Talk:Jahi McMath case/Archive 4

Archive 1

Archive 2

Archive 3

Archive 4

Archive 5

New Jersey

Added brief statement on New Jersey's religious objection provision to brain death law. I also found indication that New York has a similar law, but I didn’t include it because I’ve yet to find adequate reference for New York state law.--BoboMeowCat (talk) 17:27, 3 March 2014 (UTC)

Why? What does this case have to do with New York and New Jersey? Remember: this is an article about a person declared brain-dead and the medicolegal and ethical dispute arising from it. More general stuff belongs in other articles, and while it's certainly appropriate to reference those other articles in the article text or in the see also section, we shouldn't be incorporating content this far afield. —/Mendaliv/^2¢/_Δ's/ 18:17, 3 March 2014 (UTC)

Mendaliv It seemed appropriate as this statement is directly following a statement that brain death is legal death in all 50 U.S. states. Additionally, the McMath family later filed lawsuit that lack of such a provision for religious objection violated their religious privacy rights. This information was previously added by IP user but deleted due to lack of proper reference.--BoboMeowCat (talk) 18:26, 3 March 2014 (UTC)

I just removed it, plus the statement that brain death is legal death in all 50 states. Limited relevance at best to this topic; this article is not about brain death or legal death, but about McMath's case. A link to brain death is all we need. —/Mendaliv/^2¢/_Δ's/ 18:30, 3 March 2014 (UTC)

Mendaliv, I don't want to go into this whole thing again, but legal death seems more appropriate in this case, since it specifically means (permanent and irreversible) brain death. And using, "body is alive"-clinical death to explain McMath's position. Editors who want to expand on those topics can do so on those pages. I agree with staying with the article topic.24.0.133.234 (talk) 23:44, 3 March 2014 (UTC)

I dont understand what you mean by "And using, "body is alive"-clinical death to explain McMath's position" or why it's needed in this case. In the grand scheme of things, this is an interesting but minor case that has had no effect on any laws or statutes. A discussion of the legal definitions of death in new jersey or the other 49 states isn't needed; a link to the relevant articles on brain death and legal death (the proper location for such a discussion) is enough to establish background and context for this case. Ca2james (talk) 03:59, 4 March 2014 (UTC)

"body is alive"-in quotes meaning, don't quote me, but trying to shorten the McMath-side of the problem. I thought that was the main problem in the case, or the McMath-view? Hospital says that she is deceased, family says "no she is not" because she is not clinically dead? And I agree that a reference to legal death is much better than trying to define it on this article's page.

-But, it wouldn't hurt to have a sentence or so that explains how hospital, local, and state-laws and practices influenced McMath's treatment. I've already explained this elsewhere here, but it would also be better to not imply or leave the impression that everything about the McMath case is a national or global way of acting in related cases,so as long as the article is clear about that, the less that has to be said about other cases or laws or customs.24.0.133.234 (talk) 14:28, 10 March 2014 (UTC)

NEJM

I want to make it clear that my objection was based solely on the removal of the source/reference, and without prejudice to the idea that the section may need to be rewritten. The NEJM is an indisputable reliable source and is considered one of the gold standards of all academic journals - its articles are of notably high quality. Removing an indisputably relevant NEJM reference from this page cannot but lower its quality. NorthBySouthBaranof (talk) 03:19, 3 March 2014 (UTC)

JFTR-FWIW"death of the individual" is a little tricky, and I'm not sure how it fits with the context of the article-but to explain the death concept of permanent brain death, I kind of like it.24.0.133.234 (talk) 05:41, 3 March 2014 (UTC)

NorthBySouthBaranof, your rewording of the statement involving that journal works fine for me. I had zero objection to the journal, just the reference to worldwide consensus, because it’s my understanding there’s no such consensus in Japan (read a survey that 50% of docs disagree in Japan) and although brain death is a legal option there for those who wish to donate organs, it’s not widely accepted and it’s a serious problem for their transplant program. But I think all of that is beyond scope of this article. Anyway, this is in contrast to the situation in NJ, where there is a religious objection clause, but still, brain death is widely accepted as death.--BoboMeowCat (talk) 17:08, 3 March 2014 (UTC)

Why is this stuff being added? What does it have to do with the specific case at issue in this article, rather than the general issue of brain death, right to die, medical ethics, and the like? —/Mendaliv/^2¢/_Δ's/ 18:18, 3 March 2014 (UTC)

There should be a way to explain that due to McMath's location, California state health codes, and the hospital's policies, her situation was handled as it was, but to not give the impression that the circumstances as far as laws or policies, are national or even global. i think that pointing-out that if the girl had been declared brain dead somewhere else, that different laws and policies would apply in her case or someone in her condition.

maybe a sentence or so to clarify how california law specifically influenced the case(s), and then being careful throughout the article to not misinform or imply that the federal law as it is applied in California, and especially the local/state law as it was applied in this case............would extend nationally or globally?24.0.133.234 (talk) 05:14, 9 March 2014 (UTC)

Since the case occurred in a particular location which is named in the article, it follows that the events that occurred were constrained by the laws, statutes, and customs specific to that location. Even if an explanation of how this case might differ if it had occurred in another jurisdiction wasn't WP:OR, such a discussion is beyond the boundaries of the case and doesn't belong in this article.

In other words, this is an article about the case and what happened, not an article discussing what might have happened if something were different. Obviously if something like the location was different then things would happened differently. However, that they could possibly have been different doesn't mean that they deserve discussion in this article. Ca2james (talk) 20:08, 10 March 2014 (UTC)

Medicolegal vs. religious definition of death

I just went to a conference on medical ethics that discussed this. The issue as I see it is between the medicolegal definition of death and a particular religious definition of death.

Under the legal definition of death, which is generally the Uniform Determination of Death Act which most states have adopted, a person is dead if they have irreversible cessation of the entire brain, including the brain stem.

The overwhelming majority of doctors, and most laws, define brain death as death.

However, there are religious views that believe a person is still alive if the heart is still beating. There is a significant minority of doctors who believe that, and the state laws in New York and New Jersey accommodate that belief. I believe there were articles in the New York Times about that.

