Detroit, Mich., Nov 1, 2019 / 15:56 pm
The mother of a Michigan teenager who was recently declared brain dead is asking for prayers and support, after a judge ordered a hospital to continue life support until a Nov. 7 court hearing on her son's health status.
"We feel that human life doesn't have an estimable value, and it's invested with the highest dignity by God...To me, it's very important that we allow for him to continue fighting," LaShauna Lowery told CNA in a Nov. 1 interview.
Beaumont Hospital in Royal Oak, Michigan declared Titus Jermaine Cromer Jr., 16, to be 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 had made plans to remove his life support systems on Oct. 28, and Cromer's family challenged the decision, asking for additional medical opinions on whether he is actually brain dead.
Cromer is a junior at University of Detroit Jesuit High School, a Catholic high school in Detroit, Michigan. He was rushed to the hospital Oct. 17 after suffering cardiac arrest. Upon arrival at the hospital he could not breathe independently or regulate his own blood pressure.
After Cromer received 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.
"There are strong indicia that he is getting better everyday," the family's lawyer, Jim Rasor, told The Detroit News.
"He is currently able to breathe for short periods on his own. ...That's a dramatic improvement from when he came into the hospital."
Lowery, who is a Baptist went to a Catholic school when she was young told CNA the family's Christian faith is in important part of the whole situation.
"We're Christian, right? What I would say is, in our faith, we believe that when the soul leaves the body is when we're gone. So I think that we need to allow Titus, to allow for his brain to heal."
Lowery said the family has received independent guidance that has suggested that for a brain injury like Titus', it could take between two months and two years for the brain to really see healing.
"Seven days, nine days, right, is not enough time," she said. "So we really want to be able to give a chance for him to allow for his brain to heal, and to allow for him to fight."
She cited 1 Corinthians 6:19-20: "Do you not know that your body is a temple of the Holy Spirit within you, whom you have from God, and that you are not your own? For you have been purchased at a price. Therefore glorify God in your body."
While also asking for prayers for Titus' recovery, she encouraged any other family that is going through a similar situation to reach out to her with offer support and information.
"I didn't know I had options. I didn't know I had rights. I didn't find out about the patients' rights until it was too late," she said.
"And so when you're going through a situation like this, you're so overwhelmed by all the information that's being put at you, sometimes it's hard to digest. So I would say any family that's going through this- learn your rights, know you have options, and don't give up."
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Michael Vacca, an attorney and head of bioethics for the Catholic healthcare nonprofit Christ Medicus Foundation, urged Beaumont Hospital to defer to the rights of the parents.
"Despite being declared brain dead, a designation that is imprecise and inconsistent, these physical signs in Titus are objective indications of life," Vacca said Oct. 30.
Louis Brown, Executive Director of the CMF, called for another medical facility to take Titus on as a patient.
"It is unjust that medical institutions are seeking to end life support so quickly against the wishes of the patient's family and when patients are showing signs of life," he said Oct. 30.
The family will go to court Nov. 7, when both sides will present their case so Oakland County Circuit Judge Hala Jarbou can decide what will happen going forward.
In the interim, Lowrey said, the family is looking for facilities that will take Titus and offer him care, both in the Detroit metro area and further afield.
Cromer's 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.
