Tag: brain death

Bioethics Blogs

Israel Stinson Brain Death Lawsuit Continues

Judge Mueller

This week, the Alameda County Superior Court denied the defendants’ motion for summary adjudication in the Jahi McMath case.


Meanwhile, over in Sacramento, the U.S. District Court for the Eastern District of California heard oral arguments on those defendants’ motion to dismiss the action brought by the family of Israel Stinson against the State of California. 


Attorneys, Kevin Snider, Matthew McReynolds, and Alexandra Snyder appeared for the plaintiff. Attorney, Ashante Norton appeared for defendant Karen Smith.The court took the matter under submission with a formal written order to issue. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Judge Opens Door for Lawsuit Over Girl Declared Brain Dead

September 8, 2017

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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 damages jurors could award if they determine doctors at Children’s Hospital in Oakland botched a routine operation to remove the girl’s tonsils.

In California, non-economic damages such as pain and suffering are capped at $250,000 for medical malpractice. But juries can award unlimited economic damages far above that cap for ongoing medical care, which Jahi’s family could not claim if she were declared dead.

Jahi’s case has been at the center of national debate over brain death since the girl’s mother refused to remove her daughter from life support after doctors declared the then-13-year-old dead after surgery in December 2013.

… Read More

Image: By Blcksx – I took this photograph while visiting Riverside, CC BY-SA 3.0, https://en.wikipedia.org/w/index.php?curid=44291738

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Jahi McMath Case Now Headed to a Jury Trial on Whether She Is Now Alive

Alan Shewmon  allowed to testify

Earlier this year, the medical defendants in Jahi McMath’s medical malpractice lawsuit filed a motion
to dismiss her claims. They argued that McMath lacks standing to sue for
personal injuries because she was pronounced dead in December 2013.

Yesterday, the Alameda County Superior Court denied those motions for
summary adjudication. “[T]hough Defendants have shown that the
determination of brain death in December 2013 was made in accordance with
accepted medical standards . . . a triable issue of fact exists as to whether
McMath currently satisfies the statutory definition of ‘dead’ under the Uniform
Determination of Death Act.”

“[D]espite the fact that Dr. Shewmon has not performed a formal determination of brain death as addressed in the Guidelines, Defendants have not cited authority that his opinions are of no weight or admissibility in addressing the changed circumstances alleged in the First Cause of Action.”

“[W]hile the Guidelines are generally accepted medically, there is some discrepancy between what the Guidelines diagnose and what the statutory definition of death specifies . . .  In re Guardianship of Hailu (Nev. 2015) . . .”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

New Legal Guidelines for Determination of Brain Death

My analysis of Nevada’s recent amendment to the Uniform Determination of Death Act (UDDA) is now Online First at the  Journal of Bioethical Inquiry: “New Legal Guidelines for Determination of Brain Death.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Jahi McMath – Impact Even if the Lawsuit Fails

Jahi McMath continues to litigate medical malpractice claims against the Oakland healthcare providers who treated her in 2013. 

In July, the medical defendants argued that Jahi’s claims must fail, because there is no valid evidence that she is now alive. Consequently, she has no standing to assert personal injury claims. The judge has not yet ruled on the pending motions for summary adjudication. But it looks like Jahi has submitted enough evidence that the life/death question should proceed to trial.

At trial, the jury might conclude that Jahi is still dead, because they find Jahi’s evidence to be less credible than the defendants’ evidence. The jury might also conclude that the defendants did not commit malpractice. If the jury reaches either conclusion, then Jahi’s claims will fail.

If Jahi wins her lawsuit, that means there is something wrong with the way we measure brain death. It is supposed to be “irreversible.” 

But even if Jahi loses her lawsuit, it will have had significant impact. First, the fact that she has been sustained this long (approaching 4 years) also suggests (though less obviously) that there is something wrong with the way we measure brain death. Second, it has sown distrust and confusion across the country, resulting in more family-clinician conflicts surrounding brain death.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Brain Death: Legal Fiction Used to Justify Ending Lives Prematurely – Another California Lawsuit

Brain death is a legal fiction used to justify ending lives prematurely. That is how the family of Israel Stinson frames its argument in a new brief filed in a California federal court, last week.


Israel Stinson’s family is challenging the constitutionality of the California Uniform Determination of Death Act (CUDDA). Contrast the claims made by the family of Jahi McMath. They contend only that Jahi does not (as a matter of fact) satisfy the CUDDA standards. They do not attack the (legal) validity of the standards themselves.


