Who “Benefits” When Brain Dead People are Kept on Life Support?

Blog post -1-24-14

Hi. All, Thank you for joining our Crisis-Coaching blog and website. Happy New Year.

Presently, I am  monitoring several US national news stories.

(1)  The Marlise Munoz Texas case:  Marlise Munoz, a brain-dead pregnant woman, age, 33, who collapsed in her home on November 26, 2013, and was found by her husband, Erick Munoz.  Technically brain-dead, Texas law requires pregnant women to be kept on life support if there is the possibility of delivering a viable (living) baby. Mrs. Munoz had made it clear she didn’t want to live on life support. What wasn’t so clear is whether she would change her mind in light of being pregnant.

It came out this week that the fetus is developing abnormally.

Today (1/24/14) a Texas judge ruled that Mrs. Munoz should be taken off of life support, respecting the wishes of her husband and parents.

(2)  The Jahi McMath California case: Doctors in Oakland, California, declared Jahi McMath, age 13, to be brain dead on December 12, 2013, three days after she underwent surgery to remove her tonsils, adenoids and extra sinus tissue. Doctors believed this would cure her sleep apnea. She suffered complications from the commonly done procedure.

My interest in following these stories and the legal outcomes is this: both cases have impact on “caregiving”, “insurance companies being willing to continue to pay”, and “estate planning.”

The Uniform Determination of Death Act, states that an individual is dead when he or she "has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem."

This clear-cut law becomes murky when someone is in a deep coma.  Other two cases for consideration are the Terry Schiavo Florida case. Mrs. Schiavo was finally permitted to die in 2005, after being on life support for a decade.

Perhaps a less-known case but recently brought up for discussion again on CNN, Dr. Sanjay Gupta’s program this past week is the California medical file of Grant Virgin. JJ Virgin, his mother, is one of my colleagues. (Translation: we are both part of a large and growing group of ecommerce marketing writer – speaker – trainers and have both been at the same professional events at the same time.). Her son, Grant, was a victim of a hit and run accident, and was severely injured. He was 17.  He had a torn aorta, a traumatic brain injury -- including skull fractures and bleeding throughout his brain -- compound bone fractures and spinal fractures. Broken glass and gravel were embedded in his skin. He was in a coma and doctors told the parents, JJ and her husband John, to let Grant ‘go’.

His parents gave progesterone topically (applied to his skin) at the suggestion of friends, and Grant emerged from his coma soon after. He started speaking in a limited way. The parents consulted with Dr. Barry Sears, a US expert on using fish oil for brain injury cases to aid in recovery.  He had consulted on the Randy McCloy miner case in “2006:  It involved a miner, Randal McCloy, who was involved in a deadly explosion in West Virginia. His brain had been badly damaged by carbon monoxide, and his team of doctors was trying desperately to keep him alive.” (CNN: http://www.cnn.com/2014/01/18/health/fish-oil-recovery/ )

Grant was given high dosages of omega-3 fatty acids, which are found in fish oil through his feeding tube. About 48 hours later it is reported that he could have complete sentences.

Fish oils are thought to alleviate inflammation in the body and to improve brain function.  He has had a substantial recovery.

Read more here on his remarkable recovery – credited to Omega 3 Fish Oil!

http://www.cnn.com/2014/01/18/health/fish-oil-recovery/

"If you have a brick wall and it gets damaged, wouldn't you want to use bricks to repair it?" Dr. Michael Lewis, founder of the Brain Health Education and Research Institute, told CNN. "By supplementing using [omega-3 fatty acids] in substantial doses, you provide the foundation for the brain to repair itself."

Limited research has been done to link fish oil and recovery of the brain, but doctors believe omega-3 fatty acids can help stop inflammation.

Want to know more about JJ Virgin and her Virgin Diet? Here is her website. http://jjvirgin.com/

How Do These Case Impact Caregiving, Insurance, and Estate Planning?

For Consideration:

• If a fetus kept developing in a brain –dead mother, is delivered alive but with severe deformities, a) Is the insurance company responsible for the baby’s lifelong care, or is the government of the state that enforced it being carried to term and delivered? ( which ultimately means the tax payers are paying for the care if the state is held responsible)

• Does any woman of childbearing years now need to re-write her Healthcare Directive to say what her wishes are if she is on life support and pregnant? Does the state or federal government have the right to override someone’s personal last wishes? Can a spouse override last wishes of his / her mate?

• Consider that when you die, your Social Security number is canceled as you are no longer an asset of the state or federal government. (Executors and Personal Representatives have to ask the IRS for an EIN number for settle an estate). Does the federal or state government perhaps have the right to keep a body on life support or have control over a gestating fetus as “assets of the government”?

• Can the government force a spouse into being a caregiver for a spouse or baby that should have been allowed to die due to extreme disabilities?

• What are the “fine-line distinctions” between “coma” and “brain-dead”?  Shouldn’t this information be made more publicly available common knowledge?

• Can a state or federal court step in and override a parent who insists on keeping a child  - or spouse insisting on keeping a spouse – on life support when the person is determined to be brain-dead?

• Can insurance companies be forced to pay for care?

• If the family financial situation is such that it is stable but only pushed into needing state or federal supplement to health insurance due to mounting costs – does the government then have the right to put a lien on any real estate owned by the person needing care, when they die  (i.e. if they had been allowed to die in the first place, no supplemental insurance payment would have had to have been paid as the family would have had the money or insurance to manage healthcare premium payments and bills).

• How does “keeping someone on life support who otherwise would die” affect estate outcomes where the probate laws say that if two related people  (i.e. usually husband and wife) die within “x” number of days apart, that it affects how the estate is inherited? Could a family “argue” to keep their person on life support strictly for financial gain so that the estate settlement favors them?

• If surgeries are done on brain-dead people – who pays? Insurance company? Family? Government?

• This is the case in the Jahi McMath situation – in order to move her to a new facility, they would need to do a tracheotomy and put in feeding tubes.

• What role should religious beliefs be permitted to play - and how does this affect the separation of church and state in the courts? Do beliefs of the person on life support ‘rule’ - or do the beliefs of the spouse or parents?

• Should healthcare directives (“Last wishes”) given verbally – such as in the Marlise Munoz case – be accepted federally, or on a state by state basis? How does this change if state by state, if someone is injured or falls ill in another state?

• If the U.S. or state governments have overriding rights – over spouses and family – over coma and brain-dead persons, then as science improves, will government have the right to do medical science experiments on brain-dead people kept on life support for its own gain? OR – will this be a new “industry” – if medicine can relatively ensure a safe gestation an birthing of a fetus to live healthy baby – could brain-dead female persons on life support be used as surrogate mothers?

• Where are the boundaries on “life” and “rights to your own body?” Do your rights “end” when you become brain-dead – or – only when you die?

• How could the Marlise Munoz case possibly impact female prison populations? Could female prisoners be forced to give birth vs. abort?

• At what level of medical condition does a loving spouse or family lose control over protecting the wishes of their loved one?

Tags: brain dead, brain injury, church and state, Dr. Barry Sears, fish oil, government rights, healthcare directive, insurance, J. J. Virgin, Jahi McMath, life support, Marlise Munoz, parent rights, pregnancy, spousal rights, Terry Schiavo, Texas