Healthcare ethics expert on law involving treating brain dead patients

Healthcare ethics expert on law involving treating brain dead patients

The sad saga of 13-year-old Jahi McMath, the California teen deemed medically dead, has sparked a controversy about a family's final rights.

Dr. David DeWitt with the Louisiana State University Health Science Center has a doctorate in healthcare ethics and explains what it means to be brain dead, as well as Louisiana's law when a person is given that diagnosis.

It has been one month since McMath began suffering extreme complications from a tonsillectomy and was put on life support at Children's Hospital in Oakland, Calif.

In the days that followed, McMath was declared brain dead. Only a machine can prevent her heart from stopping yet her family believes there is still hope.

In an interview with CNN, McMath family attorney Chris Dolan said, "the situation is in limbo because the coroner on one hand says she's dead. The reason why the coroner says she's dead is not based on an independent investigation. It's because the hospital told the coroner she's dead."

A death certificate was issued to the McMath family and they won an appeal to have her moved to a facility that will keep her hooked up to a ventilator.

This public fight has raised the question over what rights a family has in making the decision to turn off the machine.

DeWitt explained what happens to a brain dead person's body when they are unhooked from a mechanical ventilator. "Their heart would slow down and stop, they would stop breathing," he said.

DeWitt said like other states, Louisiana law says it is unethical to treat a dead person and that includes brain dead.

"It is sad to say it, but they have died," he said, "It is heart-breaking, it is sad and it hurts, but medicine does not treat people who have died."

In the case of a person in a coma or vegetative state, there is still a chance that they can get better and sustain life. However with brain death, that is simply not an option. There is no chance for recovery.

"To say it politely, they have died and they are deceased," DeWitt said.

Getting to that conclusion is no easy process. Depending on the patient, there is a thorough physical exam testing reaction to pain and the eyes are checked for response to light. EEGs and nuclear medicine tests can also be used to check for any response in the brain.

When those results are negative, it can be difficult for a family to understand as they see their loved one seemingly "alive," but hooked up to a mechanical ventilator.

"They see the chest rising up and down as if they're breathing, but that's the machine," DeWitt said. "They still have their same color so to speak, but there again, that is the machine."

When all tests show the same result, a person is considered medically dead.

Even when hooked up to a ventilator, the body of a brain dead person will gradually deteriorate until the heart stops beating. That can take days or several weeks.

McMath's family is not saying where she has been taken, but it is reported that she is being given antibiotics, supplements and remains on a ventilator.

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