}

One of those moments that make you speechless

AP via Yahoo News reports about an ultra-Orthodox Jewish family who wants to keep their son on life support while doctors say his state has deteriorated beyond hope.

What strikes me is that the boy’s parents are taking the hospital to court to have it obligated to provide whatever it takes to maintain the boy’s status quo but haven’t visited the hospital since July. Maybe somebody’s got some idea as to why they won’t let go of their son if they won’t even see him. I understand losing a child must be about the most painful thing that can happen to parents, and I assume people will not always act rationally in such extreme situations.

Regardless of how you personally feel about the case, please have the little boy in your prayers.

A Washington hospital has asked a judge for permission to stop treating a brain-dead 12-year-old cancer patient, even though his ultra-religious New York parents want to keep him on life support.

Motl Brody of Brooklyn was pronounced dead this week after a half-year fight against a brain tumor, and doctors at Children’s National Medical Center in Washington say the seventh-grader’s brain has ceased functioning entirely.

But for the past few days, a machine has continued to inflate and deflate his lungs. As of late Friday afternoon, his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline.

That heartbeat has prompted Motl’s parents, who are Orthodox Jews, to refuse the hospital’s request to remove all artificial life support.

Under some interpretations of Jewish religious law, including the one accepted by the family’s Hasidic sect, death occurs only when the heart and lungs stop functioning.

That means Motl “is alive, and his family has a religious obligation to secure all necessary and appropriate medical treatment to keep him alive,” the family’s attorney wrote in a court filing this week.

The family has asked the hospital to leave the breathing machine on and keep administering drugs until the boy’s heart and lungs no longer respond.

Disagreements between families and medical providers over when to end care for terminally ill patients are common, experts say, but this case wound up in court with unusual speed.

Unlike Terri Schiavo or Karen Ann Quinlan, who became the subjects of right-to-die battles when they suffered brain damage and became unconscious, Motl’s condition has deteriorated beyond a persistent vegetative state, his physicians say. His brain has died entirely, according to an affidavit filed by one of his doctors.

His eyes are fixed and dilated. His body neither moves nor responds to stimulation. His brain stem shows no electrical function, and his brain tissue has begun to decompose.

“This is death at its simplest,” the hospital’s lawyers wrote in a court filing.

The hospital said it would help the family move what it called the boy’s “earthly remains” to another medical facility, but has found none willing to accept a brain-dead child.

The dispute wound up in court Sunday, when the family asked a federal judge to block the hospital from doing any further tests for brain activity.

The hospital responded by asking a District of Columbia Superior Court judge for permission to discontinue treatment.

Jeffrey I. Zuckerman, the attorney for Motl’s parents, says they have been “utterly shattered” by the hospital’s actions.

He stressed that the family’s demand for continued life support was based on their obligations under religious law, not an unrealistic hope that their boy will recover.

“You can always hope for a miracle, but if you are asking if they are in denial about their child’s medical condition, no, they are not,” Zuckerman said.

A hearing was scheduled for Monday, but Children’s National Medical Center said it would ask for a postponement until Wednesday.

“We respect the family’s beliefs, and have tried since the patient’s arrival in June to work closely with them in a spirit of mutual respect,” the hospital said in a written statement.

It added, however, that attempts to discuss end-of-life issues with the family had been complicated.

Motl’s mother and father, Eluzer and Miriam Brody, haven’t been to the hospital since July. The medical center says its requests to speak directly with them have been rebuffed, and in recent days, hospital employees “have been inundated with harassing and threatening calls” regarding the case.

A substantial delay in resolving the disagreement may render it moot. The hospital suggested in legal filings that the boy’s remaining body functions will cease within weeks, if not days.

Dr. Edward Reichman, an associate professor of medicine at Albert Einstein Medical College in New York, said the question of how to accommodate religious beliefs regarding brain death comes up occasionally in New York, where there is a large population of Orthodox Jews.

While there is intense debate over whether to accept brain death as the spiritual end of life, hospitals usually find a way to work through it, he said.

“More often than not, the medical team … will accept the wishes of the family, especially if cardiac death is anticipated in a short window of time,” he said.

Arthur Caplan, a professor of bioethics at the University of Pennsylvania, said physicians aren’t obligated to provide care that can’t possibly be medically helpful.

“Doctors are well within their rights to say, ‘We are stopping,'” he said. “I don’t think medicine can become subservient to religious, spiritual or mystical hopes and beliefs concerning how to manage death.”

15 Comments

  1. Yaakov M. Hammer

    11/9/2008 at 11:03 am

    Contrary to your assertion that the parents are taking the hospital to court, the hospital initiated court action, according to the article you quote and other media coverage. Did you verify the statement that the parents, who have six other children to support and care for, have not been to the hospital since July? Did you know that relatives, friends, and neighbors have maintained a 24/7 vigil for nearly six months? And in response to your question: as you note, letting go of a child cannot be easy, but here — and as Jews we need to support each other — pulling the plug is contrary to the halacha that guides and defines the parents’ lives. Yaakov M. Hammer

  2. ol cranky

    11/9/2008 at 11:33 am

    With all due respect Yaakov, the lungs aren’t functioning with support the ventilator is doing the breathing. Using this strict adherence to halacha, you could argue that even after the heart stops beating on its own the boy’s chest should be cracked to manually make the heart beat since that is, essentially what is being done to make it appear as though his lungs are still functioning. The Chasidic interpretation of halacha in this case isn’t following G-d’s will, it’s overriding it. Halacha mandates necessary and appropriate medical treatment, what Motl Brody is now getting is not medical treatment, it is battery in the form of creating an illusion of life. As such, discontinuation of mechanical ventilation is appropriate and will allow G-d’s will to be done.

