Friday, February 21, 2014

Ventilating the Dead: Jahi McMath Update

Nailah Winkfield, the mother of Jahi McMath, the girl who was declared brain dead on December 11 of last year but who is being kept on ventilation and artificial feeding in an undisclosed location, has authored a letter to the general public about her daughter's condition. In the letter, she says that her daugher is "much better" physically and that she sees changes in her condition "that give me hope." She also hopes that Jahi's story will change the way the world thinks about brain death.

I'm very sorry for Ms. Winkfield, and cannot imagine the anguish she suffered when her 13-year-old died as a result of what was meant to be a routine tonsillectomy. Nonetheless, I sincerely hope that Jahi's tragedy does *not* change the world's mind about brain death. Brain death is a useful and important criterion for determining death in the modern hospital setting where machinery can prevent the cessation of breathing and heart activity. The permanent, irreversible lack of upper and lower-brain activity also seems to me to be the very essence of death, since it signals the deceased's complete and permanent lack of experience in and relation to the world. The fact that a dead person can be kept oxygenated is indeed useful for organ harvesting and transplant; but to keep a person oxygenated after the complete cessation not only of mental life but also even of brain-stem-coordinated automatic activity seems to me at best a very sad exercise in false hope. Harsh as it seems, I think it's also a waste of valuable resources. And most importantly, it mistakes a person for her body. Persons are bodies, to be sure; but they are more than that, fundamentally more. I'll admit to struggling with line-drawing here; my father remained father to me even after he was demented and in many ways no longer the person he once was. And certainly he remained a human being with preferences and experiences. He wouldn't have wanted to live in that state, but my mother (for example) did want him alive, even in that state. But brain-death is a more thorough kind of absence, a more complete dissolution, than mere dementia. I reduces a person to a collection of living and interdependent but non-coordinated and gradually dis-integrating cells and systems. Ms. McMath's life is over; and the end of her story has already been written, even if it takes months to arrive. I wish Ms. Winkfield her peace, but I remained convinced that she has been driven by love and hope and faith into making a terrible, though terribly human, mistake.


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  3. Minor Points
    1 - when you said "routine tonsillectomy" you're not talking about the surgery Jahi had.
    2 - there are plenty of people that will argue that the brain or its contents are not really "the person". that's the kind of people you're dealing with when discussing what brain-death. there's no winning with those types, you just have to pull the plug yourself as you see.

  4. Would you say this same a year later .She moves has periods response to her mother. Is she brain dead. One may ask what is brian dead. Seems too me experts still have a lot to learn.

    1. I disagreed with the blog a year ago, but for different reasons. I think this is a terrible case, but one that is probably better for the country. There will be people who see signs of hope in random body movements and a video purporting to show some sign of improvement. People will find hope in a turnip that is shaped like a religious figure. When the shell of this girl ultimately fails, which it will, this case will just help prove the medical community’s point to the community at large. I appreciate a case like this because it makes it easier to convince people to get documents like a living will in place. Nobody I have ever met in person wants to be kept “alive” by a machine while their brain slowly liquefies.