Are We Playing God?
Are We Playing God?
By Dr. Misee Harris
How the recent debates over Brittany Maynard and Jahi McMath reveal the thin line between medicine and faith.
In the past week, two very public medical cases have been making waves through the headlines. One is about a woman who wants to choose her dying date. Brittany Maynard (29), (pictured above) who is battling with a stage 4 glioblastoma, the deadliest form of brain cancer, has scheduled the end of her life for November 1, 2014, the day after her husband’s birthday. Her reason is that she wants a less painful, less tormenting exit from a disease she knows she cannot beat. Only three states allow her to do this, so Brittany and her family moved to Oregon. No less passionate is the debate on Jahi McMath (13), (pictured below) from California. Upon being pronounced dead after a routine tonsil and adenoid removal surgery to treat sleep apnea at Oakland Children’s Hospital last year, Jahi has been kept on life support by her mother. Since California doesn’t allow keeping a legally brain dead patient on such support, she was moved to New Jersey by her family. The mother continues to claim that her daughter is “still in there and not brain dead”, providing alleged new evidence in a video that went viral within hours.
In a time where medicine allows us to determine our own death, or to keep a dead loved one alive – how far can we go? The debate in both cases is highly charged with emotional and moralistic undertones. In the wide-spread video about Brittany Maynard’s choice, soft piano music and childhood memories shared by her tearful mother make it hard to view her case with a sober, rational eye. The same is true for the “miracle” video about Jahi McMath featuring the voice of her mother asking her lifeless daughter to move her hands and feet. When spontaneous movements typical for brain-dead patients on life support occur, she cheers Jahi on with great enthusiasm.
As a woman I empathize with both stories. However as a medical professional, I am led to look at the facts and have been surprised with the lack of medical knowledge in the media coverage. Take for instance the headlines in Jahi McMath’s case, stating that she “responds” to her mother’s voice by moving her hands and feet “when prompted”. From a medical viewpoint, these are misleading statements. It is widely known in the medical field that brain-dead patients show spontaneous movements such as jerking of fingers or bending of toes that can be disturbing to family members. Such movements have even caused health care professionals to question the brain-death diagnosis. One study published by the American Academy of Neurology in 2000 suggests that 39 per cent of brain-dead patients were showing such movements even hours after being removed from life support. It is important to understand that these movements, however shocking to watch, are spinal reflexes and have nothing to do with brain activity. In Jahi’s case, her vital organs continue to function through life support. This means that such reflexes are very likely to be manifested in her hands and feet. Note that at no point in the video, the mother asks her to raise an eyebrow, smile or show any movement other than in her hands and feet.
In Brittany Maynard’s case, the public debate is rife with moral judgement and “what-ifs”. Hinting at her self-appointed dying date of November 1, several social media commenters ask, what if the cure for her disease materializes on November 2? Or, even more speculative, what if God has a miracle healing in store for her on that or a later date? Despite Brittany Maynard’s claim in interviews that there is “not a cell in my body that is suicidal”, her choice is viewed as a suicide and judged accordingly based on the moral worldview of those commenting. Try to put aside the emotional undertones in the Brittany Maynard video, and you will meet a woman who loves life and has simply come to terms with the crushing reality that there is no cure for her disease. From a medical perspective, this leaves her with two choices. She can either wait for certain death to occur while on palliative care as the disease takes its course. Or, thanks to the “death with dignity” law in a state like Oregon, determine her own date of death and avoid further pain and suffering. It is her personal commitment to the “death with dignity” cause that has led Brittany Maynard to go public.
Many comments suggest that we in the medical field are “playing God” or challenging some higher order of things when we provide a deadly diagnosis to a patient or weigh in on their chances of survival. Medicine is a science unlike any other, as all its study is continually informed and challenged by an ever-growing multitude of practical experiences. Presented with a stage 4 glioblastoma as in Brittany Maynard’s case, any judgement by a medical specialist will have to reflect the reality that this disease ends in death for virtually every diagnosed patient within a relatively short period of time. In the same way, any experienced physician will view the Jahi McMath video with professional skepticism for the reasons mentioned above.
As for the religious and moral beliefs underpinning the controversy over both cases, I am thankful to live in a society where such beliefs can be freely developed and expressed. My hope as a healthcare professional is for a higher commitment to public awareness and a deeper understanding of how the human body works.
Dr. Misee Harris is a nationally recognized leader in the realm of dentistry. Through outreach programs and healthcare initiatives, her organization’s efforts have resulted in significant gains in the quality of diagnosis and treatment options available to the families of thousands of children with urgent dental needs.