Calif. judge: Brain-dead teen can be taken off life support

The uncle of a 13-year-old Northern California girl declared brain dead by a judge today says he's hoping for a Christmas Eve miracle. 

Jahi McMath's family says she bled profusely and went into cardiac arrest following a tonsillectomy. They've been fighting to prevent Children's Hospital in Oakland from taking her off life support.

The judge sided with the hospital today after hearing from two doctors, but has given the teen's family until 5 p.m. Dec. 30 to file an appeal. She will stay on life support until then.

The doctors testified today that the teen couldn't breathe on her own when the ventilator was briefly removed during tests.  Judge  Evelio Grillo expressed his sympathy but said that he was powerless to order the hospital to keep Jahi on life support.

The girl's uncle says he and the family would discuss and decide whether to appeal or to allow the hospital to remove the Jahi from the ventilator.

Dr. Paul Graham Fisher said Jahi McMath meets all the criteria of brain death. Fisher's evaluation was the second to reach that conclusion. 

Jahi McMath was declared brain dead after experiencing complications following a Dec. 9 tonsillectomy at Children's Hospital in Oakland.

An Alameda County judge on Monday called for Jahi to be independently examined by Fisher, the chief of child neurology at Stanford University School of Medicine.

On Dec. 12, doctors concluded the girl was brain dead and since then have wanted to remove her from life support. Jahi's family wants to keep her hooked up to a respirator and eventually have her moved to another facility.

The family said it believes she is still alive and that the hospital should not remove her from the ventilator without its permission.

"It's wrong for someone who made mistakes on your child to just call the coroner ... and not respect the family's feeling or rights," Sandra Chatman, Jahi's grandmother and a registered nurse, said in the hallway outside the courtroom.

"I know Jahi suffered, and it tears me up."

Jahi's mom said last week the girl had feared she would not wake up after surgery.

The family's attorney also asked Judge Evelio Grillo to allow a third evaluation by Paul Byrne, a pediatric professor at the University of Toledo. The hospital's attorney objected to Byrne, saying he is not a pediatric neurologist.

Byrne is the co-editor of the 2001 book "Beyond Brain Death," which presents a variety of arguments against using brain-based criteria for declaring a person dead.

In a phone interview, Byrne said he could not comment in detail because he had not seen any of Jahi's medical records. But the fact that her ventilator is still functioning properly is a sign that she is alive, he said.

"The ventilator won't work on a corpse," he said. "In a corpse, the ventilator pushes the air in, but it won't come out. Just the living person pushes the air out."

Jahi's family says the girl bled profusely after a tonsillectomy and then went into cardiac arrest before being declared brain dead.

Outside the courtroom, Durand said Jahi's surgery was "very complex," not simply a tonsillectomy.

"It was much more complicated than a tonsillectomy," Durand said. He refused to elaborate, citing health care privacy laws.

Arthur L. Caplan, who leads the Division of Medical Ethics at NYU Langone Medical Center and is not involved in Jahi's case, told The Associated Press that once brain death has been declared, a hospital is under no obligation to keep a patient on a ventilator.

"Brain death is death," he said, adding, "They don't need permission from the family to take her off, but because the little girl died unexpectedly and so tragically, they're trying to soften the blow and let the family adjust to the reality."

Often families confuse brain death with a coma or a permanent vegetative state, Caplan said.

"A coma is like a television that has a picture with a lot of interference," he said. "There's brain activity, but something's not right. A permanent vegetative state is when the screen is all snow. Brain death is when the set is unplugged. There is nothing on the screen."

Keeping Jahi on a ventilator is also likely to cost thousands of dollars a day, Caplan added, and because she has been declared brain dead, is unlikely to be covered by health insurance.