From what I'm reading, I really side eye any facility that agrees to take her and joins the fight to prolong her "life". Just my opinion, but it's not compassionate and it's wrong to offer the family such hope.
It was hard enough for me to decide to say good bye and put down beloved family pets, so I sympathize with how much harder it is to make the decision to say good bye to your child. It's not how things should go. Sadly, sometimes it does happen, and I really think clinging to this hope she can live again isn't best for anyone. At some point you need to start grieving. Even though you don't want to.
I read that they are now not going to take the girl.
There was one that backed out after learning more about the state she was in, but it sounds like the family found a second. The hospital has said they won't do anything until they talk to the second facility and are sure that place understands the everything.
I have to disagree. This person has been brain dead for two weeks. The hospital has provided every service possible for the family, clerical and social worker support, special security, special visitation times, extended hours, extended amounts of people who can come in to see the girl. What they cannot do is bring the child back to life. That is what is so cruel about this. Not the fact that the hospital needs to get the ICU room back in use for someone that can benefit from it, get the ventilator back in use with a patient it can help survive and return to his or her family. This is the season of flu, pneumonia, RSV, winter ice car accidents, suicides, on top of the regular emergencies. That hospital has probably 10 ICU rooms it can provide for its critically ill children, and maybe MAYBE 50 ventilators, tops, that work on any given day, half of which need to be in use for planned and unplanned surgical procedures and ER traumas and the other half for critically ill patients who cannot breathe on their own. it is manifestly cruel to have to deny useful services to patients who can benefit from them, so as to give this family yet more time with a dead child whose body is having air forced into it 25 times a minute or more.
I've sat by my children's beds, waiting and praying and hoping against hope that something might happen to shift the hand of death away from their throats, and god help me, both times it happened. Both times they were fully functioning, with no brain injury; just so ill that they were not expected to recover. I've also sat and watched people I loved die, sometimes hard, sometimes easy, when there was absolutely nothing more to pray for but death; two of them in brain death situations. It is wickedly cruel to pretend that's 'life'.
Jfc calm down chick, all the hospital has to do is perform a trach, insert a feeding tube and xfer the girl. Instead of issuing endless statements about "body", just prolonging this pr nightmare, etc..
And walla! They can then use all that equipment on the people you and they deem worthy.
But…no?
I mean, just no. It's not "just that simple". You don't preform life saving procedures on a dead body. A hospital governed by public funding, medical boards, laws of the state and country, etc. can't make exceptions to medical policy because we feel really sad for one family. And everyone does feel sorry for them. This is tragic. And I think that many accommodations and exceptions HAVE been made already out of kindness. But you don't play medical games with real people in lieu of sympathy cards. There is no voilĂ to be done here.
It's not a matter of worthiness. This is horribly tragic. I don't think there's anyone without compassion. Including the hospital. But at this point, given the reality of the situation, the hospital needs to use clear and correct language that might feel cold but is used to make it clear exactly what the situation is and to ensure that they at no time misspeak because let's be honest, litigation is inevitable. They need to be beyond reproach.
I feel horrible for this family. I can only imagine how hard it is to process this. But their baby is gone. Prolonging everyone's suffering isn't ever going to provide comfort, particularly when it's done against all medical advice and facts. And good can still be done. Their baby could live on by saving others with organ donation - it must be incredibly hard for the medical professionals involved to know that and be unable to do anything about it, particularly given that's so much more likely to provide comfort to the family in the long run. Knowing their child's legacy lives on in others.
yeah, they were reallllllly cruel in this statement. Horrible!
"Our hearts go out to Nailah, her family and the community. We understand the intense grief of a mother who has lost a child. We are committed to fully investigating what caused this catastrophic outcome from this complicated surgery. As medical professionals, it is our responsibility to ensure that we don't create hope where there is none. When one's brain ceases to function, it never restarts. We have the deepest sympathy for Jahi's mother who wishes her daughter was alive; but the only thing maintaining this child is a ventilator machine and it would be unfair to give false hope that Jahi will come back to life."
Sometimes the truth hurts. I don't see how this is cruel? What are they supposed to do, pussyfoot around what is really going on?
Idgaf about whether or not you think the girl was loved, etc and also what anyone else would do in this situation. My position is this: the hospital could have put this behind them quickly and confidentially, albeit going against their policy. If there was a facility that was willing to take the patient, why not?
Sticking to cold clinical verbiage and policy for the sake of rules? Laughable. And I doubt this would become a normal practice for this hospital. It only garnered this much attention because of the cruel rigidity shown by the administrators. Buhbye 5 mil AT LEAST for this hospital
Idgaf about whether or not you think the girl was loved, etc and also what anyone else would do in this situation. My position is this: the hospital could have put this behind them quickly and confidentially, albeit going against their policy. If there was a facility that was willing to take the patient, why not?
