NY family opposes end to care for brain-dead boy

[LiberalNation]

Are they paying for the treatment themselves. Should the government get to decide/rule in a case like this.

http://news.yahoo.com/s/ap/20081109/ap_on_re_us/brain_death_religion;_ylt=As17XAXNk2rxxDCT1JTQq7Bv zwcF

NEW YORK – A Washington hospital has asked a judge for permission to stop treating a brain-dead 12-year-old cancer patient, even though his ultra-religious New York parents want to keep him on life support.

Motl Brody of Brooklyn was pronounced dead this week after a half-year fight against a brain tumor, and doctors at Children's National Medical Center in Washington say the seventh-grader's brain has ceased functioning entirely.

But for the past few days, a machine has continued to inflate and deflate his lungs. As of late Friday afternoon, his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline.

That heartbeat has prompted Motl's parents, who are Orthodox Jews, to refuse the hospital's request to remove all artificial life support.

Under some interpretations of Jewish religious law, including the one accepted by the family's Hasidic sect, death occurs only when the heart and lungs stop functioning.

That means Motl "is alive, and his family has a religious obligation to secure all necessary and appropriate medical treatment to keep him alive," the family's attorney wrote in a court filing this week.

The family has asked the hospital to leave the breathing machine on and keep administering drugs until the boy's heart and lungs no longer respond.

Disagreements between families and medical providers over when to end care for terminally ill patients are common, experts say, but this case wound up in court with unusual speed.

Unlike Terri Schiavo or Karen Ann Quinlan, who became the subjects of right-to-die battles when they suffered brain damage and became unconscious, Motl's condition has deteriorated beyond a persistent vegetative state, his physicians say. His brain has died entirely, according to an affidavit filed by one of his doctors.

His eyes are fixed and dilated. His body neither moves nor responds to stimulation. His brain stem shows no electrical function, and his brain tissue has begun to decompose.

"This is death at its simplest," the hospital's lawyers wrote in a court filing.

The hospital said it would help the family move what it called the boy's "earthly remains" to another medical facility, but has found none willing to accept a brain-dead child.

The dispute wound up in court Sunday, when the family asked a federal judge to block the hospital from doing any further tests for brain activity.

The hospital responded by asking a District of Columbia Superior Court judge for permission to discontinue treatment.

Jeffrey I. Zuckerman, the attorney for Motl's parents, says they have been "utterly shattered" by the hospital's actions.

He stressed that the family's demand for continued life support was based on their obligations under religious law, not an unrealistic hope that their boy will recover.

"You can always hope for a miracle, but if you are asking if they are in denial about their child's medical condition, no, they are not," Zuckerman said.

A hearing was scheduled for Monday, but Children's National Medical Center said it would ask for a postponement until Wednesday.

"We respect the family's beliefs, and have tried since the patient's arrival in June to work closely with them in a spirit of mutual respect," the hospital said in a written statement.

It added, however, that attempts to discuss end-of-life issues with the family had been complicated.

[Mr. P]

Arthur Caplan, a professor of bioethics at the University of Pennsylvania, said physicians aren't obligated to provide care that can't possibly be medically helpful.

"Doctors are well within their rights to say, 'We are stopping,'" he said. "I don't think medicine can become subservient to religious, spiritual or mystical hopes and beliefs concerning how to manage death."

Thats my opinion also.

[stephanie]

Hell Yeah, the GOVERMENT might as well decide...you all want them to decide everything else in our lives...

[retiredman]

Hell Yeah, the GOVERMENT might as well decide...you all want them to decide everything else in our lives...

take it off the feeding tube, starve it to death...

that's the humane way..they are no more use to society...:cheers2:

if the parents want to keep it alive, let them take it home and keep it alive. taking up space and precious assets in our already strained healthcare system is inappropriate, IMHO.

[stephanie]

if the parents want to keep it alive, let them take it home and keep it alive. taking up space and precious assets in our already strained healthcare system is inappropriate, IMHO.

OKEY DOKEY PREACHER MAN..

your thoughtfulness and loving guidance is overwhelming as usual..

[bullypulpit]

Hell Yeah, the GOVERMENT might as well decide...you all want them to decide everything else in our lives...

