Tuesday, 31 December 2013

Misinformation

As a father and a physician, my last post about Jahi McMath was the most difficult I have ever written.  I've been following her tragic story since it was first brought to my attention, and it still is not quite over.  As opposed to the last post, writing this one was one of the easiest.

One thing that pisses me off more than almost anything else is the willful propagation of misinformation.  The Internet is a wonderful treasure trove of information, and a wealth of information on any subject imaginable is only a few keystrokes away thanks to the magic of Google (fuck you, Bing).  But the downside is that false information is just as readily available, and people are just as liable to believe it.

The more I read about Jahi McMath, the more upset I become.   Not so much about how the family is handling the situation, though I believe they are handling it exceedingly poorly.  Not so much how their lawyer Christopher Dolan (aka Scummy McDouchebag) is making himself sound like a clueless jackass and attention-whore, though he obviously is ("It is our position that no doctor determination can end a life without parental consent", he stupidly said).  No, what bothers me the most is that in spite of the fact that six different doctors confirmed that little Jahi has died, the family wanted a 7th opinion.  And the seventh opinion they wanted was from Paul A. Byrne, MD.

If you haven't heard of Dr. Byrne, you're about to be educated on just how blinded by faith a supposed man of science can become.

Dr. Byrne is an American neonatologist and pediatrician from St. Louis, Missouri.  He is past-president of the Catholic Medical Association and an avid opponent of the entire concept of brain death, and he is vehemently opposed to organ transplantation.  Despite the stance of the vast majority of the medical community, Dr. Byrne does not believe brain death even exists - "it has become clear that 'brain death' is not true death" he wrote in August, 2011 [1].  In that story he makes several references, including quoting his own article from The Journal of the American Medical Association as if it were someone else's work.  That's red flag #1: quoting yourself.  Tsk tsk, Paul.  The second red flag, arguably much bigger, is that one of his other references is www.lifesitenews.com, a site which was started by anti-abortion zealots and which is anti-homosexual, anti-contraception, anti-stem cell research, and anti-anything-that-isn't-strictly-Catholic.  They state on their website, "LifeSiteNews gives priority to pro-life, pro-family commenters and reserves the right to edit or remove comments."

Riiiight.  Not exactly a respected scientific outfit there, Pauly.

The third (and biggest) red flag is that Dr. Byrne posts his commentary on www.renewamerica.com, an ultra-conservative website started as support for a radical whack-job.  His arguments against the concept of brain death are so ridiculous they could almost be considered comical.  The only reason it's not funny is that people actually believe him.

People have known for hundreds of years that the brain is where the person actually lives, not the heart.  The other organs (heart, lungs, intestines, spleen, liver, pancreas, etc) merely support the brain.  This is not subjective, conjecture, or opinion, this is fact.  People can live normally without a spleen.  People can live without kidneys (on dialysis).  People can live with a failed liver for months while waiting for a transplant (Yes Paul, a transplant).  People can even live without intestines (on IV nutrition).  And people can live without a heart - the first artificial heart was implanted in 1982, and people can now live for months with artificial pumps circulating their blood while waiting for a heart transplant.

But you can not live without a brain.  This is a very simple fact, one that is taught on Day 1 of medical school, and one that Dr. Byrne and his followers consistently and stubbornly and ridiculously fail to acknowledge.

Death is defined as either 1) the complete cessation of biologic function or 2) the irreversible loss of brain function.  Without the brain, there is no life.   Death by #1 is no less dead than death by #2.   But Dr. Byrne states that "Death is separation of the soul from the body."  That one line speaks volumes - this doctor, this purported man of science, defines death religiously rather than physiologically.   Dr. Byrne also likes to use misdirection to further his lies:
"Since there are two definitions of death (cardiac death and brain death), it is clear that either is enough to be called deceased.  If there are 2, Jahi must not be dead by the other method, or she would have been, or could have been declared dead by the other one." 
No, Dr. Byrne.   It doesn't work that way.  Brain dead is just as dead as cardiac dead.

