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Brain death diagnosis for second Michigan teen raises questions

October 29, 2019 CNA Daily News 0

Detroit, Mich., Oct 29, 2019 / 06:36 pm (CNA).- For the second time in a month, a family in Michigan is fighting to keep their teenage son on life support after a hospital has declared the boy brain dead and made plans to remove his life support systems.

Titus Jermaine Cromer Jr., 16, was rushed to Beaumont Hospital in Royal Oak after suffering cardiac arrest, according to local news reports. When he arrived, he could not breathe independently or regulate his own blood pressure. However, after receiving hydration, nutrition, and body temperature regulation, his family’s lawyer says he is showing signs of improvement and can now breathe independently and regulate his own blood pressure.

However, hospital officials have diagnosed the teen as brain dead, after two doctors determined that he had suffered “irreversible cessation of all functions of the entire brain, including the brain stem.”

The hospital made plans to remove his life support systems on Oct. 28, the Detroit Free Press reported.

The family challenged the decision and has asked for additional medical opinions on whether Cromer is actually brain dead.

“As a parent, if there’s a million-to-one chance that he’s going to get better, I’m going to take it,” the family’s lawyer said, according to the Detroit Free Press. “And I’m not going to get two opinions. I’m going to get 20. I’m going to fight for my boy until there’s absolutely no hope at all. And then I’m going to fight some more.”

Oakland County Circuit Judge Hala Jarbou ordered the hospital to continue life support until a Nov. 7 court hearing on the teen’s health status.

The Detroit Free Press said the family’s lawyer described them as “very much guided by their faith, and as Catholics, they believe that removing life support would be murder.”

The case is similar to that of 14-year-old Bobby Reyes, who was rushed to C.S. Mott Children’s Hospital in Michigan last month following a severe asthma attack. Repeat tests in the following days indicated that there was no blood flow or electrical activity in the boy’s brain.

The hospital declared Reyes brain dead and made plans to remove him from life support. Reyes’ family fought the decision but ultimately failed to receive relief from a court, due to a jurisdiction dispute. Reyes was removed from life support on Oct. 15.

The hospital said in a statement, “Continuing medical interventions was inappropriate after Bobby had suffered brain death and violates the professional integrity of Michigan Medicine’s clinicians.” Michigan law recognizes an individual as dead if they have undergone “irreversible cessation of all function of the entire brain, including the brain stem.”

The two Michigan cases have drawn renewed attention to the diagnosis of brain death and sparked concerns over parental rights in cases where family members question a diagnosis.

The National Catholic Bioethics Center (NCBC) maintains that cases of improvement over the course of months or years generally indicate an incorrect diagnosis of brain death in the first place.

“Stories of people continuing on a ventilator for months or years after being declared brain dead typically indicate a failure to apply the tests and criteria for determination of brain death with proper attentiveness and rigor,” said Fr. Tad Pacholczyk, director of education for the center, in a 2005 information sheet.

“In other words, somebody is likely to have cut some corners in carrying out the testing and diagnosis.”

In Cromer’s case, the family believes their teenage son has been misdiagnosed. Their lawyer cited his improvements in independent breathing and blood pressure regulation as “very strong indicia that he has not suffered brain death,” according to the Detroit Free Press.

Medical criteria for diagnosing brain death, while controversial in some circles, have been accepted by most Catholic bioethicists, provided that diagnostic tests are carried out thoroughly and carefully.

In an Aug. 29, 2000 address to the international congress of the transplantation society, St. John Paul II stated that using as a criterion for death “the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem) … if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.”

The NCBC has also stated repeatedly that “Health care workers can use these neurological criteria as the basis for arriving at ‘moral certainty’ that an individual has died.”

The NCBC noted that determining death by these neurological criteria typically involves bedside testing to assess absence of response or reflexes, apnea testing to assess the absence of the ability to breath, and “possible confirmatory tests to further assess the absence of brain activity (for example, an EEG) or the absence of blood flow to the brain.”

Similarly, the U.S. bishops’ Ethical and Religious Directives for Catholic Health Care Services indicate that “the determination of death should be made by the physician or competent medical authority in accordance with responsible and commonly accepted scientific criteria.”

And in 2008, the Pontifical Academy of Sciences stated that “brain death … ‘is’ death,” and that “something essential distinguishes brain death from all other types of severe brain dysfunction that encompass alterations of consciousness (for example, coma, vegetative state, and minimally conscious state).”

“If the criteria for brain death are not met, the barrier between life and death is not crossed, no matter how severe and irreversible a brain injury may be,” the academy added.

