CNA\/EWTN News<\/a>).- The \u201ctragic\u201d case of teenage girl Jahi McMath \u2013 now at the center of a legal controversy over brain death \u2013 shows the need to determine the facts before making ethical conclusions, says a bioethicist.<\/p>\n\t\u201cThe difficulty of these cases have to be recognized, especially in terms of the human suffering of the families,\u201d John Di Camillo of the National Catholic Bioethics Center in Washington, D.C. told CNA Jan. 2.<\/p>\n
\t\u201cIt\u2019s not something that's simply a clear-cut, back-and-white case that we can, from the outside, say we know what\u2019s going on. Because we don't,\u201d he added.<\/p>\n
\t\u201cIt\u2019s all in the details of the medical facts. We have to defer to reason when we see that the facts have been clarified, and then we can use those as our starting point for our ethical reflection.\u201d<\/p>\n
\tJahi McMath, age 13, underwent a complex tonsil removal surgery at Children's Hospital Oakland on Dec 9 to treat her sleep apnea. After the surgery, she appeared fine but then underwent cardiac arrest, lost oxygen to her brain and had extensive hemorrhaging, the Los Angeles Times reports. She was first declared brain dead on Dec. 12.<\/p>\n
\tFive physicians, two at Children\u2019s Hospital Oakland and three independent doctors requested by the family, have declared the girl to be brain dead. The doctors have said the girl is unable to breathe on her own and other tests show that there is no blood flow to her brain and no signs of electrical activity. She is presently on a ventilator.<\/p>\n
\tA federal court order has barred the hospital from removing life support systems until Jan. 7, ABC News reports. McMath\u2019s family hopes to transfer her to a long-term care facility where she can stay on life support.<\/p>\n
\tThe family\u2019s lawyer has asked Children\u2019s Hospital Oakland to perform a tracheotomy and insert a feeding tube, procedures necessary before any transfer.<\/p>\n
\tThe hospital had said it \u201cdoes not believe that performing surgical procedures on the body of a deceased person is an appropriate medical practice.\u201d It said transferring the girl would require the approval of the coroner, as she is considered legally dead.<\/p>\n
\tThe hospital added, however, that it continues to support McMath\u2019s family \u201cin this time of grief and loss over her death.\u201d<\/p>\n
\tOn Jan. 3 the girl\u2019s family and the hospital reached an agreement to allow a team to transfer her to another facility, the Los Angeles Times reports. But a judge has refused the family\u2019s request to have a doctor perform the procedures required for the move. The girl\u2019s mother will take full responsibility for her during the transfer. It is not yet known what facility will receive the girl.<\/p>\n
\tDi Camillo stressed the need to know the facts of Jahi McMath's case before making a moral judgment.<\/p>\n
\t\u201cBefore even getting to the ethical considerations, the medical facts are an absolute priority,\u201d he said. \u201cIf we have a medically clear and confirmed determination of death by these neurological criteria, then we\u2019re dealing with a situation where the body is actually the corpse of the deceased of this young girl.\u201d<\/p>\n
\t\u201cIf we're dealing with a case where the person is in fact brain damaged but still alive, then we have a whole different set of ethical criteria because we\u2019re talking about a living human being who is worthy of\u00a0 full respect and full treatment.\u201d<\/p>\n
\tHe said Catholic teaching holds that \u201cfull brain death\u201d criteria are legitimate indicators that the patient has died. However, he also warned about \u201cmisleading language\u201d which uses the term \u201cbrain death\u201d to describe those who are brain damaged or in states of reduced consciousness where a patient may still have brain stem function.<\/p>\n
\tPatients deserve proportionate care that offers a reasonable hope of benefiting them without imposing an \u201cexcessive burden,\u201d he said.<\/p>\n
\tCatholic ethics do not support the mentality of \u201clife at all costs,\u201d but rather promotes life \u201cwithin reason and within the context of one\u2019s circumstances, possibilities, pain, suffering.\u201d The bioethicist said there is a basic obligation to protect life \u201cwithin the limits of reason and the limits of that proportionality\u201d<\/p>\n
\tDi Camillo again noted that appropriate treatment depends on the facts of the case. Life support systems are sometimes ordinary means of treatment and sometimes disproportionate.<\/p>\n
\t\u201cIt\u2019s not an absolute. It has to be determined on a case-by-case basis, in light of the facts,\u201d he said.<\/p>\n
\tJahi McMath\u2019s situation has prompted comparisons to Terri Schiavo, a Florida woman who suffered\u00a0 severe brain damage in 1990, lived in a persistent vegetative state for years, and died of starvation in March 2005 after a contentious legal battle. Her parents wanted doctors to provide her nutrition and hydration, while her husband did not.<\/p>\n
\tDi Camillo said such a comparison is \u201cdifficult\u201d because it is known that Schiavo was in a persistent vegetative state and \u201cclearly not brain dead.\u201d<\/p>\n
\tSchiavo \u201ccould not satisfy any of the criteria for brain death as far as I understand it,\u201d the bioethicist said, while McMath\u2019s status is \u201cthe very question at issue.\u201d<\/p>\n
\tThe Terri Schiavo Life & Hope Network, founded by Schiavo\u2019s parents, brother and sister, said Dec. 31 it has been overseeing the effort by several groups to transfer the teen girl out of the Oakland hospital.<\/p>\n
\tThe network says McMath's case draws attention to hospital corporations' \u201cvested financial interest in discontinuing life.\u201d<\/p>\n
\n
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