Dr. Byrne also seems to have completely forgotten his basic physiology.  I'm sure he learned in medical school, just as I did, that the lungs and heart both function independently of the brain.  The heart can still beat and the lungs can still ventilate (move air in and out) and respirate (exchange oxygen for carbon dioxide) without input from the brain.  But Dr. Byrne incorrectly says, "After true death chest compressions or a ventilator can only move air; there cannot be respiration, because respiration is a function of a living human body."  This is patently false - respiration is a function of functional lungs, NOT of a living body.  Lungs simply do not require a brain to do their job.

Think that's bad?  Oh but wait, it only gets worse:
"So-called 'brain death' or 'cardiac/circulatory death' are terms concocted by transplant physicians and their allies who wanted to enlarge the donor pool by including patients who are really not dead in the traditional sense of the word."  
Another fabricated lie by the good doctor, a preposterous conspiracy theory that transplant surgeons, who wish only to give their patients a new chance at life, hover like vultures, waiting to rip organs out of unsuspecting victims, like grave robbers in the 1800's.  The concept of brain death as death was advanced by the Harvard Medical School in the 1960's to differentiate brain death from a persistent vegitative state as the possibility of organ transplantation was becoming a reality.  Brain death was not remotely a new concept, but at the time it had to be more strictly defined so ethical lines would not be crossed.  It was transformed into law in the United States in 1981 as the Uniform Determination of Death Act, which was supported by the American Medical Association and the American Bar Association (probably the only time in human history when doctors and lawyers have agreed on anything).  The Australian definition of brain death is identical.  "Brain stem death" in the UK is a similar concept.  In fact, when you look at the worldwide view, brain death is universally accepted, and there was universal agreement on the neurologic examination in diagnosing brain death, though the exact criteria vary from country to country [2].

I've spent the past week following this entire story and reading comments from other readers.  It is astounding just how many people are convinced Jahi is alive because her heart is pumping, and that she will miraculously wake up.  Several of them reference other people who have been diagnosed (obviously misdiagnosed) as brain dead who have woken up.  However, after an exhaustive search of the medical literature, I can find exactly zero documented cases of someone whose brain is actually devoid of blood flow and function coming back to life.  Brain dead is NOT THE SAME as a coma or a persistent vegitative state. 

Our job as doctors is to help patients get better, but part of our job is also to educate our patients and their families.  Spreading false information based on lies is dangerous and completely against the purpose and spirit of medicine.  Brain dead is dead, despite what Dr. Byrne and Jahi's family choose to believe.  

You may choose not to believe in science all you like.  It doesn't make it any less correct.

If you'd like to read Dr. Byrne's complete ridiculous column, make sure you're sitting down, and prepare to be completely exasperated.  Ready?  Go.

1. http://www.renewamerica.com/columns/byrne/110818 
2. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria.Neurology. 2002 Jan 8;58(1):20-5.

48 comments:

  1. Doc how did Jahi die from a tonsillectomy? I thought it was a low risk procedure. Oh and a judge has extended life support care until January 7th

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  2. She didn't die from a tonsillectomy. She had a lot of surgeries being performed at once, ranging from tonsillectomy to surgery on her sinuses. Jahi also had a lot of health problems related to her obesity. She went from surgery to a pediatric ICU which shows that the family and doctors both knew her surgery and recovery were risky. I had a tonsillectomy when I was 11 and I went home the same day. However, no surgery is without risk which is why you have to sign so many waivers. Poor Jahi died from post surgical complications, she had been up and laughing a few minutes before. It is a sad situation all the way around.

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  3. I like how when you click on Bing, it still redirects you to Google heh.

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  4. I copied DocB's earlier reference to the type of surgeries Jahi had (abbreviated UPPP) and adenoidectomy on Google. I came up with a very informative PDF describing the procedures that might be done to treat obstructive sleep apnea, which Jahi had, and the risk factors, which she also had. there is potential for complications and it is possible to die of the complications.

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  5. here it is: http://www.uvm.edu/medicine/surgery/documents/Snoring_and_OSA2.pdf

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  6. You keep stressing the difference between brain death and coma/vegetative state. You might consider giving us laymen an overview of what makes them different, how they tell which a person has, and such. After all, to the average person, they look pretty much the same. How you tell the difference would be quite interesting, and quite relevant to this particular story.

