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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsDoctors saying brain dead; patients saying otherwise
http://news.yahoo.com/brain-dead-doctors-said-yes-patients-proved-otherwise-221600587.htmlRecent cases of people being declared brain dead, then recovering contradict what doctors and organ procurement groups having been telling the public since 1968.
"Brain dead is dead. There is no 'recovery,'" one organ procurement organization says on its website. It's a familiar refrain, but one that savvy medical consumers would do well to investigate before agreeing to become organ donors.
The "Dead" Awaken
In July, a woman diagnosed as "brain dead" did the supposedly impossible. Madeleine Gauron woke up. Transplant folks had already sought consent to harvest her organs, but fortunately for her, her family refused, demanding proof she was really dead.
That case follows on the heels of a similar "miracle" in Australia in March. Doctors declared Gloria Cruz, 56, brain dead. She regained consciousness three days later.
Egnever
(21,506 posts)But i would never let that stop me from becoming an organ donor. It has been on my license since I was 16 and will remain there till I go brain dead.
Th1onein
(8,514 posts)Each to his own, I guess.
uppityperson
(115,681 posts)seems odd that you would not be an organ donor if that is you.
riderinthestorm
(23,272 posts)uppityperson
(115,681 posts)tammywammy
(26,582 posts)REP
(21,691 posts)I don't think she ever was a donor; I think this is just posing.
This was said in a response to me on DU2 as to why she wasn't a donor or a live donor of a kidney or liver lobe to save lives.
FarPoint
(12,472 posts)if the need or crisis arose in your life for a transplant....Is that your stance as well?
And not for religious reasons, either. I'm just not in the market to be here any longer than is absolutely necessary.
FarPoint
(12,472 posts)riderinthestorm
(23,272 posts)She does good and important work for so, so many people.
She's 22 months post-op from a double kidney/liver transplant (she coded during a colonoscopy which destroyed her kidneys and liver).
She has many years to go helping the poor, indigent and mentally ill. Her skills are critical to helping others in her community. She vowed not to give up, determined to "give back", especially after this incredible gift of a kidney and liver.
You purport to be some kind of advocate for "life" at all costs but obviously hold a very different standard for yourself when it comes to your own health/contributions/life skills.
Weird.
CreekDog
(46,192 posts)one organ in particular comes to mind.
Douglas Carpenter
(20,226 posts)first hand source of even one single case of a diagnosed brain dead patient waking up - If this has his happened - then this is something very rare. If society were to maintain life support on all brain dead patents - not only would it end the vast majority of vital organ transplants - the sure cost of this alone would crash the medical systems of every country in the world -
leftyohiolib
(5,917 posts)Douglas Carpenter
(20,226 posts)seen it nor has anyone I have ever worked with - anyone in 33 years of caring for mechanically ventilated patients ever seen it. If we stopped harvesting organs from brain dead patients and if we maintained all or most brain dead patients on mechanical ventilation and life support - hospital facilities would very rapidly be overwhelmed with brain dead patients and there would be far fewer resources for treatable illnesses. Even if adopting such a policy might save one or two lives a year out of hundreds of thousands of cases from across the whole world- by denying organ transplants it will cost countless lives - By overwhelming the healthcare systems with nonviable brain dead patients - not one out of thousands and thousands will ever wake up - resources that could save lives will be diverted and that will cost countless loss of lives to viable patients who have illnesses that can be treated.
Ms. Toad
(34,123 posts)I'm on her living will and durable power of attorney expressly because she does not want her body supported when she's no longer "home" - and she does not believe my father would be capable of recognizing and letting her go at that point.
(third generation organ/body donor - my daughter, the 4th generation, will also most likely also be a recipient of a liver)
MattBaggins
(7,905 posts)The issue is the sense in mechanically pumping air into a corpse.
Th1onein
(8,514 posts)That way, we don't seem so coldblooded when we talk about removing them from life support and "harvesting" their organs.
Remember the "coma"? Wonder why we don't talk about people being in a coma anymore? Don't hear much about that these days, do you? Now, these patients are determined to be "brain dead," and their organs can be harvested.
MattBaggins
(7,905 posts)They are not alive when the brain stem shuts down. The ventilator is mechanically pumping air into a corpse.
A coma and brain dead are not the same thing. I do hear about comas all the time but I work in health care so there is that.
Th1onein
(8,514 posts)We don't have the technology for it. Period.
These decisions should be left up to the family. Period.
Here's an article that should give you pause:
http://www.theverge.com/2013/9/19/4748248/new-deepest-state-of-coma-identified-brain-activity-after-brain-dead
The brain may live on after what's long been considered brain death. New research from the University of Montreal finds that there's a deeper state of coma beyond what doctors have been considering to be the final line. Traditionally, when an EEG recording a measurement of electrical activity along the scalp comes to a flatline, a brain's activity is considered to have ceased. But the Montreal research team found that it can actually return again through a medically induced coma. In a paper published Wednesday in PLOS ONE, the researchers write that this newly identified coma state is "the deepest form of coma obtained so far."
--------------------------------------------------------------------------------
Establishing brain death isn't simple
The discovery could impact what doctors consider true brain death. "At the very least the current findings should serve clinicians in their assessment of patients depth of coma," the researchers write. It should also "draw attention to the difficulties in establishing clinical brain death." Though it remains unclear why brain activity returns in this deeper coma, the researchers suggest that as major brain functions relax, other functions may become free from prior constraints and begin to initiate new activities.
Over 20 cats were anesthetized into a medically induced coma as part of the researchers' experiments. From there, the researchers measured the cats' brain activities at different coma states. The team knew to look for this deeper, medically induced state due to a discovery in a previous patient whose brain activity returned after being given epilepsy medication while in a coma. While it's still necessary for neurons to continue functioning throughout the earlier coma states in order for this to happen, the researchers write that if they do remain intact, it now appears the brain could survive.
Ms. Toad
(34,123 posts)as expressed through the person the individual designates in his or her living will and durable power of attorney. Everyone should have these two documents - and should discuss them with their designees - to ensure their end of life is handled as they want it to be.
But - absent those documents, we need to be on an opt out basis for organ donation. That does not take away anyone's rights to decide not to donate their organs. Once you have opted out no one, not even your family, can overrule your decision. What it does, though, is make organs available from people who didn't care enough to make a decision one way or the other.
