Hospital controversies, NM ruling highlight right-to-die debate

Two controversial cases have reignited the debate over the role of hospitals in keeping patients who are legally dead on life support, NPR reports.

In Oakland, Calif., 13-year-old Jahi McMath's family won the right to keep her on a ventilator even after three neurologists confirmed that complications from a tonsillectomy left her brain dead and the coroner issued her a death certificate. Meanwhile, in Fort Worth, Texas, 33-year-old Marlise Munoz lost all brain function after a suspected embolism, but because Munoz was 14-weeks pregnant at the time of the incident, the hospital refuses to remove her from life support, contrary to her husband and parents' wishes, according to the article.

"Many people confuse brain death with coma, vegetative state or other disorders of consciousness," neurologist James Bernat, M.D., who directs the clinical ethics program at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., told NPR. In comatose or vegetative patients, Bernat said, patients can usually breathe unassisted and may respond to stimuli. Conversely, in cases of brain death, "there is zero brain function," he said, and unlike comatose patients, there is no chance of recovery.

"I think doctors or nurses or facilities who...keep dealing with this body to keep maintaining the appearance of life, they really ought to be investigated because they're not acting in an ethical manner," Arthur Caplan, head of the bioethics division at New York University Langone Medical Center, told NPR. "They're not letting the family come to an acceptance of what has happened."

Meanwhile, a recent court ruling in New Mexico may help create an easier path for terminal patients seeking to end their lives, the Associated Press reports. Second Judicial Judge Nan Nash's Monday ruling established a fundamental right for New Mexicans to seek aid in ending their lives. Nash based her decision on the state constitution's provision forbidding the state to hinder citizens from "obtaining safety and happiness," according to the article.

"This court cannot envision a right more fundamental, more private or more integral to the liberty, safety and happiness of a New Mexican than the right of a competent, terminally ill patient to choose aid in dying," Nash wrote, according to the article.

The ruling contrasts with a law passed last year in Oklahoma, which prohibits providers from denying life-prolonging care to the elderly, disabled or terminally ill, FierceHealthFinance previously reported.

To learn more:
- read the NPR article
- read the Associated Press article

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