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    1. I agree. You should enlighten us on the matter, Doc.

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  7. While in a coma the person has brain activity and a chance to wake up. When brain dead the brain activity has ceased and the person is just a shell whose brain stem (which is separate from the brain itself) makes the heart pump and the lungs breath. The person who has no brain activity will not recover. Period. The comatose patient has a chance to recover. In my opinion I see a coma as a way for the body to shut itself down to minimal use to allow optimal healing internally.

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    1. Right now there is a race car driver (forget his name) who got traumatic brain injury while skiing and he is in a "induced coma" to help his brain heal. Way different that Jahi's situation. The family is not "getting it".

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  8. I'd like to add to your comment about a doctor's job being helping patients get better. I believe that a doctor's job is also to help a patient die with dignity when it is time. I experienced this with my dad last year. There was an option for a complicated, risky surgery with only a small chance of success (and poor quality of life). The other option wad a comfortable death with his family around him. The doctors and nurses were open about the risks, which I appreciated. There was no false hope. I'm happy he only lasted about 16 hours after palliative care began.

    In addition to the lack of understanding related to the different types of death, there is a pervasive fear of death by so many people.

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  9. More bizarre by the minute! The situation is FUBAR: "Jahi McMath: Hospital fights in court to remove brain-dead girl from ventilator"
    http://bit.ly/18WMW5X

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  10. The mother is crazy "However, in her petition for an emergency stay in the state court of appeal, Winkfield contends that the act violates her freedom of religion and privacy under the California Constitution."
    What? her "freedom of religion"? Her "privacy"? As she holds pressors....everyday....!
    http://lat.ms/1hdK1sI
    "Jahi McMath's mother: 'How can you possibly say my child is dead?'"
    CHO should have the coroner take possession of the body. There is NO place in NYC or just send her home and let the parents "rent a vent" and take care of her. I feel for the other parents and children at CHO having to endure this "three ring circus". How does a family tell SIX Drs. they are WRONG? Where's the video of her moving? This is insane. How long are they going to let this go on? Question for the Doc... if Jahi has another cardiac episode or something else, are there DNR orders? Or is the hospital obligated to "save a already deceased person"? Thanks.

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    1. I haven't the slightest idea if there is a DNR in place, but I strongly suspect the family would never allow it. And legally the hospital is only supposed to keep her on the ventilator. They still have no obligation (legally, ethically, or otherwise) to give any other treatment to a deceased patient. This is why they are not giving her any nutrition other than IV fluids. So I would bet that if she had another cardiac arrest, they would not do CPR.

      This is mere conjecture, since the family is still preventing the hospital from releasing any actual information, and all information we have has been severely skewed by their twisted interpretation of events.

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  11. I feel like a real dick saying this, but the first stage of grief is denial. If denial has a way to be sustained, it will continue indefinitely, as long as the hospital can legally keep her on life support. As terrible as it is for anyone to say, she is dead. The parents are only keeping her alive for their own good. Also, do you have any idea WTF went wrong with what was supposed to be a routine tonsillectomy?

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    1. From what I understand, it was not just a routine tonsillectomy. It was a combination of three operations - adenotonsillectomy, uvulopalatopharyngoplasty, and resection of the inferior turbinates. Bleeding after such surgeries is common, but it is rarely life-threatening. Since the family refuses to allow the hospital to give any specifics about the case, I have no idea what actually happened.

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    2. The family keeps saying a "Routine" sx and the news is also perpetuating lies by saying she is in a "vegetative state" and comparing her to Teri Shavio (of which the parents have hooked up with those grifters) and that is the Facility in NY she is supposed to go to that is a outpatient place?
      The whole thing is insane. I wonder how long this can go on?
      Oh reading comments from all over someone mentioned she may have had a "undisclosed bleeding problem" but didn't give a link.

