A Minnesota woman who was declared brain dead last month left the hospital Wednesday after a miraculous recovery. The 65-year-old suffered a massive cerebral hemorrhage in January. Life support had been disconnected. Somehow, she regained consciousness as her family began planning her funeral.
Dr. Martin Richards of United Hospital says “I think she probably had some stunning of her brain and then as that insult kind of resolved, at least partially, she was able to regain function.”
In Georgia, Nonnie Hawkins had hoped for the same type of outcome, standing beside her daughter’s hospital bed, steeling herself for a final goodbye. Physicians at DeKalb Medical Center, minutes earlier had disconnected a machine that was breathing for 18-year-old Tara Bottoms-Hawkins. Hawkins thought her daughter was in a coma, as she had been for four months. But doctors said the young woman was brain-dead.
It was March 18, 2004, two days after Tara gave birth to a premature son, bucking the predictions of some doctors who said the fetus wouldn’t survive. She thanked each of the physicians for everything they had done to bring her grandson into the world, then accused them of having her daughter’s blood on their hands.
Thousands of people die daily across the country, almost all before they’re declared brain-dead. That designation usually comes into play when a person suffers a traumatic injury or stroke and is attached to devices that maintain organ function.
When doctors determine the brain is not working anymore, families and hospitals usually agree that life support should then be removed. Sometimes, however, the family disagrees with the diagnosis.
That was the case with Nonnie Hawkins. About 10 minutes before her daughter was taken off the ventilator, Hawkins says people were gathered around the bed praying and pleading aloud, “Please wake up, the baby needs you,” when Tara moved her hand. When Hawkins went to get the neurologist, he said it was just a reaction from the spine, she said.
Hawkins filed a lawsuit against DeKalb Medical Center, the doctor and DeKalb Neurology Associates on May 15, 2006, on behalf of her grandson. The lawsuit alleges medical malpractice, wrongful death and negligence. Hawkins said she never consented for the hospital to take her daughter off the ventilator. At the crux of the case is whether Tara was brain-dead or just brain-damaged.
Georgia law leaves the final decision on discontinuing treatment for brain-dead patients to doctors, not family members. DeKalb Medical Center tried to have the case dismissed, but the Georgia Court of Appeals said no, noting that for “incompetent adult patients” who may have some brain function remaining, the decision to terminate life support rests with the family.
The court has not yet ruled whether Tara’s brain had ceased functioning, or whether a glimmer of life remained. DeKalb Medical Center maintains she was brain-dead, and that their decision to stop treating her was appropriate. The medical center appealed to the state Supreme Court. Beyond that, the hospital declined comment for this story.
Medical experts say that continuing to treat a brain-dead person is irresponsible and unethical. Nurses and doctors are already in short supply, as is hospital bed space.
But it may be more about money. Insurance companies won’t pay for treatments to a brain-dead person, so hospitals have to eat those expenses.
People avoid discussing their end-of-life wishes until it’s too late. Disputes between families and hospitals crop up because both sides think they know what’s best. An advanced directive can sometimes provide guidance as to the patient’s wishes. It tells caregivers whether to withhold or maintain life-sustaining treatment if a person is terminally ill, in a coma or in a persistent vegetative state.
An advance directive is a legal form or statement made by an individual to express preferences about life-sustaining treatment in the event they become unable to make such decisions or communicate them in the future. The Colorado bar Association provides a sample form of a “Living Will.”