Thursday, October 14, 2004

Brain dead?

Thanks to Elizabeth Woeckner for this story:

The Salt Lake Tribune has a long story in today's paper about the looming court case over a 6-year-old cancer patient who has been diagnosed as brain dead by two separate physicians who examined him on Monday and Tuesday of this week. His parents don't believe he is dead and want to take him home on a ventilator to care for him with naturopathic remedies until he recovers or until he's "really dead" -- presumably until cardiac death occurs. The court hearing is scheduled for Oct. 27, and the boy's physicians are predicting that his heart will stop beating by then, despite full artificial support for his bodily functions (including breathing) in the meantime. Meanwhile, the trial judge has issued a temporary restraining order requiring the hospital to keep the boy on life-support and to run another EEG before the hearing.

Utah -- like all states and the District of Columbia -- recognizes death according to neurological criteria: the irreversible cessation all all brain functions, including the brain stem. The patient's mother is quotes as saying, "I can't believe they can take this decision away from his parents. They would have to kill him for him to die." But this is not a right to die case. It is not about whether the patient should be allowed to die or should continue to receive treatments that his physicians believe to be futile. Thus, it would be a mistake to think of this case, or to litigate the case, in terms that we've become familiar with in the cases of Karen Ann Quinlan, Nancy Beth Cruzan, Helga Wanglie, and Terri Schiavo, to name just a few.

The patient is dead. It's a little misleading -- and confusing for family members -- when we talk about a patient being brain dead, or "considered dead," legally dead, or medically dead, all of which suggest that there are degrees of death, or different ways of being dead that aren't "really dead."

The patient is dead. The doctors' duty to treat and care for this patient is over. The doctors' only remaining duty to their patient is to treat his body with respect. According to the article, even while he is being maintained on the ventilator, his body has started to decompose. This is what happens to dead bodies. With luck, his grieving parents will come to accept the tragic death of their son, sooner rather than later. If not, it's going to be a grim 2 weeks in the ICU at Primary Children's Medical Center until the court hearing, if his heart holds out that long. If it does, let's hope that the judge provides the kind of closure for this patient that the adults around him have not been able to provide so far.
posted by tommayo, 9:11 AM

Health care law (including public health law, medical ethics, and life sciences), with digressions into constitutional law, poetry, and other things that matter