For example, there are orthodox Jews (and orthodox Jewish doctors) who believe a person is alive if the heart is beating. Ariel Sharon's family kept him alive for years, even though his doctors said that recovery was impossible and that most of his brain (though not his brain stem) was destroyed. Orthodox Jews are not a fringe view. There are also Christians who have similar views.

It's true that a judge decided that McMath was dead, and that an overwhelming majority of doctors would decide that she was dead given these facts.

However, that's not a religious opinion. The family has religious beliefs contrary to the judge and the doctors. The issue is, what are the rights of a family whose religious beliefs don't accept that determination? Do they have a right to move their daughter to the custody of doctors who do agree with their religious beliefs? Do they have the same rights as Ariel Sharon's family? If they found an institution willing to accommodate them, why didn't the hospital let them move her there? If there is discussion on that issue from WP:RSs, it belongs in the article. --Nbauman (talk) 17:40, 7 April 2014 (UTC)

As the article discusses, the hospital never had any objection to letting the family move McMath's body. They objected to McMath's family's demand that the hospital perform surgical procedures on McMath's body before moving it.

Her family filed a lawsuit seeking to force the hospital's doctors to insert breathing tubes and feeding tubes into McMath's body. That, the hospital refused to do, on the ethical grounds that they would be operating on a dead body. NorthBySouthBaranof (talk) 18:51, 7 April 2014 (UTC)

I don't understand a lot of details on this case. I don't understand why it's unethical to perform surgical procedures on a "dead" (by their definition) body. Hospitals perform surgical procedures on dead bodies all the time, for example in preparation for organ transplant. An autopsy is a surgical procedure. Undertakers perform surgical procedures. According to the linked NBC/AP story, the hospital wanted to turn off the ventilator, which would have stopped McMath from breathing and stopped her heart. One of the principles of medical ethics is autonomy of the patient, which in this case is transferred to her parents. If they want to maintain the ventilator, and they were willing to pay for it, until they can remove her, it seems that the hospital has an ethical obligation to maintain the respirator.

In any case, the important issue is that there is a significant minority opinion that disagrees with the Uniform Determination of Death Act, and would be permitted under WP:FRINGE. The legal definition of death, under the Act, is the law in most U.S. states. However, New York and New Jersey law have provision for heart death:

“Religious or Conscience exception” to the definition of death. The exception provides that if the physician has reason to believe on the basis of information in the individual’s available medical records or information provided by the family or any other person knowledgeable about the individual’s religious beliefs, that the individual’s personal religious beliefs would be violated by the declaration of death, then the death of the individual shall not be declared upon the basis of the neurological criteria. In such cases, death is declared, and the time of death fixed, solely upon the basis of cardiorespiratory criteria. Only New Jersey and New York recognize such an exception. http://www.lawrev.state.nj.us/UDDA/UDDAM07092012.pdf

If McMath had been in New Jersey or New York, her family would have gotten their wishes. The New York Times discussed it. I think this is worth mentioning in the entry. --Nbauman (talk) 03:38, 8 April 2014 (UTC)

Cutting into a dead body to remove organs is done respectfully, but it is done with the underlying understanding that the person is dead. It is not an attempt to "save the life" of someone who is already dead. Her parents wanted doctors to perform "life-extending" treatments on a dead body, and this the doctors refused to do, on the grounds that it would be futile to provide treatment to a dead body. Hospitals and doctors have the right not to perform medical procedures on ethical grounds. This is why you cannot walk into a Catholic hospital and demand an elective abortion. You might find someone, somewhere who would do it - but Catholic hospitals have ethical objections to them.

That's correct, the hospital originally wanted to turn off the ventilator - it would not have "stopped McMath from breathing" because McMath is not breathing. The machine is breathing into her body. As the medical affidavits make clear, McMath's brain stem is dead and hence she would not even reflexively attempt to breathe when removed from the ventilator. It is entirely normal to turn off a ventilator when someone is dead. The hospital's plans to turn off the ventilator were in accordance with its normal procedures after a patient has died in the hospital. They then sought to transfer her body to the county coroner for an autopsy, as per state law.

And no, we don't really know that her family would have gotten their wishes in New Jersey or New York - the hospital and its doctors would likely still have refused to provide treatment they viewed as unethical. McMath's family has found someone, somewhere who would treat a dead body - but Children's Hospital Oakland doesn't have to. NorthBySouthBaranof (talk) 05:02, 8 April 2014 (UTC)

By the way, this discussion is without prejudice to improving the article. If there's reliably-sourced information you think should be in the article, please feel free to be WP:BOLD and add it. However, I would think it WP:CRYSTAL to assert that the outcome would have been different in another state - we don't know what or how hypothetical courts would have ruled in a hypothetical case in a different state. A full discussion of the differences in state laws regarding death would seem to belong in an article about that issue, not an article about an individual case in California. NorthBySouthBaranof (talk) 07:44, 8 April 2014 (UTC)

I have read the New York Times article in question, and I don't think it supports the point you want it to make. All it says is that In two states, New York and New Jersey, hospitals must take into account the family’s religious or moral views in deciding how to proceed in such cases. That one-line statement is not conclusory of any outcome, nor does it make any specific claims about the Jahi McMath case, as opposed to legal death in general. That discussion, then, properly belongs in our article about Legal death. NorthBySouthBaranof (talk) 07:59, 8 April 2014 (UTC)

Agreed that "what would have happened had Jahi been in New Jersey" is not relevant to this particular Wikipedia article. For prior discussion on this issue please see above section. Funcrunch (talk) 16:14, 8 April 2014 (UTC)

Thanks for finding the NYT article. It says, in the context of the McMath case, "Under New York and New Jersey laws, people can prolong the provision of oxygen to keep a person’s heart beating for religious or moral reasons." That makes it relevant. That's what the McMaths wanted to do, and it makes their demands sound more reasonable.

You keep referring to McMath as a "dead body." That's not a fact, that's the point at issue. She's a dead body according to the medicolegal definition in 48 states. She's not a dead body according to the medicolegal definition in 2 states.

