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April 26, 2005

The Latest on Teron Francis

Topics: News

In the hearing concerning Teron Francis, Judge Douglas McKeon ruled that it is up to the family to decide if and when to remove him from the ventilator. The Montefiore medical directors are standing by the diagnosis that Francis is brain dead, and also insisting they never intended to pull the plug on him against his family's wishes. The family now needs time to decide what to do.

Read the story here.

Cross-posted on Powers That Blog.

Posted by powersthatblog at April 26, 2005 8:43 AM


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Comments

( I posted this below as well)

Sadly, some of you are misinformed about this case.

Teron is already dead. There is no blood flowing to his brain, nor has there been for almost five days now. The cells of his brain have long since died. And not just the higher functioning portion of his brain. We are talking about the cells all the way down in to the brain stem itself. In fact, the most basic act any brain can do is to "take a breath" when there is a lack of oxygen. It is the most primary of all building blocks upon which all breathing beings rely. In Teron's case, that portion of his brain is already dead and cannot regenerate. He has no eye movement, no conscienceness, no brain wave activity. Were it not for the ventilator that is "taking his breaths" for him, the electrical muscle activity of his heart would have ceased five days ago.

The permanent cessation of ALL brain function is what death is and Teron has already died. It does the memory of Terri and those like her NO GOOD AT ALL to pretend that dead people are alive or to pray for dead people to come back to life. This is a separate issue from Terri.

It is clear that the hospital did a poor job describing to the family what death is, but just because the family is having difficulty dealing with it in their grief, doesn't mean the rest of us should stop using our intelligence.

Posted by: PoliticaObscura at April 26, 2005 10:33 AM

I would agree that in the circumstances as presented to us, the family would be morally justified in discontinuing that which is "extraordinary means" of sustaining life. My own mother passed in exactly these same circumstances. And of course we must use our intelligence. I think the only concern here is that the hospital, nor anyone else, prevent the family from sustaining the child's life by whatever means they feel morally requisite. It is all, in the end, a matter of faith. If the family feels the death is when the heart stops and believe that is when God will take this child, then I, even to this extreme, will advocate on the side of life. We've all relied on common sense and compassion and intelligence for quite awhile now - and that getting us our first case of euthanasia in the country by every standard imaginable. Perhaps, as well as common sense, compassion, intelligence, we might want to add faith. No, dead brain cells cannot be regenerated, just a matter of common sense - (well, um, maybe there was one case I heard about when this happened - someone dead coming back to life). Perhaps we should err on the side of faith, on life, if we err at all.

Posted by: dea at April 26, 2005 11:20 AM

The judge's decision is good. Is the comment by PoliticaObscura correct? Or do we have another one of those bloggers here?

Posted by: mary et. al. at April 26, 2005 11:29 AM

Mary et al.,

The short answer to your question: "Is the comment by PoliticaObscura correct?" is most likely yes. I too have been concerned that we may have jumped the gun on this story, so I did a little research on what is actually meant by brain death.

It turns out that brain death is recognized as a specific medical diagnosis. According to transweb.org, "Brain death is defined as the irreversible loss of all functions of the brain. It can be determined in several ways. First - no electrical activity in the brain; this is determined by an EEG. Second - no blood flow to the brain; this is determined by blood flow studies. Third - absence of function of all parts of the brain - as determined by clinical assessment (no movement, no response to stimulation, no breathing, no brain reflexes.)"

It turns out that brain death is also legally recognized, in that once two doctors have determined a patient to be brain dead, the date of that determination is what goes on the death certificate, not the date the life support equipment was removed.

So, assuming all these tests have been correctly conducted on Teron Francis, the medical personnel at Montefiore are correct in their assessment from both a medical and legal perspective. The only way their assessment could be wrong would be if they made a mistake in the diagnosis. I do not see any reason to believe this based on the stories I have read.

Also, based on what I know of the story, it is my opinion (not necessarily that of Blogs For Terri) that Teron Francis' situation is different from Terri Schindler's was. Terri Schindler did not meet the criteria required to be diagnosed as brain dead--obviously, she showed reflexes and was able to breathe on her own. In the case of Teron Francis, his family is not contesting his diagnosis; they are merely needing to take the time to come to terms with the tragic events of the last few days. For whatever reason, they felt pressure from the hospital to rush the decision of removing the ventilator, though the hospital medical directors have repeatedly denied they pressured the family, and in the end, everyone (family, judge, hospital personnel) agreed that it is the family's decision.

