What does it mean to die

[boondocks]

I've had a long interest in biomedical ethics, the right to die, the issue of physician-assisted suicide, etc, so I always find the "hard" cases at the very razor's edge of life and death (and law, and morality) to be fascinating.

I THOUGHT I "knew what I thought" about the Jahi McMath case a few years ago. (That the family was making poor choices, and their daughter was "dead-dead."). 4 years on, and after reading this fascinating article, I'm still sure I wouldn't want to be "living" the way this young girl is. But I'm now far less sure that the line between life and death isn't a lot more complex and curious than I thought.

It's a long read, but worth it. https://www.newyorker.com/magazine/2018 ... ean-to-die

I'm still mulling this over....

 

[crossbredcalves]

I don't have any desire to post an opinion here, but that was a very interesting article.

 

[Bigfoot]

Very interesting article. I will probably read it again.

 

[Jeanne - Simme Valley]

I, for one, feel the family was "probably" wronged right from the start, but I do not believe in keeping a child on life-support like that.

 

[Bright Raven]

If the doctor recorded in his notes that the right carotid was close to the surface due to a congenital deformity - they should have anticipated the cause of the excess bleeding. That would seem to me to be malpractice.

However, as indicated by the nearly non existent brain stem, I would not want to keep a child of mine on life support unless there was a hope of some reasonable quality of life. I can see why so many of the medical experts who got involved were frustrated.

 

[Son of Butch]

Bible explaining death.
When the golden bowl is broken or the silver cord parted then the dust will return to the earth as it was
and the spirit will return to God who gave it.
Because man goeth to his long home, the mourners go about the streets. Vanity of vanities, all is vanity.

 

[Anonymous]

I couldn't read the article without subscribing to THE NEW YORKER but I did google the case. Several years ago, a very good friend lost his 8 year old daughter in a very similar way. Complications from the removal of her tonsils. She was sent home, but started bleeding severely. Rushed to hospital but she never revived. She was sent to UAB but she lost so much blood she was declared brain dead. Drs informed them that they had to make the decision. Thank God they didnt have to because she passed a few hours later. Hardest funeral I've ever been to. His daughter and mine were 2 weeks apart in age. I've changed some as I have seen death and suffering. I lost a sister to pancreatic cancer when she was 35. We prayed for a miracle until he last week of her life. Then I just wanted her suffering over. Watching her gasp and gurgle for a breath of air... late at night....no noise except that.... sitting and listening, I sure contemplated giving her a lethal dose of morphine. I didn't do it. But I sure couldn't judge someone for it after that.

 

[boondocks]

I'm simultaneously horrified and fascinated by the idea that someone that was dead (met the definition of brain death) may be subsequently declared alive.
Also intrigued by all of the public policy implications. CA declares her dead but NJ allows a family to "not believe in" brain death therefore she;s moved by the family to NJ and NJ taxpayers pick up millions in Medicaid bills for her round-the-clock care...
And: if a health care provider has the right to not assist in an abortion (if it's against his/her moral beliefs), doesn't a provider also have the right to refuse to perform surgery or otherwise care for a corpse (if their belief system says that brain death=death)? Seems many of the providers were given no choice.
And the fact that the family can't claim her as a dependent because to the IRS she's dead, even though she has some (very limited but seemingly purposeful) movement? Weird as all heck.
Just an amazing case.
And the fact that her CEREBRUM is intact?! She may well be "locked in." Ugh. "There" but unable to communicate at all. How horrifying that would be, no? If this happens to me, TG can come on over and administer his usual "prescription."

 

[Bright Raven]

I'm simultaneously horrified and fascinated by the idea that someone that was dead (met the definition of brain death) may be subsequently declared alive.
Also intrigued by all of the public policy implications. CA declares her dead but NJ allows a family to "not believe in" brain death therefore she;s moved by the family to NJ and NJ taxpayers pick up millions in Medicaid bills for her round-the-clock care...
And: if a health care provider has the right to not assist in an abortion (if it's against his/her moral beliefs), doesn't a provider also have the right to refuse to perform surgery or otherwise care for a corpse (if their belief system says that brain death=death)? Seems many of the providers were given no choice.
And the fact that the family can't claim her as a dependent because to the IRS she's dead, even though she has some (very limited but seemingly purposeful) movement? Weird as all heck.
Just an amazing case.
And the fact that her CEREBRUM is intact?! She may well be "locked in." Ugh. "There" but unable to communicate at all. How horrifying that would be, no? If this happens to me, TG can come on over and administer his usual "prescription."