It's called futility of care dearie. I deal with it every day as an ICU nurse. Families tear each other apart...while others simply can't face the fact that their loved one is gone. This only prolongs the suffering of the families, while the one in the hospital bed is long past caring. The one they loved is gone, and all that is left is a corpse animated by life support technology, technology and resources which could be better utilized in the care of a patient who actually has a chance of recovering.

So don't preach to me until you've cared for a patient whose body is on life support but whose spirit, if that's what you want to call it, is long gone. Tell me about it when you've cleaned and cared for the suppurating bed sores that won't heal because their circulatory system has collapsed. Tell me about it after you've suctioned purulent secretions from their trach because a mechanical ventilator is the only thing keeping them breathing. Tell me about it after you've coded them for the third and fourth and even fifth time, all the while praying that their heart finally stops beating, but all the while doing everything you can to keep it from doing so. Tell me about it after you've done chest compressions on a patient so ravaged by disease that their ribs break and blood comes pouring out their mouth and nose. And their families still won't let them go. They rationalize it by saying "But we don't want to play God!", never realizing that it is EXACTLY what they're doing by keeping their loved on on life support. They never realize that if a 'miracle' is going to happen, our taking them off life support will not stop it.

[stephanie]

It's called futility of care dearie. I deal with it every day as an ICU nurse. Families tear each other apart...while others simply can't face the fact that their loved one is gone. This only prolongs the suffering of the families, while the one in the hospital bed is long past caring. The one they loved is gone, and all that is left is a corpse animated by life support technology, technology and resources which could be better utilized in the care of a patient who actually has a chance of recovering.

So don't preach to me until you've cared for a patient whose body is on life support but whose spirit, if that's what you want to call it, is long gone. Tell me about it when you've cleaned and cared for the suppurating bed sores that won't heal because their circulatory system has collapsed. Tell me about it after you've suctioned purulent secretions from their trash because a mechanical ventilator is the only thing keeping them breathing. Tell me about it after you've coded them for the third and fourth and even fifth time, all the while praying that their heart finally stops beating, but all the while doing everything you can to keep it from doing so. Tell me about it after you've done chest compressions on a patient so ravaged by disease that their ribs break and blood comes pouring out their mouth and nose. And their families still won't let them go. They rationalize it by saying "But we don't want to play God!", never realizing that it is EXACTLY what they're doing by keeping their loved on on life support.



your life must be getting too stressful dear...you are evidently having these visions someone is attacking you personally..

I know you're in a stressful job...so here to you from me..

http://i106.photobucket.com/albums/m268/alaskamomma/a194.gif

[DragonStryk72]

If the soul exists, I believe that it exists in the mind, and so, when that mind is gone, so too is the spirit thus attached. They are going through the worst thing parents can go through: outliving their own child.

I do not believe that the government should be the final arbiter here, that the hospital itself should have the ability to say, "no, by every measure we have, by every study of it, your child is dead."

Everything that truly makes me who I am is not attached to my body, but my emotions, my way of speaking, of relating to others, and those are productions of the mind, not the body. The body is just a shell, the vessel that our spirits travels. the spirit of their son has already gone, and it is time to let go of the shell that lingers on.

[stephanie]

If the soul exists, I believe that it exists in the mind, and so, when that mind is gone, so too is the spirit thus attached. They are going through the worst thing parents can go through: outliving their own child.

I do not believe that the government should be the final arbiter here, that the hospital itself should have the ability to say, "no, by every measure we have, by every study of it, your child is dead."

Everything that truly makes me who I am is not attached to my body, but my emotions, my way of speaking, of relating to others, and those are productions of the mind, not the body. The body is just a shell, the vessel that our spirits travels. the spirit of their son has already gone, and it is time to let go of the shell that lingers on.

I don't diagree with any of what you said, but..

easier said than done my friend...

[DragonStryk72]

I don't diagree with any of what you said, but..

easier said than done my friend...

I know, but that is why we need leaders, which, sadly, has gone out the window on both sides of the fence. There's no one out there saying things like, "The most important thing we can do right now is not panic", nothing, just another attempt to give everyone what they want, with no real consideration to what they actually need.

[crin63]

Well gosh, if the humanists didn't try so hard to have Terry Schaivo killed and if they actually valued all life then maybe people like this might think they could trust the opinions of their doctors. But when you have people arguing to have babies killed and put no value on life that isn't perfect like Sarah Palin's son you create this type of situation.