In summary, PoliticaObscura raises some important points. Although we must remain steadfast in defending all people, no matter how injured or disabled, we need to be sure we aren't calling something murder or euthanasia that isn't. Otherwise, we risk harming our credibility.

Again, these opinions are my own and do not necessarily reflect those of the other Blogs For Terri authors.

My source on brain death: http://www.transweb.org/qa/asktw/answers/answers9509/braindeath.html

Posted by: powersthatblog at April 26, 2005 12:29 PM

Very good overview by powersthatblog.

I found an interesting article about John Paul II's view on organ donation which specifically mentions the acceptatnce of death by brain function criteria as an acceptable determinate of death.

http://www.mebtc.org/popegives.htm

Posted by: PoliticaObscura at April 26, 2005 12:43 PM

Hi Powersthatblog - I am not sure I would trust transweb as a good source for this particular information. Their motto is: "All about transplantation and donation."

they are an organ donation site. I will comment more about this, in a minute.

Posted by: juleni at April 26, 2005 12:43 PM

One further quick comment - Politica - I deeply loved Pope John Paul II. His comment you cite though, being made in the year 2000, may have been before he or any of us were aware of some of the organ harvesting - while a person is still breathing or their heart is beating - that has come to light more recently. Just a thought.

I have always been an organ donator prior to this month, based on exactly the way Pope John Paul II felt! However as of this month, in 2005, my mind is changing on that.

Posted by: juleni at April 26, 2005 12:48 PM

Juleni,

Point taken. I was actually researching organ donation which is how I found the site. I recognize the site's emphasis; however, I didn't see any reason to suspect the definition of the medical and legal diagnosis of "brain death" posted on the site. I am reasonably certain I could find that same definition on other websites that are not specifically about organ donation.

Please keep in mind, I am not advocating we rush out and pull life support off people before we can be as sure as we possibly can that it is indicated. But I am also concerned that we not jump the gun on impuning people for murder when what they are doing is pulling life support after all hope is gone.

Posted by: powersthatblog at April 26, 2005 12:51 PM

Just wanted to post what Earl Appleby said about this, a couple of days ago:

You cannot oxygenate a corpse and make it breathe. That is why we should always speak of a "ventilator" and never use the unscientific term "respirator," which misleadingly implies that the ventilator is breathing for the patient.
The ventilator assists a living human being in breathing. It does not breathe for him. The very fact that a ventilator is being used is evidence that the person is alive.

People die on ventilators all the time. If there is no foul play, they may even die a "natural death." If the ventilator is removed, however, before you are able to breathe on your own without its assistance, you will die as a victim of epivalothanasia (imposed death).

This is precisely the death that Montifiore seeks to impose on Taran Francis.

Organ donation is a prime motive for utilitarian euthanasia, since the transplant terminators must harvest living organs from living persons. It appears to be at play in this instance.

However, there are other—perhaps more pressing—motives that may well be involved in this matter, they revolve around the known link between malpractice and checkbook euthanasia. I hope to explore this further in a future analysis. But right now, we are in the midst of the battle!
Earl
Posted by: Earl Appleby at April 23, 2005 02:39 PM

Posted by: juleni at April 26, 2005 12:55 PM

Powersthatblog - understood. I love your site, and all that you did for Terri, and for life, and I know you have a really good heart!

I, too, don't want to jump any guns. But I think Earl Appleby may be on to something regarding the organ donation industry 'speeding up', now. And compromising the integrity of their work. I will study that more, and could I ask you a favor - to indeed look into finding that information from a site not at all related to organ donation or transplantation? I do still believe the organ donation sites might have reason to have an agenda in presenting brain death.

Have you read the article Earl posted about the Brain Death Hoax?

Posted by: juleni at April 26, 2005 1:04 PM

Juleni,

I just reread the article you mentioned "the hoax that won't die." I also found an interesting article here on what could be the dark side of organ donation/harvesting: http://www.all.org/issues/eol06.htm

Something neither one of these articles addresses to my satisfaction is the question of whether a patient who has been correctly (meaning according to the diagnostic tests I mentioned earlier) declared brain dead continues to sustain heart and lung function because there is undetected brain activity sustaining those functions or because the patient is hooked to a machine that is keeping those functions going. We didn't have these machines until fairly recently in the "how you define death" evolution.