It said her brain stem was only visable as two degenerated strands so that curtails the quality of life I would aspire to. I would rather have the Coup de gras.

 

[boondocks]

It said her brain stem was only visable as two degenerated strands so that curtails the quality of life I would aspire to. I would rather have the Coup de gras.

but her higher-level brain functional areas were intact. How wild is that! Clearly she is getting sufficient pituitary and other hormonal feedback loops--something that would certainly seem incompatible with "brain death."

I really hope this case doesn't lead to a whole lot more gorked people hanging out waiting to "die" a second time.
Think the first hospital really missed the bus (not only medically, but even more so culturally).

 

[Logar]

I've had a long interest in biomedical ethics, the right to die, the issue of physician-assisted suicide, etc, so I always find the "hard" cases at the very razor's edge of life and death (and law, and morality) to be fascinating.

I THOUGHT I "knew what I thought" about the Jahi McMath case a few years ago. (That the family was making poor choices, and their daughter was "dead-dead."). 4 years on, and after reading this fascinating article, I'm still sure I wouldn't want to be "living" the way this young girl is. But I'm now far less sure that the line between life and death isn't a lot more complex and curious than I thought.

It's a long read, but worth it. https://www.newyorker.com/magazine/2018 ... ean-to-die

I'm still mulling this over....

My prayer for all who read this..................

May your death - when it comes - be quick and as painless as possible - no diapers, feeding tubes and catheters.

May your family get over it quickly and move on.

Peace to all.

 

[greybeard]

I've had a long interest in biomedical ethics, the right to die, the issue of physician-assisted suicide, etc, so I always find the "hard" cases at the very razor's edge of life and death (and law, and morality) to be fascinating.

I THOUGHT I "knew what I thought" about the Jahi McMath case a few years ago. (That the family was making poor choices, and their daughter was "dead-dead."). 4 years on, and after reading this fascinating article, I'm still sure I wouldn't want to be "living" the way this young girl is. But I'm now far less sure that the line between life and death isn't a lot more complex and curious than I thought.

It's a long read, but worth it. https://www.newyorker.com/magazine/2018 ... ean-to-die

I'm still mulling this over....

In these kinds of heath related discussions, both about humans and animals, I frequently see phrases such as 'living that way' or 'quality of life' type come in to play. We formulate those thoughts based predominantly in contrast to what we view as a normal life and health, but we don't always take in to consideration what a 'less than perfect' life might mean to the affected person.
I don't mean to come off as offending anyone, but I have far too many times seen people say such things when it comes to members, and what they are really getting at is they don't want to have to deal with the problems long term themselves. The cleaning up, the caring for the ill or 'handicapped' etc. I have also seen the same curious attitude when it comes to people and their pets. Most living things, desperately want to live regardless of what deficits they might have, mentally or physically.

When we go to sleep at night, we are, immobile, physically minimally active/mostly inactive, incapable of controlling our thoughts (and sometimes-actions) unresponsive to many outside sensory receptions, and until we awake, have no sense at all of the passage of time. We dream, breathe, our hearts beat, our digestive systems work.... we think and all the rest of what 'life' entails..we just aren't active in the usual sense. But, we are still living. I've had some pretty dang good dreams and an equal number of horrible dreams, but didn't associate any kind of identification until I awoke and compared those dreams to reality..'normalcy'.

Seen plenty of people say they would rather be dead than be blind, paraplegic, incontinent, on a colostomy bag, confined to bed or a wheelchair etc, yet there are millions with those conditions (and far worse) that will certainly tell you they want to continue with life and it's certainly true for people that were born with similar conditions and know no other way of life....to them, how they are IS normal.