There are two sides in this story, and it would be WP:POV to accept one side in Wikipedia's voice. There is the medicolegal definition of death in 48 states, and the medicolegal definition of death in 2 states, and neither is inherently true. There is the medicolegal definition of death, and the McMaths' religious or philosophical definition of death, and neither is inherently true. --Nbauman (talk) 18:51, 8 April 2014 (UTC)

No, it's not POV, any more than it is POV to describe someone as guilty of a crime when they have been convicted of that crime in a court of law. Many convicted persons contest their innocence, but Wikipedia articles nonetheless describe such persons as convicted and guilty of the offense until and unless a court of law rules otherwise.

A competent court in the state of California has ruled that Jahi McMath is dead. Thus, we describe her as dead. We mention the competing claim and theory, but that claim and theory must not be given undue weight. The claim that she is alive has been tested and rejected by a court of law and is adhered to by only a small fringe group. Thus, it is subordinated to the view which is predominant in reliable sources and predominant in the law. NorthBySouthBaranof (talk) 19:30, 8 April 2014 (UTC)

BTW, this article http://www.mercurynews.com/ci_24993245/jahi-mcmath-could-her-case-change-how-california which is cited in this Wikipedia entry also refers to the New York and New Jersey laws, and the conflict between the Uniform Determination of Death Act and religious beliefs. It also gives an account of the similar death of a 12-year-old Jewish boy, Motl Brody. That's 2 WP:RS about McMath that referred to NY and NJ laws, which is a good argument for mentioning it in the Wikipedia entry. --Nbauman (talk) 19:12, 8 April 2014 (UTC)

I disagree. This article is about the events that happened, not about what might have happened had it occurred in another state or about the laws in other states. The fact that something is mentioned in a reliable source does not mean that the thing is relevant to the article. Such a discussion belongs in a broader overview page, if one exists. Note that the Motl Brody case is linked in the box at the bottom. Ca2james (talk) 20:42, 8 April 2014 (UTC)

I think a general statement about the NJ law is beyond the scope of this article, but if we can find something regarding the NJ law that relates DIRECTLY to this case, it seems appropriate. For example, I think I remember Christopher Dolan stating in an article that this would not have been a legal battle if it had happened in NJ. If that statement was recorded in a reliable source, it seems appropriate because it relates directly to this case. --BoboMeowCat (talk) 23:52, 8 April 2014 (UTC)

There's no context for such a statement and adding that context would be WP:COATRACK. We don't have to add every sourceable statement to the article just because it can be verified. Ca2james (talk) 01:12, 9 April 2014 (UTC)

Byrne said the family was removing McMath to New York. That makes New York law relevant. --Nbauman (talk) 01:32, 9 April 2014 (UTC)

Not exactly. They were trying to move McMath somewhere - anywhere - and ended up moving her somewhere within California. The fact is, the New York destination was suggested not because of the laws in that state but because someone reached out to the family. Suggesting that New York's law should be included on that basis is WP:COATRACK. Ca2james (talk) 02:21, 9 April 2014 (UTC)

I don't believe there's been any official statement from the family on exactly where they moved Jahi. There's been some speculation in the media, but no proof of current location. Funcrunch (talk) 16:44, 9 April 2014 (UTC)

You're right; we don't know where they moved her, and I was wrong saying that she'd been moved somewhere in California. No matter where she is - even if she was in the NY facility that offered to taker her - suggesting that NY's law should be included in the article would still be WP:COATRACK because that facility wasn't chosen based on the laws of that state. Ca2james (talk) 17:14, 9 April 2014 (UTC)

1. In one of the legal filings linked in this entry, Byrne said they were moving McMath to a facility in New York.

2. Independent of that, if multiple [[WP:RS]s about the McMath case bring up the New York and New Jersey laws -- which they do -- then WP:WEIGHT requires us to include that in the entry. It's not WP:COATRACK if multiple WP:RSs make that connection. --Nbauman (talk) 14:45, 10 April 2014 (UTC)

I found LA Times article which contains a direct quote from McMath family attorney, Christopher Dolan regarding NJ law in relation to case.

http://www.latimes.com/opinion/commentary/la-oe-0121-dolan-jahi-mcmath-brain-death-20140121,0,5121800.story#axzz2yWEcQW4Z

There is context for this because article currently contains: “At least one commentator has asked whether this case will affect how California's determination of death laws work.” That is toward top of article, but should really be moved to the Aftermath section (because ref is from 1/25 - after transfer) where it can be incorporated with NJ quote something like this:

According to Dolan, “the McMath family's position isn't ridiculous or unheard of. There would have been no legal battle if Jahi had had her tonsils out in New Jersey”, referring to a New Jersey state law allowing religious objection to a declaration of death on the basis of neurological criteria. At least one commentator has asked whether this case will affect how California's determination of death laws work.

I’m going to be bold and add this. Hopefully, it will resolve issue regarding information Nbauman says belongs under WP:WEIGHT. I tend to agree with others that NY law is beyond the scope of this case, even if Byrne mentioned Jahi moving to NY, because Jahi’s location is officially unknown. Although I can see the argument for including NY if multiple reliable sources make reference to it in regards to this case, it still seems to me information about the NY law as well as any detailed info about the NJ law would be better placed in an article about brain death in general under a section regarding how laws differ by jurisdiction.--BoboMeowCat (talk) 22:00, 10 April 2014 (UTC)

Thanks, BoboMeowCat. I'd read Nbauman's earlier comment and meant to post a reply to say that I saw the point being made. Thanks for updating the article. Ca2james (talk) 03:22, 11 April 2014 (UTC)

Sourced and relevant. Good work, BoboMeowCat. Thanks! NorthBySouthBaranof (talk) 06:18, 11 April 2014 (UTC)

Tracheostomy

McMath's body is hooked to mechanical ventilation. It is unsourced and wrong to state that the tracheostomy was performed "so she can breathe without assistance." Mechanical ventilation is the very definition of assistance. NorthBySouthBaranof (talk) 15:41, 20 May 2014 (UTC)

WoW! Looks like she is in NJ! And NOT a "decomposing corpse" like everyone said

http://sanfrancisco.cbslocal.com/2014/06/20/questions-raised-over-condition-of-jahi-mcmath-after-lawyer-said-girl-is-improving/

So I guess NJ law is now relevant?24.0.133.234 (talk) 15:04, 18 July 2014 (UTC)

