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Caplan: The case against care for those who are brain dead
Arthur Caplan   Jan 10, 2014  

Thirteen-year-old Jahi McMath died on Dec. 12 at Children’s Hospital & Research Center Oakland. Yet about a month later, Jahi is still on a ventilator because her parents refuse to accept her death. Aided by a misguided legal decision, she has been moved to another facility to be kept on artificial life support, which makes no medical or moral sense. What’s being done to her corpse is wrong, but a bigger issue is the threat her case poses to the rational and moral use of health care resources.

Photo credit: AP | Dede Logan of Oakland, Calif., decorates a poster in support of Jahi McMath in front of Children's Hospital Oakland. (Dec. 23, 2013)

Her parents had taken her to the Oakland facility for surgery to remove her tonsils to help her sleep apnea, a condition that disrupts sleep. Things went tragically wrong, although exactly how is not known. Her parents hired a lawyer and won a court order to keep Jahi on artificial life support.

Jahi suffered complications post-surgery, including a heart attack and hemorrhaging of her brain. Experts in neurology could not find any sign of brain activity. They knew with certainty that she was brain dead.

To keep Jahi's body on machines is ethically wrong because definitive brain death is death and maintaining a corpse by artificial means is only slowing the inevitable decay and collapse of bodily remains.

Jahi's case is different from that of a pregnant woman in Texas whose husband said was diagnosed as brain dead by a hospital. That hospital denied the husband's request to take her off life support because it says a state law bars it from following a family directive when there's a pregnancy. In Jahi's case, keeping her on a ventilator amounts to desecration of a body.

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Arthur L. Caplan, Ph.D., is the Drs. William F and Virginia Connolly Mitty Professor and head of the Division of Bioethics at New York University Langone Medical Center in New York City.

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