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Home > Topics > Patient assessment
June 22, 2014

Expert: N.J. 'best destination' for brain dead patients

New Jersey is the only state with a law requiring hospitals to accommodate brain dead patients who belong to a religion that does not accept the diagnosis as a final verdict for death

By David DeBolt
Contra Costa Times

NEW BRUNSWICK, N.J. — If Jahi McMath is in fact at a New Jersey hospital, as one TV news station reported this week, the 13-year-old Oakland girl would be in the "best destination" for a patient declared brain-dead, a medical expert said Thursday.

The move from the Golden State to the Garden State would be a logical one, according to Arthur Caplan, director of the division of medical ethics at New York University's School of Medicine. While California law allows for reasonable accommodations for brain-dead patients to be made -- usually giving time for family to arrive to say goodbye -- New Jersey goes a step further.

It is the only state in the U.S., Caplan said, with a law requiring hospitals to accommodate brain-dead patients who belong to a religion that does not accept the diagnosis as a final verdict for death.

And it appears Jahi's case could be the first to test the law, though it is not clear if it would satisfy it, he said.

"As far as I've been able to tell, no one knows if anyone has ever used it," said Caplan, who has followed Jahi's case and researched the 1991 law. "You'd probably have to show you belong to a church that doesn't accept brain death or a religious group. But all that said, New Jersey ... is the best destination."

Six months after Jahi was declared brain-dead, KPIX reported Wednesday that she is at St. Peter's Children's Hospital in New Brunswick, New Jersey. Successful court battles and crafty negotiating on the part of the family's attorney, Christopher Dolan, allowed the family to take the unusual step of moving Jahi out of UCSF Benioff Children's Hospital Oakland, where she had the original surgery to remove her tonsils and other tissue from her nose and mouth.

The teen left the hospital in an ambulance on Jan. 5, and her whereabouts were not made public until Wednesday. Dolan declined to confirm if Jahi is located there, as did a hospital spokesman. In a statement to this newspaper Wednesday evening, Dolan said Jahi's condition has improved since leaving Oakland.

"I have seen much more movement in Jahi, response to her mother's touch and voice and what appears to be movement in response to voice command," Dolan said. "But I am not a doctor and there may be explanations for this dramatic difference in her presentation."

Dolan said the family might ask for a fourth test to determine if she has brain activity. The first three -- including one by an independent physician -- found that Jahi had no brain function.

Wade Smith, director of the neuroscience intensive care unit at UCSF, said it possible for brain-dead patients to have muscle spasms, but not to respond to commands. Smith said he knows of no recorded cases of a brain-dead patient recovering brain function.

"If there is response to stimulation that is not reflexive and that was validated by a neurologist with expertise than I think it's a very important case to document and show the rest of the world," Smith said. "I would be very interested in seeing the results of that evaluation. Short of that, I would be skeptical that the claims are accurate."

David DeBolt covers breaking news. Contact him in Richmond at 510-262-2728. Follow him at Twitter.com/daviddebolt.

———

McClatchy-Tribune News Service
©2014 the Contra Costa Times (Walnut Creek, Calif.)

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