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More on Jahi McMath

January 9, 2014

Hi Reader.

The macabre spectacle that is the case of Jahi McMath just keeps getting ridiculouser and ridiculouser. I wrote a summary of the story yesterday, but for a Twitter version, it can be summarized thusly: Jahi is dead. Tragic. Those involved with poking, prodding corpse should be shunned as they prevent family from grieving.

Today, there is additional information about the case, which is getting more vile by the second. Yesterday, I read an interesting article about Christopher Dolan, the attorney for Jahi’s family, and felt a soupçon of understanding for his position in working for the family. This feeling was utterly nuked today when he opened his yap again and stated that Jahi is”improving” now that she is “getting the treatment she should have gotten 28 days ago”.

First, there is NO “treatment” for death. Dolan seems to be slithering right by that understanding, which is hardly surprising since, by his own admission, he knows absolutely nothing about brain death. Second, to state that a deceased person is “improving” is quite possibly the most ignorant thing that has ever been said in the Annals of Ignorance–and as you know, Reader, we see quite a bit of it in the world of anti-vaxxers. Dolan may think that he is advocating for the family, but what he is actually doing is apparently confusing large numbers of people, who do not understand that Jahi is dead. Further, Dolan is executing an even crueler trick. He is preventing a family that needs to properly grieve for a child from doing so.

I have heard people who have lost loved ones wish that they could fast-forward a year, so that they could reach a time when the pain would not be so horribly acute. If Jahi’s family had been able to accept her death, and were not encouraged to perpetuate this circus, then they would already be nearly a month past the death of a child. I am not at all implying that they will ever get over her death–they will not. But a month of grieving is still a month when the healing, however slowly, could have begun.

Those involved in encouraging this magical thinking are nothing short of vermin. And while Dolan claims that he will not be involved an any potential lawsuits against the hospital should they be filed, he sure appears to be trying to set it up for a buddy.

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  1. One question that this case has brought up for me is whether a diagnosis of brain death can be mistaken? I am NOT suggesting that the diagnosis is mistaken in Jahi’s case – clearly with all the public attention the medical people will have re-checked and re-checked in this case – but it seems that in a more general sense a false positive diagnosis must occasionally occur in the same way that catastrophic medical mistakes of other types are occasionally made. Every so often human fallibility plus the weight of numbers leads to incredibly awful mistakes being made – I’m thinking mistakes in the one-in-a-million category like a surgeon accidentally removing the one functioning lung from a man with lung cancer who was scheduled to have the diseased side amputated.

    When I google likely strings (“mistaken diagnosis of brain death”, etc.) it *seems* that there are many results. Are these results mistaken in the same way that googling “do vaccines cause autism?” will get you falsehoods, or is something else going on? I’d like to see a decent article which went into all the issues – cases like Zach Dunlap make people understandably nervous. When Steve Novella wrote it up he added: “It should also be noted that this case is a rare anomaly. The criteria for brain death are very conservative, and if properly employed there is almost no chance (I am tempted not even to say “almost”) of error or of meaningful recovery following a diagnosis of brain death.” which sounds very sensible but as a layperson I don’t know how to tell what the criteria are or how I determine whether somebody is “properly employing” them.

    If I ever find myself in the situation of being told a loved one is brain dead, is there any way that I – as a lay person – could usefully evaluate whether things have been done “properly” or do I have to cross my fingers and hope? I recognise that the likelihood of somebody being mistakenly declared brain dead are extremely extremely extremely low, but the consequences of misdiagnosis in this situation are pretty much as high as they can ever be, so I don’t think it’s irrational to want to feel that we can somehow reassure ourselves no mistakes have been made.

    • I think this is a fair question. My first thought is that you have carefully and rationally laid out all of the reasons that the odds of a mistaken diagnosis of brain death are extremely low, to the point that it approaches zero. It is entirely possible, as you point out, that googling this is very analogous to finding sites that claim that vaccines cause autism. “Brain-dead” has entered the lexicon of most people by now and as such is thrown around very casually, with very little understanding of what it actually means. Regarding the alleged cases of people with “brain death” who “recover”, I am extremely skeptical of their claims. I would put the odds at one in a billion of it happening, and the odds of it happening to you are basically zero. Whether or not there is blood flow to or electrical activity in the brain is really not a gray area.

      However, to address your questions, if you were ever concerned or had doubts about any diagnosis a loved one received, my advice would always be to seek a second opinion from a completely independent source. I would also recommend that if you were ever in a situation similar to the family of Jahi that you consider the power of emotion in decision-making, and if the second opinion is not what you wanted to hear, you still must be open to accepting it. It would be a tremendously difficult situation, but the fact is that the family is essentially torturing themselves. Much like the logic-resistant position of anti-vaxxers, they believe that she might wake up, and as such no amount of science will persuade them otherwise. It’s truly a tragedy all around.

      • Upon further reflection you are right about the emotion thing – the psychological effect of feeling guilt that you might not have “done enough” is tremendous. I think getting a second opinion if concerned is a good idea here, even if only for the psychological reassurance value of calming oneself. Thanks for letting me muse on this :)

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