Jahi McMath case

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The Jahi McMath case centers on a 13-year-old girl in California who was declared brain-dead following surgery, and the bioethical debate surrounding her family's rejection of the medicolegal findings of death in this case, and their efforts to maintain her body on mechanical ventilation and other measures, which her parents considered to constitute life support of their child but which her doctors considered to be futile treatment of a deceased person.[1][2][3][4][5][6]

Background[edit]

On December 9, 2013, McMath suffered massive blood loss and consequent cardiac arrest after undergoing surgery at Children's Hospital Oakland aimed at relieving symptoms from sleep apnea. The loss of blood circulation caused whole brain death, according to her doctors. Her family refused to accept the medical declaration of death by neurological criteria, said that McMath was not dead, and initiated legal proceedings in an effort to force the hospital to continue treatment.[4][7][8][9] [10][11]

According to court documents,[12] McMath was admitted to Children's Hospital Oakland on December 9, 2013 to perform an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates. It was hoped these procedures would provide improved airflow during her sleep at night. The family described the surgery as a routine tonsillectomy, while the hospital described the procedure as complicated in court documents.[13]

After the surgeries were performed, McMath was conscious and recovering and, according to her mother Latasha "Nailah" Winkfield,[14][15][16] asked for a Popsicle while in the recovery room.[17] She was later moved to the ICU before she started to bleed from her nose and mouth and went into cardiac arrest. During this time, blood flow to the brain was lost for an undisclosed period of time. On December 12, 2013, her doctors declared her brain-dead. Her family was informed that she was legally dead,[18] and that as a result, life support systems would be removed.[12] According to the hospital, this was in accordance with standard guidelines for determining brain death.[19]

This case has prompted commentators to discuss the futility of life support in such cases and even refer to it as "death support".[20]

Legal action[edit]

On December 20, 2013, McMath's family filed a lawsuit in Alameda County Superior Court, petitioning the court to require Children's Hospital Oakland to keep McMath on life support. In a pretrial conference on December 23, Judge Evelio Grillo appointed Paul Graham Fisher, the chief of Child Neurology at Stanford University School of Medicine, to provide an independent medical opinion. McMath's family also moved to have Paul A. Byrne, M.D. conduct his own independent examination. Byrne, a pediatric neonatologist, has campaigned against the medical consensus of accepting brain death as death.[19][21][22] The court declined that request.[23]

Fisher examined McMath and affirmed the diagnosis of brain death, reporting that she had no activity on an electroencephalogram, no blood flow to the brain and did not breathe when removed from mechanical ventilation, all of which are standard clinical indications of total brain death.[24][25]

On December 24, 2013, Judge Grillo ruled that McMath was legally dead,[disputed ] basing his decision on the medical evidence presented by physicians from Children's Hospital Oakland and from independent expert Paul Fisher, but ruled to keep McMath on mechanical ventilation until December 30, 2013,.[24] later extending this order until January 7, 2014.[26] Grillo told the family "This has been very, very hard on you. No one anywhere would wish this to happen to anyone."[24]

On December 30, 2013, the family appealed the decision to the Second District, California Courts of Appeal[23] and the United States District Court for the Northern District of California, calling for the hospital to continue life support measures until other arrangements could be made by the family.[26] McMath's mother argued that applying the Uniform Determination of Death Act to the case was a violation of constitutional religious and privacy rights[27] and that because Jahi's heart was still beating, she was still alive.[28] Byrne stated in court documents that he witnessed McMath move in the hospital and that he considered her to be alive.[29] The hospital stated that it would be unethical and "grotesque" to require the hospital and its doctors to provide further medical care to a dead body and referred to Byrne as an "ideologue" who does not accept the concept of brain death. The hospital further stated that reflexive movements are not uncommon in cases of brain death.[19] After the hospital and McMath's family engaged in settlement talks, the United States District Court for the Northern District of California denied the family's petition to force hospital staff to perform a tracheostomy and insert a feeding tube, but an agreement was facilitated in which McMath could be released from the hospital, with the ventilator and her intravenous fluid lines, to the custody of her mother.[10]

Transfer[edit]

On January 5, 2014, Children's Hospital released McMath's body to the Alameda County coroner. The coroner's office had issued an unofficial death certificate for McMath on January 3, 2014, with the date of death listed as December 12, 2013. The death certificate was incomplete, pending an autopsy to determine cause of death.[30] After receiving custody of her body from Children's Hospital, the Coroner then released her to the custody of her mother, who was warned of and assumed all risk regarding cardiac arrest during the transfer.[31][32][33] The family moved the girl to an undisclosed location where a tracheostomy was performed and a feeding tube was inserted.[34] As of March 2014, McMath’s mother continues to maintain that McMath is alive and "not a dead body."[35][36][37]

Aftermath[edit]

In the aftermath of this case, a public records request enabled a report to be released in March 2014 in which the state of California investigated Children's Hospital Oakland, primarily in response to questions about McMath's care.[38] State officials found Children's Hospital Oakland to be in compliance with multiple assessments of patient care, with no sanctions issued.

