Brain death and refusal to remove life support

[Legaltrends]

I am looking to understand which nursing ethics principles are being violated when a patient is legally brain dead and the family refuses to withdraw support. I feel that it is non-maleficience to the family. Would you agree or disagree?

[Julius Seizure]

What about the case of the 13 yr old child, Ja hi McMath? She was legally declared and her family dug their heels in to keep her on life support. It seems that the patient, who had been declared, is not a factor. Which is why I think that the family is the people that we are hurting by not getting them to accept the fact that she is gone. This is why I say non-maleficience. Am I wrong still?

The family not wanting to remove life support might be THEM trying to be non-maleficent to the patient, because they don't understand or won't accept that their family member is no longer alive. Jahi's family clearly felt that they medical team was maleficent in their decision to remove life support after brain death was declared.

[Here.I.Stand, BSN, RN]

I'd be more concerned about non-malefiscence to the pt, who is dead and should be laid to rest.

(Of course if they are a donor that would be delayed by a couple of days...but in those cases the family KNOWS their loved one is dead, and is acting SELFLESSLY by consenting to donation.)

[Here.I.Stand, BSN, RN]

I also don't use the term "life support" -- a brain dead person is not alive. I call it what it is. A ventilator.

[LovingLife123]

I think they moved to New Jersey specifically because its state laws accommodate religious beliefs that do not recognize brain death. She is on NJ Medicaid.

Jahi McMath, girl declared brain dead three years ago, might still be technically alive, judge says - LA Times

So, if I'm reading that article correctly, she was declared brain dead and the family refused a brain flow study? That's a sticky situation. Brain death was determined by physician judgement. She's still declared dead though. I wonder how the citizens of New Jersey feel that there tax dollars are being spent on treating a dead person?

I don't know that case very well, just for what I remember in the news from a few years ago. I'm very interested to know what Christian religion does not recognize brain death and the reasoning. It makes no sense.

While I'm always respectful of religious beliefs, this is one of those things that makes me hate religions all together. They preach things that are absolutely not true.

[Penelope_Pitstop, BSN, RN]

I wonder how the citizens of New Jersey feel that there tax dollars are being spent on treating a dead person?

She isn't the only one being "treated" despite being dead. My friend was a nurse in NJ at a LTACH and "cared for" brain dead people. I thought she was mistaken about their brain dead status but then I learned of the referred-to law.

NJ's laws and governing in general are quite unique. (Do any other states forbid motorists from pumping gas into their cars at gas stations? What's the deal with the left turn thing (I'm married to a dude from NJ so I'm being somewhat silly with that)? And...Chris Christie... (wish I was being silly with THAT)

[Julius Seizure]

NJ's laws and governing in general are quite unique. (Do any other states forbid motorists from pumping gas into their cars at gas stations? What's the deal with the left turn thing (I'm married to a dude from NJ so I'm being somewhat silly with that)? And...Chris Christie... (wish I was being silly with THAT)

Left turn thing?

Also, I think you can't pump your own gas in Oregon either.

[Penelope_Pitstop, BSN, RN]

Left turn thing?

Also, I think you can't pump your own gas in Oregon either.

I've not been to OR, so thank you for that (possible, haha) info.

As for the left turns, NJ has many, many jughandles, requiring "left" turns to turn right - but at the same intersections in other states, there would be a legal left. I do agree that it's safer but it's bizarre if you're passing through. I've ended up having to reroute myself considerably in a relatively unfamiliar area when driving there.

[TriciaJ, RN]

I've not been to OR, so thank you for that (possible, haha) info.

As for the left turns, NJ has many, many jughandles, requiring "left" turns to turn right - but at the same intersections in other states, there would be a legal left. I do agree that it's safer but it's bizarre if you're passing through. I've ended up having to reroute myself considerably in a relatively unfamiliar area when driving there.

That is correct about Oregon. No pumping your own gas.

[chare]

Jahi McMath, girl declared brain dead three years ago, might still be technically alive, judge says

A California judge has ruled that a teenage girl declared brain-dead more than three years ago after a tonsillectomy may still be technically alive, allowing a malpractice lawsuit against the hospital to proceed.

Alameda County Judge Stephen Pulido ruled Tuesday that it's up to a jury to determine whether Jahi McMath is alive, which would increase the amount of damages if jurors decide in the family's favor.

[…]

[Horseshoe, BSN, RN]

Jahi McMath, girl declared brain dead three years ago, might still be technically alive, judge says

Well that's just brilliant. Judges and juries, all lay people, get to decide a medical issue after multiple experts from Stanford and Children's Hospital in Oakland did all of the required and (not required) tests and determined her to be brain dead. Yep, Ralph from San Bruno is more qualified than the head of pediatric neurology at Stanford.

[Ruby Vee, BSN]

I think they moved to New Jersey specifically because its state laws accommodate religious beliefs that do not recognize brain death. She is on NJ Medicaid.

Jahi McMath, girl declared brain dead three years ago, might still be technically alive, judge says - LA Times

Oh good Lord! THAT is the ethical issue. Should the tax payers be forced to support keeping a dead girl on machinery to keep the body going after the soul has departed? If the parents are footing the bill, it's their money and as long as the hospital bed and the equipment isn't required for a LIVING patient, I guess that's for the involved parties to decide. But if they're using someone ELSE's money to support their religious belief that has been disputed with facts, I don't think they have that right.

Years ago, I worked at a university hospital where part of our orientation was a presentation by the medical director of the ER. An inmate from the state prison had been admitted to the ER and was subsequently pronounced dead by Dr. Letsmakeapoint. "Life support" was about to be removed when the prison liaison demanded that it not be removed because to do so would be to shorten the inmate's life sentence. Dr. Letsmakeapoint argued that since the patient was dead -- "I pronounced him" -- removing the devices would not be shortening the life sentence -- it had been served to completion. Mr. Fulllifesentence, the liaison argued, rather ignorantly it seems, to the contrary. The devices stayed on the body, the body went to ICU until such a time as even the devices would not support the illusion of life and the patient was once again pronounced.

The University Hospital provided an itemized hospital bill to the state prison for the time the patient was pronounced the first time until the second "death." The state prison declined to pay it, citing that the patient was already dead. Dr. Letsmakeapoint insisted that the prison's employee had forbidden the hospital to discontinue "life support". The hospital resubmitted the bill. The prison again refused to pay it. At the time I started the job, the matter was being "decided" in the courts and had been for a number of years, and when I left more than a decade later, it was STILL being "decided" in the courts.

[Ruby Vee, BSN]

So, if I'm reading that article correctly, she was declared brain dead and the family refused a brain flow study? That's a sticky situation. Brain death was determined by physician judgement. She's still declared dead though. I wonder how the citizens of New Jersey feel that there tax dollars are being spent on treating a dead person?

I don't know that case very well, just for what I remember in the news from a few years ago. I'm very interested to know what Christian religion does not recognize brain death and the reasoning. It makes no sense.

While I'm always respectful of religious beliefs, this is one of those things that makes me hate religions all together. They preach things that are absolutely not true.

While I agree with your first paragraph, I don't think it matters whether the religion in question is a Christian religion or not.