Nuclear Unicorn
(19,497 posts)That gives me chills. I own my body. No one else. Unless I give explicit consent it's not for anyone else. Period. End of discussion.
Ms. Toad
(34,123 posts)you still own your body. You just have to make a decision.
Both opt in systems and opt out systems respect a person's right to determine whether their organs are donated or not. Once you make a decision, and express it, no one gets to override it. From a public policy perspective, opt out systems are better at ensuring that organs which are no longer needed to sustain life are used by those who need them, while still respecting the right of every person to make that decision for their own body.
Nuclear Unicorn
(19,497 posts)Opt out assumes that, unless indicated otherwise, someone else gets to decide. The evils that makes people vulnerable to are too many to number. It is absolutely wrong and no amount of appealing to higher good will change that.
Ms. Toad
(34,123 posts)Anyone who does not want their organs donated for transplant has the absolute right to refuse.
The problem is that far too many people would want their organs used for transplant if anyone asked them - but the question was never been posed to them before they died, or the people they discussed it with didn't have the legal authority to make the decision, or couldn't be reached soon enough to make the call, and so on. Because the decision to donate organs is extremely time sensitive, and the opt in system results in far too many organs which individuals would have chosen to donate being lost - and the deaths of too many people on the transplant list. I have lost a half dozen friends in the last year either directly, or indirectly, because there are not nearly enough organs available for everyone who needed them - friends who would still be alive if the organs of all of those who are actually willing to donate had not ended up in the ground. Those individuals lost their lives because the presumption in the absence of the right kind of statement, accessible immediately by those who need to know quickly, is that they would choose not to donate.
People who feel strongly, on either side of the question, are going to make the effort to opt in - or opt out. What we are talking about is what we should presume about the wishes of an individual who has not made a decision. You should do some research - the reality of the system is a lot different than whatever "evils" you are imagining.
It is perfectly fine to disagree about which system (opt in or opt out) should be in place, but neither side is "absolutely wrong," because both give the individual the absolute right to decide (directly or through a named proxy) whether or not their organs are used to save the lives of others when they are no longer useful to sustain the life of the individual who has died.
Nuclear Unicorn
(19,497 posts)No amount of rationalization will change that fact. You're taking people's bodies without their consent. You're assuming they belong to someone other than the individual and once you start there is nothing to keep the evil from spreading. This is no different than vileness of the anti-choicers.
Ms. Toad
(34,123 posts)Last edited Thu Jan 2, 2014, 02:11 PM - Edit history (1)
What part of guaranteeing every single person the absolute right to choose to refuse do donate their organs (by opting out) has any similarity to prohibiting a woman from being able to choose to having an abortion?
Opt out programs only provide a legal presumption about the wishes of an individual, when no choice has been made. The same as other laws relating to death. Inheritance, for example. All states have presumptions about how the individual who died would have wanted his or her estate to be distributed (many including provisions for property reverting to the state). An individual can opt out of this presumptive distribution by making a will - the principle is the same (including, in many instances, property being dedicated for public good).
There is nothing inherently evil about making a presumption, one direction or the other, which takes effect only if the individual chooses not to make his or her wishes known. 24 European countries have an opt out system.
But you don't like an opt out system, then adopt a mandated choice model. Everyone renewing their driver's license or state ID would be required to decide one way or the other - and that consent/lack of consent would be binding, regardless of the family's wishes. Illinois uses this system, and has a donor sign up rate 50% higher than the national average. And, unlike many other states, once an individual has decided to donate, it allows donation to move forward in a timely manner because the decision cannot be changed after the fact by family members who may feel differently (either way) about organ donation.
Nuclear Unicorn
(19,497 posts)Said every date-rapist ever.
There it is!
That is exactly the mindset I'm speaking about: people who appoint themselves as the ministers of all that is right and holy mandating to everyone else.
What next? Presumptive euthanasia? I'm sure you'll balk and bristle at such a suggestion but there isn't one argument that you have presented for your mandatory organ harvesting scheme that couldn't be twisted to accommodate euthanasia without consent. "It's for the greater good...scarce resources...they'll never know...all the professionals say...we're really just trying to help the still-living...blah-blah-blah."
Ms. Toad
(34,123 posts)Try reading again, take a few deep breaths, and respond to what I actually said rather than what you imagine I said. I've even gone back and bolded and underlined the portions you read past, apparently without any comprehension of what you were reading.
Nuclear Unicorn
(19,497 posts)Ms. Toad
(34,123 posts)Because every single person gets to have exactly what they want done with their organs. The ONLY two things which are mandatory, under the mandatory choice model in Illinois is that (1) you make a choice - to donate, or not to donate - when you or renew your driver's license and (2) once you've made a choice, no one gets to override it.
That second part is where rejecting it is inconsistent with everything else you've been saying. In most parts of the country your family - not you - has the last say. Even if you declined to be an organ donor under the opt in scheme in place in most of the country, your family could override it and give your organs away anyway. Under the mandatory choice scheme (which I still don't think you've calmed down enough to understand) they don't have that right. If you have chosen not to donate your organs, no one - including your family - has the right to donate them on your behalf.
enlightenment
(8,830 posts)The underlying issue is a rejection of organ donation - based on what, I don't know.
It doesn't appear to be a lack of comprehension, but a rejection of the base premise with lots of emotional baggage attached.
Ms. Toad
(34,123 posts)With a heavy emphasis on **lots** of emotional baggage - so much so that Nuclear Unicorn is - shall we say - going nuclear on a scheme which guarantees that their decision to carry their organs into the grave cannot be overridden by parents, siblings, or boyfriend/girlfriend/spouse.
ohheckyeah
(9,314 posts)Nobody is entitled to another person's organs unless that person expresses so.
Ms. Toad
(34,123 posts)The costs associated with being listed with no available organ are very high - and, in large part, are borne by all of us. Making more organs available is in the general public good.
The opt out system allows anyone who really cares about it to decide not to donate. If you don't care enough to opt out, your organs will be available for those who need them. Studies indicate far more people would choose to donate than actually go through the process to make those wishes known. An opt out system doesn't take anyone's rights away - but results in more organs being available, less loss of resources (via loss of productivity, quality of life, etc. while on the waiting list), and lower overall costs (being on the waiting list is often tremendously costly because of the frequent hospitalization associated with living with failing organs).
ohheckyeah
(9,314 posts)an opt out system doesn't take rights away.......whose going to make sure people know they have to opt out?