I would submit that if brain death can be declared with certainty, that is an OK standard to go by. I mean, if blood supply is completely cut off to the brain, the brain is dead, and if the brain is dead, it cannot command the rest of the body to carry on life. I think we have all heard of people who made the decision to pull life support from a loved one (with or without later donating organs) and I don't think we call those people murderers.

In my mind, the question of organ donation ultimately comes down to the question of do we trust the medical community? More specifically, when a doctor tells us our loved one is brain dead, do we believe him? Over time, that trust has been eroded, and I think it's perfecly understandable why people are opting to not become organ donors for precisely that fear that their organs will get harvested when they're not truly brain dead. But I think that is a question of trusting the medical community, not a question of whether there is such a thing as brain death.

In surfing around the internet for some more information, I came across this quote from (http://www.geocities.com/eappleby/braindeath.html):

"Indeed, anaesthetists have called for sedation and analgesia to be given routinely to brain dead organ donors during the process of organ removal."

From “Nursing practice and the definition of human death”

In my opinion, if there is enough doubt as to a person's death that people are calling for anasthetics as a precautionary measure, that ought to be enough reason to stop organ harvesting right there--at least for that patient. But again, the question is about whether or not we trust the medical community, and no, I wouldn't trust a doctor who told me my loved one was brain dead and couldn't feel pain but then ordered a painkiller for the "brain dead" person. There's a fundamental problem with honesty there.

I definitely do not know quite enough about this issue to have my mind completely made up, and I am going to continue researching this. If anyone knows of some well researched, informative websites on either brain death or organ donation (both sides of the issues), please let me know by leaving a comment here or on my blog (www.powersthatblog.blogspot.com).

For more of my thoughts on our eroding trust in the medical community, see http://powersthatblog.blogspot.com/2005/04/when-doctor-says-theres-nothing-more.html

Posted by: powersthatblog at April 26, 2005 1:53 PM

I find it interesting that the criteria for determining Brain Death ( http://www.aacn.org/aacn/jrnlccn.nsf/c54ad59fdf5d6228882565a0006a1369/5ebf8de743ead0fa8825674e005a8950?opendocument ) could easily be used on many people who are deep sleepers. Other studies warn that the "criteria" seem to vary depending on how much the hospital wants the organs ( http://qjmed.oupjournals.org/cgi/content/full/92/7/407 )

Posted by: Danny Carlton at April 26, 2005 2:01 PM

One point I do want to stress here that is important to me, anyway: Even the ABC article linked admits that the heart will stop beating on its own despite the use of the ventilator. And I read in an earlier story on this same case that we're talking in 2 weeks or less.

So it isn't the case that this is going to go on forever. If there is no rush to take organs, how much difference can two weeks make? It's not like it's going to kill anybody else to wait until his heart stops despite the ventilator. Unless, that is, you think it counts as "killing somebody" to refrain from taking Teron's organs for some other person. And I _don't_ look at it that way.

And if his heart doesn't stop, then we should question the diagnosis.

This is something I never really understood until recently--that you can't "keep people alive forever on machines."

Posted by: Lydia at April 26, 2005 3:05 PM

By the way, I've come seriously to question the ethical nature of organ donation, aside from the question of diagnosing "brain death." I'm not Catholic, so I'll be willing to decide it's just plain wrong even if the official Catholic teaching is that it's moral.

I'm beginning to think organ donation is rather like in vitro fertilization: When the result of it is that people start treating other people as disposable things, as objects for use, maybe this should be a _clue_ (though not necessarily a decisive argument) that there was something wrong with it from the start. I call it the "smell test" for a medical policy. And this one is starting to smell like old fish.

I'm thinking of a post on the group conservative philosophy blog to which I contribute

http://rightreason.ektopos.com

My argument would be that organ donation has way too much in common with cannibalism.

Posted by: Lydia at April 26, 2005 3:09 PM

I agree with you, Lydia, that this is eroding respect for life and respect for the medical community, not to mention trust.

