No one will argue that what happened to Jahi McMath isn’t a tragedy. But, John Di Camillo of the National Catholic Bioethics Center reminds us, it may not be the cut-and-dry case of a hard-hearted hospital wedded to the culture of death that some reports are making it out to be.
Jahi McMath went in for tonsil surgery and ended up being declared brain dead three days later, and there has been a legal struggle ever since, to determine whether or not she can be moved to another facility which will agree to continue keeping her on life support. The whole story is horrible and heart-wrenching, and I can’t even begin to imagine what I would do if I were the parents of this girl.
But we, as readers, don’t know all the details of it. In an interview with the Catholic News Agency, Di Camillo says:
“It’s not something that’s simply a clear-cut, back-and-white case that we can, from the outside, say we know what’s going on. Because we don’t,” he added.
So even though this is a highly emotional case, it’s important for Catholics not to make rash statements about the decisions of the people involved. The other day, I almost commented somewhere that that the hospital probably wanted Jahi to die to cover up any evidence of malpractice during the surgery. But that would have been a serious sin of detraction. Not only do I not know the motives of the doctors involved, I do not have any specific medical information about the case.
Di Camillo stressed the need to know the facts of Jahi McMath’s case before making a moral judgment. “Before even getting to the ethical considerations, the medical facts are an absolute priority,” he said. “If we have a medically clear and confirmed determination of death by these neurological criteria, then we’re dealing with a situation where the body is actually the corpse of the deceased of this young girl.” “If we’re dealing with a case where the person is in fact brain damaged but still alive, then we have a whole different set of ethical criteria because we’re talking about a living human being who is worthy of full respect and full treatment.”
Di Camillo reminds us that end-of-life decisions must be made on a case by case basis, and that “[l]ife support systems are sometimes ordinary means of treatment and sometimes disproportionate.” He reminds us that the case is not truly similar to Terry Schiavo, because Schiavo was clearly not brain dead; her husband simply didn’t want her to be alive anymore.
I wrote an article for Catholic Digest exploring some of the dilemmas caregivers face when they have to make life or death choices about the people they love. (The article includes some links for further reading on Catholic medical ethics, and a site that provides samples of an advance directive with durable power of attorney or healthcare proxy.)
The Church does not, as many people imagine, insist that we squeeze the last possibility out of every beating heart. I do not mean to imply that that’s what Jahi McMath’s parents are doing! The point is, we simply do not know. It is appropriate to pray for the family, and it is appropriate to have public and private conversations about what the Church teaches about end of life medical decisions. But it is wrong to assume we know what is going on in this particular case.
The only thing I’m not clear about is whether it ought ever to be up to hospitals to make the decision about whether to remove life support, assuming that the patient truly is past saving. I know that there are cases in which a person really is truly dead, and is being kept artificially “alive” because the family can’t bear to say goodbye. In those cases, should the hospital be able to make the decision for them? I don’t know.