Ms. Toad
(34,123 posts)And you seriously believe that a change in the legal presumption regarding consent for organ donation wouldn't circulate just as quickly as the completely false "death panel" provisions of the health care law?
ohheckyeah
(9,314 posts)Th1onein
(8,514 posts)LWolf
(46,179 posts)does not make your point any more or less valid, or convince listeners or readers of your authority to end discussion.
Just saying.
I don't have a side to take in this discussion; I could argue it from all sides, and prefer to read and think. I tend not to read further, though, or give much thought or weight, to statements followed by "period," because I find it offensive.
Th1onein
(8,514 posts)I'm certain that you, and everyone else, makes a habit of doing certain things in their posts. Whatever. It's your loss when you can't overlook that, and pay attention to the points of the argument.
Glad you like to read and think. Sorry that you have that impediment.
Period.
BigDemVoter
(4,158 posts)Brain dead means that no brain activity is there. Being in a coma means that you are unconscious for one reason or another, BUT brain activity is detected.
Chan790
(20,176 posts)you're beginning to turn me off from wanting to agree with you.
I've spent a lot of time in hospitals, more than I probably should have...there were a period where I was working on a novel and a good way to make a living while writing is/was to take jobs as caretaker/companions for terminally-ill people...point is, I've spent a lot of time around people on ventilators and in ICUs. From there, I became an advocate for people who wish for home funeral and home-burial...I've seen a lot of dead people; washed them, waked them, shrouded them, buried them.
There's a difference between people in comas on life-support recovering from injury or illness...and people who are brain-dead mechanically-aspirated flesh. Dead is dead. They're not people anymore...the spirit or soul or animus or whatever has left...they're bodies, if you stop flagellating artificial life into them they cease to function.
I'm sorry if that's crass and blunt but we need to be crass and blunt and honest about death.
Th1onein
(8,514 posts)As for turning you off? Makes no difference to me. That is not the issue here, is it? And if you can't separate your personal feelings from those issues, it's you who has the problem, not me.
notadmblnd
(23,720 posts)It was a valentines gift from her husband in 2001 right before he blew his own brains out. Other than that, there wasn't a damn thing wrong with her, but her family let her go. Maybe there was or maybe there wasn't any functioning part of her brain left. Even IF she ever was able to open her eyes again, she herself would not have called that life.
Now I don't know if your anti choice views are a result of your religious beliefs- but if they are, please explain to me: why it seems that those who profess to to have a close relationship with God- also seem to be the most hesitant meet him?
Th1onein
(8,514 posts)I am what you call a "seamless garment" kind of pro-lifer. I am against the death penalty, against war, and against euthanasia--all for the same reason. I am not against suicide, though. I think that people's lives are their own, and they should be able to end them when they want to.
grantcart
(53,061 posts)It's not surprising that individuals in their last year of life consume a disproportionate share of medical resources. One percent of the population accounts for 30 percent of the nation's health care expenditures. Nearly half of those people are elderly.
Medicaid, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months
We need to have a rational discussion about the best use of resources and how to have the greatest impact on life expectancy and quality of life.
For 93 years my mother said, on a regular basis, don't let me end up just half alive on a hospital bed. And yet the last 3 years resulted in maintaining a miserable, blind woman that was conscious for about 1 hour a day and seemed to sustain life on a bowl of ice cream a day. She didn't have many lucid moments but the few that she had always ended in "how much longer do I have to suffer like this".
Spending millions on medical outcomes where the best scientific evidence knows that there is either no good outcome or a one in a billion doesn't make sense when there are millions of children with untreated health problems. Other countries are able to look at these questions tastefully and rationally, why can't we, why are Americans so afraid of death?
bhikkhu
(10,725 posts)I'd hate to see the whole organ donation system wrecked because a few doctors screwed up and declared "brain dead" where it wasn't the case.
I imagine its more like an auto mechanic insisting that your car won't start because the battery is dead and gone, only to find out that its actually a blown fuse. People make mistakes, and usually there's a simple explanation.
Douglas Carpenter
(20,226 posts)dionysus
(26,467 posts)20 minutes with no oxygen to the brain.
the doctors did the best they could. they put her in an induced coma and used some device that kept her very cold, trying to preserve what they could, if anything.
her heart was beating no its own but she could not breathe without a ventilator.
after 2 days they took her off of sedation. it was the most horrible thing I have ever seen. she was rolling her eyes, moaning, and posturing. it was plain to see that she was gone. it would have been cruel for the doctors to blow sunshine up our asses and give us false hope. thankfully, they did not.
bananas
(27,509 posts)Mel Brooks @MelBrooks
Last Sunday I followed my own advice from the NYT http://nyti.ms/1edeDK6 & bet $10 on # 6 which was 50-1. He won! Always bet on a miracle.
12:31 PM - 17 Dec 13
"Miracle" is the name of the horse in Mel Brooks' "History of the World Parts I and II".
Unfortunately Part II was never released so we don't know how it ends.
Happy New Year Th1onein!
sakabatou
(42,198 posts)riderinthestorm
(23,272 posts)So you have 4 cases from around the globe to substantiate this, none of them recently....
What is the criteria used for declaring someone "brain dead" in say, Australia? Is it the same as the US?
My sister's had a double kidney/liver transplant and I've seen absolutely ZERO evidence that the transplant system is a profit game. In fact I think its despicable to even accuse the transplant treatment centers across the US of this when you have no knowledge at all of malfeasance.
All you are doing is trying to prevent people from signing up to be organ donors and I find that really disgusting.
KittyWampus
(55,894 posts)We know that science writing and journalism is really bad and misleading.
Douglas Carpenter
(20,226 posts)to give vulnerable people false hope based an a faulty premise that has less tangible evidence than alien abduction
riderinthestorm
(23,272 posts)etherealtruth
(22,165 posts)Capt. Obvious
(9,002 posts)There's one person in the story who is American. Zack Dunlap.
riderinthestorm
(23,272 posts)liberal_at_heart
(12,081 posts)I am signed up for organ transplant and their post has not scared me so much that I refuse to go through with it.
riderinthestorm
(23,272 posts)She's pretty clear that she thinks organ donation is a racket and tries hard to dissuade others from signing up to be a donor.
edited to add link from another thread for clarification:
http://www.democraticunderground.com/10024253921#post35
Ms. Toad
(34,123 posts)I was going to respond to your earlier post suggesting you were reading things into the OP that weren't there - but this link makes it clear where it came from.
