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Is ‘brain-dead’13-year-old dead?

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POSTED October 3, 2014 8:16 p.m.

SAN FRANCISCO (AP) — Debate over the definition of “brain-dead” reignited this week when a California family and its lawyer asked a judge to declare that 13-year-old Jahi McMath is alive 10 months after a coroner signed her death certificate.

Attorney Christopher Dolan is seeking the unprecedented ruling, arguing that new tests show Jahi has brain activity. Jahi has been kept on a ventilator and feeding tubes since an operation to treat sleep apnea went awry in December. Three doctors, including one appointed by the judge, declared her brain-dead after finding no neurological activity.

Dolan says researchers at the International Brain Research Foundation found signs of activity in Jahi’s brain last week after testing at Rutgers University in New Jersey. Researchers, doctors and others remain skeptical of the foundation’s findings and are calling for other tests from independent organizations.

Q: What is brain death?

A: Brain death is the irreversible loss of all functions of the brain. Brain-dead patients are comatose and have lost brain stem reflexes and the ability to breathe on their own. Brain-dead patients are considered legally and clinically dead.

Q: What did the International Brain Research Foundation find?

A: Philip DeFina, chief executive of the foundation, said researchers found electrical activity after conducting a brain scan. DeFina also said blood is flowing to Jahi’s brain, which remains intact despite predictions that it should have “liquefied” by now. Finally, Dolan showed reporters video clips of Jahi apparently responding to commands from her mother to move her foot and hand. DeFina argues that Jahi is not brain-dead.

Q: What do other experts say?

A: Many experts remain skeptical and are calling for further testing by independent sources. They say they have never heard of a brain death diagnosis being reversed, and there have been no documented cases. DeFina told reporters Thursday that his foundation is treating a woman in the Middle East who he says was declared brain-dead but is now considered to be “minimally conscious.”

Q: Where is Jahi?

A: Dolan says she is in a “home environment” somewhere in New Jersey and is cared for around the clock. Her mother and stepfather live in the same house, Dolan said. Her eyes remain closed and she is hooked up to breathing and feeding tubes. Unlike California, New Jersey law allows families to reject a declaration of brain death on religious grounds and allows brain-dead patients to remain connected to ventilators.

Q: What’s next?

A: A court hearing is scheduled Thursday in Oakland where the judge who declared Jahi brain-dead may make a ruling. In court documents this week, the judge said he’s skeptical that the court has any further jurisdiction over the case, noting that the deadline for a rehearing passed months ago.

Q: Is this case different from other high-profile cases in which families have gone to court over prolonging medical intervention?

A: The person whose name has become most associated with end-of-life legal fights in the U.S. is Terry Schiavo, a Florida woman who collapsed at her home when she was 26 years old. After her heart stopped and she suffered brain damage, Schiavo entered what doctors refer to as a “persistent vegetative state,” or prolonged coma. Doctors say Jahi’s heart would stop beating if she were removed from the machines helping her breathe, because her brain stem is not functioning, but Schiavo maintained signs of limited brain activity and was able to breathe without a ventilator. She died in 2005 after her husband won a protracted court fight with Schiavo’s parents to have her feeding tube removed.

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