Talk:Jahi McMath case/Archive 3

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Dr Byrne

I attempted to integrate some of the information regarding Dr. Bryne previously added by 24.0.133.234 and also mentioned by Ca2james in talk. I think this edit could use a stronger ref for the statement that brain death is legal death in all 50 states. Currently, it’s only referenced by an article in the popular press regarding the McMath & Munoz cases, but I suspect there are much stronger references for this from legal sources, etc.--BoboMeowCat (talk) 22:05, 1 March 2014 (UTC)

Great addition, and I think it fairly presents the views of the opposing sides. Nice work. NorthBySouthBaranof (talk) 22:06, 1 March 2014 (UTC)

Do you mean this? Uniform Determination of Death Act I'm hesitant to add much info. about (general)topics that are not directly related to this case, but I do believe that this issue was raised in this case 24.0.133.234 (talk) 22:56, 1 March 2014 (UTC)

You have not provided reliable sources for your claims, and your persistent use of a phrase ("irreversible whole brain death") that does not have support in the cited literature is unacceptable. NorthBySouthBaranof (talk) 23:12, 1 March 2014 (UTC)

Lets not all pile-on at the same time. That last edit conflict makes the paragraph look crazy-maybe you should fix it? Also-regarding my changes, as far as I know all of the changes are already supported by references in this exact article-(my source material). I can re-arrange so that each and every change is directly supported by a cite, but I thought that would be tendentious and redundant but I can see why. I just don't want to have long trains of cites.24.0.133.234 (talk) 23:22, 1 March 2014 (UTC)

While trying to fulfill a request to an editor of this section, and add my own edits to the new material, I was caught in an editing conflict here---> http://en.wikipedia.org/w/index.php?title=Jahi_McMath_case&diff=prev&oldid=597734496 I also had an additional sentence to apply the entire paragraph to the Jahi McMath case which is unfortunately lost to the article at this point.(McMath's family challenged California to provide this option in their case but the federal appeal was dropped by both sides after they reached an agreement to release McMath.) I still think that a timeline of events in this case might help and I'm afraid that we have all lost the plot and the timeline here.24.0.133.234 (talk) 23:31, 1 March 2014 (UTC)

24.0.133.234, your recently reverted edits didn't seem supported by the current refs. Also, it's not a consensus view of the "hospital" but the "medical establishment" in general, although there is some dispute. The refs I cited regarding dispute that brain death = true death were from MD's and PhD's, including a neurologist. No ref from anesthesiologist included so adding that not supported by current refs. I believe your statement regarding NJ giving a choice to be factually correct, so if u can properly reference that, it seems a reasonable addition. --BoboMeowCat (talk) 23:44, 1 March 2014 (UTC)

Consensus view of the hospital is established and properly cited in this case.(Again if we are going to insist that cites be added & re-added to each term I am willing to go there if that is correct) The alleged general view of some undefinded "medical establishment"-is more appropriate to some other article. I was trying to tie-down how what was already placed in the paragraph relates to the McMath case without going off-course into broader topics.

Also, trying to clarify that this opinion presented as a "minority" view, does not and never did disagree with the (requested information by the editor who started this paragraph) UDDA the legal definition of irreversible brain death "in all 50 states" (as the paragraph implied)--while again, bring the topic back to the article at-hand and relating that in one state--(there are more but posting the statutes in "all 50 states" belongs in another article I hope! And don't forget Japan...) New Jersey specifically because the way that NJ law handles it is the exact opposite of Cali and exactly what McMath's family requested.24.0.133.234 (talk) 00:07, 2 March 2014 (UTC)

My references actually state brain death is generally agreed upon by med establishment (and not just this hospital). Disagreement is the minority view, but highly relevant to this article because the minority opinion that Jahi isn't really dead is the crux of this case. While I think a brief statement regarding NJ would be appropriate to clarify the law as it applies to the 50 states, I think Japan's policy, though interesting, is off topic and would be more appropriate addition on such a discussion on the brain death page.--BoboMeowCat (talk) 00:31, 2 March 2014 (UTC)