It is sad that there is so much misinformation about organ procurement, organ distribution, and how the transplant system works.
magical thyme
(14,881 posts)Other countries do not have the same standards or protocols to declare irreversible brain death that we have in the US.
In the sole US case they cite, it seems as though they did not follow the protocols that I've read about. They relied on a single, not very sensitive test to confirm a premature diagnosis. This was nearly 7 years ago, so I expect a lot has changed since then.
Th1onein
(8,514 posts)It's a recipe for disaster. Of course, the victims don't talk.
Did you know that they often have to administer anesthesia to organ donors who are "brain dead," because they respond to the pain of the scalpel when they're harvesting their organs? Strange, having to administer anesthesia to a dead patient.
JNinWB
(250 posts)Six specialists have determined brain death.
How many more brain exams would satisfy your concern?
Th1onein
(8,514 posts)As the exams stand right now? I simply don't trust the criteria. I think there's a lot more going on in the brain than we are able to test for.
JNinWB
(250 posts)How long do you believe her brain can survive with no detectable electrical activity?
Today is the 18th day since death and Jan 7 will make it 26 days.
Barack_America
(28,876 posts)Th1onein
(8,514 posts)The outer layer of her brain has zero blood flow. You have no idea about the entire brain, nor do we have the technology to determine blood flow in the entire brain.
MattBaggins
(7,905 posts)Doctors can determine blood flow in the carotid arteries and even in the circle of Willis.
Th1onein
(8,514 posts)But it sounds real good, so you just keep on with it. Or are you saying that there's no blood flow through either, for Jahi? I somehow doubt that.
MattBaggins
(7,905 posts)I of course have not seen any of the charts but considering the given length of time there is high likelyhood of a significant occlusion of the deep arteries and veins of her brain as well as in the cortex.
Barack_America
(28,876 posts)When brain dies as a result of oxygen deprivation, it swells. The swelling cuts off circulation, which will kill any remaining neurons that are hanging on. This is why holes are cut into skulls in order to "relieve pressure on the brain". It is an attempt to keep blood flowing.
Jahi's initial anoxic event was so catastrophic that there was no way to prevent this from happening, blood stopped flowing and all of her remaining neurons died.
I'm not sure you appreciate what happened to this girl. She had a large bleed. She appears to have aspirated a large amount of blood. She went into cardiac arrest from the blood loss and the fact that her lungs were filled with blood. Because of the bleeding in her throat and her obesity, doctors had a hard time intubating her. When they did, she was still compromised by the blood in her lungs. All of this time, there was insufficient oxygen to her brain. Much of her brain died. What didn't die initially then died from the subsequent swelling and lack of blood flow. She now has no blood flow to or electrical activity in her brain. It is dead. She is dead.
Th1onein
(8,514 posts)NO blood flow, is that what you are maintaining? None, to any part of her brain?
Barack_America
(28,876 posts)CNN has obtained a copy of a medical report, contained in a court filing, that lays out in extensive detail the testing that supports the hospital's conclusion that McMath has no hope of recovery.
The report was prepared by Dr. Paul Fisher, Chief of Pediatric Neurology at Stanford University, who was appointed by Alameda Superior Court Judge Evelio Grillo to examine the girl and report his findings to the court.
Fisher found that the girl's pupils were fully dilated and unresponsive to light and that she did not respond to a variety of intense stimuli.
His report also says McMath showed no sign of breathing on her own when a ventilator was removed: "Patient failed apnea test." While the family has referred to Jahi's heart beating, the report says it is only beating because of the mechanical ventilator.
In addition, an imaging test showed no blood flow to Jahi's brain, while another showed no sign of electrical activity.
Fisher's conclusion: "Overall, unfortunate circumstances in 13-year-old with known, irreversible brain injury and now complete absence of cerebral function and complete absence of brainstem function, child meets all criteria for brain death, by professional societies and state of California."
http://www.cnn.com/2013/12/30/health/jahi-mcmath-girl-brain-dead/
Th1onein
(8,514 posts)Barack_America
(28,876 posts)The meninges that cover the brain? The grey matter on the surface of the brain that comprise the actual cell bodies of neurons (as opposed to the underlying axons that merely convey electrical signals)?
Have you ever seen functional neuroimaging? Do you have any clue how it works or what it shows?
As for angiography and the circulatory system itself, blood flows away from the heart in large vessels that get progressively smaller. True, we can't always visualize the brain at the capillary level, but if there ain't no blood in the larger vessels, there ain't none in the smaller ones either.
Or do you truly believe that tissues can survive without blood flow. If so, I'd love to hear your thoughts on the likelihood of an actual zombie apocalypse (I'm guessing pretty high?)
Th1onein
(8,514 posts)You know, if you're going to start with the ad hominem attacks, (ie., zombie attacks), I'm going to put you on Ignore.
Barack_America
(28,876 posts)Neuronal cell bodies = the part of the brain that makes us who we are and do what we do. No blood flow to cortex = dead neurons = dead brain (differentiating from brainstem here).
Th1onein
(8,514 posts)ie., "No blood flow to cortex = dead neurons = dead brain"
uppityperson
(115,681 posts)That no blood flow means the neurons are dead or that because the neurons are dead the brain is dead?
sendero
(28,552 posts)... that one can just excise the outer layer of the brain and somehow lead a life worth living
You can check my posts, I'm a regular and vociferous critic of American medicine and it's pronouncements, particularly pharmaceuticals but other parts of the process as well. I learned at an early age that the guy who graduated last in his class is still called "doctor" and that like any other profession there are competent practicioners and there are the rest.
But when 8 doctors agree on just about anything medical, you can bank on it.
This person is dead.
Anyone wanting to achieve something useful from this tragedy would find out just how this happened and make damn sure it does not happen again. There was a serious breakdown of some sort when someone can die over this sort of surgery.
arthritisR_US
(7,300 posts)that is the thinking part of the brain, the part that is the essence of who we are.
Her neocortex is necrotizing and eventually without blood flow so too will her primitive brain. The outcome is inevitable it's just so sad that the suffering has to be prolonged unnecessarily.
Th1onein
(8,514 posts)that's hard to pinpoint, isn't it? However, the brain has holographic abilities, and we only test the first couple of layers; that's all we have the technology to test, so I'm not satisfied until they have the ability to test the entire brain.