There's presently no proof of anything. There's only her family's word. 67.165.114.238 (talk) 05:53, 30 July 2014 (UTC)

"body" again

req. to move to talk page. so talk. I undid that last one because my browser was crashing and i had made a mistake by adding the same ref. twice while I had meant to add the Contra Costa Times reference.24.0.133.234 (talk) 22:48, 11 August 2014 (UTC)

And as far as the "body"-edit that is currently on the way to edit-warring, the reason I removed it was because it was unnecessary and confusing. It also implied that McMath is (publicly known to be24.0.133.234 (talk) 23:00, 11 August 2014 (UTC)) a corpse, or clinically dead, which would misinform article readers. That is why I went back and added an internal link to clinical death, but I would be OK with just having the implicit, "body" removed.24.0.133.234 (talk) 22:58, 11 August 2014 (UTC)

In other words-I am hoping that we can agree to use the word "body" only for publicly known clinically dead people to avoid misrepresentation and to follow WP:NPOV . For this article, if somewhere in the future, there is a valid announcement of Ms. Mcmath's clinical death, I think that it would be helpful to not refer to her as a (implied "dead") "body" for the time period where she is not known to be clinically deceased.24.0.133.234 (talk) 23:05, 11 August 2014 (UTC)

She has been declared dead by the Alameda County coroner, a ruling which was affirmed by a judge of competent jurisdiction. Until and unless there is convincing and confirmed scientific evidence that the declaration of death was incorrect, that ruling is controlling. Brain death is death, under California law and according to the overwhelming majority of medical viewpoints. NorthBySouthBaranof (talk) 04:40, 12 August 2014 (UTC)

As NorthBySouthBaranof said, she was declared clinically dead already and "body" is the appropriate term to use. The fact that she is apparently in new jersey (which was reported by one news outlet and later picked up by others and which hasn't been confirmed by the family) and they're keeping the body on mechanical ventilation is irrelevant. --Ca2james (talk) 17:32, 12 August 2014 (UTC)

Ca2james-NorthBySouthBaranof did NOT say that because NorthBySouthBaranof knows that is NOT TRUE. Mcmath has not-as far as the public knows, been declared clinical death. Until proven otherwise, she is the same exact amount of "dead" that she was when she left the hospital, which was brain death. Also-for the record. if anyone can find any reliable reference that states ANYTHING about legal death and relates to this case? I recently noticed that we had sprinkled the term in the article here-BUT--the references do not back it up. (one instance I rm said that Judge Grillo had declared "legal death" when the article cited said NO SUCH THING! I have a problem using the term in the article in that case-but I could be wrong, so if there IS a good ref. for legal death and this specific case-where is it? And to NBSB--we went around about this already. The Coroner's declaration of "death" has never been completed or filed. So I think we have already answered: "Until and unless there is convincing and confirmed scientific evidence that the declaration of death was incorrect, that ruling is controlling."-----not "scientifically", just legally, not dead, or not dead since she has moved to NJ.24.0.133.234 (talk) 22:05, 12 August 2014 (UTC)

[1] "The Alameda County Coroner issued a death certificate Friday for Jahi McMath" A death certificate is the same thing as legally dead. How many people are going to have to tell you you are wrong before you realize the WP:Consensus is that you are wrong and you should concentrate your efforts elsewhere. CombatWombat42 (talk) 22:19, 12 August 2014 (UTC)

"A death certificate is the same thing as legally dead" WP:OR no-in this case that is not what it meant at all, and if you look at the article which was referenced, Judge Grillo said that he found McMath to be "brain dead"--the words "legally dead" were not used. same with the other erroneously quoted ref. that I took out.24.0.133.234 (talk) 22:23, 12 August 2014 (UTC)

CombatWombat42A:It doesn't matter how many people incorrectly tell me that I am wrong, it won't change the facts will it? The mentioned death certificate-we discussed that on this page, it was never completed so it is invalid-(not OR, a fact and there are refs. that back that up AFAIK). Unfortunately, it could even have been MY edits which were incorrect in this article as i did some work on it and there was some confusion. I'm not confused anymore.24.0.133.234 (talk) 22:28, 12 August 2014 (UTC)

From the wikipedia page for legal death "Legal death is a legal pronouncement by a qualified person that further medical care is not appropriate and that a patient should be considered dead under the law. " From [2]: "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.", from [3] “A young lady has died. No one takes that in a callous or uncaring manner,” Straus told Superior Court Judge Evelio Grillo, “but she is dead.” from [4]"Ms. McMath is dead and cannot be brought back to life," the hospital said in the memo, adding: "Children's is under no legal obligation to provide medical or other intervention for a deceased person.". That is 2 sourced doctors("by a qualified person") and a hospital saying she is dead("patient should be considered dead"). CombatWombat42 (talk) 22:36, 12 August 2014 (UTC)

The death certificate is unofficial only because the family has refused to permit an autopsy to determine the cause of death. That fact does not change or nullify the legal finding of death. NorthBySouthBaranof (talk) 01:07, 13 August 2014 (UTC)

CombatWombat42 Everything you just said is not in dispute. Except for using the WP definition of legal death to define death, and to relate it to what was quoted by Judge Grillo- and that other item that I took out of the article which you keep trying to put back in. One-why is it so important for you to have it your way with that particular term? Everything else you have quoted would be fine as long as it is properly cited and not WP:OR, which in this case, using the term legal death IS WP:OR, especially when it is used as a QUOTE that was NEVER SAID. IMO legal death should probably be linked as see also24.0.133.234 (talk) 23:33, 12 August 2014 (UTC)

I don't find the phrase "her body" a problem. "Her body" doesn't seem to imply she is alive or dead. Living people have bodies so do dead people. "The body" I'd think would be nonNPOV because "the body" unambiguously refers to a dead person./corpse, but I'm not sure I understand your objection to "her body". --BoboMeowCat (talk) 22:40, 12 August 2014 (UTC)