NorthBySouthBaranof, wasn't testimony from Bryne included somewhere in the family's court docs? It was my understanding that although Bryne wasn't used as an opinion to decide the legal brain death issue, his opinion/testimony was considered at some point by the courts, so I'm not sure it is accurate to say the court "rejected the request" as I believe the McMath family used Bryne as their legal expert at some point --BoboMeowCat (talk) 23:54, 1 March 2014 (UTC)

BoboMeowCat, in State court the family requested that Dr. Byrne be assigned to evaluate Jahi the way Dr. Fisher was and the hospital objected because a) he doesn't have a license to practise in California and b) he's not a neurologist. I believe that petition was rejected but I'm having trouble finding the outcome of that petition; it's possible that it was rejected because of the settlement. Dr. Byrne also submitted an opinion to the Federal court. The Federal suit was ultimately dismissed as moot because the family and hospital ended up settling after being instructed to do so by the State court. There aren't a lot of references involving this doctor but I'm still looking. Thanks for your attention on this. Ca2james (talk) 00:42, 2 March 2014 (UTC)

It turns out Dr. Byrne did submit an opinion to the State court; I have to try and find what happened with the Federal court. Anyways, Dr. Byrne's State court statement is here (Exhibit C) and there's a news article here. That reference has quite a bit of other information, including that the petition to put tubes in Jahi was denied by the State appeals court and that there were filings in the State court, State appeals, and Federal courts. Ca2james (talk) 01:25, 2 March 2014 (UTC)

He may have submitted an opinion, but it wasn't based on a full physical examination of McMath while she was in Children's Hospital Oakland. The family had requested an order that he be permitted to conduct an independent examination of her and that that examination be considered by the judge before he ruled on the case. That request was denied - Judge Grillo ruled based exclusively on the examinations from Children's Hospital doctors and the independent expert. NorthBySouthBaranof (talk) 01:31, 2 March 2014 (UTC)

If the court considered his opinion, I don't think it is accurate to make a blanket request denied staement. Anyway, the next line of text makes it clear that Dr. Byrne's opinion was not included in legal brain death determination.--BoboMeowCat (talk) 01:57, 2 March 2014 (UTC)

The request to have Byrne make an independent evaluation was rejected. That is factual. The end. NorthBySouthBaranof (talk) 02:51, 2 March 2014 (UTC)

It seems that the request to have Byrne make an independent evaluation was not so much requested as ignored, as per "In ruling Tuesday [December 24], the judge made no mention of the family’s desire for Dr. Paul Byrne, a pediatric professor at the University of Toledo, to examine the teen." [1] Ca2james (talk) 03:11, 2 March 2014 (UTC)

Courts do not simply "ignore" motions and filings. Anything not explicitly granted is denied. The fact that the motion was not explicitly granted acts to deny it. If you would prefer, we could use language such as "The court did not grant the motion." NorthBySouthBaranof (talk) 04:32, 2 March 2014 (UTC)

It is not "the end". I actually read every word of your source and it does not indicate the court refused to consider Byrne's opinion. So you have restored improperly referenced content. Again. This repeated occurrence is becoming disruptive. Reread that article, nowhere in there does it state the court refused to consider Byrne's opinion. Also, stating I need to "actually read the references" in your edit line is inaccurate, as your ref for the American Academy of Neurology mention is brand new, it wasn't there at all for your previous two edits including that content. --BoboMeowCat (talk) 03:22, 2 March 2014 (UTC)

Uh, yes it was. Right here. NorthBySouthBaranof (talk) 04:27, 2 March 2014 (UTC)

I have to make an objection the the resources used in this paragraph and even the content. Using British medical journals which was apparent by the spelling of the word, "defences" in the title of one said ref., We are going waaaaaaay beyond the Jahi McMath case. Dr Bryne, objection to Dr. Bryne, yes. That is part of the case, but using foreign medical references takes this too far-off the topic and does not even apply to the same criteria that is used, (UDDA) in the US where the McMath case is. Foreign definitions and foreign references may have a place somewhere in this article, but not as it applies to the Jahi McMath case content.The British do not use the same criteria to determine irreversible brain death as we do here anyways so it cannot be used to apply to this case can it?24.0.133.234 (talk) 00:29, 2 March 2014 (UTC)

