Brain death is still misunderstood by the public

On December 9, 2013, 13-year-old Jahi McMath underwent a tonsillectomy at a children’s hospital in Oakland, California. She suffered postoperative hemorrhage and became comatose. She was declared brain dead by doctors at that hospital on December 12th. This was later confirmed by a court-appointed outside consultant.

There are many issues surrounding this case. Was the tonsillectomy indicated? Some stories reported that it was done to improve her obstructive sleep apnea. Why wasn’t she successfully rescued from her complication of bleeding? I can find no discussion about how she could have bled so much without intervention in any article about the case.

But one of the most distressing aspects of this poor child’s demise is that despite many years of experience with brain death, it is still misunderstood by laypeople, the courts, and even some medical providers.

As of December 26th, 14 days after the brain death declaration, the child remains on a mechanical ventilator with apparently stable vital signs.

A lawyer for the family had petitioned the court for the outside expert’s consultation and to prevent the hospital from disconnecting the child’s life support.

After all this time, a judge has finally ruled that the hospital may remove the life support but not until December 30th to give the family time to appeal to a higher court.

What a shame. It is bad enough that this girl has died. But to realize that in 2013, society still cannot deal with the concept that brain death is “death” makes it sadder.

It may be a problem of terminology. When we say “brain death,” it somehow does not sound like real death.

The problem is compounded by other words used in this post such as “life support” and “vital signs.” These terms perpetuate the mistaken notion that life is still present.

The Harvard Criteria for brain death were written in 1968. That is 45 years ago. Why are we still debating this in court?

The answer is, we have failed to properly educate the public about this relatively straightforward fact.

It must be extremely difficult for this child’s family to accept that the girl is dead after what many have called routine surgery. I feel very bad for them.

Something that has not been mentioned in any report about this case is another issue that society has trouble handling — organ donation. Perhaps the family should consider this. Those who have been in similar situations say that donating organs gives them some comfort in that part of their loved one lives on and that someone else has been helped.

I hope the higher court does the right thing and declines to review the case and that the family can eventually find peace.

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.

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