OK BoboMC-maybe to you use of the word "body" does not imply a corpse, but then why is it so important to some editors to keep it? "Her" body is preferable to me over "the" body, fine but in my opinion both are ambiguous and purposely misleading. It has been made clear here on this talk page and in the edit notes, that the only purpose for keeping "body", is to falsely imply that the child is a corpse rather than a patient who has been declared permanently brain dead. If the article can be made more neutral for all-sides, I am not against that either but it could get a lot more wordy and confusing. Also-again, in the event that Mcmath does suffer permanent cardiac death-(if she cardiac dies for good), having her correct state of being at that time in the article, will help finish the story of the case by giving the readers better context clues such-as, (while she was brain death, but still being maintained, and then if she does maintain clinical death....you know what I mean here! In the event of permanent cardiac death, the timeline will be much easier for readers to follow if we leave-OUT the "corpse-like"/body references, until if that becomes a part of the story.-24.0.133.234 (talk) 23:33, 12 August 2014 (UTC)

The reliable sources state that what was transferred was a body. We reflect the statements of reliable sources. Someone who is brain-dead is not "a patient," they are dead, as per the overwhelming medicolegal consensus that brain death is death. NorthBySouthBaranof (talk) 00:53, 13 August 2014 (UTC)

Any ideas where to take this?

Anybody have any good ideas where this can be arbitrated? Is there a good syntax MOS board? Seriously, it is pretty clear where most of the editors on this TP stand and I agree with moving-on to other articles, except that this is just wrong and it bothers me. Consensus does not apply if everyone is wrong, including myself-Is there anyone who can just NPOV this whole article?24.0.133.234 (talk) 23:59, 12 August 2014 (UTC)

When an overwhelming consensus says that your edits are wrong, it is time to step back and consider that you may be, in fact, wrong. Multiple reliable sources discuss the legal ruling that the independent expert and Children's Hospital Oakland were correct and that McMath is dead according to California law. The fringe opposing view that she is not dead is mentioned with due weight, but we will not treat it as true. NorthBySouthBaranof (talk) 00:51, 13 August 2014 (UTC)

Um-yeah except that I am not wrong so it needs to be explained. Do you really think that by calling matters of fact-"fringe" that you are going to be correct here? "Body"-may be open to interpretation, but due to the fuss that is being made over keeping the term rather than avoiding it, I think that speaks for the motive and agenda of editors arguing to keep it. Since when is NPOV and properly quoted references and citations "fringe". What exactly do you mean by that anyways? My only agenda here is NPOV and a factually correct article. I am not arguing for anything "fringe" here period. Just the facts.24.0.133.234 (talk) 01:37, 13 August 2014 (UTC)

Legal death dispute

I have tagged the offending sentences with . Specifically, the items which continue to be warred:

• 1 "On December 24, 2013, Judge Grillo ruled that McMath was legally dead, basing his decision on the medical evidence presented by physicians from Children's Hospital Oakland and from independent expert Paul Fisher, but ruled to keep McMath on mechanical ventilation until December 30, 2013,.[22] "
• 2 " On December 12, 2013, her doctors declared her brain-dead and her family was informed that as she was legally dead[disputed – discuss], life support systems would be removed.[12] "

The addition of these "legally dead" Legal death 24.0.133.234 (talk) 02:01, 13 August 2014 (UTC) statements are based-on WP:OR and more importantly NOT supported by the cited references given.

If I am incorrect here I would really like to know how. My edits keep being reverted/undone, and I am being repeatedly told that 'consensus' is telling me that I am wrong-but I do not see it.24.0.133.234 (talk) 01:30, 13 August 2014 (UTC)

Request for assistance at NOR Noticeboard : http://en.wikipedia.org/wiki/Wikipedia:No_original_research/Noticeboard#Legal_Death_and_OR_in_Jahi_Mcmath_article 24.0.133.234 (talk) 01:58, 13 August 2014 (UTC)

Point 1: whether or not you (or I, or anyone else) agree with the ruling of legal death is not particularly relevant. What the article states is:

1. that Judge Grillo made that ruling;
2. that he based his decision, in whole or in part, on medical evidence presented by physicians from Children's Hospital Oakland by an independent expert;not in dispute, as far as I can see
3. that he rules to keep McMath on mechanical ventilation until abovementioned date. Not in dispute, as far as I can see
   

As to the ruling of legal death:

• Background information:

• the (medico-)legal meaning of brain death is legal death, at least in the US and thus the state of California (which is what is relevant here). This is per the Uniform Determination of Death Act, adopted by California in 1982 (and thus can also be found as CALIFORNIA CODES HEALTH AND SAFETY CODE SECTION 7180), which specifically states the following:

"Determination of Death. An individual who 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, is dead.
A determination of death must be made in accordance with accepted medical standards." (emphasis mine)

(Can be found in multiple places, amongst others here). Thus, in this context, and in many others, brain death equals legal death. Another two, more secondary sources, confirm this: CNN: Why brain dead is really dead. Brain Dead Is Dead-Jahi McMath Family and Unethical Actions

• It can be reasonably considered factual that as judge of the Superior Court of Alameda County, and especially as judge on this case, Grillo was aware of this legal act and thus of the legal consequences of declaring McMath to be brain dead.
  

• Sourcing:
  

• Several available sources cover the ruling of Judge Grillo, and I believe that there can be no dispute that Judge Grillo ruled that "McMath is brain dead". (Just for reference, however: source used in article,other source)
• However, it can be reasonably stated that while the source used in the article for this sentence heavily implies, based on legal and medical background information, that the ruling of Judge Grillo equals a ruling of legal death, it does not outright state it. Although legally speaking (per above background information, amongst others) brain death equals a form of legal death (with other forms of legal death coexisting), the source itself does neither confirm nor deny it.
• On the other hand, multiple other available sources do outright state this, either by specifically saying that Judge Grillo ruled that McMath is legally dead, or by saying that Judge Grillo ruled that McMath is brain dead and stating that this means a ruling of legal death. (Some of many sources: 1(Directly uses "legally dead" in title; uses "brain dead" throughout body of text, showing that this source ((medico-)legally speaking correctly) considers these to be synonymous); 2 (includes "The news comes despite doctors and previous judges agreeing that there is no way to bring the legally dead teen back" (emphasis mine); "Superior Court Judge Evelio Grillo has agreed with the hospital that Jahi has died.", amongst other things); 3 (which includes the following: "An Alameda County Superior Court Judge allowed numerous outside doctors to conduct tests, and all came to the same conclusion that Jahi could not breathe on her own and all brain activity had ceased. Therefore, she was legally dead."). I can dig up more such sources if needed, but I feel these illustrate the point pretty clearly.)
• Furthermore, the Children's Hospital Oakland have, since the ruling, repeatedly been quoted as saying that this ruling means that Jahi McMath is legally dead. I have been unable to find any response by the Judge or judicial system claiming this is incorrect; nor a response by any other legal expert claiming such, and by only one medical expert—Dr. Paul Bryne—who even then did not outright deny the legal meaning of brain dead, just the medical conclusion that brain dead always means dead. This as opposed to several legal and especially medical experts (some of whom are cited and/or mentioned in the sources above, but I can dig up more references if needed) agreeing with the conclusion that brain dead = (legally) dead.
• Furthermore, the transfer required signing off by a coroner. This would not be the case if McMath was not considered legally dead as a result of Judge Grillo's ruling. (Source for the signing off can be found in the article and probably is covered in at least once source I list above. If you REALLY need me to, I can dig up a source for the second part of the statement as well).