[stephanie]

I know, but that is why we need leaders, which, sadly, has gone out the window on both sides of the fence. There's no one out there saying things like, "The most important thing we can do right now is not panic", nothing, just another attempt to give everyone what they want, with no real consideration to what they actually need.


.....

[bullypulpit]

your life must be getting too stressful dear...you are evidently having these visions someone is attacking you personally..

I know you're in a stressful job...so here to you from me..

http://i106.photobucket.com/albums/m268/alaskamomma/a194.gif

No, not too stressful at all. It's the most challenging and rewarding work I've done as an RN.

I do, however, get dangerously excited about no-nothing busy-bodies talking as if they have some authoritative knowledge in the fields of health-care, end of life issues and medical ethics. And thanks for the sunny face.

[bullypulpit]

Well gosh, if the humanists didn't try so hard to have Terry Schaivo killed and if they actually valued all life then maybe people like this might think they could trust the opinions of their doctors. But when you have people arguing to have babies killed and put no value on life that isn't perfect like Sarah Palin's son you create this type of situation.

I'd REALLY like to know what you base the opinion that "humanists" had Terry Schiavo "killed" on.

[Said1]

Bully:

When the brain dies, it actually begins to desinigrate, or turn to mush doesn't it? does life support technology prevent this from happening even though the person is brain dead? I had a cousin who was declaired brain dead prior to dying of other causes. I was quite young, but I do remember my aunt saying something to that effect, but i dont recall all the details.

[Nukeman]

Bully:

When the brain dies, it actually begins to desinigrate, or turn to mush doesn't it? does life support technology prevent this from happening even though the person is brain dead? I had a cousin who was declaired brain dead prior to dying of other causes. I was quite young, but I do remember my aunt saying something to that effect, but i dont recall all the details.When you have a brain death it is usually followed by the body cutting off the blood flow. No reason to feed somehting dead. this is one of the ways they determine brain death

[Said1]

When you have a brain death it is usually followed by the body cutting off the blood flow. No reason to feed somehting dead. this is one of the ways they determine brain death

So that would be a 'yes' to my question about decomposition!!!????!!!!!!

[bullypulpit]

Bully:

When the brain dies, it actually begins to desinigrate, or turn to mush doesn't it? does life support technology prevent this from happening even though the person is brain dead? I had a cousin who was declaired brain dead prior to dying of other causes. I was quite young, but I do remember my aunt saying something to that effect, but i dont recall all the details.

Let me refer you to an <a href=http://classic.aacn.org/AACN/jrnlccn.nsf/0/5ebf8de743ead0fa8825674e005a8950?OpenDocument>American Association of Critical Care Nurses article</a> on the subject...just follow the link.

Brain death involves the loss of function of the brain and/or brain stem. This can be the result of trauma, which causes acute damage immediately visible in radiologic studies. Less obvious is the damage from anoxic brain injury. This occurs commonly in cardiac/respiratory arrest or stroke, when the blood flow and oxygen supply to the brain is interrupted...6 minutes is generally accepted as the upper limit for recovering from respiratory/cardiac arrest with few deficits as a result. This damage is not immediately apparent on a CAT scan, but as time progresses, days to weeks, the damage becomes readily apparent as the oxygen starved brain tissue dies and is replaced with cerebro-spinal fluid. Once this tissue is gone, it will never return.

Normal CT images of the brain can be found <a href=http://www.med.harvard.edu/AANLIB/cases/caseM/mr1_t/024.html>HERE</a>

For comparison, the following image shows a normal CT on the right and anoxic brain injury on the left.

http://www.amptoons.com/blog/images/schiavo_ct_scan.jpg

And no, life support technology cannot reverse the damage.

[gabosaurus]

My parents have stated that they do not want to be kept alive by machines. Neither do I.
Once you are dead, you are dead. Machines should not be used to keep you alive.

[Mr. P]

My parents have stated that they do not want to be kept alive by machines. Neither do I.
Once you are dead, you are dead. Machines should not be used to keep you alive.

Are you an organ donor?

[gabosaurus]

Actually, I am. An organ transplant can prolong the life of someone else.

[Mr. P]

Actually, I am. An organ transplant can prolong the life of someone else.