I don't know how long her brain can survive with no detectable electrical activity ON THE SURFACE OF IT, but I also don't think that that is either our, or the medical professionals' call. It should be left up to the family, period.
MattBaggins
(7,905 posts)Th1onein
(8,514 posts)Nobody You Know
(33 posts)going back to life.
You cannot find a single case here in the United States. Never happened. Never will. The brain stem is the MINIMAL function needed to remain alive. There is none in Jahi's case. She is not in PVS and cannot breathe without aid of machines.
You tell me that this person is still alive in your insane opinion, you are not a real person. Many have already ridiculed your stances, and believe me, many pro-lifers would agree with the doctors - she is dead, and there is no way to keep her alive. The soul is gone, there is no way back for Jahi's family. All they are doing is believing in woo, just like you. You love junk science. I hate junk science. You don't belong in this forum if you believe in woo. That's a Republican behavior.
Th1onein
(8,514 posts)Here's one for you, below the last link. But, besides that one, I'm surprised that you haven't done this work, yourself, without coming to me and demanding the information. If you had not made an assumption that I "cannot not find a single case here in the United States," you would not, now, look so foolish.
Okay, now, let's see, got to have another one in the US, because medical tests outside of the US don't work. Hmmm......how about the next link? You'll notice she's in Minnesota, and the site is ABC News.
http://abcnews.go.com/GMA/OnCall/story?id=4290829
How about Colleen Burns? She's from Syracruse, NY. Good enough for ya?
http://www.huffingtonpost.com/dr-lindsey-fitzharris/dissected-alive_b_3570667.html
Oh nooees! It seems the doctors might have made a "mistake," in Coleen's case! Those don't count in your scenario, right?
And then there's the case of Steven Thorpe: http://www.bbc.co.uk/news/uk-england-17757112
Whoops! He's from England! Gosh, sorry, that doesn't count. Got to stick with the US patients who woke up after being declared brain dead. Them foreigners don't count, even when FOUR doctors declared him brain dead before he awoke.
http://theness.com/neurologicablog/index.php/brain-dead/ Here's a snippet from this article:
It is often said of Paris Hilton that she is famous for being famous. Well, Zack Dunlap might have her beat he is famous for not being dead.
In November 2007 Zack Dunlap was involved in a serious 4-wheel off-road biking accident, a roll-over resulting in severe head injury. He was flown to a nearby hospital where he was treated by trauma surgeons. His condition was critical. At 36 hours after his accident the doctors taking care of Zack feared that he might be brain dead. As Zack was a registered organ donor, they wanted to perform a confirmatory test so that if brain death were confirmed, the process of organ donation could begin.
A PET scan was performed at 36 hours. PET scanning (technically referred to as Technetium-99m hexamethylpropyleneamineoxime brain scan) is a measure of blood flow to the brain. Zacks doctor, Leo Mercer, showed his parents the scan his brain was entirely black. No blood flow. This was sufficient to meet criteria for brain death. The process of organ donation began.
Zack is from Oklahoma, by the way. As to your other statements:
You tell me that this person is still alive in your insane opinion, you are not a real person. Many have already ridiculed your stances, and believe me, many pro-lifers would agree with the doctors - she is dead, and there is no way to keep her alive. The soul is gone, there is no way back for Jahi's family. All they are doing is believing in woo, just like you. You love junk science. I hate junk science. You don't belong in this forum if you believe in woo. That's a Republican behavior.
Opinions, per se, are not insane, only sometimes the people delivering them. My opinions are based on good science, because I have taken the time to research these questions. You, very apparently, have not, since you insisted that there was not one case in the US where a person who had been declared brain dead had awoken. And, it does not matter to me how many, or who, "ridicules" my stances. If I am right; I am right. It's as simple as that. When I am proven wrong, I admit it. Until then, I wouldn't be much of a person if I didn't stand up for what I know to be true, no matter how much "ridicule" I receive.
As for loving "junk science," I love science, period. You can call anything you like "woo," and as far as I'm concerned, that term has been used too much, to discount differing opinions. It's quite shameful. I am a published scientist; how many articles have you published?
One last thing: You have SEVENTEEN posts and you've been here THREE days. I would suggest to you that now is not the time to tell someone who's been here for almost ten years and who has almost eight thousand posts, that they don't belong in this forum, OR that they are a Republican.
riderinthestorm
(23,272 posts)What does "essentially" brain dead mean in the case of Rae Kupferschmidt? Was she legally pronounced brain dead by (as in the the case of Jahi) SIX doctors? What does "essentially" mean in this case? The same as Jahi?
There's absolutely NO information provided in your link about Colleen Burns. The rest of the stories in that Huff Post "weird news" article are historical and certainly NOT based on new data on how to evaluate brain death.
The last case is from the UK which has different standards than the US (a point that's already been made clear to you several times over on this thread).
vankuria
(904 posts)appeared in my morning newspaper today: "Colleen Burns was at St. Joseph's Hospital for a drug overdose in October 2009. Her relatives consented to donating her organs after doctors told them she was brain dead".
She had been wheeled into the operating room where Dr's were about to remove her organs for transplant when she opened her eyes. Per the story in The Post-Standard, "The State Health Dept. investigated the incident at St. Joe's. The agency found the hospital's care unacceptable and issued a $6,000 fine". Also, "The Federal Centers for Medicare and Medicaid Services, it it's own review, criticized St. Joe's response for the incident".
Sorry I can't give you the link but you can go to Syracuse.com to get more info.
Response to Th1onein (Reply #134)
Name removed Message auto-removed
catbyte
(34,514 posts)as tragic as that is. This has gotten ghoulish.
Th1onein
(8,514 posts)Instead of her life.
Let her family be; leave them alone; let them decide what THEY should decide.
catbyte
(34,514 posts)Welcome to ignore.
Th1onein
(8,514 posts)I didn't study to make money, or to have a career. I did it to learn; there is honor in that.
It is arrogant to think that knowledge must come from a certain source--such as a classroom.
KittyWampus
(55,894 posts)with higher brain functions.
Douglas Carpenter
(20,226 posts)in Oakland we are way beyond Terri Shiavo level - we are dealing with a dead corpse - I can understand the emotions of the family - But these attempts by a few nutters to bamboozle them into continuing and the latest ruling by the judge is somewhere between crackpottery and pure down right evil.
