Monday, 6 January 2014

Liverpool Care Pathway - Concerning The Defining Of Death

"If you believe it then follow it, that's the motto. My father believed I was alive - and he was correct."

This is The Telegraph
"My father believed I was still there.
"He expressed his views to Julia Piper and I think she listened very closely to what my dad had said.
"My impression is maybe the hospital weren't very happy that my father wanted a second opinion.
"I think the doctors wanted to give me three days on the life support machine and the following day they said they wanted to turn it off. 
"The words they used to my parents were 'you need to start thinking about organ donations'. 
"I think that's what gave my dad energy, he thought 'no way'. 
"I think if my dad would've agreed with them then it would've been off in seconds. 
"If my parents hadn't asked for the second opinion, and if Julia hadn't been there, I wouldn't be here today." 
Steven, from Kenilworth, Warks., was been travelling home from nearby Leamington Spa in February 2008 when the vehicle he was in was involved in a collision with two other cars and a horse that had run loose. 
The horrific crash left one man dead and the horse was also fatally injured.Steven was rushed to hospital and surgeons performed a craniotomy to help alleviate any swelling on his brain. 
But despite the operation being successful, brain scans failed to detect any electrical pulses and he was declared brain dead.
 Steven Thorpe:
"Hopefully it can help people see that you should never give up. I've had so much positive feedback about it. 
"If you believe it then follow it, that's the motto. My father believed I was alive - and he was correct."

This is CNN 
(CNN) -- The family of Terri Schiavo has joined the battle over Jahi McMath, a 13-year-old girl on a ventilator who has been declared dead by doctors.

"Together with our team of experts, Terri's Network believes Jahi's case is representative of a very deep problem within the U.S. healthcare system -- particularly those issues surrounding the deaths of patients within the confines of hospital corporations, which have a vested financial interest in discontinuing life," the Terri Schiavo Life & Hope Network said in a prepared statement.
The hospital says:
"To date, they have been unwilling or unable to provide a physician to perform the procedures necessary, transportation, or a facility that would accept a dead person on a ventilator. Our hearts and thoughts go out to them in this tragic situation, but the statements being made by their attorney and some family members are misleading and untrue."
The hospital, whatever their determination of what constitutes a definition of death, OWE this family big time. They botched a simple tonsillectomy and put Jahi where she is today. They should have been falling over themselves to fall into line with this family's wishes. They wanted Jahi out of their facility. Fair enough...

According to Jahi's uncle, Omari Sealey, the hospital had "refused to agree" to allow the proceedures necessary to take place. The hospital deny this.

The hospital refused to fit Jahi with a feeding tube or breathing tube to help stabilize her during the move. They refused to allow an outside doctor to do the procedures. That is not being obstructive? What is "misleading and untrue"?

They should have performed the procedures requested for that purpose for the family to proceed to attend to her care. There is a moral duty here, a responsibility. There are consequences, always consequences. And this hospital has declined to face up to those consequences.

Do they intend to try to outrun the financial consequences? They have yet to negotiate the financial settlement that is surely coming this family's way by way of the malpractice or negligence that has proceeded.

This is KTVU on Sunday –
McMath left the hospital in a private ambulance shortly before 8 p.m. Sunday, Christopher Dolan told The Associated Press. 
She was taken by a critical care team while attached to a ventilator but without a feeding tube, Dolan said. Her destination was not immediately disclosed.
"It was a very tense situation," said Dolan. "Everybody played by the rules."
David Durand, the hospital's Chief of Pediatrics, said the girl was released to the coroner. The coroner then released her into the custody of her mother, Nailah Winkfield, as per court order, Durand said in an email.

The Coroner's Office has issued a death certificate for Jahi but said the document is incomplete because no cause of death has been determined pending an autopsy.
"They may have issued one but we don't have it. We don't think she's dead," Dolan said. "We got all the necessary legal paperwork in order to get Jahi out of there."
There is a moral duty. We're talking ethics here. And where are their ethics? Ethics is the reason they gave in refusing to fit Jahi with a feeding tube or breathing tube to help stabilize her during the move.

Medical ethicists are actually concerned that if Jahi's case should gain headway then they might not be able to so readily pull the plug when they want to.

Medical ethics is in the pits.

This is KTVU 
OAKLAND, Calif. — Medical ethicists say they are worried, even alarmed, about how far the Jahi McMath case has gotten. Brain death has been an accepted standard of death for decades, they say, and the dispute should never have gotten any traction with a judge.
"That's always bad news, always a disaster," David Magnus told KTVU.
Magnus is a professor of pediatrics and biomedical ethics at Stanford University, and directs the Center for Biomedical Ethics at the University.
 Magnus continues his pontifications...
In fact, Magnus says there is universal agreement in the legal and medical community that the teenager is deceased.  Unlike a coma, patients cannot come back from brain death. Yet with the dramatic case, and coverage it has received, it seems to encourage other grief-stricken families to mount their own challenges.
Magnus complains they are 'changing the rules'.
"If you change the rules, and say that you're only dead when families say you're dead, or agree to stop, that could be disastrously bad for medicine," added Magnus.
Ethicists are already 'changing the rules'...

Read further here -
Liverpool Care Pathway - Redefining Death
According to Dolan, the family has located an unaffiliated physician to put in the tubes and that an outpatient clinic in New York that treats people with traumatic brain injuries has expressed willingness to care for Jahi.

Further reading -
Liverpool Care Pathway - Cold, Cruel, Callous, Heartless, Without Pang Of Remorse

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