Sticking to cold clinical verbiage and policy for the sake of rules? Laughable. And I doubt this would become a normal practice for this hospital. It only garnered this much attention because of the cruel rigidity shown by the administrators. Buhbye 5 mil AT LEAST for this hospital
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
Idgaf about whether or not you think the girl was loved, etc and also what anyone else would do in this situation. My position is this: the hospital could have put this behind them quickly and confidentially, albeit going against their policy. If there was a facility that was willing to take the patient, why not?
Sticking to cold clinical verbiage and policy for the sake of rules? Laughable. And I doubt this would become a normal practice for this hospital. It only garnered this much attention because of the cruel rigidity shown by the administrators. Buhbye 5 mil AT LEAST for this hospital
So the hospital should in ONE special case set aside its rules and cater to the family's wishes? What do you think should happen to future pronounced brain dead patients? This story is incredibly sad but most of the perceieved cruelty that you are talking about comes from the same denial that her family is suffering from. The girl is clinically and legally dead.
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
Idgaf about whether or not you think the girl was loved, etc and also what anyone else would do in this situation. My position is this: the hospital could have put this behind them quickly and confidentially, albeit going against their policy. If there was a facility that was willing to take the patient, why not?
Sticking to cold clinical verbiage and policy for the sake of rules? Laughable. And I doubt this would become a normal practice for this hospital. It only garnered this much attention because of the cruel rigidity shown by the administrators. Buhbye 5 mil AT LEAST for this hospital
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
A million times this! The public may be happy but professionals could lose their licenses over unethical practice. Also, healthcare providers take oaths to practice in the best interest of the PATIENT. Even if the doctor was persuaded, I, as the patient's advocate, would have disagreed and convened the ethics counsel if necessary.
This isn't a story about Walmart where the customer is always right.
Idgaf about whether or not you think the girl was loved, etc and also what anyone else would do in this situation. My position is this: the hospital could have put this behind them quickly and confidentially, albeit going against their policy. If there was a facility that was willing to take the patient, why not?
Sticking to cold clinical verbiage and policy for the sake of rules? Laughable. And I doubt this would become a normal practice for this hospital. It only garnered this much attention because of the cruel rigidity shown by the administrators. Buhbye 5 mil AT LEAST for this hospital
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
And what about the doctors who would be willing? Lets be clear here, this had nothing to do with compelling a surgeon to go against their ethics. This is hospital policy and policy only in the worst pr disaster I have seen all year
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
And what about the doctors who would be willing? Lets be clear here, this had nothing to do with compelling a surgeon to go against their ethics. This is hospital policy and policy only.
This is not the policy of only this hospital. It's silly to think otherwise.
Eta: and it's not policy. It's law. The patient is legally dead.
angelaa73 - I like you, but I think you're missing a very broad point. It's not as simple as "finding a physician that will do this." The child has been declared brain dead by multiple physicians, by the state courts. She is DEAD, legally and physically. What you are stating is "hospital policy only" doesn't have ramifications on just *this* hospital but by every hospital in the state, as binding law, and possibly as a standard of care by hospitals in other states as well. This family is grieving, and I feel the greatest amount of sympathy for what they are going through, but the hospital can't just say "come on in and operate on this child who has been declared dead legally and in every way possible." It sets a precedent for *every* hospital, not just theirs.
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
And what about the doctors who would be willing? Lets be clear here, this had nothing to do with compelling a surgeon to go against their ethics. This is hospital policy and policy only in the worst pr disaster I have seen all year
Well, why do you think the policy exists?
And why should PR matter more than ethical patient care?
Because you cannot compel physicians to perform procedures that they believe are unethical. Hospitals and physicians are not in the practice of performing unnecessary procedures just to placate families if they are not medically indicated. A trache and g-tube are not small meaningless procedures. The more they do the harder it is to undo.
And what about the doctors who would be willing? Lets be clear here, this had nothing to do with compelling a surgeon to go against their ethics. This is hospital policy and policy only in the worst pr disaster I have seen all year
I don't think the hospital made the definition of what makes a person dead which is the basis of this case. Anything the doctors do to a dead patient is governed by ethics. The hospital is following standard rules on a dead person (same as all the other hospitals). If you want something to change you need to change the definition of "death".
I feel like I said dead so many times I am starting to sound like a callous cold hearted bitch!
Even if it's hospital policy, I support it. Even if this girl could come back from being brain dead, the odds are so ridiculously slim. And can you imagine her quality of life after this long of being brain dead? Even if, and I use that in such an incredible way, even if she were to be alive again, it would not be a good way to live. Her life would be horrendous.