Barack_America
(28,876 posts)Numerous responses and reflexes are tested, as is the ability to support respiration off the ventilator. All in the complete absence of sedation, pharmacologic paralysis or severe metabolic derangement.
When a patient has no pupillary response, no blink, no gag, no grimace, no ocular movement and quickly desats and goes into cardiac ectopy off the vent, it's pretty obvious. Yet still, 2 neurologists generally must come to identical conclusions before a diagnosis is made.
Th1onein
(8,514 posts)We also don't have the technological ability to test the activity of the whole brain. I don't care which responses/reflexes you test, you and I both know that this is true. Only the very arrogant, or the very stupid, maintains that the current criteria for brain death are determinant of true death.
MattBaggins
(7,905 posts)You are playing the same game that creationist do demanding that every fossil that ever existed be found before they will accept evolution.
YOU and YOU alone don't know enough about the brain. Stop using the term we.
Douglas Carpenter
(20,226 posts)are "the very arrogant and the very stupid" - I do not know nor have I ever met one single person who works in an intensive care setting who believes we should continue artificial life support and mechanical ventilation on diagnosed brain dead patients who show no response to any stimuli or any spontaneous respiratory effort. There is no serious debate about the reality of brain death in the neurological or any medical science community. That is reality. As with global warming and evolution science is now a sinister conspiracy - While anti-scientific extremism tries to set the agenda- If the scientific consensus is somehow overthrown on this issue - countless numbers of people are going to die from completely treatable illnesses while our whole medical systems collapses under the weight caused by waisting its resources blowing air and oxygen into dead corpses.
liberal_at_heart
(12,081 posts)evaluate and improve. In fact, that is what science and medicine do on a constant basis. Science and medicine are always questioning itself and trying to find better ways to do things. We don't know very much about the brain. I would imagine over the next 50 to 100 years we will learn things we could never have imagined we would learn. That is the great thing about medical advancement. We may not declare death the same way 50 years from now that we do now. Or, maybe we will. Who knows?
Douglas Carpenter
(20,226 posts)delivery is that - they are much quicker than the U.S. to declare a patient DNR/DNI (Do not resuscitate/Do not intubate) - The U.S. had actually dragged its feet on this issue - It has been more or less in the last ten to twenty years that the U.S. has somewhat caught up with Europe and other advanced western medical systems on this matter.
liberal_at_heart
(12,081 posts)in medical care, but that does not mean that they are necessarily correct on this one issue. Or maybe they are. I'm not saying one way or the other. I just hate absolutes. I always support more investigation and evaluation. That's how we learn to do things better.
Douglas Carpenter
(20,226 posts)actually study the matter and know something about it more than I trust the judgment of people who read a couple of articles by those on the farthest reaches of the fringe and then think they know everything about it.
Th1onein
(8,514 posts)Just because people agree doesn't make them correct. The Bay of Pigs fiasco is a good example of that fallacy.
There IS a serious debate about brain death. It is ongoing: http://www.theverge.com/2013/9/19/4748248/new-deepest-state-of-coma-identified-brain-activity-after-brain-dead
Douglas Carpenter
(20,226 posts)would in fact cause a great deal of death and destruction as it inspires the naive and the vulnerable with false hope while draining away from our medical systems the resources needed to care for treatable patients who would actually benefit from treatment.
Th1onein
(8,514 posts)Your argument doesn't hold water.
Douglas Carpenter
(20,226 posts)lot of harm
Th1onein
(8,514 posts)Hmmm......wonder why?
It's cruel and inhumane, what they are trying to do to this family.
Douglas Carpenter
(20,226 posts)Th1onein
(8,514 posts)But it is revealing that you would attempt to cage it in those terms.
What I am saying is to let the family, who cares about the patient the most, and has the patient's best interests at heart, make the decision. It is THE most humane thing to do.
Douglas Carpenter
(20,226 posts)be unethical to waist government resources or to drive up insurance premiums in order to satisfy a families emotions.
Th1onein
(8,514 posts)Th1onein
(8,514 posts)a lot of harm, as well.
Barack_America
(28,876 posts)...and respiratory activity constitutes "life" doesn't hold water.
Why such a special status for the beating heart? You'd recognize a "heart dead" relative kept going by bypass machinery much more than a brain dead relative.
FYI, before mechanical ventilation, "brain death" was a non-issue. It wasn't until we achieved the ability to pump air into corpses that we needed to confirm that brain death is death..
Th1onein
(8,514 posts)"in the absence of brain..." THIS is the bone of contention, isn't it? You are saying that there is no measurable brain activity. I am saying that you don't have the means to measure that activity.
FYI, before mechanical ventilation, "brain death" WAS a non-issue. When we achieved the ability to pump air into humans, and to transplant their organs, the condition of "brain death" was created.
VanillaRhapsody
(21,115 posts)what are we going to do with them in your scenario? Giant warehouses of brain dead people on ventilators?
VanillaRhapsody
(21,115 posts)do you understand that an injury to the frontal lobe often results in permanent personality changes?
Barack_America
(28,876 posts)And, as a matter of fact, we have many tools with which to test the "activity of the whole brain". There is EEG, fMRI, diffusion-weighted MRI, angiography, and so on. Neurons are living cells with measurable function and metabolism. When they stop metabolizing, they are dead. The brain is dead.
You are trying to confuse the finite physiology of the brain with the mystery of the soul. That is non-scientific, disingenuous quackery.
Th1onein
(8,514 posts)"And, as a matter of fact, we have many tools with which to test the "activity of the whole brain".
Barack_America
(28,876 posts)I can't discuss medical science with someone who believes only in fantasy.
Cells. They take in nutrients, metabolize them and excrete wastes. They perform functions. Yes, we have many ways of watching neurons do these things. These medical facts may not agree with whatever existential soul woo you are trying to push here, but they remain facts.
Do you have similar disdain for EKG or other methods of studying the heart? Do you dispute that the "lub-dub" heard through a stethoscope indicates that a heart is beating (or that it has stopped doing so)?
Or do you just refuse to reject medical science pertaining to the nervous system?
Th1onein
(8,514 posts)Or is this a special case?
I have no disdain, whatsoever, for tests that actually test for what is pertinent. Actually, I am a self-taught scientist. I think it is dangerous to make assumptions before all of the facts are in.
One more personal attack, and you're on Ignore. Either discuss the issue, or we discuss nothing more.
MattBaggins
(7,905 posts)that is reflex arcs they are giving that for.
