What Does It Mean to Die?

The New Yorker has a piece on Jahi McMath, a California teen whose routine 2013 tonsil removal surgery went horribly wrong. Declared brain dead after hemorrhaging, Jahi’s family refused to accept the pronouncement. With the help of a GoFundMe page and the same network that supported the Schiavo family in the Teri Schiavo case, the family had Jahi removed from the hospital in Oakland and sent to a Catholic hospital in New Jersey willing to accept her. Five years later, supported by a ventilator and a feeding tube and now out of the hospital, Jahi exists in an apartment hovering between life and death.

I remember this story; I wrote blog posts about it at the time of the original surgery.

If an upcoming trial determines that the 2013 declaration of brain death should be overturned, then the Oakland California hospital where the surgery was originally performed could well be on the hook for Jahi’s very costly maintenance.

This is a truly bizarre case. No one, not even her family, now thinks that Jahi will ever get up and out of bed or speak or smile or even open her eyes. No one thinks she could survive without the vent and feeding tube. But some neurologists, and her family, think that Jahi hears them and moves her extremities slightly in response to requests. Delusion, or is there some level of consciousness there? Who knows?

Jahi’s situation goes to the heart of what life is, and what death is. Physicians and medical ethicists thought they had the question resolved, but Jahi throws the question up in the air anew. She’s officially declared dead and her family can’t take an IRS deduction for her as a dependent child, but she’s still in New Jersey being cared for by family and 24 hour nurses being paid for by Medicaid. She wears pink pajamas and gets her nails done. Brain scans show that her brain stem is nearly destroyed, and the neural connections between right and left sides of her brain are hardly visible. But she has some brain matter; not all of her brain has liquified, as might be expected in a brain dead corpse.

As taxpayers, we’re all contributing to Jahi’s being maintained in this curious state. Whether or not her situation continues depends on that jury trial in New Jersey, which will determine whether the original pronouncement of brain death should be overturned. If the declaration of death is upheld, I doubt that Medicaid can continue to pay for her care. I know one thing: I’d hate to serve on that jury.


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