I've read your comments and they seem wise to me. I'm relying on that because I can't and don't intend to pursue this aspect myself. Those who do follow these particular paths will be doing a great service to all who are called to deal with other aspects of this war.

However, I should think it would be incumbent on the medical community to take action to recover their previous integrity and reputation.

Posted by: mary et. al. at April 26, 2005 3:35 PM

Hmm, I do agree, Politica, that organ donation after death, can save a life!

And that is one good reason why this whole issue of organ donation needs to be researched some more and reported here. I don't have time right this moment, as I am working for Charlotte's life, but I will try to do some research on it, in a few days from now.

However I do know taking organs from a person with a beating heart or who is breathing is definitely, 100%, absolutely, no doubt in my mind, wrong.

And if we cannot trust the medical community, and if there is organ donation which is alright, if it is after death, how can we resolve it? Perhaps only if we know the doctors involved are pro life? And they are guaranteed not to step across the boundary between life and death, and kill someone for their organs? I don't know. More has to be looked into.

But I am still tearing up my donor cards, as at this moment I don't know whose hands I will be in when they might want my organs. I am not against it if it is after I am dead, that is no heart beating, no breath, no brain activity or nerve impulses left. But whom can I trust to not violate my living body before that time? That is the question for me.

To your question about why are some of these sites making a fuss over a child who is already dead.....

Not dead! (See my story in the post below.)

By the way, I wanted also to ask you, Politica, are you one of the bloggers of a blog for Terri? I ask that because you say "our own efforts in favor of life." I apologize if I didn't recognize you. And which blog?

Posted by: juleni at April 26, 2005 5:48 PM

One person's very personal comment at one of the NY news sites, as to why not to give up in a case like Taran's! ****(Miracles can occur!!)******:


-I'd just like to say to you if I may-and that is,"Don't ever stop praying,hoping and believing that there is a great chance for your son to get better,and all the hurt and anger and frustration has been taken and placed on Jesus' shoulder." No matter what happens never give up on GOD,'cause he's the only one who CAN make a way out of no way.

I have a 13yr.old severly autistic son named Charles(Charles Fredrick ,after charles Ingals' son on,"Little House on The Prarie.").

Well,Charles just beat a deadly severe and rare case of double-pneumonia and the mortality rate for that type of pneumonia is 70-80%,the doctors gave him up as soon as he came into the emergency room and all they could do was to stand out in the hallway and shook their heads in nodding no at Charles,yet at the same time I was shaking my head back at them and telling them how so wrong they were.

Charles was in intensive care for three and a half months and lying in a doctor induced coma due to the extremly and unusual high blood pressure and a severly high fever that was plauging him,yet I never gave up the notion that he would recover. We almost lost Charles four times in less than week after he was put in intensive care,the first and second time his heart stopped and he had to be defibulated both times,the second time his fever rose to 107.4 degrees,the third time his blood pressure sky-rocketed to 280/195,onne of Charles' doctors made a comment to my pastor that if there were a fifth episode,they probably wouldn't be able to bring him back.

After that Charles started to make progress at a snails pace,yet we all felt(exculding the doctors),that Charles was on his way back to us and he has made a full recovery with no brain or heart damage whatsoever,and with him being autistic that was a whole other blessing all by it's self.

So,my fellow beings as parents,sisters,brothers,uncles,aunts,cousins and if I've missed any one, I apologize----PLEASE KEEP ON KEEPING ON AND DON"T GIVE UP NO MATTER WHAT THE doctors say,YOU KNOW YOUR SON MORE THAN MOST AND AS FAR AS I AM CONCERNED<AND BELIEVE ME I AM VERY CONCERNED AND DO NOT GIVE UP 'CAUSE GOD DOES'T GIVE UP ON US!! My Deepest Love And Devotion,Thoughts And Prayers Are with you consistantly Through This Most Difficult Time,And I Do Nt Take It Lightly!

Please Keep Me Informed and Let Me Know How He Progresses, Your sister in CHRIST JESUS, Jackie Miller."


I know it is not exactly the same as Terron's case, being a doctor induced coma, but a coma nevertheless. However, we hear of people coming out of comas all the time. Even years afterwards. Those folks' loved ones had not given up on them! And evidently, Jackie Miller feels Terron's coma is like her child's, to have posted this.

