Jahi's "Brain Death" Case: What Do We Know and What Does the Church Teach?
I've observed with great interest and prayerful intention, the case of Jahi McMath, who suffered complications in a surgery related to a tonsillectomy, resulting in a condition of brain death. On December 12 she was declared dead by doctors at the Children’s Hospital Oakland. There was an article published by bishop Robert Finn, who essentially opined that, "the brain death criteria were developed primarily because of the desire to transplant non-paired vital organs". Now, this may or may not be the case, but there is a fact question here … a medical question … as to whether the brain is indeed completely dead and not evincing any neurological activity, even in the brain stem, the lowest functioning part of the brain. The reason this is an important question is because the Church does, in fact, teach that TOTAL brain death is an acceptable indication that death has occurred. In fact, once the brain is dead (unlike the heart) it does not "restart". Once the brain has died there is no integrating principle of the body and we have disintegration … death. The significance even of cardio-pulmonary arrest and cessation is not so much that they have stopped but that the brain is not receiving oxygenated blood and will, within a certain limited time frame, die. One can have their bodily organs kept functioning for a certain period of time artificially (as in Jahi's case) even after brain death but eventually they will disintegrate.
Blessed John Paul II told a congress on organ transplants that death is “a single event consisting in the total disintegration of that unity and integrated whole that is the personal self.” The National Catholic Bioethics Center notes,
"The use of neurological criteria for the determination of death is legitimate according to the Catholic Church. Pope John Paul II approved this approach in an address he gave to the 18th International Conference of Organ Transplant Specialists in August 2000. Neurological criteria consist of four key signs: coma or unresponsiveness, absence of cerebral motor responses to pain in all extremities, absence of brain stem reflexes, and apnea."
They further note that, "The use of brain death criteria does not cause the death of the patient, but only assesses whether that death has already occurred."
In the several articles I have read, I have not found sufficient detailed information about Jahi's actual medical condition to determine ethically with moral certitude… whether she is dead or not. Did her brain evidence neurological activity after the surgery and as of December 12th? When the doctors declared her dead on that date was it based on TOTAL brain death or only partial? The latter would be unacceptable to the Church's moral teaching. So, this is a case that is still in obscurity, at least from my vantage point. More recently, I have seen an article indicating that at least three neurologists confirmed Jahi was unable to breathe on her own, had no blood flow to her brain and had no sign of electrical activity. If that is true, the parents would be morally justified in discontinuing mechanical support because they would be reasonably regarded as disproportionate treatments. The Church teaches:
"A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden."
(Ethical & Religious Directives, n. 57)
But, this is an occasion for us to pray for her and her family and all of those charged with the responsibility to take care of her. It does, however, give us occasion as well to reflect on the Church's teaching on the determination of death. The absence of neurological activity in the brain is sufficient and appropriate evidence that the soul has left the body. Peace + DDG