Which refs are you referring to? I agree foreign refs should be trimmed and replaced with US refs if possible --BoboMeowCat (talk) 00:35, 2 March 2014 (UTC)

The foreign ones lol. I don't want to play with that paragraph right now as all of my work is being wholesale deleted. I have requested that I just be BLOCKED from admin. to make my censorship on this article official. BTW Here is a pdf. titled Want to Terminate Life Support? Not in New York... which goes on to mention NJ in answer to a source that explains NJ law from 2012. I cannot post a link to the pdf. Here is the complete title of this reference if anyone wants to search it; Want to Terminate Life Support? Not in New York: Time to Give New Yorkers a Choice 24.0.133.234 (talk) 01:20, 2 March 2014 (UTC)

I've supported your addition of info regarding NJ, as I believe it is accurate, but it needs to be properly referenced. I don't really have time to investigate such refs myself right now. Maybe later.--BoboMeowCat (talk) 02:17, 2 March 2014 (UTC)

It's quite a stretch to assume you know the specific country a resource was published in based on the spelling of a common word. If you have a problem with a specific reference it would really help if you research the specifics first and then post a link with proof of your point here. Funcrunch (talk) 01:13, 2 March 2014 (UTC)

UH-pretty sure that an American medical journal would have used the American spelling? Not that far of a stretch. (it is an international Bioethics publication btw). Also-see bold below for clues that these new sources are not American and do not particularly apply to this case. Part of an article on the International standards regarding irreversible brain-death, death, or brain-death? Yes. I don't think that we need to explain anything about a "minority": opinion and who does or does not have one for this article unless it strictly applies to the Jahi McMath case. There are other articles on WP that do that and we can link there if we have to. Maybe if the paragraph was sub-titled something like, "Dr Bryne, expert witness for McMath says that brain-death is not death"-maybe then international supporting references could be used to illustrate other similar opinions to his stance? But that's going pretty far from the case still I think but the resources are interesting. I just don't know how they fit here. Then-again wouldn't we need a section that states why the hospital insists on calling McMath a dead body? I don't even know if that is possible since it just looks to me like they are wrong.

Goila AK, Pawar M (2009). "The diagnosis of brain death". Indian J Crit Care Med 13 (1): 7–11. doi:10.4103/0972-5229.53108. PMC 2772257. PMID 19881172.

Goila AK, Pawar M (2009). "The diagnosis of brain death". Indian J Crit Care Med 13 (1): 7–11. doi:10.4103/0972-5229.53108. PMC 2772257. PMID 19881172.

Joffe AR (2009). "Brain death is not death: a critique of the concept, criterion, and tests of brain death". Rev Neurosci 20 (3-4): 187–98. PMID 20157989.

Shewmon AD (October 2001). "The brain and somatic integration: insights into the standard biological rationale for equating "brain death" with death". J Med Philos 26 (5): 457–78. doi:10.1076/jmep.26.5.457.3000. PMID 11588655.

Joffe A (February 2010). "Are recent defences of the brain death concept adequate?". Bioethics 24 (2): 47–53. doi:10.1111/j.1467-8519.2008.00709.x. PMID 19210745.24.0.133.234 (talk) — Preceding undated comment added 02:09, 2 March 2014 (UTC)

24.0.133.234 has a point. I seem to have made an error with ref #22 & #23 which were to support statement "a view which is in contrast to the consensus view of the medical establishment". For one thing, these are the exact same ref, and they appear to come from foreign journal. I had some issue with the formatting of the refs and appear to have lost some.(??) This statement needs better refs to be maintained. Can anyone help out with refs that support the assertion that brain death is currently accepted by mainstream medical establishment as true death?--BoboMeowCat (talk) 02:35, 2 March 2014 (UTC)