Barack_America
(28,876 posts)MattBaggins
(7,905 posts)Abdominal reflexes while trying to remove organs for transplant would not be a good thing.
Barack_America
(28,876 posts)uppityperson
(115,681 posts)For instance, touch a hot stove and the reflex nerves between what touched and the spinal cord react without any brain involvement. Cut the spinal cord, make someone a quadriplegic and these reflexes still react. Yes, it is strange to have nerves react without the brain, but there are ones that do.
Go Vols
(5,902 posts)My 21 year old son was declared brain dead after a car wreck a few years ago.4-5 people got organs that helped them keep living tho.
Still makes me sad.He just looked like he was asleep.
Th1onein
(8,514 posts)I lost my son to Cystic Fibrosis when he was 21. It's never easy; it hurts forever.
Logical
(22,457 posts)uppityperson
(115,681 posts)too sad.
Ms. Toad
(34,123 posts)And as a mom whose daughter will need a liver transplant someday, thank you for allowing your son's body to be used to help others continue to live.
SomethingFishy
(4,876 posts)This is no different. The percentage you are talking about is miniscule.
The world needs MORE organ donors, and no amount of paranoia about "organ harvesting" is going to keep me from having that little "heart" on my ID...
MattBaggins
(7,905 posts)mechanically animated.
Ventilators, TPN and dialysis for years I suppose.
Th1onein
(8,514 posts)They are the ones who care most for the patient.
MattBaggins
(7,905 posts)Sometimes you have to tell the family the truth. That should be left to the Hospital's counselors but they have to come to terms with the truth.
The medical staff should refuse to perform any new procedures. It is very sad that the family wants to do this to body but as the kidneys and other organs shut down her death will become very clear.
Th1onein
(8,514 posts)But the decision to prolong life should be left up to the family. Period.
And, if she's going to die anyway, what is all the fuss about?
MattBaggins
(7,905 posts)Do we animate all the corpses in every hospital for decades? Do we shut down entire wards, tie up equipment and waste massive resources on dead bodies?
Th1onein
(8,514 posts)became legally synonymous with true death.
The level of civilization in a society can be measured by how they treat their most helpless. I think someone who is unconscious can clearly be classified as helpless.
MattBaggins
(7,905 posts)They are not unconscious. They are dead.
Brain dead is not just "legally" synonymous with death it is death. Without a ventilator to pump oxygen into her she not be in this quasi animated situation.
Th1onein
(8,514 posts)You are incorrect. Simply restating, over and over again, your beliefs, does not add to this discussion. I am AWARE of what the status quo is; I am not arguing that it IS the status quo. Repeating it over and over again does not further your argument that it is the right thing to do.
Either add information, or find your place on my Ignore bench.
HERVEPA
(6,107 posts)How do you not get that?
And how do you not get that the one in a trillion trance (probably 0 in a trillion) chance that the person will revive is a drop in the bucket compared to those who will live because of the donor transplant. Those donees don't count in your calculus.?
Please, just a little bit of critical thinking skills.
Th1onein
(8,514 posts)It is also not the pervain of medical professionals to make this decision for the family, who cares the most for the patient.
Moreover, it's a slippery slope. In Texas, we have the Futile Care Law, which allows physicians to withdraw care for a patient if they determine that it is futile to care for them anymore. Not brain death; that's not even the criteria; it's much less than that. At what point do we begin to say that this person has less "quality" of life, so their lives are not as viable as another's? It's simply not a good road to start down on.
MattBaggins
(7,905 posts)They declare death and as sad and devastating as it is for the family; it's final.
Th1onein
(8,514 posts)I am fully aware, as is most everyone here, what the status quo is. The disagreement lies in whether it is the correct thing to do, or not.
MattBaggins
(7,905 posts)There are no alternatives.
Th1onein
(8,514 posts)Your arguments are circuitous, at best, and at worst, tautologous.
MattBaggins
(7,905 posts)uppityperson
(115,681 posts)Th1onein
(8,514 posts)O.M.G.
SomethingFishy
(4,876 posts)Talk about projecting.
What I said was you are complaining about something that happens in medicine on a daily basis. Not just to "brain dead" patients. And the numbers are so minuscule as to not even merit the paranoia you show in not wanting to be an organ donor because you might be the one person in 10 million to be misdiagnosed.
I am so sick of DU'ers who pull this shit.
You fucking know damn well that's not what I said. And if you don't then you really need to take some reading comprehension lessons before attempting to call me out again.
Th1onein
(8,514 posts)The fact that this happens on a daily basis doesn't excuse it. Nor does it make it a good reason for organ donation. In fact, it makes a good case against organ donation.
Ms. Toad
(34,123 posts)deathrind
(1,786 posts)Personal experience "Life" sustained by a machine is not life. It is an advance in medical technology pausing/interrupting what the natural process of human biology has already decided.
nadinbrzezinski
(154,021 posts)Vs the world.
By the way my drivers license marks me as an organ donor and I (in the case of this kid, she's dead) but i do not want to be connected to a vent when there's no hope. It's torture.
In this case six doctors have concluded this. Let her go. Let the family grieve. It's a tragedy. Oh and believe you me, none will be harvesting organs at this point.
GoneOffShore
(17,342 posts)840high
(17,196 posts)till 1-7.
cthulu2016
(10,960 posts)Something could, theoretically, stop observable brain activity without destruction of the tissues nessecary for brain activity.
One would hope that MRIs and such would be useful in determining the difference
But the key point to be drawn here is that dead persons who come back to life were usually misdiagnosed as dead.
Misdiagnosis is a thing. It happens.
And it is much less likely in high profile cases, for obvious reasons.
(And the president is less likely to wake up finding the wrong limb was amputated than you or I are.)
Scootaloo
(25,699 posts)I like how the article writes about "organ harvesters," as if this were a Larry Niven story about organleggers.
Th1onein
(8,514 posts)These are the ones that we know about, Scootaloo. These are the ones that made the news. And, the problem is, these patients, once they are pulled off of life support, are dead--they can no longer speak for themselves. Their families cannot speak for them, because how are they to know if they were actually brain dead or not, when they are now deceased?
I'm not against organ donation. In fact, I'm all for it. What I AM against is the money in it. Where there's money, there's corruption. We also need better knowledge of the brain and better ability to test it, before we continue along this road. Until we do, I think the best thing to do is leave these sorts of decisions to those who care the most for the patient: the family.