  3. froylein

    11/9/2008 at 12:14 pm

    The dispute wound up in court Sunday, when the family asked a federal judge to block the hospital from doing any further tests for brain activity.

    The hospital responded by asking a District of Columbia Superior Court judge for permission to discontinue treatment.

    I’ve understood those lines as the family taking the hospital to court (asking for stopping brain examinations that would verify Motl’s state, thus maintaining the status quo) and the hospital responding in kind.

    I do understand that the family’s got other kids to care for, still, the hospital’s annotation that the parents hadn’t visited Motl since July struck me as strange, no matter how many family members or neighbours are around. (And knowing how cautious hospitals over there are about public statements, particularly when there might be a breach of data or patient privacy guidelines, I’m willing to believe there must be something to the claim).

    I hope it became clear enough that the family does have my sympathies and that I will refrain from weighing in when life-support should be stopped; I know the pros and cons on that issue from various perspectives, and all I can say is that I would never want to be in a situation where I have to take such a decision.

  4. chutzpah

    11/9/2008 at 12:56 pm

    I don’t think the financial drain on the hospital is justified here. If they want to keep him there, tell them to pay out of pocket for his medical expenses or have “the community” cover those costs…they’d come up with a heter quite quickly.

  5. chutzpah

    11/9/2008 at 12:58 pm

    Who is paying Zuckerman’s fees? The only people that benefit in a case like this are the fucking lawyers.

  6. Tom Morrissey

    11/9/2008 at 6:55 pm

    There is a silver lining here, chutzpah.

  7. Ben-David

    11/10/2008 at 8:20 am

    Chutzpah: arguing end-of-life issues based on costs is not just flippant, it’s the chilling shadow that keeps many thinking people fearful of doctors taking on end-of-life decisions.

    Whenever active medical euthanasia has been authorized, there inevitably are abuses of the system.

    You obviously haven’t thought this issue out in your rush to make a snarky anti-Orthodox comment.

  8. Chutzpah

    11/10/2008 at 2:38 pm

    The Orthodox are entitled to their opinion and they are absolutely entitled to take every measure possible to provide services to their child, IF they can affored to pay for those services privately.

    Forcing Medicaid to pay the Hospital less than what it costs it to keep the child there offends my rights as a taxpayer as much as using tax dollars to fund abortions offends pro-lifers.

    In a society that is on the brink of bankruptcy, the cost to the many must outweigh the ideology of the few.

  9. Chutzpah

    11/10/2008 at 2:43 pm

    Cost is the over-riding factor in all decisions by even the most pious. Like I said, offer to let them pay for it and see how fast they say to disconnect the services.

    And this case does not involve active medical euthanasia, it involves a decomposing body which belongs in the ground.

  10. ol cranky

    11/10/2008 at 7:20 pm

    Ben-David: in cases of medical futility (actually especially in cases of medical futility such as this) the cost of care and waste of healthcare resources have to be considered. Every resource used to maintain an illusion that this boy’s heart and lungs are supporting his life (instead of equipment providing an illusion of living) is a resource not used to maintain the health and well being of another. One must not ignore that this unnecessary and futile use of healthcare resources could potential divert life saving measures for one or more others. That is truly a shunda.

  11. Chutzpah

    11/10/2008 at 8:04 pm

    We are talking about a community that has a culture of cutting corners on taxes because they believe their tax money is spent on things which go against their ideology, then they have the chutzpah to ask tax dollars to support something like this? They should audit every family in the community, what they collect in unpaid taxes can cover the boy’s end-of-life medical services.

  12. DK

    11/11/2008 at 1:15 am

    I heard this is a Bobov chassidic family. Is that true?

  13. Ben-David

    11/11/2008 at 2:30 am

    Chutzpah:
    America just elected a guy who is going to give money to the 40-50 percent of Americans that pay no federal taxes at all. He also intends to enlarge that number.

    Which makes your selective umbrage at haredi “corner-cutting” all the more revealing.

    Sorry folks – anyone who has followed the ethical/policy debate around end-of-life issues knows how stupid/dangerous it is to argue based on costs.

    The point is that the treatment is futile, and no longer has medical merit.

    That’s all that needs to be said.

  14. chutzpah

    11/11/2008 at 12:57 pm

    Doctors call “time of death” every day in emergency room across this country and on our battefields abroad.

    To let Rabbis micro-manage Doctors is dangerous to both the individual patient and entire health-care system.

    This community is trying to make some kind of political grand-stand with this maneuveur and they are probably hoping for a large cash settlement offer from the Hospital to go away.

    They are asking for medical testing but when it comes to performing autoposies on their own victims of Shaken-Baby Syndrome, they want nothing to do with medical testing.

    The idea behind giving money to Americans who pay no federal taxes is that they will then get on their feet and pay back into the system.

    I make no attempt at hiding my distain for Hasidic and Ultra-Orthodox “Americans”. I think they will gladly take from the system but then will always find an ideological excuse not to pay back into it.

Leave a Reply

Your email address will not be published. Required fields are marked *