The President's Commission report on “guidelines for the determination of death” culminated in a proposal for a legal definition that led to the Uniform Determination of Death Act (UDDA). The act reads as follows: “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. A determination of death must be made with accepted medical standards.” Most US state laws have adopted the UDDA. Several states have added amendments regarding physician qualifications, confirmation by a second physician, or religious exemption. The UDDA does not define “accepted medical standards.” The American Academy of Neurology (AAN) published a 1995 practice parameter to delineate the medical standards for the determination of brain death. The parameter emphasized the 3 clinical findings necessary to confirm irreversible cessation of all functions of the entire brain, including the brain stem: coma (with a known cause), absence of brainstem reflexes, and apnea. [2]

The leading professional organization of certified neurologists is an indisputable reliable source in this matter. NorthBySouthBaranof (talk) 02:54, 2 March 2014 (UTC)

BoboMeow -it doesn't really matter who accepts irreversible brain death as determined per UDDA, that is the law, and a fact that patients in that condition are "legally brain dead"-by definition. Even accepting the fact that UDDA is the law of the land, that does is no way speak to being in that condition,("legally irreversibly brain dead"), as being a "corpse", "dead body", "macabre dead body ", or "grotesque" or even deceased. To clarify, in Jahi's case I believe the hospital's argument was that since Jahi was diagnosed per UDDA-(legally dead), that she was to be treated and referred-to as equal to a deceased corpse.UDDA also allows states to make their own determination per health laws which speak to plug-pulling etc. And they (hospital) used the state statute of California which i guess allowed them to do that-(I'm not 100% there), BUT-McMath's family said that they would challenge the state statute, but that was dropped when the hospital agreed to release McMath. In other states, a family is able to assert their civil right to ask for what the McMaths wanted, (mainly to maintain Jahi's body on ventilation, to not end the life of her body by denying basic care). In those states where civil rights and family decision either way prevails by state statute they usually mention religious and/or privacy rights, as were claimed by McMath's family.

Those refs are interesting btw and it does help to illustrate that legal brain-death and what happens AFTER is handled differently depending on location.24.0.133.234 (talk) 03:18, 2 March 2014 (UTC)

24.0.133.234, I think brief mention of how the legal status of brain death differs in NJ would be both interesting and on topic, as the preceding line is that it's the law in all 50 states. but I don't really understand your objection regarding majority/minority view on brain death being same as true death. Are you saying such statements are true but should be removed as irrelevant?--BoboMeowCat (talk) 12:57, 2 March 2014 (UTC)

How about this reference? "Over the past several decades, brain death has become well entrenched as a legal and medical definition of death. It is clearly defined by the neurologic community (see box), standards for diagnosis are in place, and it is established in law. [3] Ca2james (talk) 03:21, 2 March 2014 (UTC)

Isn't it better to stick to the topic of the article? And use WP links to other topics, like legal death, and brain death? And phrase/link items about Dr. Bryne within the context, and with actions he did took regarding the case-- (was he called to be an expert witness for McMath's side?), and that the Children's hospital specifically had some written objections to him in their (aborted) legal pleadings? Children's hospital said that he was biased. That he was from Ohio--(but other docs. also mention that both sides were given a list of 5 local doctors which both sides approved and all five doctors refused to play)....stuff that pertains to the case.

I made a mistake trying to leave "all 50 states" etc. in the paragraph I think. I was trying to Not remove material from WP, but make it fit the article, but maybe it just needs more info. about people directly involved with the case, and facts relating to that?24.0.133.234 (talk) 13:47, 2 March 2014 (UTC)

