals over whether to disconnect life-support systems are nothing new. Optimistic family members plead with hospitals and insurance companies to keep their loved one on life support, while doctors argue the person has already died and the machines are the only thing keeping the heart beating. Such disputes gained national media attention when a California court blocked the hospital from disconnecting life support from a 13-year-old girl.
Jahi McMath checked into Children’s Hospital & Research Center in Oakland, California for a routine tonsillectomy to treat her sleep apnea. After the December 9 surgery, Jahi’s family said Jahi woke up and appear stable. Jahi then asked for a popsicle. Shortly thereafter, Jahi started bleeding profusely from her mouth and nose. Jahi went into cardiac arrest due to a lack of oxygen to the brain and was placed on life support. Three days after her surgery, a CT scan of her head revealed that two-thirds of her brain was swollen and she was declared brain dead.
Authorities from the Oakland coroner’s office were told of Jahi’s death, and began preparations to obey their obligation of investigating the cause of death. Although the coroner can request termination, Children’s Hospital’s policy is to work with the family to determine when the termination will occur.
Although doctors wish to take Jahi off life supports, her family is doing everything in their power to fight the hospital’s decision. The family presented the hospital with a cease-and-desist letter aimed at preventing the hospital from taking Jahi off the ventilator. The family forced the hospital to seek authorization from a judge to terminate the life support, rather pressure the family into making a decision.
The two parties prepared to argue their case in court. A court appointed physician concurred with prior medical opinions that the teenager is brain dead. Additionally, a judge declared Jahi brain dead as well. Legal statutes in California provide that if a person is determined brain dead, then no further medical intervention is warranted. Many would contend the law is unambiguous and the court must hold a opinion consistent with the law. However, a judge (initially) delayed disconnection of the machines until Monday, December 30 at 5 pm. But shortly before Jahi could have been cut off, the same judge extended his order to January 7 at 5 pm.
Brain Death in New York
New York regulations define brain death as the irreversible loss of all function of the brain. The diagnosis of brain death is conclusively performed with clinical examination, including assessment of brain stem reflexes and an apnea test. No other test are required. All New York hospitals are required to establish written policies that specifies the process for determining brain death which must include the clinical examination. The hospital must have a policy of notifying the individual’s next of kin, as well as a procedure for the reasonable accommodations of the individual’s religious or moral objection. New York does not implement a waiting period to exclude the possibility of recovery, rather the physician shall “wait an appropriate period of time, sufficiently long as is relevant to the patient’s condition.” It is well established in New York that the hospital has the authority to terminate life support so long as it has been determined that the person’s condition does in fact constitute brain death as defined by the statute.
The case of Jahi is a very unfortunate and tragic situation. The family is currently seeking assistance from an un-named New York facility who will allow Jahi to be transferred there.