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    3. Its getting worse since she hooked up with the Shavio grifters... "McMath tragedy used for shameless fundraising" - SFGate - http://s.shr.lc/1hXsIcM

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    4. I don't have a link either (as I don't remember where I read it), but I did read a comment from someone who claimed to have been at the scene when Jahi died. Naturally, I don't know how much weight to put upon the comment except to consider it as a possible explanation for Jahi's death. The commenter said the bleeding was normal after the operations, but Jahi choked on a blood clot. The stress of the choking caused the heart attack. She was given CPR, but the choking had prevented the brain to receive oxygen which caused the cessation of the brain to work. The brain tissues died without oxygen. Even though the respiration and heart function can be kept operating by machines, the brain is dead as well as the brain stem. Just think of what happens to a foot that has had the blood flow cut off from it. Tissues will die and the foot will require amputation.

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  12. Thanks for the warning that Dr. Byrne's article would be completely exasperating; I couldn't even finish reading it. It's astounding to read so many comments around the web written by people who have no understanding of physiology or the medical system. The facts will come out, and I appreciate your keeping us up to date with information as you discover it. I hope this family will come to terms with their loss and let her body go with dignity. Especially if her brain does begin to breakdown (as you were discussing in your comments on the previous post).

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    1. Exactly! Many of the comments are from people who are none medical or pretty non educated and want to say Jahi is in a PVS instead of braindead. This case is going to inspire new laws for hospitals I'm sure to either not use the vent or only use it in cases or organ donation. This family is despicable slamming the hospital all over the place. Now the mother is also demanding a tube be inserted b/c her daughter is "starving"...!
      The courts are slow and they are not Drs.!

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  13. It is a sad thing. Sadly the family cannot understand that if someone is brain dead they cannot come back currently(Maybe in the future hopefully we can develop a way)
    I assume it could be possible for misdiagnosis to happen but ti has been 7 times so far so I really doubt it is a misdiagnosis. To be fair this sort of thing has happened before http://www.dailymail.co.uk/health/article-2134346/Steven-Thorpe-Teenager-declared-brain-dead-FOUR-doctors-makes-miracle-recovery.html but that was four times 7 is much more so I doubt they are missing anything.

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    1. I just read this article, and it says that the patient was in a chemically induced coma. I'm speculating that it was probably done to help the swelling in his brain from the car accident. Also the doctors also said he had "extensive brain damage"--but didn't say that he was brain dead. Interesting article. As with Ms. McMath's case, I would LOVE to read these patient's charts to see how these events happened.

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  14. Just read the column. Website is a pile of shit, Dr. Byrne's head is also most likely full of shit.

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  15. Dr.Byrne's 15 minutes are over. He needs to stop now. He's giving this family false hope and it's just wrong. The mother is in denial. I won't judge her as I'm not walking in her shoes. This fruit loop Byrnes..... Disgusting!

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  16. As a mother, this situation as me torn up, and I ache for this family. As a nurse practitioner, however, I am disgusted at the misinformation that is being spread about this patient. As a commenter mentioned above, it has indeed turned into a "three ring circus". And the willful ignorance and hope of that "doctors" like Byrnes (how does this man have a license to practice medicine?) feeds to this family is abhorrent. Having worked with terminal cancer patients, I truly believe that giving families false hope is the CRUELEST thing that a medical provider can do. Not only is this child dead, but eventually her heart will stop, and what will her family do then?
    Sorry for the rant--I've been following this story since the beginning, and it upsets me quite a lot; both for the family, and for the hospital.
    For those that wanted a layman's difference between coma, vegetative state, and brain death, here is a link from "How Stuff Works",that has some nice pictures and definitions. http://science.howstuffworks.com/life/inside-the-mind/human-brain/brain-death2.htm

    Click on the link for "coma" on the second page for more information about how a coma is different from a vegetative state.
    The third page has an excellent description of how physicians assess neurological function in brain dead patient.
    This is where the case aggravates me; if a physician (you don't need SIX) assesses a patient and discovers these findings, that patient is DEAD. There is NO coming back. Ever. That the physiology of how the brain works.