The Pontifical Academy of Sciences said that after brain death, “the ventilator and not the individual, artificially maintains the appearance of vitality of the body. Thus, in a condition of brain death, the so-called life of the parts of the body is ‘artificial life’ and not natural life. In essence, an artificial instrument has become the principal cause of such a non-natural ‘life’. In this way, death is camouflaged or masked by the use of the artificial instrument.”

Still, some pro-life advocates question the medical criteria used for diagnosing brain death and argue that taking organs from individuals diagnosed as brain dead amounts to homicide. The NCBC rejects that stance as “irresponsible” and “in tension with Catholic teaching,” countering that while a body may appear to be alive due to oxygenated blood being mechanically pumped through the body, thorough and rigorous testing can confirm that an individual is truly dead.

Dr. Alan Shwemon, former chief of the neurology department at Olive View-U.C.L.A. Medical Center, is an outspoken critic of the criteria used to diagnose brain death.

Shewmon had diagnosed some 200 patients as being brain dead throughout this career, according to the New Yorker. But he began to have doubts about the condition, which were intensified when he saw the case of a 13-year-old girl in Oakland who had been declared brain dead but began to show signs of improvement after being given tube feeding and hormone replacement.

Over the next four years, the girl was able to respond to simple motor commands and underwent puberty-related physical developments before dying of unrelated conditions, Shewmon said. His analysis of the situation led him to believe that the girl had not been brain dead, but was instead in a “minimally conscious state,” with brain flow in the brain too low to be detected by imaging technology, yet sufficient to prevent the death of brain cells – a condition known as global ischemic penumbra.

“Her case challenges the claimed infallibility of diagnostic criteria for brain death and supports the hypothesis that global ischemic penumbra can mimic both clinical brain death as well as absent blood flow on radionuclide scans,” Shewmon asserted in a December 2018 article.

Cromer’s family is now seeking additional medical opinions and a long-term care facility that will accept their son.

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Archdiocese faces third discrimination complaint over same-sex marriage policy

October 29, 2019 CNA Daily News 0

Indianapolis, Ind., Oct 29, 2019 / 04:00 pm (CNA).- The Archdiocese of Indianapolis on Wednesday defended its decision not to renew the contract of a school employee who publicly defended the same-sex marriages of two former colleagues. 

Kelley Fisher, who had worked as a social worker at Roncalli High School for 15 years, lost her job last spring after she publicly defended guidance counselors Shelly Fitzgerald and Lynn Starkey, two former guidance counselors who were both dismissed last academic year for being in same-sex marriages, the Indianapolis Star reported. 

Fisher, who has said she identifies as straight, was an employee of Catholic Charities of Indianapolis, an entity that is also overseen by the Archdiocese. Fisher was contracted as a social worker by the school through Catholic Charities and reportedly received multiple warnings from the school before her contract was not renewed. 

In a statement made following the filing of Fisher’s complaint and provided to CNA, the Archdiocese of Indianapolis defended its decision to not renew Fisher’s contract.

“If a school’s leaders reject core aspects of the Catholic faith, it undermines the school’s ability to accomplish its mission,” the Archdiocese stated. “Because of that, the Supreme Court has repeatedly recognized that religious schools have a constitutional right to hire leaders who support the schools’ religious mission.” 

The statement added that parents rely on the Archdiocese to ensure that their students are receiving an authentically Catholic education. 

“Many families in our community have sacrificed so their children can attend schools where they will learn the Catholic faith. They rely on the Archdiocese to uphold the fullness of Catholic teaching throughout its schools, and the Constitution fully protects the Church’s efforts to do so,” the Archdiocese said. 

Fisher filed a discrimination complaint with the Equal Employment Opportunity Commission against Roncalli and the Archdiocese, both of which are also facing a recently filed federal lawsuit from Fitzgerald, who claimed her firing was discriminatory in nature. 

Fitzgerald entered a civil same-sex marriage in 2014. According to the Indianapolis Star, after her civil marriage was brought to the school’s attention, Fitzgerald was asked to resign of her own accord, dissolve the civil marriage, or to maintain discretion about the situation until her contract expired. She refused these options and was placed on administrative leave at the beginning of the last school year, and remained on leave until her employment contract expired.

David Page, Fitzgerald’s lawyer, argued in the lawsuit that his client was treated differently than heterosexual employees who have disobeyed other Catholic teachings.

In an interview with the Indianapolis Star, Fisher said she was let go after she made two public Facebook posts in support of Fitzgerald and Starkey and advocating for a change in the archdiocesan contracts that require employees to adhere to Catholic teaching in and out of the classroom. 

“As an advocate for social justice and against discrimination, I really felt, you know, propelled to make that public statement,” Fisher told the Indianapolis Star.

