Tuesday, December 31, 2013

Misguided Judicial Sympathy

The ghoulish circus surrounding the tragic death of Jahi McMath continues. Alameda County Judge Evelio Grillo has ordered Children's Hospital Oakland to keep her on a ventilator for another week while the family attempts to find a facility that will receive the brain dead girl following complications from a tonsillectomy last week.

I don't know what Judge Grillo is trying to accomplish by prolonging this agony. Multiple physicians, including a court appointed neurologist from Stanford University, have declared Jahi brain dead. Very specific and universally accepted guidelines have been developed over the years to help doctors decide without a doubt when patients are dead. These rules were made to prevent this very type of madness that can occur when grieving families refuse to let loved ones go and doctors are afraid to step up and make the decision for the good of the deceased.

Judge Grillo has taken it upon himself to overturn decades of medical ethics teaching and ruled to keep a human body hooked up to machines despite the unanimous consensus of doctors that Jahi is never going to recover her neurologic functions. Does he think he is doing her family a favor by keeping their daughter on a machine? How can this family ever have closure and grieve properly when they see their child involuntarily twitch to the touch and continue to have a pulse that the machines are providing for her?

What do the actions of Judge Grillo say to doctors all over the country about how their medical decisions can be overturned at the whim of the family and a single non medically trained person wearing a black robe? This is the reason doctors are so leery of stopping treatments for the terminally ill, or in this case deceased, even though all hope of recovery is lost. We are the ones who are at the patients' bedsides every day and are in the best position to decide the best course of action. But because of legal actions like the ones being made by Judge Grillo, any disgruntled family member can make a simple call to a lawyer and effectively make a law judge the patient's caregiver despite having little to no knowledge of medicine. I also find it extremely ironic that the courts will allow a family to keep a dead patient alive on a machine yet at the same time have no difficulty declaring the killing of living fetuses as a constitutional right.

In the meantime the McMath family is trying to find a nursing home that will accept Jahi once she has a gastrostomy tube and a tracheostomy. I don't blame the hospital or its doctors for refusing to perform either of those procedures. It is ethically unacceptible to perform these surgical procedures on a deceased patient. The best thing the family can do is accept the tragedy that has beset them and donate her organs to others who will truly survive with their daughter's gifts. Only then can they come to peace with her fate. After that they can call their medical malpractice lawyer for issues that the courts really are supposed to adjudicate.

1 comment:

  1. Great post. I suspect that the communication with the family regarding the iatrogenic death is the cause of much of the conflict here. Families who are well taken care of by hospital staff. In twenty years of working with families of those who are declared brain dead, I can remember no more than five or so who utterly refused to accept the decision the way this family has.