• Conclusion: While it might be a good idea to add an additional source to this statement that outright uses the wording "legally dead" or "legal death", there is plenty of proof that this statement is factually correct: Judge Grillo declared McMath to be brain dead and thus legally dead.

Point 2:

• Awkward wording, but not necessarily factually wrong. I suggest "On December 12, 2013, her doctors declared her brain-dead. Her family was informed that she was legally dead and that, as a result, life support systems would be removed". That way, the statement can be broken up into the following parts:

1. McMath's doctors declared her brain-dead on December 12, 2013. Factual, doubt this is in dispute
2. Her family was informed that she was legally dead See above for the whole legal death part, but that aside, the hospital did inform the family that she was legally dead. See below for more info.
3. Her family was informed that life support systems would be removed as a result of being (considered) brain dead and thus legally dead. Not in dispute as far as I can tell, but honestly, much of the same as point two: it did not actually HAPPEN (or at least, not the way the doctors informed the family it would), but the family WAS informed of that.

• As to point two (and thus ever so slightly point three): Whether or not the family and/or others (or even the whole world) disagree with McMath being legally dead is not relevant; was is relevant is if that was the information given. Which it was. If someone informs me that the moon is made of cheese, I was informed that the moon is made of cheese. Regardless of how correct or incorrect the information itself may be.

• Conclusion: Slight rewording wouldn't be amiss here, do wonders here. AddWittyNameHere (talk) 03:55, 13 August 2014 (UTC)

• Agreed and I have implemented your suggested wording. NorthBySouthBaranof (talk) 04:12, 13 August 2014 (UTC)

Please show me where it is stated that Grillo "ruled" that McMath was "legally" dead. Please show me where it is stated that McMath's family "was informed that she was legally dead". Can you please give a reliable source that confirms these statements? Anything less, and you are insisting that your long-winded synthesis of original research be included with citations and references that DO NOT SAY THAT24.0.133.234 (talk) 05:06, 13 August 2014 (UTC)

"Judge Declares Oakland Teen Jahi McMath Legally Dead" - KNTV News. It's not "original synthesis" when a reliable secondary source has made it for us. NorthBySouthBaranof (talk) 05:27, 13 August 2014 (UTC)

JFTR-I see no where in that article where the judge "declared", ruled, or said that in any way! We had the court docs. here at one point. The judges ruling is whatever the ruling says, which I am pretty sure is that he agreed with the doctors and the hospital that Mcmath had suffered brain death. Apparently that "declaration" of legal death, was OR, and a synthesis made by the NBC-affiliate. If you want to work that into the article-good luck, but there is still nothing to confirm or actually quote judge Grillo "declaring"-"legal death". I think that we may need to look at the ruling? But we decided here earlier that the rulings and court docs. were primary sources, so we left them out of the article.24.0.133.234 (talk) 05:38, 13 August 2014 (UTC)

WP:OR prohibits only original synthesis — that is, synthesis never before published in a reliable source and created anew by a Wikipedia editor. Since we have a reliable source stating it, we may use that source's synthesis. It is not an original synthesis and is acceptable on Wikipedia. NorthBySouthBaranof (talk) 05:58, 13 August 2014 (UTC)

I have no problem introducing legal death in California, (but we already cleaned-up the article because of jurisdictional and global problems with the term being applied unilaterally) vs clinical death into the article. In fact in my opinion that is the cruxt (sp?) of the case. But attributing dialogues and apparent quotes, statements, conversations, and rulings, that are not referenced, except for one sensationalistic headline with nothing in the context to verify, is false. I would agree with the suggested ""On December 12, 2013, her doctors declared her brain-dead. Her family was informed that she was legally dead and that, as a result, life support systems would be removed". with, she was legally dead and that, as a result, being removed because we do not have a reference to this "legal death" information being conveyed to them. The statement paints a picture of a conversation happening that is not referenced anywhere as far as i can tell. The ref. that were cited stated that the family was notified that the hospital stated that they had the right to remove treatment, and the family decided to take it to court, and they won.Maybe the judge did rule "legal death"--but right now i don't know exactly where that specific ruling is and none of the references state that point clearly so why should WP?24.0.133.234 (talk) 05:54, 13 August 2014 (UTC)

The following references confirm that the hospital did inform the family that she was legally dead:

• Mail Online/Dailymail: "Hospital told her heartbroken family that they will switch off her life support as she has been declared legally dead.";
• Contra Costa Times, article by Oakland Tribune: "Jahi spent Tuesday on a ventilator. By 2 a.m. Wednesday, doctors said she had swelling in her brain, and Thursday, she was declared legally brain-dead, family members said.";
• San Jose Mercury News: "The hospital says she is legally dead. That they can legally stop her breathing" (Quote from a letter by McMath's mother. I'd say that if anyone is qualified to state whether or not the family has been informed, it's the family (and the hospital)).
• There are several more such sources, but I hope these three will suffice?