    I hope this is helpful--J

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    1. That is a excellent link thank you.... tweeted out to Try to educate people...if that is possible...

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  17. Almost every article referring to Dr. Byrne identifies him as a "Catholic doctor." However, he apparently didn't get the memo that the Roman Catholic Church recognizes "brain death," referred to in Church documents as "determination of death by neurological criteria." Pope John Paul II endorsed this (and organ donation) in a speech on 8/29/2000. See section 5: http://www.vatican.va/holy_father/john_paul_ii/speeches/2000/jul-sep/documents/hf_jp-ii_spe_20000829_transplants_en.html

    The National Catholic Bioethics Center has a FAQ on the matter:
    http://www.ncbcenter.org/page.aspx?pid=1285

    Dr. Byrne's nonsense has needlessly contributed to the suffering of this family and the general confusion around these matters.
    And I'm really annoyed about that!!

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  18. She's my cousin, and trust me everybody talkin about how we gonna sue, now that I read this, I guess jahi is dead. Sad man...

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    1. Is Jahi Really your cousin? Her mother is a nutcase.

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  19. "CaliGirl9":
    "I am afraid that thousands of previous cases of brain dead/brain stem death sadly prove that what has happened to Jahi is not reversible. All of the anecdotal "I know someone who woke up" probably did NOT receive a diagnosis of brain death via exams, imaging and EEGs and the opinion of three board-certified neurologists. This sets a dangerous precedent in medicine. How can anyone believe that at least three doctors wanted to pronounce Jahi dead? I am sure they were looking for the tiniest spark. The next time this happens—and no doubt somewhere someone has been declared brain dead today—is it a healthy thing for a family to deny the inevitable? So now we have people telling doctors how to practice, even if it is a futile treatment like a gastrostomy tube, which will turn into feces in Jahi's gut, eventually causing skin breakdown because stool will leak and there is simply no way medical staff can stand around waiting for the next ooze to clean it up. She is not receiving any medication keeping her unconscious. Because her cerebral cortex is liquefying, it’s likely there will be more reflex arc movements. Google Lazarus reflex video. Her heart beats because hearts don't need brains in order to beat, they need lungs oxygenating them. What if, when her internal organs breakdown her body develops a bleeding disorder called Disseminated Intravascular Coagulation? She will bleed from every orifice and every pore and it will not be stoppable. Her body temperature will decrease, her blood pressure will decrease, having a negative effect on her kidneys and heart. Her lungs will fill with fluid, there will be cardiac arrhythmias, and diabetes insipidus which will result in high serum sodium and dehydration. Jahi will not feel a thing. Her mother will remember all of it. Did you watch the video? Does the idea of keeping this child's mortal remains on earth long enough to see her brain liquefy sound good? The family is unleashing some horrific memories of Jahi on themselves by continuing to deny that she is deceased. Her organs WILL fail and it will be very distressing to watch.

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  20. I thought this video from YouTube was very informative. http://www.youtube.com/watch?v=Ffqz-vKZO5Q

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  21. I heard Dr. Byrne speak about 6 years ago and thought he was off base in his criticism of "brain death." However I just heard him speak again and am convinced. There is no universal way of determining "brain death" and in fact, some people who have been declared "brain dead" have come back to life. Jahi McMath herself is showing purposeful movement, demonstrating that she did not die.

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    1. No, no one in the history of mankind who was correctly diagnosed as brain dead has ever come back to life. Ever. It is physically impossible. When brain tissue dies, it is dead and cannot regenerate. Full stop.

      Her "purposeful movement" has not been repeated. The videos that were circulating a few months ago prove nothing, only that her limbs are moving (which is a normal reflexive movement after brain death). If she actually was moving purposefully, it would be very easy to prove. The fact that no new videos have come out since then tells me everything.

