The concepts of the definition of human life and death, and brain death on the one hand and compassion on the other are critical to the wider subject of ethical issues and end of life care. Among the actual recent cases that brought this issue to the fore is the case involving Jahi McMath, a minor who was declared brain dead in 2013. However, the family declined the medical conclusion based on the fact that Jahi’s heart was still beating. The issue resulted in the protracted legal case of Winkfield v. Children's Hospital Oakland and intensified the faith-based debate on brain death. Based on the above, the ethical issue of brain death is also a legal issue making it exponentially complicated for the professionals involved. The nursing and caregiving concept of compassion also applies in the case based on the interaction between the patient and the professionals (Sinclair et al., 2016) . This research paper evaluates how compassion and the definition of human life and death, brain death at the end of life care is a gray area according to available research.
Background Information
Definition of human life and death, brain death is one of the most complex and controversial subjects relating to modern healthcare. For a start, the definition of life and death in healthcare extends both to the issue of end of life care and also embryo related issues such as abortion and embryonic research. When the issue of brain death is added to the matrix, the definition takes the perspective of the difference between physical death as signified by physical activities such as the beating of the heart or the flowing of blood and brain death which relates to the cessation of all neurological activities (Greer et al., 2016). Compassion, on the other hand, relates to the ability to sympathize with the plight of others, and forms the core of modern nursing and caregiving. The case of Jahi McMath involves a 13-year-old girl that underwent surgery to ease her breathing while asleep. The surgery went well as according to court documents, Jahi recovered and even talked with her mother. However, she later developed hemorrhage related complications that left her brain dead ( Winkfield v. Children's Hospital Oakland ). The parents disputed the diagnosis and moved to court to have the clinicians compelled to continue treating Jahi. Later, the parents moved the minor out of the hospital and continued to take care of her, even as the case and associated debate continued.
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Definition of Human Life and Death, Brain Death
Based on available research, it is hard to judge who was right, between the family of Jahi and the Children's Hospital Oakland as the concept of human life and death, brain death has gradually degenerated into a debate. The concept of life and death was traditionally based on physical attributes hence a person was considered alive as long as the heart was beating. The concept of brain death is predicated on a new definition of life and death in humans, based on sentiency, hence unless the brain is functional to some extent, a person is considered brain dead and, therefore, legally dead (Greer et al., 2016). The second part of the debate pits the law, professional opinion, and religious beliefs. According to the law, if a person is brain dead as confirmed by a qualified professional such as a doctor, then the person is legally dead. However, some religious affiliations, a good example being the Catholic Church believe that a beating heart is an evidence that a human is alive hence the concept of brain death is a fallacy. Based on the above analysis, the ethical issue regarding human life and death, brain death has metamorphosed from an ethical issue into an ethical dilemma. On the one hand, the doctors hold one position which is supported by the law while the patients and their families may hold another position, which is supported by the First Amendment (Greer et al., 2016). Normally, the caregiving nurse, operating under the concept of compassion will be caught between the two groups.
Compassion
Whereas legal and ethical definitions may lead to quagmires and dilemmas, compassion is definitive and can hence be a positive mitigating factor in the debate above. Under the modern nursing practice, as based on available research, compassion is at the center of nursing and caregiving (Sinclair et al., 2016). However, the application of compassion in the instant case may also create a larger dilemma for the nurse. The definition of a patient under modern nursing also extends to the family members of the patient, more so when the patient is not able to make personal decisions as is in the case of Jahi. The nurse, therefore, has to be compassionate towards Jahi, but also compassionate towards her parents. In the instant case, compassion becomes yet another dilemma as the interests of Jahi seems to contradict with those of her parents. For example, with Jahi being brain dead, it would be in her best interest if she was allowed to rest, but spiritual beliefs of her parents must also be put into account. Just as with the doctors and their definition of brain death, the nurses will also be in a dilemma.
Conclusion
The pure application of available research relating to the concepts of the definition of human life and death, brain death on one hand and compassion on the other when applied to the Jahi case results in a dilemma. The definition of life and death from the perspective of professional opinion and application of the law is definitive that as long as there is no detectable brain activity, a patient is brain dead, hence legally dead. However, as argued in Jahi’s case, patient’s families have a leeway under the First Amendment that may enable them to disallow a determination of brain death. Similarly, the normally definitive concept of compassion is also unable to solve the instant impasse as empathizing with the patient seems to contradict with empathizing with the parents. Compassion and the definition of human life and death, brain death in the end of life care, therefore, seems to be a gray area.
References
Greer, D. M., Wang, H. H., Robinson, J. D., Varelas, P. N., Henderson, G. V., & Wijdicks, E. F. (2016). Variability of brain death policies in the United States. JAMA Neurology , 73 (2), 213-218
Sinclair, S., Norris, J. M., McConnell, S. J., Chochinov, H. M., Hack, T. F., Hagen, N. A., ... & Bouchal, S. R. (2016). Compassion: A scoping review of the healthcare literature. BMC Palliative Care , 15 (1), 6 . https://doi.org/10.1186/s12904-016-0080-0
Winkfield V. Children's hospital oakland , No. C 13-5993 SBA (N.D. Cal. Jan. 22, 2014)