As to the "one sensationalist headline with nothing in the context to verify" - I STRONGLY disagree. There is plenty in the text and context to verify that headline. Although the headline may be the only place in the article where the specific combination of words "Judge declares [...] legally dead" is used, there certainly are multiple other places in the article where they refer to it, including (but strictly speaking not limited to) the following:

• "A judge ruled Tuesday that a 13-year-old Oakland girl who has been on life support since suffering bleeding and a heart attack following a tonsillectomy "meets all the criteria of brain death."" - 'Combined with the title, shows strongly that KNTV considers such to mean she IS legally dead.
• "Although the judge ruled he could not force the hospital to continue the teen's care, an existing restraining order keeps Jahi on life support until 5 p.m. Monday, giving the family time to appeal his decision." (emphasis mine) - Keywords: could not. The only circumstances in which it is impossible to force a hospital to continue care is if the patient is legally and medically considered to be dead.
• "[..] judge selected an independent doctor to determine whether Jahi McMath shows any signs of life." (emphasis mine) - In this context (namely, if she is or is not brain dead, which is what the doctor was selected to evaluate), this shows again that brain death is considered to mean death.
• "The judge said he doubts that he will be the final word on the matter and has expressed his condolences to the family." (emphasis mine) - you don't condolence people in regards to a person unless said person is dead. AddWittyNameHere (talk) 21:43, 13 August 2014 (UTC)

YES-thank-you AddWittyNameHerethis ref. does fit with family being told that Jahi was legally dead. http://www.mercurynews.com/breaking-news/ci_24773831/oakland-emotional-letter-from-jahi-mcmaths-mom-keep?source=pkg I am adding it at the appropriate spot.24.0.133.234 (talk) 03:39, 14 August 2014 (UTC)

Glad to have been of help. That's one issue solved. Means we're making progress. Filled out the reference more in-depth, by the way. Makes it easier to find it back should the url change at some point in the future. AddWittyNameHere (talk) 04:06, 14 August 2014 (UTC)

Life support

Revisiting this page after recent edits made it pop up on my watchlist, I noticed that the lead stuck out as using a term not used by reliable sources. Specifically the phrase "....their efforts to maintain her body on mechanical ventilation". Reliable sources say efforts to maintain her body on "life support". They often even use phrase "life support" in the title:

http://www.cbsnews.com/news/teen-jahi-mcmath-brain-dead-after-tonsil-surgery-court-appointed-doctor-confirms/

http://www.nbcbayarea.com/news/local/Judge-Orders-Oakland-Hospital-to-Keep-Jahi-McMath-on-Life-Support-236808851.html

http://www.huffingtonpost.com/2013/12/21/jahi-mcmath-life-support_n_4485119.html

http://www.mercurynews.com/nation-world/ci_24788294/document-hospitals-petition-opposing-an-independent-expert-asking

In addition to following RS here, this is actually what the family was fighting for because life support includes the feeding tube and they were fighting for that along with the ventilator. This should be changed (but along with this change we should probably also add somewhere text regarding RS referring to "life support" as "death support" in this case. http://edition.cnn.com/2013/12/28/health/life-support-ethicsBoboMeowCat (talk) 21:29, 11 August 2014 (UTC)

IIRC, "mechanical ventilation" was used instead of "life support" because mcmath isn't actually alive, "life support" is an inaccurate term for what she was receiving, and the proper medical term is "mechanical ventilation". "Death support" isn't even a phrase, AFAIK and wouldn't including it be WP:OR? --Ca2james (talk) 17:38, 12 August 2014 (UTC)

"Mechanical ventilation" is just the ventilator. "Life support" is the medical term that includes the ventilator and the sugar water in her veins, and it's also a broad term to include all sorts of other possible steps to maintain the body and includes things like the feeding tube (which they were fighting for). For sake of NPOV, I don't think we should write as if we, as editors, have taken a stance regarding whether or not McMath is "actually alive" and instead just report the cold hard facts in the case, such as her doctors have declared her brain dead. In almost all states she is legally dead. In NJ she wouldn't actually be considered legally dead (and reports are that is where they moved her). Either way, "life support" is the phrase used by the RS here, so I think we should use it too. It's also notable that "Life support" is the term used when such steps are taken to keep a brain dead person's body alive prior to organ removal for transplantation, so it's not a controversial term that implies recovery or non-brain dead status. Regarding the phrase "death support", I wasn't actually suggesting we use that in any sort of official capacity, but rather think we should mention somewhere in the article that RS referred to "life support" in this case as "death support" http://edition.cnn.com/2013/12/28/health/life-support-ethics --BoboMeowCat (talk) 18:43, 12 August 2014 (UTC)

Beyond being the phrase that RS used in the Jahi McMath case (see above) "life support" is also the phrase used in general cases regarding maintaining a brain dead body prior to organ donation, see quote from the National Institute of Health organ donation info site: "Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject it." http://www.nlm.nih.gov/medlineplus/ency/article/003003.htm --BoboMeowCat (talk) 03:26, 17 August 2014 (UTC)

The term "ventilator" is also used in reliable sources. More to the point, the term "life support" has a specific implication and imputes a disputed claim. I have replaced "mechanical ventilation" and explained the specific conflict - her parents believed it to be life support while her doctors believed it to be futile treatment of a deceased person. This presents the factual type of system that McMath was on, and spells out in a neutral fashion the fundamental root of the dispute. NorthBySouthBaranof (talk) 08:40, 17 August 2014 (UTC)

Mostly in agreement with your additions, but I've changed both "believe" and "view" to forms of "consider", because "[x] believes such and such" expresses slightly more doubt than "[x] views [y] as such and such". Saying both considered something to be the case is slightly more neutral, is still factual and might avoid some future NPOV discussions. AddWittyNameHere (talk) 13:14, 17 August 2014 (UTC)

I reviewed the references currently used for the article and all that cover the issue use the phrase "life support" and none use the phrase "mechanical ventilation". Some of the sources discuss the ventilator specifically, such as the apnea testing, and allowing her to be released from the hospital with the ventilator and her fluid lines in place, but that's already covered in the article. Also, please refer to the text and links above regarding "life support" being the phrase used in other neutral, non-disputed cases such as maintaining a brain dead body prior to organ removal for organ transplants. We should use the phrase used by RS, and the phrase used by the medical professionals in general for such cases. She wasn't only on the ventilator. She was also receiving fluids and sugar water in veins. Medically, doing these things to maintain a body is referred to as "life support". --BoboMeowCat (talk) 17:10, 17 August 2014 (UTC)

The fact is, there is a dispute over whether there was life to support. It is not true that all sources use that phrase - the Los Angeles Times specifically refers to it as a ventilator and not life support. I have added "and other measures" to indicate that there were things in place besides ventilation.