The Stinson family argues that “the biological basis for brain death is hotly disputed and central to this case.”  They allege that Israel remained alive AFTER an official death certificate was issued. They describe brain death as a “haphazard, uneven, and utilitarian-driven rush to declare patients dead, ignoring that possibility they might be alive.”


The State of California filed a motion to dismiss the family’s Third Amended Complaint on jurisdictional grounds. The hearing is scheduled for August 11.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Jahi McMath – Accurate and Precise Language for Brain Death

Having talked with a few reporters, this week, about the status of the the lawsuits concerning Jahi McMath, I realized that is is essential to use careful and precise language.  The following is a summary of the allegations in the state medical ma…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

End-of-Life Healthcare Sessions at ASBH 2017

The 2017 ASBH
conference
 in October 2017 includes over 400 workshops, panels, and
papers in bioethics and the health humanities.  Here are ones that pertain
to end-of-life issues.


THURSDAY, OCTOBER 19


THU 1:30 pm:  End-of-Life Care and Decision-Making in the ICU – Limited
English Proficiency as a Predictor of Disparities (Amelia Barwise)


Importance: Navigating choices in predominantly English-speaking care settings
can present practical and ethical challenges for patients with limited English
proficiency (LEP). Decision-making in the ICU is especially difficult and may
be associated with disparities in health care utilization and outcomes in critical
care. 


Objective: To determine if code status, advance directives, decisions to limit
life support, and end-of-life decision-making were different for ICU patients
with LEP compared to English-proficient patients. 


Methods: Retrospective cohort study of adult ICU patients from
5/31/2011-6/1/2014. 779 (2.8%) of our cohort of 27,523 had LEP. 


Results: When adjusted for severity of illness, age, sex, education, and
insurance status, patients with LEP were less likely to change their code
status from full code to do not resuscitate (DNR) during ICU admission (OR,
0.62; 95% CI, 0.46-0.82; p


Conclusion: Patients with LEP had significant differences and disparities in
end-of-life decision-making. Interventions to facilitate informed
decision-making for those with LEP is a crucial component of care for this
group.


THU 1:30 pm:  “But She’ll Die if You Don’t!”: Understanding and
Communicating Risks at the End of Life (Janet Malek)


Clinicians sometimes decline to offer interventions even if their refusal will
result in an earlier death for their patients. For example, a nephrologist may
decide against initiating hemodialysis despite a patient’s rising creatinine
levels if death is expected within weeks even with dialysis.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Brain Death Conference in Cuba

The 7th International Symposium on Brain Death will be held in Havana, Cuba, from December 5 to 8, 2017.


Topics include:
•    Conceptual approach to human death
•    BD criteria in different countries
•    Ancillary tests in BD
•    Autonomic nervous system assessment in BD
•    BD in childhood
•    Anencephalic infants
•    End-of-life dilemmas: terminal patient, euthanasia, assisted suicide, 
•    Legal considerations surrounding BD
•    Philosophical, theological, sociological, historical and cultural considerations of human death
•    Organ transplantation

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

First case of deceased donor uterine transplantation. It is a relevant medical and social issue

Being able to resolve the reproductive problems suffered by women who have no uterus – whether due to an organic cause or functional abnormality of the uterus – is unquestionably a major medical and social issue.

The two possible solutions to this problem are uterus transplantation or surrogacy, the latter solution presenting objective ethical difficulties.

Uterus transplants to date have been performed using living donors, with unpredictable outcomes. Now, the first case of deceased donor uterine transplantation performed in the United States has been published. The recipient of the uterus was a woman with Mayer-Rokitansky-Kuster-Hauser syndrome, that is, she had no uterus.

The journal Fertility and Sterility has disseminated a video describing the essential steps in this transplantation process, particularly as regards selection of a suitable donor with no history of infertility or uterine malformations. The death of the donor should be determined by presentation of brain death but not cardiac death. The authors concluded that: “Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this treatment.”

Ethical approach

For our part, as the organ donor is a deceased person with brain death (see true definition of this death HERE), we see no ethical issue for this practice; on the contrary, it seems an encouraging medical prospect to resolve the reproductive problem of women who have no uterus or whose uterus is not functionally useful, although the risk-benefit balance must always be taken into account, especially as regards the surgical act.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.