Continuing confusion about Byrnes role in the case. He was proposed as third opinion, but Dr Fisher was used. Also-5 local drs were accepted by both parties at some point to provide an outside opinion, but all five declined to participate. Byrnes was ALSO proposed and/or used as the McMath's side, "expert" witness. Timeline is important here. McMath wanted Brynes as DR/third opinion?, outcome of THAT court was that Dr. Fisher was used, THAT ruling was appealed, but the appeal became moot when McMath was released? (don't take my word for it on the spelling or timing of events or correctness, this is a basic attempt at a timeline but also pointing out that Bryne's status was utilized differently throughout the case. 24.0.133.234 (talk) 17:30, 2 March 2014 (UTC)

Do you have a reference for this statement? "Also-5 local drs were accepted by both parties at some point to provide an outside opinion, but all five declined to participate." Ca2james (talk) 19:21, 2 March 2014 (UTC)

Jahi's family wanted Byrne as a third opinion after Fisher and they filed a motion in Grillo's court *prior to the Dec. 24 ruling.* On Dec. 24, Children's Hospital doctors and Fisher testified that Jahi was dead, and according to the San Jose Mercury News, "Alameda County Superior Court Judge Evelio Grillo handed down the verdict after hearing testimony from two doctors, one an independent expert appointed by the judge on Monday and the other a 30-year veteran of the hospital. Both testified that the teen is brain-dead and that her body is alive only because of a ventilator hooked up to her since Dec. 12." [4] This mooted the motion as far as Grillo's court goes - his verdict was a final one at the Superior Court level. NorthBySouthBaranof (talk) 20:59, 2 March 2014 (UTC)

I think I've got it now. Judge Grillo (State court) issued a temporary restraining order on December 20. On December 23, there was a hearing where Grillo listened to both sides and then appointed Dr. Fisher as the independent expert assigned to evaluate the state of Jahi's brain. I think that the family also requested that Dr. Byrne examine her during that hearing. I can't find records of the hearing itself; only records of the results of the hearing (which do not mention him) are available, as well as news reports saying that the family wanted Dr. Byrne to examine Jahi. The next day (December 24), Dr. Fisher presented his findings to the court. The hospital also filed a document opposing Dr. Byrne as examiner. Judge Grillo then extended the restraining order for a week and did not mention Dr. Byrne. Later, on January 2, the family filed with the Federal court to have tubes put into Jahi. Part of that filing was a statement by Dr. Byrne[5]. This filing was later rendered moot after the settlement conference was concluded[6]. Ca2james (talk) 19:20, 2 March 2014 (UTC)

UGH! I added it way back as a ref. The family's legal petition but can't find it now. It was in the article but not now unless it is moved elsewhere? I'll go back in history to try and find it.24.0.133.234 (talk) 21:03, 2 March 2014 (UTC)

http://www.scribd.com/doc/199529494/Children-s-Hospital-Oakland-Petitioner-s-Writ-Petition-Mcmath-12302013 — Preceding unsigned comment added by 24.0.133.234 (talk) 21:55, 2 March 2014 (UTC)

Somewhere around pg 11 speaks to five alternate doctors declining. This petition is still in the article (currently #24 citation). I'd ♥ to bullet-point the timeline, but giving it a little time to firm-up and re-check.24.0.133.234 (talk) 22:07, 2 March 2014 (UTC)

So the sutuarion was that the two parties agreed on five names, and then all five declined, so Fisher was appointed to do the exam. Why does it matter that the five declined? The relevant point is that someone was appointed, not that five didn't do it. If the five had declined for ethical reasons, this would be a different story, but the reasons they declined aren't stated and so cannot be assumed to be relevant. Moreover, the fact that this detail hasn't been covered by the media says that this fact deserves no weight in the article and so mentioning it at all would be WP:UNDUE. Ca2james (talk) 00:13, 3 March 2014 (UTC)

To correct the timeline, the hospital's opposition to Dr. Byrne was filed in in U.S. District Court, well after the Dec. 24 ruling, and it would therefore be anachronistic to use that opposition to discuss the motion filed on Dec. 23. So I've used other sources to describe Byrne's point of view. NorthBySouthBaranof (talk) 23:52, 2 March 2014 (UTC)