JTFrog
(14,274 posts)I doubt you'd be removing yourself as an organ donor.
Seems you are all for it about as much as you are pro-choice.
riderinthestorm
(23,272 posts)Not only that but different countries have different definitions of "brain dead". Your grotesque distortion of this as a "problem" is noted.
Your persistent slams against US transplant treatment teams as avaricious is disgusting and despicable. Please stop. Please. Just stop.
If the families of these patients had the millions of dollars to care for these dead people indefinitely then I'd be okay with this. Unfortunately it falls on all of the rest of us taxpayers/insurance payers to warehouse dead people to the tune of several hundreds of thousands of dollars of resources that could go towards real LIVE people who could benefit from those dollars.
Scootaloo
(25,699 posts)They are exceptional cases. You can count them without using either thumb. If these four cases illuminate a problem, then clearly hte couple hundred people hit by lightning annually illuminate the problem that we've abandoned Zeus.
Th1onein
(8,514 posts)This is why we should learn from our mistakes.
Barack_America
(28,876 posts)It is not possible to recover from brain death. It is possible for a physician to do the exam improperly, or not follow the criteria to the letter. This could lead to a misdiagnosis. Many states do not require that a neurologist make the determination, but realistically, one should. There is a sad reality that ICU beds are limited and that brain dead patients occupy ICU beds. It is not uncommon for intensivists to pressure neurologists to declare a patient brain dead. Fortunately, I've yet to see a neurologist to give in. I would be wary of a hospital that lets non-neurologists make these determinations.
Th1onein
(8,514 posts)Time and time again, in these cases, it is the family member that either alerts, or TRIES to alert the medical professionals that the patient is not brain dead. Time and again, they are brushed off, as deceiving themselves, having false hope, or the all time favorite brush off: "That's just reflexes." And when the patient wakes up on the operating table, scalpel poised to dissect them? Oh, then THAT'S just an honest mistake!
The fact is that the family is the one who is with the patient most of their stay in the hospital. Family is the entity that has the most to lose, and the least to gain, if the patient dies.
I asked you before: Was it MRI that they used for imaging on Jahi? For some reason, you did not answer me.
I think I know why.
If it is not possible to recover, then there are mistakes made, Barack_Obama, right? People are pressured, people who should not be making these determinations are making them. And people are dying because of it.
And while we're talking about not answering--why don't you comment on this article?
http://www.theverge.com/2013/9/19/4748248/new-deepest-state-of-coma-identified-brain-activity-after-brain-dead
I think I know why.
Barack_America
(28,876 posts)That's the law. Take it up with your legislators if you think every citizen has the right to declare others deceased.
I must have missed it, you have an issue with MRI? Sure they're expensive and overused, but the quality of the images is very good.
That's an interesting article, but extremely scant on the details. Brain death is not defined as flatlined EEG, and such a finding is not sufficient to declare brain death. I don't see anywhere a discussion that the reflexes that brain death is actually predicated on we're also absent. Interestingly, reading the original article (of which this sensationalized piece is based), they make no claims of life after brain death, rather merely a reiteration of why EEG cannot diagnose brain death.
From that article:
That's what they claim the study shows, nothing more. The rest was dreamed up by this "verge" piece.
Th1onein
(8,514 posts)It's not a matter of whether only physicians have the ability, or the authority, to declare someone dead. It's that physicians are declaring people dead who are NOT dead. Who has the ability to say whether they should live or die? It should not be the physician.
The EEG is used to confirm brain death. If the EEG is not useful for that, then what can confirm brain death? That is my point. As to the MRI, I asked you if the imaging they used on Jahi was an MRI?
Barack_America
(28,876 posts)It *can* be used only as a back-up method if the patient's cardiovascular function is so precarious that the physician fears it will cease during the apnea test, or when there is facial trauma that make assessment of reflexes difficult. The brain death exam is a clinical exam, is based on the presence or absence of crucial functions and reflexes. It is also extremely accurate when performed by a physician who knows what he or she is doing (and not all do).
You've mentioned Texas before, why not read about how this is actually done there.
http://www.utmb.edu/policies_and_procedures/IHOP/Clinical/End_of_Life/IHOP%20-%2009.15.09%20-%20Determination%20of%20Death.pdf
Th1onein
(8,514 posts)And I am very familiar with Texas' laws regarding brain death, actual death, futile care, etc. Been there, done that.
You still haven't answered my question regarding the MRI in Jahi's case,
Barack_America
(28,876 posts)Either CT or MRI, based on multiple factors specific to her condition and the hospital's resources. Both would be angiography using a contrast agent. Absence of the contrast agent reaching the brain would indicate cessation of blood flow.
Th1onein
(8,514 posts)And to test blood flow to the entire brain, wouldn't you need a PET?
Barack_America
(28,876 posts)Which is similar to PET in that a radioactive marker is used. Failure of the ligand to reach the brain is indicative of zero blood flow. The brain can only last a matter of minutes without blood flow before neurons dies.
Somehow a news agency in CA got the chart record of her brain death exam by the Chief of Pediatric Neurology, which details the exam that was done (including full apnea test with blood gasses), and her brain death declaration form.
http://media.nbcbayarea.com/documents/Fisher+-+Redacted+Rpt_1.pdf
Th1onein
(8,514 posts)Barack_America
(28,876 posts)Same for your vasopressin comment. Tissues die within minutes of not getting blood flow. That's what a heart attack is, for example. You seem to think that her brain is able to live in the absence of blood flow and I'm not sure why that is.
Th1onein
(8,514 posts)I'm making the point that a swollen brain is not going to show much blood flow. And people have swollen brains all the time, especially in traumatic brain injury. Don't you think it would behoove the med profs to get the swelling down before they do a PET scan? I've read where this can confound the test results.
Also, vasopressin is for hypotension, which can also confound the test results.
riderinthestorm
(23,272 posts)Th1onein
(8,514 posts)Scootaloo
(25,699 posts)Not a problem with these four individual cases scattered among thousands and thousands of non-problematic cases.
Again, you are using the exceptional as an example of the regular, and it just doesn't work that way.
Th1onein
(8,514 posts)Usually. Abd the laws are being changed to make this situation even worse.
Mariana
(14,861 posts)at his or her own funeral.
Maybe no one should ever be pronounced dead. No one should be autopsied, embalmed, cremated, or buried. You know, just in case the doctors got it wrong and those people are still alive.