And is it the usual situation that in any coma the readings are the same as to brain activity? Whether it is doctor induced or not? That would be good info if someone has it.

Posted by: juleni at April 26, 2005 5:59 PM

Maybe I've missed it, but I don't recall reading that there has been no blood flowing to Terron's brain. Is he on a heart/lung machine? If he is being "kept alive forever" by the machine then that is one thing, BUT if not then it is something altogether different. I suspect that it is the latter.

What gives?

Posted by: Tom Spence at April 26, 2005 6:31 PM

Hi guys,

I wrote Earl a little bit ago and asked him to weigh in on this, as I havae gotten perfectly confused about the real state of affairs here. I think Earl is privvy to this. Am I wrong?

Posted by: mary et. al. at April 26, 2005 6:50 PM

Just did a bit of research on this, not time for more:

Here is what Earl had posted that someone wrote regarding Pope John Paul II's address regarding organ donation:

http://www.catholic.net/rcc/Periodicals/Igpress/2001-03/essay.html

Also, here is an important insight to this topic, from this web location - http://www.geocities.com/organdonate/AAACh3ApnoeaBrainDeathTe.html

The Apnoea Brain Death Test
May Kill The Patient


As disquieting as the possibility that donors may feel pain during organ harvesting is a body of scientific research opinion that says the brain death test not only falsely attributes death to the donor but also injures the patient and delays crucial treatment.

Associate Professor Cicero Galli Coimbra, Head of the Neurology and Neurosurgery Department at the Federal University of Sao Paulo, Brazil has completed the study, "Implications of ischemic penumbra for the diagnosis of brain death. Apnoea testing may induce rather than diagnose brain death".

The study discovers that where there is brain damage there may be an area of the brain that is destroyed plus an uninjured section (even if there is no apparent function) and between the two a penumbra where brain cells are not functioning but recoverable. In severe cases a person may be wrongly declared brain stem dead or brain dead.

Coimbra's research shows that the testing for brain death both delays treatment for the patient and that the actual Apnoea test may bring on that state.


READ IT ALL.

Finally, this site is interesting in its objections to organ donation, because it complains not from a prolife or religious perspective at all, but purely based on the financial scams going on behind much of it:

http://www.organkeeper.com/

Posted by: juleni at April 26, 2005 6:59 PM

But no matter the case...I absolutely, absolutely believe that the judge should have put this back into the family's hands as he did, as it should never be the hospital's "right", ever.

It should never even have to go to a judge at all.

Posted by: juleni at April 26, 2005 7:02 PM

Mary, thank you for asking Earl in, on this!!

Posted by: juleni at April 26, 2005 7:02 PM

Amen, Juleni, and good job of research. What horror stories must be being told in the after life.

Posted by: mary et. al. at April 26, 2005 7:04 PM

Tom, from all I have read, Terron's heart is beating all on its own. No heart/lung machine.

Posted by: juleni at April 26, 2005 7:04 PM

Tom, as I understand it from _all_ the news stories I've seen, Teron is _only_ on a ventilator. That's why they expect his heart to stop on its own within a relatively limited time. No "keeping alive forever" stuff.

The "no blood flowing to the brain" strikes me as questionable, but my understanding here is that the person who posted it is taking it not from info. about Teron's own case but from a statement somewhere of what is supposedly happening when someone is correctly diagnosed as "brain dead." I find that a tad surprising. Such an extreme claim wouldn't be necessary if the only goal is to say that no part of the brain is _functioning_. You can have an organ with blood flowing to it that isn't functioning. But as I say, I'm pretty sure that Politica got this from something about brain death generally, not from knowledge about Teron specifically.

But again, even if this is true, Teron is only on a ventilator, not on full heart-lung bypass. That's very clear from everything I've read about him.

Juleni--one common practice is to keep someone declared "brain dead" on a ventilator, but before their heart stops on its own while on the ventilator, to take them into the operating room, all ready to take the organs. Then they stop the ventilator, wait five minutes to make sure there wasn't some mistake and to make sure the heart has stopped (which it does, if they haven't screwed up their diagnosis, after they stop the ventilator), then take the organs while they are as fresh as possible. This is called NHBD for non-heart-beating donation.

