The Science Behind Brain DeathBy BENEDICT CAREY and DENISE GRADYJAN. 9, 2014
In one way, the cases are polar opposites: the parents of Jahi McMath in Oakland, Calif., have fought to keep their daughter connected to a ventilator, while the parents and husband of Marlise in Fort Worth, Tex., want desperately to turn the machine off. In another way, the cases are identical: both families have been shocked to learn that a loved one was declared brain-dead — and that hospital officials defied the family’s wishes for treatment.
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A person who has received a brain-death diagnosis cannot breathe on his or her own and is legally dead, in all 50 states. In two states, New York and New Jersey, that hospitals must take into account the family’s religious or moral views in deciding how to proceed in such cases. In all others, including California and Texas, hospitals are not required to consult the family in how to terminate care.
Doctors at Children’s Hospital in Oakland pronounced Jahi, 13, brain-dead on Dec. 9. She developed complications after surgery for sleep apnea and lost a large amount of blood. Ms. Muñoz , 33, got the diagnosis at John Peter Smith Hospital after she collapsed from a blood clot when she was 14 weeks pregnant. The hospital, citing a state law, refuses to remove the ventilator because it would harm the fetus, now in its 20th week.
The two cases are poignant in part because of a biological quirk of the body: The patients’ hearts continue to beat. Hearts have their own biological pacemaker and can continue to function for days and even months after brain death, experts say, depending on the health of the patient and how much treatment is provided. The heart usually stops within a day or two, with ventilation and no other medical intervention.
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