 

[Nesikep]

It's definitely a hard problem to tackle legally and ethically... I think what the family went through legally, from the hospital, media, and the public in general is reprehensible...
That said, if it was me on that table, pull the darned plug already... To me, as much as I'd miss it, if I lost some of my senses, sight, hearing, or limbs.. I could still have a meaningful life despite hardships

 

[Ryder]

In these kinds of heath related discussions, both about humans and animals, I frequently see phrases such as 'living that way' or 'quality of life' type come in to play. We formulate those thoughts based predominantly in contrast to what we view as a normal life and health, but we don't always take in to consideration what a 'less than perfect' life might mean to the affected person.
I don't mean to come off as offending anyone, but I have far too many times seen people say such things when it comes to members, and what they are really getting at is they don't want to have to deal with the problems long term themselves. The cleaning up, the caring for the ill or 'handicapped' etc. I have also seen the same curious attitude when it comes to people and their pets. Most living things, desperately want to live regardless of what deficits they might have, mentally or physically.

When we go to sleep at night, we are, immobile, physically minimally active/mostly inactive, incapable of controlling our thoughts (and sometimes-actions) unresponsive to many outside sensory receptions, and until we awake, have no sense at all of the passage of time. We dream, breathe, our hearts beat, our digestive systems work.... we think and all the rest of what 'life' entails..we just aren't active in the usual sense. But, we are still living. I've had some pretty dang good dreams and an equal number of horrible dreams, but didn't associate any kind of identification until I awoke and compared those dreams to reality..'normalcy'.

Seen plenty of people say they would rather be dead than be blind, paraplegic, incontinent, on a colostomy bag, confined to bed or a wheelchair etc, yet there are millions with those conditions (and far worse) that will certainly tell you they want to continue with life and it's certainly true for people that were born with similar conditions and know no other way of life....to them, how they are IS normal.

Very good post greybeard.
How are we to know what another thinks or feels when we are not and never been in their situation.
I don't think we even know what we would want ourselves in a situation we have never experienced.

 

[greybeard]

I don't mean to come off as offending anyone, but I have far too many times seen people say such things when it comes to members,

That was intended to be typed "family members"..my fingers frequently move at a different pace than my brain.

 

[boondocks]

The article notes that (well-intending) doctors, biomedical ethicists (and a theologian and an attorney) worked on the original idea of a criteria for "brain death" because the advent of ventilators in the 1960s essentially allowed us to keep "dead" people alive. To GB's point, the good folks who decided that a brain-dead person was a dead-dead person were people who were very well-educated---used to the "life of the mind" and couldn't conceive of anyone wanting to continue on in an "animal" existence. I thought that's a fair criticism of the original panel.
And yet, isn't there a distinction to be made between an existence where one is blind and/or paraplegic, versus the condition of Jahi McMath? What make us "human"? Do we need the ability to interact (in some small rudimentary fashion) with loved ones and our physical environment?
Do we get to consider the cost to society of a Jahi McMath? What of hundreds of Jahi McMaths? Is it ethical to consider the $ cost to keep her in that dim tunnel between life and death, potentially for decades?

 

[True Grit Farms]

NJ

The article notes that (well-intending) doctors, biomedical ethicists (and a theologian and an attorney) worked on the original idea of a criteria for "brain death" because the advent of ventilators in the 1960s essentially allowed us to keep "dead" people alive. To GB's point, the good folks who decided that a brain-dead person was a dead-dead person were people who were very well-educated---used to the "life of the mind" and couldn't conceive of anyone wanting to continue on in an "animal" existence. I thought that's a fair criticism of the original panel.
And yet, isn't there a distinction to be made between an existence where one is blind and/or paraplegic, versus the condition of Jahi McMath? What make us "human"? Do we need the ability to interact (in some small rudimentary fashion) with loved ones and our physical environment?
Do we get to consider the cost to society of a Jahi McMath? What of hundreds of Jahi McMaths? Is it ethical to consider the $ cost to keep her in that dim tunnel between life and death, potentially for decades?

Putting a value on what a human life is worth is the starting point for reforming the medical system. If you can't afford to pay for your medical care you die. About a million dollars per person during a lifetime sounds about right to me. You can bet the people wouldn't let let the hospitals and doctors over charge the insurance companies anymore. No one with a common cold or splinter in their finger would be going to the emergency room either.

