Friday, 9 March 2018

ROLE OF TECHNOLOGY IN DETERMINING THE END OF HUMAN LIFE


Jahi McMath is legally dead in California, where a routine tonsillectomy on the thirteen-year-old girl done on Dec. 9, 2013 and she basically bled to death.  But she is still legally alive in New Jersey.  After refusing to let the California hospital harvest her organs, her family insisted that she was still alive and moved her to New Jersey to take advantage of a law that allows them to do so. 

New Jersey and New York are the only states which allow families to refuse a diagnosis of brain death if it violates their religious beliefs.  This exception was made to accommodate the beliefs of Orthodox Jews, who believe that breathing indicates life.  Not so long ago, most people and governments would have said the same thing, but then medicine developed the ability to monitor brain function via electroencephalography (EEG machine) as well as more sophisticated technologies such as MRI scans and automatic ventilator machines. 

These changes were reflected in a 1981 report written by a Presidential commission entitled Defining Death:  Medical, Legal and Ethical Issues.  Modern ventilator machines can keep the rest of a human body functioning even after the brain is destroyed - for a time.  But the ability to detect brain function with EEGs, plus the increasing popularity of organ transplants (which stand a better chance of success if the organ is harvested from a donor whose systems are still functioning) led to a redefinition of death as cessation of activity in the whole brain. 

In New Jersey, Jahi underwent a tracheotomy with insertion of a feeding tube.  Although she is still dependent on a ventilator, an MRI by a New Jersey brain researcher showed that parts of her cerebrum were intact.  The cerebrum is considered to be the seat of higher mental activity.  And there are videos showing that she can occasionally respond accurately to her mother's request to move certain fingers, as well as heart-rate changes when she hears familiar voices.  Because the legal limits on malpractice damages are capped at $250,000 but only if the victim dies, Jahi's parents are suing the State of California to bring about a trial in which a jury will determine whether Jahi is dead or alive in that state. In dealing with death, we have to base our actions on some theory that involves two different current narratives.

  1. Secular Narrative:  Human life on the whole is good, but utilitarian considerations of the greatest good for the greatest number tell us that if we use the criterion of brain death rather than more traditional definitions of death, organ transplants can benefit other people more.  

  1. Religious Narrative: God created the heavens, the earth and all that is in them.  He created humans with the ability to sin, which they unfortunately took advantage of, and death entered the world.  A person's spirit uses the brain, but brains are not necessary in order for a person to exist. 

There are both present and future reasons why Jahi's parents don't want her taken off the machinery that keeps her going.  One is the simple human desire to have your child with you.  

Medical science tells us that this is very unlikely in Jahi's case.  But broadly similar cases have resulted in the eventual recovery of the person involved.  In the magazine article's photo of Jahi on her bed in New Jersey, she is covered with a blanket that reads "I Believe in Miracles - Mark 11:24". Sometimes even the best and most advanced technology won't tell us everything we want to know.  And in such cases, faith may be a better guide than technical expertise.

Dr. Sanjeev Punia
Assistant Professor
Computer Science & Engineering


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