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12/18/2015

Jahi McMath “at 15″

One year ago today (12/17/14), Steve Phillips posted on this blog on the approximate one year anniversary (Dec. 12) of the declaration that then 13-year old Jahi McMath was brain dead, after complications of, of all things, what one would think should have been a simple tonsillectomy.  At the time, she was described as having her vital functions artificially maintained, as her parents pressed their case that she was responsive to some stimuli, and not dead.

One year later, the situation appears to be the same.  Internet postings at least appear to show her not on a ventilator, with no deterioriation of her skin, and with claimed responses to stimuli.  Like many who have commented on this case, I have no insight into the medical details, and cannot attest to the accuracy of these posts.  Surely, if she is brain dead, she would have to be on a ventilator (not shown in the photos I’ve seen.) And lawsuits are in progress, bringing the implication that the search for a legal payoff could be motivating the medical measures being taken with her.

To be sure, the title of this post implies her family is right.  If she is indeed brain dead, she cannot have lived to her 15th birthday.  But I must stop short of drawing a conclusion about her medical case.

Steve’s post defended the criterion of brain death, reasonably, in my opinion.  Outside commentators have published reviews defending the ethics of the physicians in this case.  See for example this review from the journal Neurology in 2014.   I certainly have no standing or reason to question their medical judgment; I don’t know the facts.

But from that review, and the online service UpToDate, it appears that, if Jahi’s heart is still beating and her body has not deteriorated by now, hers is an unusual, confounding, outlier instance of brain death.  This underscores Steve’s point that the criteria for brain death are not perfect, and that the diagnosis must be made with care (as it was, by the accounts I have seen, in this case).

For my part, I can only watch and try to learn.

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