“Our job is, as a counselor or social worker, that we don’t bring our values or judgment into a session,” she added. “And I feel very strongly about that.”

Fisher and three anonymous employees also told the Indianapolis Star that they were told by Roncalli that they needed to get permission to attend an event for Shelly’s Voice, a non-profit founded by Roncalli students in support of Fitzgerald after she was placed on leave.

The Archdiocese of Indiana said in its statement that these employees were “mistaken.”

“No teachers or counselors were told they need permission to attend outside events or civil weddings of any kind,” the Archdiocese said. “The expectations for all teachers and counselors at Roncalli are clearly laid out in the school handbook, and the superintendent of Catholic schools meets with any employees who have questions.” 

The Archdiocese has been the subject of multiple recent complaints and lawsuits due to its policy on same-sex marriages for school employees.

A Jesuit high school in the archdiocese, Brebeuf Prep, appealed to the Vatican after the archdiocese revoked its Catholic status earlier this year when it would not terminate an employee in a same-sex civil marriage. That appeal is still pending.

In August, Joshua Payne-Elliot, a teacher dismissed from Cathedral High School in Indianapolis, filed suit after he was dismissed for contracting a same-sex civil marriage. In September, the federal Department of Justice said the school’s decision was protected by the First Amendment. 

Despite these challenges, the Archdiocese reported that “staff retention at Roncalli High School was 88 percent this past year, which is Roncalli’s highest staff retention rate in the past five years.”

“The Archdiocese of Indianapolis remains committed to providing high quality, holistic Catholic education and formation so that young people recognize the many gifts with which they have been blessed, and in turn strive to make God known, loved, and served,” the statement added.

“We invite anyone seeking a Christ-centered, student-focused learning environment where young people are supported in being the best versions of themselves to check out one or more of the 67 Catholic schools in central and southern Indiana.”

 

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Alabama abortion ban blocked in federal court

October 29, 2019 CNA Daily News 0

Montgomery, Ala., Oct 29, 2019 / 11:38 am (CNA).- A federal judge on Tuesday blocked an Alabama law banning most abortions, which passed in May, from going into effect on the planned date of Nov. 15.

The “Human Life Protection Act,” which Alabama Governor Kay Ivey signed into law May 14, would have made attempting or performing an abortion a felony offense for medical professionals.

Despite the judge’s ruling, an Alabama lawmaker who helped sponsor the legislation is welcoming the legal challenge, in the hopes that the Supreme Court will ultimately review the law.

“Today’s ruling is both expected and welcomed. Our law was designed to overturn Roe v. Wade at the Supreme Court level, and today’s ruling is merely the first of many steps on that legal journey,” said Rep. Terri Collins as quoted by AL.com.

“I remain confident that our mission will be successful and appreciate the support of millions of citizens who support our effort to preserve unborn life,” Collins said.

AL.com reports that District Judge Myron Thompson issued a ruling blocking the law from taking effect while a legal challenge, brought by the American Civil Liberties Union of Alabama and Planned Parenthood Southeast Advocates, makes its way through the court system.

Under the Alabama legislation, doctors who perform an abortion could be charged with a Class A felony and could face between 10 years and life in prison.

The law includes an exception for “cases where abortion is necessary in order to prevent a serious health risk to the unborn child’s mother,” and includes no exceptions for cases of rape or incest.

The penalty would apply only to doctors, not to mothers, who, according to the law’s sponsors, would not face criminal penalties for seeking or undergoing abortions.

The sponsors, including Rep. Collins, have said that the law is designed to be a direct challenge to Roe v. Wade, the 1973 Supreme Court decision that found a constitutional right to abortion.

Ohio, Georgia, Iowa, North Dakota, Kentucky and Mississippi have all passed various restrictions on abortion designed to challenge Roe v. Wade, many of which have also been blocked by courts.

Missouri passed a near-total ban on abortion in May designed to stand up to judicial scrutiny, but in August a federal judge issued a preliminary injunction against the new law, preventing it going into force.

Bishop Robert Baker of Birmingham, Alabama said in April that the state’s legislation reflects “the strong commitment that the people of Alabama have to life.”

In an April 3 statement, the bishop praised the lawmakers’ efforts.

“I strongly support these bills and stand behind the efforts of these legislators to promote life and to, hopefully in the near future, eliminate this evil we know as abortion from within the boundaries of the State of Alabama; and, eventually, to make the killing of unborn children in our country something that is no longer viewed as anything but the horrendous and inhumane killing of the most innocent among us that it is,” he said.

There are currently three abortion clinics operating in Alabama.

[…]