 

[Nesikep]

NJ

The article notes that (well-intending) doctors, biomedical ethicists (and a theologian and an attorney) worked on the original idea of a criteria for "brain death" because the advent of ventilators in the 1960s essentially allowed us to keep "dead" people alive. To GB's point, the good folks who decided that a brain-dead person was a dead-dead person were people who were very well-educated---used to the "life of the mind" and couldn't conceive of anyone wanting to continue on in an "animal" existence. I thought that's a fair criticism of the original panel.
And yet, isn't there a distinction to be made between an existence where one is blind and/or paraplegic, versus the condition of Jahi McMath? What make us "human"? Do we need the ability to interact (in some small rudimentary fashion) with loved ones and our physical environment?
Do we get to consider the cost to society of a Jahi McMath? What of hundreds of Jahi McMaths? Is it ethical to consider the $ cost to keep her in that dim tunnel between life and death, potentially for decades?

Putting a value on what a human life is worth is the starting point for reforming the medical system. If you can't afford to pay for your medical care you die. About a million dollars per person during a lifetime sounds about right to me. You can bet the people wouldn't let let the hospitals and doctors over charge the insurance companies anymore. No one with a common cold or splinter in their finger would be going to the emergency room either.

That is an interesting idea, not sure how it would work in practice though.. And it perhaps could be extended to liability insurance for vehicles.. Around here the personal injury claims are astronomical and driving the insurance rates up

 

[TexasBred]

I'm simultaneously horrified and fascinated by the idea that someone that was dead (met the definition of brain death) may be subsequently declared alive.
Also intrigued by all of the public policy implications. CA declares her dead but NJ allows a family to "not believe in" brain death therefore she;s moved by the family to NJ and NJ taxpayers pick up millions in Medicaid bills for her round-the-clock care...
And: if a health care provider has the right to not assist in an abortion (if it's against his/her moral beliefs), doesn't a provider also have the right to refuse to perform surgery or otherwise care for a corpse (if their belief system says that brain death=death)? Seems many of the providers were given no choice.
And the fact that the family can't claim her as a dependent because to the IRS she's dead, even though she has some (very limited but seemingly purposeful) movement? Weird as all heck.
Just an amazing case.
And the fact that her CEREBRUM is intact?! She may well be "locked in." Ugh. "There" but unable to communicate at all. How horrifying that would be, no? If this happens to me, TG can come on over and administer his usual "prescription."

It said her brain stem was only visable as two degenerated strands so that curtails the quality of life I would aspire to. I would rather have the Coup de gras.

Unfortunately you don't get to make the decision. Someone else does. This whole thread is nothing more than someone else applying their definition to things they know nothing about and someone else just as unqualified representing the other side.

 

[Bright Raven]

I'm simultaneously horrified and fascinated by the idea that someone that was dead (met the definition of brain death) may be subsequently declared alive.
Also intrigued by all of the public policy implications. CA declares her dead but NJ allows a family to "not believe in" brain death therefore she;s moved by the family to NJ and NJ taxpayers pick up millions in Medicaid bills for her round-the-clock care...
And: if a health care provider has the right to not assist in an abortion (if it's against his/her moral beliefs), doesn't a provider also have the right to refuse to perform surgery or otherwise care for a corpse (if their belief system says that brain death=death)? Seems many of the providers were given no choice.
And the fact that the family can't claim her as a dependent because to the IRS she's dead, even though she has some (very limited but seemingly purposeful) movement? Weird as all heck.
Just an amazing case.
And the fact that her CEREBRUM is intact?! She may well be "locked in." Ugh. "There" but unable to communicate at all. How horrifying that would be, no? If this happens to me, TG can come on over and administer his usual "prescription."

It said her brain stem was only visable as two degenerated strands so that curtails the quality of life I would aspire to. I would rather have the Coup de gras.

Unfortunately you don't get to make the decision. Someone else does. This whole thread is nothing more than someone else applying their definition to things they know nothing about and someone else just as unqualified representing the other side.

But Richard if we only posted on subject matter that we had a knowledge of, this place would be a ghost town. :lol: