If you want something very, very badly, let it go free. If it comes back to you, it’s yours forever. If it doesn't, it was never yours to begin with.
Everyone has heard that very famous phrase (or the slightly more compact version) which is often incorrectly attributed to Richard Bach. After scouring the vast reaches of the universe (ie a 0.392 second Google search), I have been unable to identify the true source of these wise words. Apparently they were originally written by an anonymous student of Jess Lair, a teacher and author who published it in his book “I Ain’t Much Baby—But I’m All I’ve Got in 1969. Sting popularised the saying further in his grammatically-incorrect song "If You Love Somebody Set Them Free" in 1985 (subject-verb agreement, Sting).
So on the subject of people who deserve to be set free, the continuing story of Jahi McMath has caught the attention of people around the world. It has sparked emotions on both sides of the issue ranging from sadness to sheer outrage. The outpouring of support the family has gotten (both in prayer and in monetary donations) has only been overshadowed by the almost-criminal accusations made against Jahi McMath's doctors and Children's Hospital Oakland, as well as similar wild accusations made against her family. The vehement conjecture on both sides has done nothing but push the actual tragic loss of a young girl to the side in favour of bitter and worthless squabbling.
But this post is not about Jahi McMath. Not primarily, anyway. On the opposite end of the spectrum from Jahi lies Marlise Munoz. Marlise, just 33 years old and 14 weeks pregnant, collapsed at her home in Texas on November 26, 2013. Her husband Erick found her lifeless on the floor, and she was rushed to John Peter Smith Hospital in Fort Worth where, despite exhaustive efforts, she was pronounced dead by neurological criteria, possibly due to a fatal pulmonary embolus. She and her husband had discussed this possibility after she lost her brother in an accident, and she had decided she would not want to stay on machines. To honour her wishes, Erick asked her doctors to remove her from life support and let her go, to set her free.
Despite his request, her doctors refused to turn them off.
Wait, what? Why? Do her doctors believe in miracles? Are they, like Jahi's family, trying to defy medicine, science, and logic?
No, they were simply following the law. Unbelievably, Texas has a law (Section 166.049) stating that "A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient". And because Marlise was pregnant when she died, the hospital and her doctors have adamantly refused to remove her from the machines according to her wishes 7 weeks later.
"Wait, wait, wait", I hear you thinking. "Something isn't right here. The law specifically says 'life-sustaining treatment'. There's no life to sustain! She's dead!"
Well, yes. You know that, I know that, and I'm sure her doctors and the hospital know that. But despite that very logical argument, the hospital's spokesperson said, "In all cases, JPS will follow the law as it applies to health care in the state of Texas. State law says life-sustaining treatment cannot be withheld or withdrawn from a pregnant patient."
But it says . . . life-sustaining . . . and she's . . . but . . .
To try to clear my head from the insanity of that statement, I decided to research pregnancy and brain death, and I was a little surprised by what I found. The journal BioMed Central published a review article in 2010 where they found 30 documented cases of pregnant women declared brain dead between 1982 and 2010 and kept on machines, essentially as incubators, until their babies were delivered. These women averaged 22 weeks pregnant at their time of death, and the babies were born an average of 7.5 weeks later (though 2 of them were kept on support for over 100 days). Only 12 of the 30 delivered a healthy baby who survived more than a few days.
The most interesting thing to come out of this report is that 10 of the 30 deceased women were then able to donate their organs after delivery, weeks after being declared dead. So with maximal support (including ventilatory, hemodynamic, endocrine, fetal, thermoregulatory, nutritional, and infectious), even brain dead bodies can be sustained for weeks, months, or possibly even years.
We are living in the future, where the science of medicine has advanced to the point where even dead bodies can be sustained on machines. But the obvious question is
Why do it? In the case of Jahi McMath, that question has not been answered. Her brain is gone, never to return. "Jahi" as a person is gone. What purpose does it serve keeping her body functioning? I understand the family not wanting to let go, but at the end of the day they have to understand that death is a part of life. It is inevitable for all of us. And keeping a lifeless shell on machines just because you aren't ready to say goodbye is denial and futility at their most basic.
On the other hand, in the case of Marlise Munoz, the answer to "Why?" is clear - to give her foetus a chance. But that brings up another even better question: Just because we can, should we? Marlise didn't want this, her husband doesn't want this, and her parents don't want this. But the state and hospital are forcing this treatment on them, twisting the law to fit a patient for whom it was never intended. Two of the three people who helped draft the law have even said that brain-dead women would not be covered by the law, because it only specifies "life support" (hmm, where have we heard that before?).
So here we are, two families with similar, though almost opposite, problems. In one case, Jahi McMath has been reduced to a hollow vessel, forced to stay on machines by a family in denial who can't say goodbye. In the other, Marlise has been reduced to an incubator, forced to stay on machines against her will and that of her family who want to let go but can't.
- UnknownIt seems to me that both Jahi's family and the hospital in Texas need to let them go free.
Note: If you are interested in reading the full article from BioMed Central, click here.