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    2. To Mark M,

      It appears you were thinking more clearly six years ago. ;)
      As for you saying -"There is no universal way of determining 'brain death'..."
      That can be refuted with this source in the Health & Medicine website- "The concept that death can be defined as the irreversible cessation of brain functions is universally recognized in the world through statutes, judicial decisions, or regulations."
      DocBastard informed you that NO ONE has ever come back to life after being correctly diagnosed as brain dead. I don't know why non-medical ones think that they know more about medicine than the professionals. Their favorite saying is "Doctors don't know everything...many times doctors can be wrong..mother's always know best."
      I wonder if they follow their own words of ignorance by treating themselves when it comes to medical emergencies, or giving their "expert" opinions to others on how to treat their illnesses or medical conditions.
      I thought that by now, most brain functioning adults would comprehend that brain death = dead= 100% dead. No ifs ands or buts about it.
      What makes YOU think and claim that Jahi is making "purposeful movement??"
      If you're referring to the {non-revealing} 15 seconds of video clippage that was "released" in Oct., that right there just goes to show how some folks were sold snake oil and bought into the Pyramid schemes.
      Mark, FYI- that video was filmed back in Dec. 2013 at CHO. The family thought of it as proof that Jahi was alive and would prohibit CHO from disconnecting the vent. Their favorite slogan "Keep Jahi on life support."
      Obviously when the video was shown to legitimate medical professionals, back in Dec. of 2013, it didn't prove a damn thing then, and the sudden "earth shattering" news {resurrection} in Oct. 2014, proved plenty to the savvy ones. ;)

      DocBastard, I immensely enjoy your brains, humor, and blog!

      A fan- Shelly L.

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  22. What is life, and what is death? I am baffled by the arrogance on all sides. Life is a mystery. A 14 year old girl is breathing with the aid of a respirator, and is continuing life processes like menstruation, and is growing., and continuing to comfort her family with her 'aliveness' Is she actually alive? The mother who gave birth to her, has hope. The doctors who tried their best to render medical services to her, think not. Someone has to pay for all of this care "in-between", and someone has to be held accountable for the harm that befell a sweet, loving child who was overweight and had sleep apnea and sought treatment. Someone wanted to harvest her organs--no doubt, with the best of intentions--but was this right, given the circumstances? Complicating all of this are the ridiculous, insensitive trolls--where the heck do these idiots come from???

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    1. Without wading into the religious/philosophical questions of the nature of life and death, and without dealing with the allegation that someone was over-anxious to harvest her organs (which I don't know about either way) I want to address the question of costs.

      This is a stumper, and some of us have puzzled over it amongst ourselves. Who IS paying for 24 hour nursing care for well over a year? The family does not have this kind of money, and attempts to raise sums in this amount have not been successful. Is there some way that someone with a death certificate in California can still qualify for Medicaid in New Jersey? (I am hoping not, but I am not familiar with New Jersey law or with the law of Medicaid.) The Schaivo group does not have this kind of money either, according to their financial filings. Some Brain Foundation has been involved from time to time. We don't know much about them.

      Is it possible that Jahi's body deteriorated seriously months ago, a year ago, and that efforts to maintain it failed and she was buried long ago somewhere in New Jersey? (This would square with what we were told about the condition of the body when it left CHO.)

      People keep claiming to have seen her (I believe that Dr. Byrne has claimed to have seen her) but these people are not very reliable. There have been no pictures or films released for many months, and the ones we have seen are not dated.

      We may never find out the whole story.

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  23. funny that you should mention "just how blinded by faith a supposed man of science can become", when it is you who are blinded by your faith in the religion of hermes.
    caduceus - staff of hermes - god of thieves.
    "Conventional Medicine is the Leading Cause of Death...
    iatrogenic death rate in the US (death caused by doctors and/or medical treatments) is 783,936 a year."
    doctor. doctrine. indoctrinate. doctor of the church.
    doctor: to falsify "she doctored the results".
    doctors and nurses, doctors of the church and nuns.
    Rx eye of horus
    “pharmakon” in Plato's dialogues: remedy, poison (either the cure or the illness or its cause), philter, drug, recipe, charm, medicine, substance, spell, artificial color, and paint.
    Pharmakos. A pharmakós (Greek: φαρμακός, plural pharmakoi) in Ancient Greek religion was the ritualistic sacrifice or exile of a human scapegoat or victim.
    Proscription (Latin: proscriptio) is, in current usage, a "decree of condemnation to death or banishment"
    Prescription: latin - an order.

