Should End of Life Decisions be Made by Doctors or Families?

Jahi McMath has been declared "Brain Dead" by doctors, but her family isn't ready to take her off life support.  Should end of life decisions be made by Doctors or Families?
Jahi McMath has been declared “Brain Dead” by doctors, but her family isn’t ready to take her off life support. Should end of life decisions be made by Doctors or Families?

I think by this point, everyone is familiar with the story of Jahi McMath, a little girl who has been declared brain dead after a tonsillectomy went horribly wrong in Oakland, CA.  Despite the declaration of brain death and the hospital’s eagerness to turn off life support, her parents fought it in court and have taken Jahi to an undisclosed location where her life support is being continued.

But is Brain Death really the end of life?  In fact, many religions maintain that only cardiac death is truly death.  And while some might say that religious scholars shouldn’t be regarded as people who know anything about medical practice (although this is not always true), I think religious scholars would counter by saying death is not merely a medical event, but a spiritual event as well.

In fact, it’s not unheard of that patients pronounced as brain dead make recoveries.  Even more importantly, they’re not zombies.  It’s exceptionally rare, but it’s possible.  The human body is an incredible piece of bio-machinery that has the ability to repair itself given enough time and the right circumstances.  Furthermore, medical doctors will be the first to tell you that humanity still doesn’t know everything there is to know about our bodies, especially the end of life process.  And, as much as atheists hate it, medical miracles continue to occur in the 21st century.

Around the country, liberals – who always know what’s best for everyone – are telling the McMath family that “it’s time to let her go” and, less compassionately, “Enough: This Girl Is Dead!”  Really?  Look, I understand the difference between brain death and a coma.  Brain death is something that people don’t usually just come out of.  I am by no means suggesting that those families who have decided to end life support since the 1970s when brain death was accepted as the clinical definition of death in the United States made the wrong decision.  Many families have talked about their wishes and most have said that they don’t want to live the remainder of their lives incapacitated and depending entirely on machines to keep themselves alive.  We don’t know if the McMath parents had this discussion with their daughter. We don’t know what their beliefs are relating to spiritual death.  We don’t know that Jahi won’t make a full or partial recovery – and we don’t know because as unlikely as it may seem, it has happened before.

End of life decisions aren’t supposed to be made by doctors and bureaucrats in hospitals or in Washington, DC.  They’re supposed to be made by families.

The McMath family has decided to keep Jahi on life support.

That’s their business and NOBODY ELSES!

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Kevin Tracy is an Air Force veteran, terrorism/counterterrorism expert, and jack of all trades. KTracy's day job is designing electrical systems for new fossil power plants and environmental solutions. On the side, he keeps a blog, fundraises for political candidates and the St. Baldrick's Foundation, writes and illustrates comic books, and studies foreign affairs in depth.

2 thoughts on “Should End of Life Decisions be Made by Doctors or Families?”

  1. This case isn’t about making end of life decisions. There is no decision to be made. Death has already occurred.

    People (or religions) who insist that the only true death is “cardiac” death are simply not knowledgeable about the mechanism of death. People actually do come back from “cardiac” death. On a daily basis, medical professionals around the world restart hearts, returning people to life. Because what really causes a person whose heart has stopped to die isn’t actually the heart stopping: it’s that the heart stopping means that no more oxygenated blood is flowing to the brain. If the heart can be restarted before the brain fails, the person can be “brought back to life.” Once the brain has ceased all function, though, there is nothing to be done.

    The heart can be made to beat mechanically (as is the case with Jahi). It can even be made to beat when fully removed from a human body. Or a person whose heart is beyond repair and function can be kept alive (conscious, aware, talking alive) by being hooked up to a machine that fills in for the heart. There is no machine, though, that can truly fill in for the brain. The brain is where communication, memory, the very essence of the person is found. Once that is dead, there is no coming back.

    Yes, there are cases of misdiagnosis of brain death. This is why it’s important for the tests to be done hours (even days) apart, to be done by more than one doctor, to be thorough and done properly. But a misdiagnosis of brain death would have been found by now. Long, long ago. That she is dead is not a matter of opinion or a valid topic of religious dispute. It is simply the fact.

    1. In the example I cited above, a young man was determined to be brain dead by four different doctors before he made his recovery. I’m not disagreeing with those who say that brain death is a legitimate clinical definition of death. Families who choose to stop life support when this has been declared should never feel any guilt for the decision. Likewise, doctors should never be charged with a crime for using organs from a brain dead body to save the lives of others.

      Yet, these decisions need to be made by families in accordance with their own traditions and beliefs. The mechanism of death is still not totally understood. The definitions of brain death and death in general vary from state to state and country to country. I’m not about to say anything is wrong with anybody’s definition. It’s an intensely personal, family time and the last thing we need are doctors, review boards, and politicians getting involved to determine when someone should be pulled from life support.

      Families, and families alone, should be making the call.

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