NHBD is sometimes even done when the person _hasn't_ been declared brain dead previously. In that case the time of death is given as the time when the heart stops after being taken off the ventilator.

I'm pretty sure they do sometimes also take the organs while the person's heart is beating, if and only if the person has already been declared dead by the "brain death" concept.

Posted by: Lydia at April 26, 2005 7:08 PM

No surprise there, ergo there is blood to his brain. He's "Not Dead Yet" -- http://straightupwsherri.blogspot.com/2005/04/testimony-of-diane-coleman-of-not-dead.html

Juleni, you are incredible!

Posted by: Tom Spence at April 26, 2005 7:11 PM

Creme de la creme, Tom. Pardon my french--I don't write it so well. Thank you, Lydia, for clearing THAT up.

Posted by: mary et. al. at April 26, 2005 7:17 PM

Please people ...think this out. If there were no blood flow to the brain.that would mean the brain tissues would not be replenished with oxygen and would die... The brain tissue under the skull would be dead..And after 5 days, that dead tissue would be mushy and reek to heaven....He would never be able to be in a hospital bed because of the smell and health sanitation issues.
If he is not smelling putrid, turning black with rot, swollen and mushy....he is not dead.

The way these terms, "brain dead, PVS, etc, etc," get thrown around is really a terrible insult to the dignity of critically impaired patient. Brain dead means DEAD. If the heart is still pumping then the brain stem is still functioning ...NOT dead.

The family really needs support and to have availabel optiopns presented to them...Nursing home maybe until he stabilizes ??...stimulation therapy with lights and sounds...???
Does anyone know if they are being advised of their options..? I would hate to think that hey are staring of this boys minimally responsive body and thinking death is their only option...then for sure they will opt for death....They need to get in touch with rehab specialists...

Posted by: JoJoFox at April 26, 2005 7:47 PM

Please people ...think this out. If there were no blood flow to the brain.that would mean the brain tissues would not be replenished with oxygen and would die... The brain tissue under the skull would be dead..And after 5 days, that dead tissue would be mushy and reek to heaven....He would never be able to be in a hospital bed because of the smell and health sanitation issues.
If he is not smelling putrid, turning black with rot, swollen and mushy....he is not dead.

The way these terms, "brain dead, PVS, etc, etc," get thrown around is really a terrible insult to the dignity of critically impaired patient. Brain dead means DEAD. If the heart is still pumping then the brain stem is still functioning ...NOT dead.

The family really needs support and to have available options presented to them...Nursing home maybe until he stabilizes ??...stimulation therapy with lights and sounds...???
Does anyone know if they are being advised of their options..? I would hate to think that they are staring at this boy's minimally responsive body and thinking death is their only option...then for sure they will opt for death....They need to get in touch with rehab specialists...

Posted by: JoJoFox at April 26, 2005 7:52 PM

Hi, JoJo,

Definitively intelligent answer. Thank you.

Posted by: mary et. al. at April 26, 2005 8:11 PM

I am afraid I do not have time to do this justice, I'm still tryin to help Taran, but I'll simply say that the mentality that would say that Taran Francis or anyone with a beating heart is dead reflects the same anti-life TAB bigotry that lies behind the murder of Terri Schindler Schiavo.

That being said, the idea that Terri's case provides the measure by which others must justify their God-given right to life constitutes a fatal concession to the Culture of Death, and only illustrates the simple fact that not everyone who supported Terri opposes euthanasia. CURE's stand is clear, we can not save some on the graves of others! We wil fight for every victim!

JoJo has said it well both about the lethal language of social engineering about anti-life catchwords like "brain death" and "PVS" and about our need to support the family in protecting Taran's life, not criticism, which reflects more ignorance than their simple and thus profound faith in life.

Finally, I hope Tim will set up a forum where this confusion can be addressed because if Blogs for Terri does not become blogs for life, it will become part of the problem rather than part of the solution.

In the interim, read the articles I have posted below and listen to Dr. Byrne's interview also below when you have the chance. And e-mail me, offline, if I can provide you further information or answer any honest question.

Pray and act for Taran!