McMath's attorney, Christopher Dolan, said that he was angered by the report and that the report illustrates "why medical negligence lawsuits are necessary".[38] Dolan also said “the McMath family's position isn't ridiculous or unheard of. There would have been no legal battle if Jahi had had her tonsils out in New Jersey”, referring to a New Jersey state law allowing religious objection to a declaration of death on the basis of neurological criteria.[39] At least one commentator has asked whether this case will affect how California's determination of death laws work.[40]

In March 2014, the Terri Schiavo Life and Hope Network awarded McMath's family an annual award. The award recognizes "the unconditional love they have for Jahi, and their courage as they continue the fight for their daughter against overwhelming odds". McMath's mother stated she was honored to receive the award and referred to her daughter as “still asleep”, clarifying she does not use the phrase "brain dead" to refer to her daughter.[41][42]

According to media reports,[43] as of June 2014, McMath has been at St. Peter's University Hospital in New Brunswick, New Jersey.[44]

See also[edit]

References[edit]

  1. ^ Simon; Schoichet, Catherine E. (December 24, 2013). "Judge: California teen is brain dead after tonsil surgery". cnn.com. Retrieved January 9, 2014. 
  2. ^ Grossman, Cathy Lynn (Jan 3, 2014). "Family, ethics, medicine and law collide in Jahi McMath’s life - or death". Washington Post. 
  3. ^ Sabo, Liz (Jan 10, 2014). "The Ethics Of Being Brain Dead: Doctors And Bioethicists Discuss Jahi McMath And Marlise Munoz". USA Today. 
  4. ^ a b Banks, Sandy (January 3, 2014). "In Jahi McMath saga, science and religion clash". latimes.com. Retrieved January 9, 2014. 
  5. ^ Veatch, Robert (2 January 2014). "Let parents decide if teen is dead". CNN Opinion. Retrieved 27 February 2014. 
  6. ^ [1]
  7. ^ Mungin, Lateef; Condor, Chuck (January 4, 2014). "Jahi McMath's family, Oakland hospital discussing girl's transfer". CNN.com. Retrieved January 9, 2014. 
  8. ^ Fernandez, Lisa (December 21, 2013). "Judge Orders Oakland Hospital to Keep Jahi McMath on Life Support". NBC News. 
  9. ^ Lee, Henry K. (January 3, 2014). "Hospital agrees to let Jahi McMath family take girl". SFGate. Retrieved January 9, 2014. 
  10. ^ a b "Jahi McMath Family Cleared to Take Brain-Dead Teen From Hospital". NBC Bay Area. January 4, 2014. Retrieved February 27, 2014. 
  11. ^ Branson, Hailey (January 5, 2014). "Jahi McMath, brain-dead teen, transferred to undisclosed location". latimes.com. Retrieved January 9, 2014. 
  12. ^ a b Bender, Kristin J.; Alund, Natalie Neysa (December 21, 2013). "Judge grants restraining order keeping brain dead Oakland girl on ventilator through Monday". Oakland Tribune. Retrieved February 27, 2014. 
  13. ^ Collins, Terry (December 21, 2013). "Jahi McMath, Girl Left Brain Dead From Routine Tonsillectomy, To Be Kept On Life Support". Huffingtonpost.com. Retrieved February 19, 2014. 
  14. ^ http://www.nbcbayarea.com/news/local/Urgent-Request-to-Keep-Jahi-McMath-8th-Grader-Alive-After-Tonsillectomy-236241341.html
  15. ^ http://www.childrenshospitaloakland.org/main/response-to-media-coverage-decemb2013.aspx
  16. ^ http://www.nbcbayarea.com/news/local/Burning-Up-the-Phones-to-Find-Center-for-Jahi-McMath-Attorney-238372101.html
  17. ^ "Document: Appeal describes Jahi McMath's post-surgical bleeding before heart attack, brain death". Contra Costa Times. December 30, 2013. Retrieved February 27, 2014. 
  18. ^ Gafni, Matthias (21 December 2013). "Oakland: Emotional letter from Jahi McMath's mom to keep daughter 'warm'". San Jose Mercury News (Contra Costa Times). Retrieved 14 August 2014. 
  19. ^ a b c OPPOSITION TO PLAINTIFF’S MOTION TO COMPEL FURTHER LIFE SUPPORT AND THE INSTALLATION OF A TRACHEOSTOMY TUBE AND GASTRIC FEEDING TUBE TO ALLOW TRANSPORTATION OF JAHI MCMATH, United States District Court for the Northern District of California, Jan. 7, 2014
