The following two articles appeared in today’s Washington Post:
ARTICLE #1: (By DAVID B. CARUSO)
A Washington hospital has asked a judge for permission stop treating a brain-dead 12-year-old cancer patient, even though his ultra-religious New York parents want to keep him on life support.
Motl Brody of Brooklyn was pronounced dead this week after a half-year fight against a brain tumor, and doctors at Children’s National Medical Center in Washington say the seventh-grader’s brain has ceased functioning entirely.
But for the past few days, a machine has continued to inflate and deflate his lungs. As of late Friday afternoon, his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline.
That heartbeat has prompted Motl’s parents, who are Orthodox Jews, to refuse the hospital’s request to remove all artificial life support.
Under some interpretations of Jewish religious law, including the one accepted by the family’s Hasidic sect, death occurs only when the heart and lungs stop functioning.
That means Motl “is alive, and his family has a religious obligation to secure all necessary and appropriate medical treatment to keep him alive,” the family’s attorney wrote in a court filing this week.
The family has asked the hospital to leave the breathing machine on and keep administering drugs until the boy’s heart and lungs no longer respond.
Disagreements between families and medical providers over when to end care for terminally ill patients are common, experts say, but this case wound up in court with unusual speed.
Unlike Terri Schiavo or Karen Ann Quinlan, who became the subjects of right-to-die battles when they suffered brain damage and became unconscious, Motl’s condition has deteriorated beyond a persistent vegetative state, his physicians say. His brain has died entirely, according to an affidavit filed by one of his doctors.
His eyes are fixed and dilated. His body neither moves nor responds to stimulation. His brain stem shows no electrical function, and his brain tissue has begun to decompose.
“This is death at its simplest,” the hospital’s lawyers wrote in a court filing.
The hospital said it would help the family move what it called the boy’s “earthly remains” to another medical facility, but has found none willing to accept a brain-dead child.
The dispute wound up in court Sunday, when the family asked a federal judge to block the hospital from doing any further tests for brain activity.
The hospital responded by asking a District of Columbia Superior Court judge for permission to discontinue treatment.
Jeffrey I. Zuckerman, the attorney for Motl’s parents, says they have been “utterly shattered” by the hospital’s actions.
He stressed that the family’s demand for continued life support was based on their obligations under religious law, not an unrealistic hope that their boy will recover.
“You can always hope for a miracle, but if you are asking if they are in denial about their child’s medical condition, no, they are not,” Zuckerman said.
A hearing was scheduled for Monday, but Children’s National Medical Center said it would ask for a postponement until Wednesday.
“We respect the family’s beliefs, and have tried since the patient’s arrival in June to work closely with them in a spirit of mutual respect,” the hospital said in a written statement.
It added, however, that attempts to discuss end-of-life issues with the family had been complicated.
Motl’s mother and father, Eluzer and Miriam Brody, haven’t been to the hospital since July. The medical center says its requests to speak directly with them have been rebuffed, and in recent days, hospital employees “have been inundated with harassing and threatening calls” regarding the case.
A substantial delay in resolving the disagreement may render it moot. The hospital suggested in legal filings that the boy’s remaining body functions will cease within weeks, if not days.
Dr. Edward Reichman, an associate professor of medicine at Albert Einstein Medical College in New York, said the question of how to accommodate religious beliefs regarding brain death comes up occasionally in New York, where there is a large population of Orthodox Jews.
While there is intense debate over whether to accept brain death as the spiritual end of life, hospitals usually find a way to work through it, he said.
“More often than not, the medical team … will accept the wishes of the family, especially if cardiac death is anticipated in a short window of time,” he said.
Arthur Caplan, a professor of bioethics at the University of Pennsylvania, said physicians aren’t obligated to provide care that can’t possibly be medically helpful.
“Doctors are well within their rights to say, ‘We are stopping,'” he said. “I don’t think medicine can become subservient to religious, spiritual or mystical hopes and beliefs concerning how to manage death.”