True..and YOU'LL be on life support until the harvest.

[gabosaurus]

My organs will not be taken until I am dead.

[Mr. P]

My organs will not be taken until I am dead.

Only brain dead. I promise you'll still be on life support, the organs must be kept alive.....so in turn must you.

[bullypulpit]

Only brain dead. I promise you'll still be on life support, the organs must be kept alive.....so in turn must you.

Bad analogy.

[Mr. P]

Bad analogy.

Yeah sorta..but you know what I mean..the organs must be kept viable. So life support is necessary.

[Immanuel]

if the parents want to keep it alive, let them take it home and keep it alive. taking up space and precious assets in our already strained healthcare system is inappropriate, IMHO.


Well gosh, if the humanists didn't try so hard to have Terry Schaivo killed and if they actually valued all life then maybe people like this might think they could trust the opinions of their doctors. But when you have people arguing to have babies killed and put no value on life that isn't perfect like Sarah Palin's son you create this type of situation.

His name is Motl Brody. He is not an IT! It is extremely insensitive to the family to refer to him as an it, despite his condition.

Thank you crin for using Terry's name and not making her into an IT.

May God guide the doctors and the family to the right decision.

Immie

[bullypulpit]

His name is Motl Brody. He is not an IT! It is extremely insensitive to the family to refer to him as an it, despite his condition.

Thank you crin for using Terry's name and not making her into an IT.

May God guide the doctors and the family to the right decision.

Immie

With brain death... the person is GONE. There's a body...not a person...left behind.

[manu1959]

if i want to pay to keep my son alive why should i not have the right that choice........

[Mr. P]

if i want to pay to keep my son alive why should i not have the right that choice........

That's not the issue. As I read it the issue is the kid is either dead or alive and who decides? Then at that point what to do. If the parents want to maintain what is medically deemed a dead body by all means take him home and do so.

[manu1959]

That's not the issue. As I read it the issue is the kid is either dead or alive and who decides? Then at that point what to do. If the parents want to maintain what is medically deemed a dead body by all means take him home and do so.

why can't i pay to keep the "dead" boy alive if i believe he is "alive"....

[Mr. P]

why can't i pay to keep the "dead" boy alive if i believe he is "alive"....

You can...at home or in a long term care facility. Hospitals treat curable folks, they don't house the dead or those who have no hope in the long term that can receive care elsewhere.

[Immanuel]

With brain death... the person is GONE. There's a body...not a person...left behind.

It is still insensitive to the family.

You are an RN, are you not?

Would you refer to that boy when speaking to his parents as "IT"? Somehow, I believe you have much more tact bedside than that.

For the record, I don't know how I would handle this situation as a parent. Basically the child is gone, but if it were my child... I just don't know that I could let go.

Immie

[bullypulpit]

It is still insensitive to the family.

You are an RN, are you not?

Would you refer to that boy when speaking to his parents as "IT"? Somehow, I believe you have much more tact bedside than that.

For the record, I don't know how I would handle this situation as a parent. Basically the child is gone, but if it were my child... I just don't know that I could let go.

Immie

No, I'm not that insensitive. I do all I can to help a family accept what has come to be. But sometimes you have to be utterly blunt with them, because they refuse to accept that their loved one is gone. Fortunately, that is for the docs to do, not me.

As for letting go, one has to ask what they are holding on to. If they cherish the memory of their child laughing and playing and full of life...It's time to let go. If that's not the case then what is it? If a miracle is going to happen, it will happen regardless of what medical professionals do. They may be praying for a miracle, but sometimes the answer to one's prayers is "No.".

[Immanuel]

No, I'm not that insensitive. I do all I can to help a family accept what has come to be. But sometimes you have to be utterly blunt with them, because they refuse to accept that their loved one is gone. Fortunately, that is for the docs to do, not me.

As for letting go, one has to ask what they are holding on to. If they cherish the memory of their child laughing and playing and full of life...It's time to let go. If that's not the case then what is it? If a miracle is going to happen, it will happen regardless of what medical professionals do. They may be praying for a miracle, but sometimes the answer to one's prayers is "No.".