What point am I missing? This one? If we do it for her, we have to do it for everybody? Please. Not gonna happen.
This family should be allowed to take their daughter to a facility that will take her. And the hospital should let it happen.
Would I do this? Fuck no. Would you? Probably not. But this is not about us.
It doesn't work that way. At all. If they allowed this, it WILL open the way for people to follow suit. Absolutely. It's ridiculous to think that others will say "oh, yeah...we are in a similar situation, but we won't do what they did, even though they got their way".
You're brighter than this. I'm surprised at the stance you have taken.
there's the part where she's dead. I don't know if you skipped over that or not.
And then there's the legal part, which is that procedures are not performed on dead persons. so that's not ethics, either.
the ethical issue is a huge one, which is what makes this such a great sensation for the news. but remember that it's the family of the deceased that sought the press and not the hospital itself.
The recovery from a trach and PEG is not simple. And this girl, whose body has no independent function, will likely never heal from these incisions. And then there's the idea that, since she's brain dead and won't wake up, her body's nutritional needs are minimal to non existent. So the feeding tube will be put in to feed her food that she doesn't need. Her belly will become distended, because since she's brain dead and her body has no functions left, she won't move her bowels. And then, if she felt pain -- which she doesn't, because that's a brain function -- she'd be ridiculously uncomfortable. And this doesn't even go into the idea of bed sores, etc.
Also, mofongo, the whole brain death thing isn't usually on the transplant side. It's in the hospital policies for determining when a patient can be declared dead for the purpose of donation. We had those criteria in my ICU for brain death donation. DCD donation is a whole other ball of wax from a nursing standpoint.
Post by NewOrleans on Dec 28, 2013 15:11:24 GMT -5
Since I only occasionally come over to ML and don't know everyone, does this poster always come out swinging like this, or is it just the intense sadness of the case that makes her all SAYING DEAD IS 5 MILLION DOLLARS' WORTH OF MEAN?
ETA: Does non-maleficence apply here (since the patient is dead)? Because that is a core part-- like, the very definition-- of medical ethics, and it would be sort of huge to call upon a medical professional to violate it.
ETA 2: Isn't it also actually illegal to compel the medical staff to trach her, under federal right of conscience law?
Since I only occasionally come over to ML and don't know everyone, does this poster always come out swinging like this, or is it just the intense sadness of the case that makes her all SAYING DEAD IS 5 MILLION DOLLARS' WORTH OF MEAN?
angelaa is known for her swift judgements. She has good insight, gives sound advice, and is usually spot on. I kind of feel like I've been punked.
I mean, based on this discussion alone, it apparent that while most feel incredible levels of sympathy for the family, few support the hospital preforming unnecessary, invasive procedures on the body of a little girl to placate a distraught family.
And I think saying it's bureaucratic policy versus compassion is an oversimplification. I don't think that preforming invasive procedures out of sympathy for the family to avoid a "PR nightmare" actually is the compassionate thing to do. I think THAT would be cruel and cold, frankly. The hospital, in it's way, is advocating for the patient, too.
This is horribly sad. I feel awful for the family. But they need to gain enough clarity in this tragedy to make the brave choice that will provide them comfort down the road. Right now, they are being selfish in their grief.
Has anyone else read Proof of Heaven by Dr. Eben Alexander? Granted, he wasn't declared brain dead if I recall correctly, but it was pretty damn close. And he came back from the brink. So I do think it's possible, even if we don't understand how or why it happens sometimes. I think there are some instances where the human body and mind behave in ways that even doctor's themselves can't explain.
All that said, I believe you @pnkbride. Dr. Alexander isn't the only one it's happened to.
He was in a medically induced coma, and apparently his book has been highly criticized.
Has anyone else read Proof of Heaven by Dr. Eben Alexander? Granted, he wasn't declared brain dead if I recall correctly, but it was pretty damn close. And he came back from the brink. So I do think it's possible, even if we don't understand how or why it happens sometimes. I think there are some instances where the human body and mind behave in ways that even doctor's themselves can't explain.
All that said, I believe you @pnkbride. Dr. Alexander isn't the only one it's happened to.
He was in a medically induced coma, and apparently his book has been highly criticized.
there is no similarity between a medically induced coma and brain dead. (directed at lemon, not you, amoosed).
Trying for #3; FET 8/18 -- BFN. Leaving things up to chance for now... After three years, three IVFs, and two FETs, we finally have our miracle babIES!
No difference medically but we use that term when writing hospital policy and when talking to the family about organ donation.
I work in transplant, what term are you referring to? In my experience doctors don't speak in these terms to patients or families, at all. They usually speak in terms they can all understand.