Posted by: Earl Appleby at April 26, 2005 11:27 PM

One final word for now, from the conclusion of "Brain Death"--The Hoax That Won't Die:

As for CURE, we wholeheartedly endorse the views expressed by Doctors Joseph Evers and Paul Byrne in their landmark expose, "Brain Death-Still a Controversy" (The Pharos, Fall 1990):

"To say that a patient on a ventilator, declared 'brain dead,' is certain to die, and is, therefore, no longer a person is to deny reality.

"Great care must be taken not to declare a person dead even one moment before death has actually occurred. Death should only be declared after, not before the fact, as to declare death prematurely is to commit a fundamental injustice. A person who is dying is still alive, even a moment before death, and must be treated as such.

"...Death ought not to be declared unless and until there is destruction of the entire brain, and of the respiratory and circulatory systems as well."

Posted by: Earl Appleby at April 26, 2005 11:33 PM

Thank you again, Earl. I've thought some more about it and it seems to me that beside the manner which PoliticaObscura presented this mis-information, was the fact that I didn't know what the physical status of Teron was. And I don't know enough about this stuff to discern false facts. One thing I did catch on to finally through this was the impossiblity of keeping dead people "alive" forever. That needs to be stressed, I think, as it would have to be the biggest boogeyman of all.

At present I am a medical dingbat and am grateful to all you watch dogs, esp. the great care Earl has taken of us.

Posted by: mary et. al. at April 27, 2005 8:47 AM

Just a quick pop-in, here...

Earl, and everyone, just an update. Tim is working on a forum site, however he has been ill. He has been down with a bad cold, and needs our prayers. Please pray for him!

I think it is interesting to me that we have been coming under attack while we are all working so hard for life. Satan is having a little heyday with us, each. I know I've had some things happen in the last two days, to try to throw me off course, I know that a couple of others have, as well. Attack, and also just how tired we all must be / lowered immune systems. So, please pray for each other, for Tim, and try to make sure and get enough rest and stay hydrated (just a bit of good health advice...wish some doctors would have followed it in the case of a young woman we all came to love...)

Posted by: juleni at April 27, 2005 12:13 PM

You've got it, Juleni. As Tom says, if God is for us, who can be against?

Also, Eyes Wide Open has broken her elbow. She's carrying a lot of pain for someone.

Posted by: mary et. al. at April 27, 2005 1:19 PM

Hello,

I've been following your thoughtful discussion of the case and the discussion of brain death with interest. Although I have not specific details regarding this instance I would like to add some facts from my own experiences.

I have, unfortunately, been involved in more than a few cases of children who were critically ill and who progressed to brain death. This has happened at multiple hospitals in several different US cities (I am a pediatric sub-specialist, who has travelled some to complete my training). In response to some of the questions regarding the diagnosis of lack of blood flow:
I have seen this arrived at multiple times. They use of radio-labeled red blood cells and the patient lies under a special camera. Every organ that is perfused with blood lights up. Typically, the skin over the skull has blood flow with no blood flow underneath the skull--giving an appearance of a big empty ball. Horrible to see.
The question was raised as to does the devitalized, unperfused tissue begin to decompose (rot) and the answer is yes. Its not recieving blood and it begins to deteriorate. I have only seen the beginning of this process as the ventilator has always been removed at this point.

Every institution I have ever been at uses multiple tests (blood flow, EEG, physical exam) and 2 different specialists at different times. Brain death is very different from the so-called vegetative state and I don't believe the 2 could be confused. With such strict criteria (at the places I have observed) probably the diagnosis is under-called not over, which is what you would want in this situation.

One of the things I have learned from this discussion is how much work needs to be done to improve communication around these issues.

thanks

Posted by: reed at April 28, 2005 8:38 AM

There will be a court hearing at Noon today which without objection from the family, the court will allow the hospital to disconnect the ventilator.

I think that the lesson here is for the doctors and hospitals: treat everyone, even the poor, with dignity.

Everything about this case stinks -- from the fact that an infection went untreated causing a massive swelling of the brain to the necessity of this family to have to go public with their story to get a court hearing.

Teron's family was lied to so often that they became skeptical of anything told to them by doctors.

Posted by: extremecatholic at April 28, 2005 8:41 AM

Reed, thanks for your insight. Understanding is the beginning of wisdom.

Posted by: Tom Spence at April 28, 2005 1:17 PM