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04/20/2015

Brain Death & Medical Futility – Empowering Families in the ICU

Patrik Hutzel runs IntensiveCareHotline.com, where they improve the lives of families of critically ill patients in intensive care, so that you can have peace of mind, real power, real control and so that you can influence decision making, even if you’re not a doctor or a nurse in intensive care.

I talked with Patrik on a recent episode of the IntensiveCareHotline.com podcast.  Listen to the interview here.  (I also did another podcast back in 2014.)

In the interview, Patrik and I explore and discuss recent controversial and highly publicized cases in Intensive Care related to brain death and perceived end of life situations.
  • Two recent cases of two brain dead Patients in California, where one family is trying to rescind the death certificate for their 15 year old daughter Jahi McMath who is currently on a ventilator and life support in New Jersey
  • What it would mean for the future of Intensive Care and the diagnosis of brain death if death certificates would be annulled
  • Why a Family’s value judgement is important when dealing with brain death
  • Why some states in the USA have a law where Families who object out of religious believes to brain death can dispute the diagnosis
  • Why Jahi McMath may be legally alive in New Jersey and maybe legally dead in California and the controversy and discussions around it
  • Why some Intensive Care Units give Families 24-48 hours time to come to terms with the death of their loved one and others aren’t giving Families enough time to grieve
  • Another highly controversial case where a young lady (Lisa Avila) has been diagnosed with brain death after she had given birth to her 8th child and she got misdiagnosed with an undiagnosed ectopic (tubal) pregnancy that caused her to go into cardiac arrest, where she ended up brain dead
  • Massive trust issues between families and Intensive Care teams cause disputes around the diagnoses of brain death
  • Most Intensive Care Units have a policy to not treat brain dead people and therefore withdraw life support.  Listen to what Professor Pope has to say about the legal issues surrounding brain death
  • Massive legal and ethical challenges when a family disputes the brain death of a loved one
  • Other futility cases that have made headlines such as the Hassan Rasouli case in Canada, where the Intensive Care team wanted to withdraw treatment without family consent.  The family objected the Intensive Care team’s decision and went to court where the supreme court of Canada protected Families rights when it comes to perceived futility cases in perceived end of life situations.  The Rassouli family successfully challenged the “perceived power” and “perceived authority” of the Intensive Care team 
  • Why transparency in end of life or perceived end of life situations is critical and how families in Intensive Care can get transparency and full disclosure simply by positioning themselves correctly by asking the right questions 
  • How families in Intensive Care can get what they want in a real end of life situation.  Professor Pope is referring to the hospital dispute process if Families need help and advice in medical futility cases 
  • Why families in Intensive Care should be asking the Intensive Care team for their end of life policies if they are in doubt

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