This blog came to me while watching CNN discuss the case of Jahi McMath and hearing Jeffery Toobin (a man I usually respect) shout over and over again “She’s dead, she’s dead!”, as if trying to brain wash any one from thinking any different. The media would have the public believe that brain dead is the same as a corpse on a ventilator. Important questions are not being asked or answered by the CNN interviewers. Put a fresh corpse with blood still in its body on a ventilator, with hormones and blood pressure medication and observe. I will guarantee you there will be no real measureable blood pressure. Since the body releases urine and bowel at the moment of death, there should be no more urine or excrement, except for fluids released in different places as the body goes into various states of decomposition. If you wash the skin, the body will still smell because it will decompose from within. No metabolic processes are happening within the organs or cells. No electrical activity takes place in the heart, although the machine is moving the heart.
However, this is not the case for those classified as “brain dead”. Low level processes are still being maintained by life in the body – it is not a corpse. In other words, although the machine is doing a vast amount of work to maintain the person’s life, although the brain might be mush without blood flow, their body is responding by base levels of life. Some people who were declared “brain dead” died while waiting for a determination from the courts to remove the ventilator. How does a corpse die on a machine? If one is already “dead”, their corpse can’t die too. A machine cannot sustain a life indefinitely – the body will quit eventually even on life support.
The truth is the moment of death is a process. Before life-saving technology that process, when at the end stage, happen rather quickly. It appeared to take a couple minutes. We now know that’s not exactly the case. The heart shuts off first, stopping the breathing. This is known as clinical death. When breathing ceases than brain cells die from lack of oxygen. Permanent brain damage happens within 3 to 6 minutes of the brain without oxygen. Longer durations without oxygen will eventually cause biological death. Biological death occurs when resuscitation is no longer possible. After clinical and biological death, the rest of the cells in the body continue to die from lack of oxygen. The cells in arms and legs can take up to 6 hours to totally die according to Wikipedia. That’s why after a person loses a limb in an accident, doctors can reattach it even after several hours with little damage. Clinical death is the stage where intervention can reverse the dying process. This is done by resuscitation. Timely medical intervention makes it possible to stop, or interrupt, or suspend that dying process. Therein lies the rub.
When attempting to prevent death by medical intervention, if someone recovers and goes on to lead a “normal” life, most would agree that, that was a good thing and praise God for it. If medical intervention saved a life and leaves someone conscious, but permanently impaired either mentally or physically, some would say that’s not so good, they should have died rather than be permanently disabled. Others would say at least they’re alive and still praise God for this life. What one can conclude is, to the degree the brain damage effects the person’s consciousness and the ability to communicate, directly correlates to the degree the medical profession believes this person is worthy of life. With this bias against a life lived with a severe brain disability it’s difficult to trust terms that mimic diagnoses such as; minimally conscious, vegetative or brain dead. These are sensational, even inflammatory terms used to elicit a repulsive reaction to significant degrees of brain injuries. “Vegetative”, “minimally conscious” and “brain dead” equate to the old terms such as; invalid, mongoloid, and feeble minded where as they are also used to dehumanize the individual living with that disability. These terms are not a medical diagnosis. However, “Brain Death” is a legal term for the window for organ procurement. The purpose for using such inflammatory terms is to instill fear and to get the public to agree that ending life should be done in such cases.
This bias against a life lived with a disability was affirmed in my mind on January 14, 2014 by Dan Savage, a guest on Anderson Cooper, who claimed another reason Marlise should be removed from the ventilator is the child within her might be brain damaged and therefore significantly disabled. He went on to say why should this man be saddled with a disabled child, and who is going to pay for this disabled child’s needs? It was pointed out by Sunny Hostin that other women who continued their pregnancies in this condition had healthy children, so there’s no precedent for the child of “brain dead” women having a disabled child. Again, if there was a precedent for the child having a disability that would have been a good reason to take her off, clearly indicating if there’s a legal way to prevent the disabled life it should be pursued. More importantly, someone please explain to me the science or biology behind how a “corpse” keeps another life alive until its viable?
Whether one believes the 13 year old Jahi McMath, or the pregnant woman in Texas, Marlise Munoz, should have their respective vents shut off or not, is really not the issue here. The issue is; how can you trust what is being said is actually the truth? Our society so devalues a life lived with a disability, (especially significant brain damage) that that disability is seen as something so horrible and dreaded that it is thought to be kind to put the person out of their misery. How do people in such a society even start to have a serious discussion about the right time to allow someone to die? Of course, if one is “brain dead” they are supposedly “dead”, so how can they be in any misery at all?