——
ARTICLE #2: (By DAVID WATERS)
As a father, I can’t begin to imagine the agony of the death of one of your children, but how much more agonizing would it be to have to determine whether a child is actually dead? When do you pull the plug? When does God pull the plug?
Those are some of the questions now faced by the Brody family. A hospital in Washington says 12-year-old Motl Brody is dead. “This child has ceased to exist by every medical definition,” Sophia Smith, one of the child’s physicians, wrote in court papers. “There is no activity in any portion of his brain, including the brain stem.”
Motl’s Orthodox Jewish parents and their advocates disagree. They say their religious beliefs do not recognize the concept of brain death, and their son is alive as long as his heart beats. “The child may not be conscious, may not be interactive, but that doesn’t mean that in the eyes of Jewish law, the value of that life is any less,” Rabbi Edward Reichman, a rabbi and doctor at Albert Einstein College, told the Post.
Motl remains in intensive care in Children’s National Medical Center while hospital officials seek a court order allowing them to disconnect the boy from machines and medications that keep his lungs working and his heart beating. A hearing in D.C. Superior Court is scheduled for Monday.
According to The Uniform Determination of Death Act, “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem is dead.” The law is accepted by all 50 states and the District of Columbia.
Not by all religions.
Two years ago, a Buddhist family in Boston argued that Cho Fook Cheng, their brain-dead, 72-year-old father and grandfather, was still alive and should not be disconnected from a ventilator and medications that kept his heart beating. “Even if someone is brain-dead, there may be a level of consciousness communicated by the heart beating,” said John J. Makransky, a professor of Buddhism at Boston College, told the Boston Globe.
The family won a court order that prevented the Boston hospital from disconnecting Cheng, but the family later agreed stop the medications and allow Cheng’s heart to stop beating naturally.
Other religions accept brain death. “As long as person has total brain death, we accept that person has died,” Rev. Alfred Cioffi, S.T.D., Ph.D., of the National Catholic Bioethics Center, told The Bulletin in Philadelphia.
Some states like New York allow religious exceptions for medical determination of death. The District of Columbia does not. Reichman said some Orthodox Jews base the definition of death on brain activity but others base it on a heartbeat.
In either case, Reichman said, death is defined religiously as the moment when the soul leaves the body. “Obviously, no physician or human being is capable of determining when that happens, so we have to have a medical definition,” he said.
Dylan Thomas told us to “Rage, rage against the dying of the light,” but who should get to decide when and how the light has gone out? Shouldn’t the state allow make allowances for religious understandings of death?
Join the official YWN WhatsApp status
26 Responses
Is it true that the parents have not been to the hospital since july? Sounds very odd. That reporter is probably either wrong or making it up to make the parents sound like they do not care.
does anybody know why parents dont vist
hashem should help them
Just an observation according to the Hospital the parents have not visited their son since July 2008!
Are they lying or is this the truth?
Parents where there… Where not there… You people know how much courage and heart you need to have to see a child in such a situation… I belive that someone from the family or a shliach was there, no yid is never alone, after all its in DC ant not around the corner, the rest of the family still needs parents… – the people who call the hospital should make sure their request call or email should be calm and nice so it should be a kidush hashem and not a chilul hashem… And keep daveninig for that still alive boy, al tisyaesh, afili cherev minachas al tzavoro shell odom, even the sword is on your neck, never give up! Hashem helps and does!
DAVEN VERY HARD!!! THIS BOY IS FROM A VERY SPECIAL FAMILY. HE NEEDS RACHAMAY SHAMAYIM AND WE- THRU OUR TEFILLOS CAN BRING IT! what if it were u chas vshalom!!!!! PLEASE YIDDEN- HAVE A HEART AND DAVEN FOR mordechai dov -n MIRIAM SHAINDEL for a refua SHLAIMA!!!
AND PLEASE do a little hishtadlus for your fellow brother and try 2 contact the hospital via email or calls to protest their terrible desires.