My version is an improvement because it specifically details the crux of the dispute in the lede in an entirely-NPOV manner - her parents wished to continue what they believed to be life support of what her doctors considered to be a dead person. We can let readers decide who is correct. NorthBySouthBaranof (talk) 17:53, 17 August 2014 (UTC)

This point is well taken - I didn't intend for there to be a difference but if one might be perceived, then that would be bad. Thanks for your edits. NorthBySouthBaranof (talk) 17:58, 17 August 2014 (UTC)

@NorthBySouthBaranof: I figured as much and figured that if I had just pointed you to it, you would have changed it yourself. The only reason I changed it immediately is that on articles like this (as in, any kind of controversial article, really), the slightest wording-related issues can become full-blown disputes within hours. AddWittyNameHere (talk) 18:51, 17 August 2014 (UTC)

@BoboMeowCat: I strongly disagree that "all that cover the issue use the phrase "life support" and none use the phrase "mechanical ventilation"".

• The family's attorney used "ventilator" at least once: ""What this case represents legally is that parents can say no when a hospital says, 'We're pulling the plug.' They thought that a hospital shouldn't tell them their child was going to be removed from a ventilator," Dolan told reporters." (Emphasis mine, source: CNN, which is the first source on the article);
• As has the hospital: "We have the deepest sympathy for Jahi's mother, who wishes her daughter was alive; but the ventilator cannot reverse the brain death that has occurred and it would be wrong to give false hope that Jahi will ever come back to life," Dr. David Durand, the hospital's chief of pediatrics, said in a statement Monday." (Emphasis mine. Source: same as previous).
• A quote from McMath's mother can be read either as McMath's mother using "ventilator" or quoting the hospital's use of ventilator: ""They have not given me a reason yet of why she went into cardiac arrest. They haven't even given me a reason for her bleeding. They haven't given me a reason that they couldn't stop the bleeding," Winkfield told CNN. "The only thing they keep pushing for me is to get her off their ventilator."" (Emphasis mine. Source: LA Times, fourth source in article).
• At least one unrelated ethicist (DiCamillo, of National Catholic Bioethics Center) has used similar terminology: "In Jahi’s situation, DiCamillo said if rigorous testing showed there was no medical doubt that her entire brain no longer functioned, “there would be no Catholic ethical objection to ending mechanical support for her.”" (Emphasis mine. Source: Washington Post, which is the second source on the article).
• The Huffington Post referred to "ventilator" twice in this article (which is source 3 on our article), using life-support only once in relation to Jahi McMath, in a direct quotation: ("“Orders should have been immediately written to discontinue all life support,” said McCullough, who has no personal knowledge of Jahi’s case."), and that quote barely suffices for calling it life support, because it strongly suggests it should have been stopped once brain death was concluded. (The other occurrence of "life support" in the article refers not to McMath but to the case of Munoz).
• LA Times (source four on the article) uses "life support" to describe what happened directly after the operation/in result of complications, but uses "ventilator" and "machine" for anything from the declaration of brain death onwards.
• CNN Opinion (source five on the article) even expressively highlights the problem we have here: "And no law prohibits continued ventilation of a dead body. We do it routinely to preserve organs for transplant. Jahi's parents have decided to try to continue ventilation -- if you call it life-support you are taking a stand on whether she is dead -- so the issues become who will provide the treatment and who will pay." (emphasis mine). It also pretty clearly uses "ventilation" and variant.
  

That's just from the first five sources on this article. If you want me to, I'll happily comb through the remaining 39 sources, but I think this proves pretty clearly both why "life support" is problematic and that not quite all that cover the issue use "life support" as opposed to "ventilation", "mechanical ventilation" or a variation thereof. Most use a mixture, with exception of pieces that illustrate a strong opinion in one way or another (those that strongly feel McMath is alive and/or that the hospital is otherwise in the wrong use "life support" solely; most of those that strongly feel that McMath is dead, continued support of some kind is wrong and that the family is wrong or mistaken go out of their way to avoid "life support" out of direct quotations). I feel that NorthBySouthBaranof's solution of mentioning both is the most neutral we can use in a situation like this, as either use on its own either expresses or strongly suggests the expression of bias in one direction or the other. AddWittyNameHere (talk) 18:51, 17 August 2014 (UTC)

Joan Rivers vs Jahi....or NY vs Ca Cultural differences in "plug-pulling"

This talk page is for improving this article, not for random discussions about the topic
The following discussion has been closed. Please do not modify it.
http://www.nydailynews.com/entertainment/gossip/joan-rivers-private-hospital-room-professionally-decorated-friend-article-1.1927433?cid=bitly So no one is currently saying that Rivers is "Brain Dead"-or if that has been determined-or not. But, aside from the fact that Rivers is a global celebrity, IF Rivers is permanently brain dead, Jahi and Joan would share a diagnoses and they both are on life-support machines. Being in NYC--it is startling to me how different the cultural attitude between the 2 cases are. In Jahi's case, people expressed disgust, claiming that Mcmath's family were trying to keep a "dead" corpse alive, wasting medical resources etc. In NYC---as per law there, "pulling-the-plug", is up to the patient or their family and a family would not be publicly castigated for prolonging the machines. For Jahi--that option had to be decided in court because by Ca law, the hospital gets to decide. Just thought I would post this here to illustrate the cultural differences and perceptions that editors should be aware-of. Being from NJ myself-as an editor, the cultural differences between the way the Mcmath case was described and how "pulling-the-plug" is left-up to the family in cases that I have known about here----well it was shocking to me in a way that California just seems to have an entirely different perspective. Not trying to forumize the talk page here just hoping to point-out that NPV will help the article and readers, especially considering culturally different backgrounds24.0.133.234 (talk) 18:08, 4 September 2014 (UTC)