See!!! I knew there was a heart in there somewhere!! I just knew it. :laugh2:

I agree with you in the second paragraph. My point was, though, that if I were in that situation, I honestly don't know what I would do. Personally, I don't want to be kept on a machine if I am dead. I also, would not want to keep my child "alive" like that... but, what if the doctors are wrong? I mean maybe there is still hope! Maybe he will wake up... I just know they are wrong. I just know it.

It would be a very difficult thing to go through and giving up is so final.

Immie

[gabosaurus]

Medically deceased is dead. That is why we have medical professionals.
My test is this: If you disconnect all the machines, will the person still live? That is what I want -- no machines to prolong life. Once I am dead, I am dead. Same thing for my parents, my husband and my child.
Yes, it is beyond difficult to let go. But you can't put your arms around a memory.

[LiberalNation]

If you disconnect all the machines, will the person still live? That is what I want -- no machines to prolong life.
Sometimes those machine can keep you alive long enough for the body to heal. Not in brain death of course but other things.

Be very specific to your kids, in the event you have Alzheimer’s in old age and your children have to decide. Many of them have feeding tubes which is another form of keeping them alive when they can no longer swallow/eat enough to keep them going.

Some trachs were the worst. They never got suctioned enough. Chocking all the time, spilling out all over the place when you were trying to clean them up.

[LiberalNation]

Oh and Bully, I'm in nursing school to be an rn right now. The ICU is one place I hope to eventually end up. Sometime later, if you don't mind, I'd like to ask you a bit more about the work you do daily.

[bullypulpit]

why can't i pay to keep the "dead" boy alive if i believe he is "alive"....

Then by all means, set up a trust where people can send their donations...don't do it at tax-payer expense.

[LiberalNation]

Boy whose religious parents battled hospital dies

http://news.yahoo.com/s/ap/20081116/ap_on_re_us/brain_death_religion

NEW YORK – A 12-year-old New York boy with brain cancer has died after his family battled a hospital to keep him on a ventilator.

The lawyer for the Orthodox Jewish family says Motl Brody's bodily functions ceased Saturday. A machine had continued to work his lungs after he was pronounced dead Nov. 4 at Children's National Medical Center in Washington, D.C.

The boy had already been declared brain dead, but some adherents of Jewish religious law say death occurs only when the heart and lungs stop functioning.

The family had asked a judge to prevent further tests for brain activity. The hospital argued that its "scarce resources" were being used "for the preservation of a deceased body."

[Immanuel]

Boy whose religious parents battled hospital dies

http://news.yahoo.com/s/ap/20081116/ap_on_re_us/brain_death_religion

NEW YORK – A 12-year-old New York boy with brain cancer has died after his family battled a hospital to keep him on a ventilator.

The lawyer for the Orthodox Jewish family says Motl Brody's bodily functions ceased Saturday. A machine had continued to work his lungs after he was pronounced dead Nov. 4 at Children's National Medical Center in Washington, D.C.

The boy had already been declared brain dead, but some adherents of Jewish religious law say death occurs only when the heart and lungs stop functioning.

The family had asked a judge to prevent further tests for brain activity. The hospital argued that its "scarce resources" were being used "for the preservation of a deceased body."

My heart goes out to this boy's family. It had to be a tough ordeal to go through.

May they find peace at the end of this trial.

Immie

[Trigg]

Medically deceased is dead. That is why we have medical professionals.
My test is this: If you disconnect all the machines, will the person still live? That is what I want -- no machines to prolong life. Once I am dead, I am dead. Same thing for my parents, my husband and my child.
Yes, it is beyond difficult to let go. But you can't put your arms around a memory.

My husband and I have discussed this at length. Since both of us are in the medical profession we've seen people who are unable to let go of a family member.

[Mr. P]

My husband and I have discussed this at length. Since both of us are in the medical profession we've seen people who are unable to let go of a family member.

This is where a living will becomes so important. "I know what you want dear but this is what I want, don't keep me on machines".

[Immanuel]

This is where a living will becomes so important. "I know what you want dear but this is what I want, don't keep me on machines".

It is unlikely though that a 12 year old would have a living will or even that it would be valid if he did.

Immie

[Des]

I can't even imagine being in a situation like this...

[Mr. P]

It is unlikely though that a 12 year old would have a living will or even that it would be valid if he did.

Immie

I was addressing the post by Trigg..not the kids situation..he was a minor anyway..the parents have the say.