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    1. Over Reliance on random capital letters, quotation marks and disjointed lists lacking even the barest narrative are the hallmarks of the ill-educated and insane. Is there something you are trying to say here?

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  24. Sir with all due respect you stated yourself:

    "Several of them reference other people who have been diagnosed (obviously misdiagnosed) as brain dead who have woken up."

    Why is it that Jahi could not fall into the category of being misdiagnosed like these others you mention???

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    1. Because 6 different doctors all confirmed the diagnosis with bedside examinations, and these were corroborated by multiple flat EEGs and a negative brain flow study.

      If all of these are wrong, then everything we think we know about brain death must be wrong. I will not deny that there is a very small possibility of this being the case.

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  25. I have a quick question. Let me preface by saying I understand brain death is death just like physiological death. I'm an educator for special needs students, so clearly I'm not knowledgeable in the world of medicine. I say this so you excuse my naivety and know I'm not challenging your knowledge by asking the following questions, just clarifying. I have read many articles and research articles that state breathing is a reflex of the brain stem and is part of the primitive reactions doctors check for brain activity. Thus if a patient can breath on their own they have activity in their brain stem. If this is true, can a person with limited yet noticeable activity in their brain stem be declared brain dead? If so what is the difference between brain death involving both the brain and brain stem and that of only the brain itself (or are they considered one entity). Also, how is it known that brain death is irreversible if no studies have been done to see what medical intervention would do (such as nutrients and do forth) in a longitudinal study? I apologize for my ignorance!

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    1. "can a person with limited yet noticeable activity in their brain stem be declared brain dead?"

      No.

      "how is it known that brain death is irreversible if no studies have been done to see what medical intervention would do (such as nutrients and do forth) in a longitudinal study?"

      Because unlike essentially all other parts of the body, the central nervous system (which includes the brain, brainstem, and spinal cord) has no capacity to regenerate. When central nervous tissue dies, it is permanently dead. Thus when the brain and brainstem die, there is no ability to recover.

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  26. Quote: "Several of them reference other people who have been diagnosed (obviously misdiagnosed) as brain dead who have woken up."

    This is still frightening. I understand anything can be misdiagnosed, but if someone is falsely declared brain dead and his organs are removed, it's a serious error. Is there any official record of the number of false positives on a brain dead test?

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    1. I'm going to assume you are the same Christopher Bogosh who wrote the book "Compassionate Jesus: Rethinking the Christian's Approach to Modern Medicine". With your overwhelming bias in mind, I think you are in no position to comment on anything medico-legal, especially something as complicated as brain death.

      But with your obvious bias aside, let's break down your comment a bit, shall we:

      1) The phrase "non-functioning brain" is found nowhere in the President's Council on Bioethics paper. A phrase that IS found is this: " Many years of experience with total brain failure have revealed the truth of such a condition: the “brain-dead” patient will never recover the essential ability to interact with his or her environment that is characteristic of the living organism".

      2) Your analogy with anaesthesia is false, deceptive, and utterly ridiculous. If you can't see the difference (mainly that there is no non-functional brain with anaesthesia), then you should probably have your own head examined.

      3) His name is Paul Byrne, not Bryne.

      4) Byrne's 1979 JAMA "article" Brain Death—An Opposing Viewpoint (http://jama.jamanetwork.com/article.aspx?articleid=367186) is an opinion piece, not a scientific paper. What's worse, he's wrong. He incorrectly states that organ donation is "morally wrong" for most Christians and Orthodox Jews. However, organ donation is allowed and encouraged in Israel, and the Pope has said that declaration of death is up to doctors, not clergy. There is no position in Catholicism against organ donation or brain death.

      I am woefully unimpressed with your word-salady nonsense (radical materialist, nihilistic and pessimistic bent, etc). If you would just be honest and say "I don't like brain death because Jesus", I think I would be able to respect your position more. But you are simply trying to advance your agenda with false analogies, lies, and damned lies. That is not respectable.

      Delete

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