  20. ^ Landau, Elizabeth (30 December 2013). "When 'life support' is really 'death support'". CNN. 
  21. ^ Jahi McMath Case Renews Moral Debate Over Brain-Death Diagnoses, Stephen Vincent, National Catholic Register, January 14, 2014
  22. ^ Calif. judge: Brain-dead teen can be taken off life support, Associated Press, Dec. 24, 2013
  23. ^ a b "Children's Hospital Oakland, Petitioner's Writ Petition Mcmath-12302013". 
  24. ^ a b c DeBolt, David; Hurd, Rick (December 24, 2013). "Jahi McMath: Judge denies petition to keep girl on ventilator past Dec. 30". San Jose Mercury News. Retrieved February 27, 2014. 
  25. ^ "Document: Hospital's petition opposing an independent expert, asking to lift the order to keep Jahi McMath on life support". San Jose Mercury News. December 24, 2013. Retrieved February 27, 2014. 
  26. ^ a b "Extension Granted to Keep Jahi McMath on Life Support". NBC Bay Area. December 31, 2013. Retrieved February 27, 2014. 
  27. ^ Romney, Lee (December 30, 2013). "Hospital says conditions must be met for Jahi McMath's transfer". Los Angeles Times. Retrieved February 27, 2014. 
  28. ^ Ford, Dana (December 27, 2013). "Jahi McMath's family seeks to move brain-dead girl to another facility". CNN. Retrieved December 27, 2013. 
  29. ^ Fernandez, Lisa (9 January 2014). "Catholic Organization Says Jahi McMath "With Jesus Christ"". NBC Bay Area. Retrieved 6 March 2014. 
  30. ^ "Jahi McMath's family, Oakland hospital discussing girl's transfer". "The coroner's office said that the death certificate -- which still needs to be accepted by the health department to become official -- has a date of death of December 12, 2013" 
  31. ^ Branson, Hailey (January 5, 2014). "Jahi McMath's body released from hospital". latimes.com. Retrieved January 9, 2014. 
  32. ^ DeBolt, David; Bender, Kristin J.; Hurd, Rick (January 5, 2014). "Jahi McMath: 13-year-old brain-dead Oakland girl moved by family from hospital". Contra Costa Times. Retrieved February 27, 2014. 
  33. ^ Payne, Ed; Shoichet, Catherine E.; Hanna, Jason (January 7, 2014). "Brain dead girl Jahi McMath released from California hospital". CNN. Retrieved February 27, 2014. 
  34. ^ Golgowski, Nina (January 8, 2014). "Lawyer for Jahi McMath's family says brain dead teen is on feeding tube and 'improving'". nydailynews.com. 
  35. ^ "Jahi McMath: Complete text of letter from brain-dead girl's mother". San Jose Mercury News. February 20, 2014. Retrieved February 23, 2014. "Thank you to all of the people who view my daughter as the sweet, innocent, 13 year old girl that she is and not a dead body or a corpse," 
  36. ^ Hurd, Rick (27 January 2014). "Jahi McMath video claims to show her feet and toes move". San Jose Mercury News. Retrieved 28 February 2014. 
  37. ^ Wells, Jason (March 28, 2014). "Mother of brain-dead Jahi McMath says daughter is 'still sleeping'". Los Angeles Times. Retrieved April 11, 2014. 
  38. ^ a b Gafni, Matthias (March 13, 2014). "Jahi McMath: State releases report on Children's Hospital Oakland's handling of patients". Contra Costa Times. Retrieved March 13, 2014. 
  39. ^ "McMath attorney: Jahi's family aren't fools; they deserve better than ignorant attacks". Los Angeles Times. 21 January 2014. Retrieved 10 April 2014. 
  40. ^ Gafni, Matthias (25 January 2014). "Jahi McMath: Could her case change how California determines death?". San Jose Mercury News. Retrieved 3 March 2014. 
  41. ^ Gafni, Matthias (27 February 2014). "Jahi McMath's family to get award from Terri Schiavo foundation". Contra Costa Times. Retrieved 1 March 2014. 
  42. ^ Fernandez, Lisa (27 March 2014). "Jahi McMath's Family to Be Honored by Terri Schiavo Network". NBC10.com. Retrieved 5 April 2014. 
  43. ^ "Jahi McMath being kept at New Jersey hospital". 
  44. ^ "13-Year-Old Jahi McMath Moved To New Jersey Hospital, Lawyer Says Condition Improving".