Hashem yeracheim!!
may we only hear major besuros tovos bkarov!!
I agree to everythin that the poshiter yid says but still find it hard to believe that a parent would be able to leave a little yingele(even unconcious) for sucha long period of time.
May hashem have rachmunus on the family and my they only know simchas.
I wonder if this is a money issue meaning if the hospital is getting full compensation for the bed, doctor bills, medications etc. If yes, then the question is purely an ethical one and the family should be able to have their wishes respected without any of the doctors or hospital administrators losing too much sleep over it. But on the other hand if the hospital is not getting properly compensated maybe we as a community can assume the expenses to keep this heilige neshama alive until the eibishter takes him.
I applaud this brave family.
I know these wonderful, eidel, ehrliche people, and my heart breaks for them. May Ha-Shem help them in this very difficult and trying time.
How cruel and callous some of us seem, to be questioning and criticizing these parents, who have another 6 children to take care of. How distraught these parents must have been to leave their son’s bedside, or to leave their other children in NY for extended periods of time. May none of us know the pain they experienced. Any may we yidden stop being judgemental.
Rabosi,
This is only a tiny bit of what we will face if there is CHAS V’SHOLOM any sort of socialized medicine aka Govt Healthcare. The decision of Mi Yichyeh u’Mi Yamus will be up to the government and you wont be able to do anything about it. If they decide you are too old for a transplant or any particular procedure you wont get it. There are reasons that people from Canada as well as other countries who can afford it, come to the USA for treatment.
No one is ever denied treatment in the USA and dont you ever let anyone tell you otherwise. It is simply a lie!
DONT LET THEM INSTITUTE SOCIALIZED HEALTHCARE!
mark levin,
I’m confused. Currently we _don’t_ have socialized medicine in this country. Yet this very article is about a boy who is being denied treatment in this country. So waht exactly do you mean when you write:
“No one is ever denied treatment in the USA and dont you ever let anyone tell you otherwise. It is simply a lie!”
To bacci,
Some poskim hold brain death is considered death. I’m not saying the parents have to hold that way, but don’t make it out that the hospital doesn’t have a point at all. Your strange- certain things you have the most liberal position and in this you are being machmir.
To #13,
I’m sure he meant in a regular case. With socialized medicine the medical care in the US will go down tremendously.
I remember such a case with an older patient and the Posek Hador, Rav Yosef Sholom Eliyashiv shlit”a, giving a brilliant suggestion which everyone was pleased with. I think the parents should also contact Rav Eliyashiv shlit”a.
To # 6
Careful what you daven for. A refuah Shelama means “compleate cure” which is not possible and we are not allowed to daven for miracles. A more appropriate Tefila would be…have rachmunus on his neshama.
“The hospital said it would help the family move what it called the boy’s “earthly remains” to another medical facility, but has found none willing to accept a brain-dead child.”
— AHA! Isn’t this a way we Yidden can help? How about our fellow tri-state area Yidden who own nursing homes or other such facilities? What a zechus it would be for them to accept this patient! No more of these revolting discussions by Non-Jews about Jews, no more articles about murder. And since it’d be closer, family could visit more often, if they could handle it…. Bikur Cholim could send others to visit…
“the boy’s remaining body functions will cease within weeks, if not days.”
If someone were dead, would he still have body functions?
“his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline”-isn’t it possible for his heart to stop beating when he’s on these medicines-it’s not soully the medicines that is keeping his heart beating
I have to state upfront that I am not Jewish, but I am a nurse who worked for many years in a Neuro-Trauma ICU. I certainly agree that no one can dictate how a specific religious group can define death, but whether anyone admits it or not, Motl Brady is dead. His heart has pacemaker cells that will keep working for an indefinate period of time if they receive a supply of oxygenated blood, and they will keep getting oxygenated blood as long as he is on a ventilator. His lungs are working because a machine is making them work…the drive to breathe originates in the brain and if he is brain dead, that drive is nonexistent. My heart goes out to these parents and I would hope that a resonable compromise can be reached, but the hospital is acting reasonably. If the ventilator was not breathing for him, his heart would stop beating.
