Posted on 11/07/2008 12:13:12 PM PST by SJackson
Children's National Medical Center in Washington, D.C. took the family of a 12-year-old Orthodox Jewish boy on life support to court yesterday.
Motl Brody's family wants to keep their brain-dead son on mechanical assistance for religious reasons, but the hospital said its resources are being used to preserve a deceased body. The case is currently disputed in the D.C. Superior Court.
Mr. Brody, under care for brain cancer, was pronounced dead Tuesday night after tests showed no signs of brain activity. His family said their Orthodox Jewish faith does not define death as cessation of brain function alone. The hospital argued that Mr. Brody is dead, and no religious principle can deny that.
"This child has ceased to exist by every medical definition," Sophia Smith, one of Mr. Brody's physicians, wrote in court papers. "There is no activity in any portion of his brain, including the brain stem."
Kenneth H. Rosenau, an attorney for the hospital, told the Washington Post, "There is no religious principle at issue in this case, but a clash of life and death."
The hospital's lawyers noted that alternative care facilities had denied acceptance of the boy because he is brain-dead.
Jeffery Zuckerman, the Brody family's lawyer, is challenging the hospital's plans to take Mr. Brody off life support on the grounds that religious beliefs must be respected under federal law.
"Under Jewish law and their faith, there is no such thing as brain death," he told to the Washington Post. "Their religious beliefs are entitled to respect."
Some states like New York and New Jersey have provisions in their laws and regulations that make exceptions for Orthodox Jews in similar instances. Washington, D.C. does not.
Rabbi Moshe Bogomilsky of Congregation Yeshiva of in Crown Heights, New York agreed with the Brody family's wishes. "There are some that feel brain-dead is sufficient [to declare a person's death]," said. "But the authoritative [Orthodox Jewish] opinion is we follow the heartbeat to declare the difference between life and death."
"As long as the heart is beating, he's alive," he added. "It may not be the best situation, but if a person's alive, we can't do anything that would shorten a life for a person."
In situations where congregants have a choice of whether or not their loved one should go on life support, Rabbi Bogomilsky said he would "encourage them to go on life support."
While Orthodox Jews do not believe in brain death, other religions, like Catholicism, do.
"We do accept the total brain-dead criteria," Rev. Alfred Cioffi, S.T.D., Ph.D., of the National Catholic Bioethics Center, said. He noted that there are two definitions of death.
"The classical definition is the cessation of heartbeat and respiration. It typically doesn't require much equipment to detect that," he said. "The neurological definition requires an Electroencephalogram (EEG). If it's a flat line, there are no brain waves."
In cases of a coma or trauma to the head, it is possible to have partial brain death in the cerebral cortex. Catholics believe a person must have total brain death, however, to discontinue life support. In total brain death, even the brain stem, which controls involuntary activities like heartbeat, breathing and digestion, among others, ceases to function.
"As long as person has total brain death, we accept that person has died," Rev. Cioffi said. He noted, "Even a corpse requires dignity and proper handling but may be disconnected from vital support. A corpse may be sustained on vital support systems for organ donation because once there is death, there is disintegration."
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DC hospital suing to cease life support on youth November 7, 2008 — 12:17pm ET | By Dan Bowman http://www.fiercehealthcare.com/story/dc-hospital-suing-cease-life-support-youth/2008-11-07
At Children's Medical Center in Washington, D.C., a Brooklyn youth is at the center of a controversy about whether the hospital has a right to discontinue life support after ruling the boy brain dead this past Tuesday evening. The boy, 12-year-old Motl Brody, was diagnosed with a "severe form of brain cancer," and had been at the D.C. hospital for six months. After tests revealed no brain activity, doctors wanted to end life support; the boy's parents, Eluzer and Miriam Brody, disagree with that decision, citing that their religion (they are Orthodox Jews) "does not define death as cessation of brain function alone."
A D.C. Superior Court hearing is scheduled for Monday to determine whether the hospital will be able to take the boy off of life support. The law in D.C. states that doctors can declare a patient dead if there is no brain activity. "This child has ceased to exist by every medical definition," wrote Sophia Smith, one of the boy's doctors, in court papers. "Ethically, there is no appropriate treatment except removal of the ventilator and of the drugs."
The parents' attorney, Jeffrey Zuckerman, argues that ceasing life support would "infringe upon religious freedom."
"Under Jewish law and their faith, there is no such thing as brain death," he said. "Their religious beliefs are entitled to respect."
“for Terry, who was on minimal support compared to this child, there was medical dissent about her prognosis and it was about quality of life, not quantity”
For Terry it was about inhumanely starving/dehydrating someone to death.I went through the tough decision to remove mechanical devices from a loved one with very little hope of even surviving in a vegetative state earlier this year. It’s not easy, and I pray for this family.
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If “brain dead” is the sole criterion we use to determine whether a life is worth sustaining, then based on the recent election, half the American electorate should be offered the opportunity of assisted suicide.
I was quite surprised at the reaction of his family and his classmates to the fact of his death. It was as if he had just been run over in the street by a car, not as if he'd been wasting away for months on a respirator in a dark hospital room.
If this is the case I'm thinking of, I recall hearing that he's on medication to keep his heart beating.
If that's the case, along with the cessation of any brain activity at all, it seems to me that they are merely keeping a dead body from decaying.
There has to be some point at which this boy is declared dead.
Not exactly. Absent signals from the brain the heart will continue to beat. It's been twenty years sense I took biology and the TLA for the built in backup heart bear circuit escapes me. It's very much like a neural 555 IC timer.
Heart transplant patients don't have any CNS control of their heart beats. They run on the backup circuit (which means they can't exert themselves and have their heartbeat increase).
Breathing is controlled exclusively by the brain stem.
:>)
That's the question that's presented so clearly in this case. For an Orthodox Jew, that's cessation of breathing and heartbeat. Removal of life support and medication generally not permissible either, once started.
I recognize you, and I’m sure a vast majority of Americans and Freepers would disagree with that definition. But it’s the parents beliefs, one supported by millennia of tradition, they’re able to pay for his care, and it’s not denying another patient care, though that wouldn’t be an issue either.
So what’s happening is that the state is substituting their values for that of the patients family. And though it wouldn’t matter to me, I see no discernable state interests here. I would suggest that’s a very slippery slope.
That's where I see the irony. If cessation of breathing and heartbeat are the criteria for when life ends, and it's God's call as to when that should be, then WHY did they ever decide to put him on the machines to begin with?
Wouldn't that be considered subverting God's will? Taking the decision out of His hands?
It so seems to defy the concept of letting God take control. Now THEY'RE in control, not God. Just how many other body functions need to shut down before they admit that he's dead. They can perform dialysis if his kidneys quit.
With all those machines, how can they determine what's truly functioning? Does every single organ have to stop?
When my mom was dying from cancer, she told them no heroic measures and signed a do not resuscitate order. They had her on oxygen only and an IV for fluid. They kept her comfortable and clean. She didn't last long because the cancer was so aggressive, but we (and she) couldn't see prolonging it. We just decided to let it take it's course.
Of course, it wasn't easy, but there was no *pull the plug* decision to make either.
I just don’t know about the specifics of this case, from the articles I read I suspect the treatment was post operative, the family may or may not have had input.
In general there is no obligation to undertake heroic measures, or to resuscitate. Pain medication can be administered in doses which would accelerate a patients death, if done for the relief of pain. But once begun, measures of sustenance can’t be withdrawn.. As I noted earlier, there might be some disagreement about respirators as opposed to feeding and iv, but I’m already beyond my level of specific knowledge, and the parents decision here is a mainstream one.
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