#20, you never know. If this was your kid, wouldn’t you waant to give him any chance, however slim, at life?
IM AM PERSONALLY DISGUSTED AT THE HOSPITALS COMMENTS THAT THE PARENTS HAVE NOT BEEN TO THE HOSPITAL SINCE JULY. THEY ARE TRYING TO TWIST AROUND THE FACTS TO MAKE THE PARENTS LOOK BAD WHICH IS TERRIBLE. I KNOW FOR CERTAIN THAT THERE HAVE BEEN FAMILY MEMBERS, AS WELL AS FRIEND AND PEOPLE FROM THE GREATER WASHINGTON COMMUNITY WHO HAVE BEEN DOWN TO THE HOSPITAL. THERE HAS ALWAYS BEEN SOMEONE AT THE HOSPITAL 24 HOURS A DAY FOR THE CHILD SINCE THE CHILD WAS ADMITTED TO THE HOSPITAL. I TRULY AM UPSET BY THE COMMENT OF THE HOSPITAL TO MAKE THESE PARENTS WHO CARE DEARLY ABOUT THEIR SON, AND MAKE IT OUT THAT THEY HAVE ABANDONED HIM. THIS IS NOT TRUE!!
If you are not in someone elses shoes don’t talk.
The child has never been left alone for one second, there is ALWAYS someon on his bed side.
The parents have been advised not to go do to coming home frome there in terrible state and not able to function well with there other six children. The parents would LOVE to go but where told not to. Therefore they do make sure to have someone there all the time. He is NEVER left alone.
WE (THE FAMILY) MISS HIM AND WOULD LOVE TO SIT THERE DAY AND NIGHT BUT PEOPLE CAN’T JUDGE WHAT THEY DON’T KNOW.
AL TUDIN ES CHAVEIRCHA AD SHETAGIA LIMKOMO!
YOU SHOULD NOT JUDGE OTHERS TILL YOU ARE IN THEIR SHOES! (NOONE SHOULD EVER BE IN THEIR SHOES)
bacci40, i never thought i’d say this to you, but i couldn’t agree more.
isnt it against HIPPA for the hospital to comment at all about who is at this poor child’s bedside
To bacci,
I never defended M. Levin, I just explained what he meant.
“the only thing that matters is the halachic consequence of this act- he is halachically still alive…therefore cannot be removed from the lifesupport…end of story.” My comment was on the quote above. “Some poskim hold brain death is considered death. I’m not saying the parents have to hold that way, but don’t make it out that the hospital doesn’t have a point at all.” Then you condradict yourself in your answer to me and agree with me!
A couple of issues to think about:
1. If according to the hospitals opinion, and many rabbinic opinions, brain death IS death…then he is a dead person and burial is required. The boy’s parents’ chumra becomes a problem with the mitzva of burying a dead person. We are required to bury a dead person as soon as possible, and it is a violation of torah law to leave a dead person unburied.
2. How is the hospital supposed to pay for this? The medical insurance is surely not paying anymore. The boy’s parents it would appear don’t have the money to support the costs. If they could provide the money, I’m sure Children’s Hospital would be happy to keep him on life support. Children’s Hospital of Washington provides incredible support and pediatric care for children, not just in the DC area but for other regions such as NYC, obviously. Are they supposed to go bankrupt caring for this child? It takes hundreds of thousands of dollars per year to take care of this child. And yes, you can’t put a value dollar on a single human life. But if he’s niftar then why should they spend incredibly valuable resources and become bankrupt over this? If the Bobover and Orthodox community feel so strongly about this, they should raise the funds to pay back Children’s. The lawsuits by the child’s family endangers the valuable community service that Children’s Hospital provides by draining them of their money. Instead of lawsuits, how about getting the money instead?
Read the court memo and you will see that the costs to the hospital are negligible as insurance has covered everything.