Also, as per this appeal document filed by McMath's family's attorneys, the trial court judge explicitly declined the request to have Byrne conduct an examination. See Page 4. NorthBySouthBaranof (talk) 00:13, 3 March 2014 (UTC)

Thank you! I knew it had to be documented somewhere but I thought it would be in docs related to the Dec 23 hearing, rather than the appeal. Ca2james (talk) 00:17, 3 March 2014 (UTC)

I disagree with the inclusion of Dr Byrne's statement about the ventilator not working on a dead body. He is not named in court rulings and is a supporting character in this drama. Therefore, his opinions are just bystander opinions, of no more direct relevance than Bob the Builder's would be. When included in the article with Dr Fisher's court-requested comments, his opinions are given equal weight which is WP:UNDUE, even when they're qualified by the statement that he didnt examine her. I'm fine leaving the preceding statement in but that quote needs to go. Ca2james (talk) 04:17, 4 March 2014 (UTC)

Legal action/transfer timeline

I've been doing some research into the order of the various legal motions in the various courts and the timeline for what happened. I think it might be important to note that the first few motions were just to keep the girl on the ventilator while the motions starting on December 30 were to insert the tubes required for the transfer. I'm not sure how best to include all of this info in the article (I think it's too long and convoluted for a simple bulleted timeline) so I thought I'd put out my notes for you all. I know my references aren't in the right format but I can fix that if you want.

December 9 - Surgery

December 12 - Brain death

December 16 - Family upset with hospital because hospial wants to turn off ventilator [7]

December 17 - Family lawyer issues "cease and desist" action to keep Jahi on ventilator [8],[9]

December 20 - family meets with hospital and are very unhappy [10]

December 20 - Family seeks temporary restraining order in State court, which is granted [11]

December 23 - Fisher appointed [12], [13]

December 24 - hospital opposes Dr. Byrne and and asks life support to be dismissed (Alameda County Superior Court) [14],[15][16]

December 24 - Grillo orders Jahi kept on breathing machine (extends restraining order) after hearing hospital expert (Robin Shanahan) and independent expert (Fisher)[17][18], [19]

December 24 - "In ruling Tuesday, the judge made no mention of the family’s desire for Dr. Paul Byrne, a pediatric professor at the University of Toledo, to examine the teen."[20]

December 26 - Family wants to transfer Jahi to another location. Sticking point is that they want tubes inserted and hospital says no [21]

December 27 - Hospital agrees that Jahi can be transferred[22], [23]. Hospital places conditions on transfer: must happen through coroner, hospital must speak with receiving facility, and hospital will not install tubes[24]

December 30 - Family files appeal (1st District Court of Appeal) to prevent disconnection of ventilator. Appeals court granted temporary stay which expires 5pm December 31 so appeals judges can review case [25]

December 30 - Family files in Federal court to equire CHO to insert ventilation and tubes [26],[27]

December 30 - Federal court defers restraining order and denies tube insertion [28],[29]

December 30 - Grillo (Alameda County superior court) extends stay to Jan 7 [30]

December 31 - Dolan applies to 1st District Court of Appeal to force hospital to insert tubes; appeal denied [31] Appeals court will not compel hospital to put in tubes; case must work its way through lower (superior) court first. Federal court says case must work through state court [32]

January 2 - Federal judge orders settlement conference [33],[34]

January 2 - Family files federal appeal to force hospital to insert tubes [35],[36],[37] - this filing includes a statement by Dr. Paul Byrne

January 3 - settlement reached. Body goes to mother, who takes responsibility for care (including cardiac); no tubes inserted [38]

January 3 - Hospital response to January 2 Federal appeal to insert tubes [39]

January 6 - Jahi transferred from CHO to undisclosed location [40]

January 6 - Federal court denies motion for tubes as moot and terminates Dec 30 motion for restraining order [41],[42]

January 8 - Jahi receives tubes [43]

January 29 - Notice of voluntary dismissal in Federal court by family[44]

Ca2james (talk) 01:09, 3 March 2014 (UTC)

Good work. I would add that on the 24th, as per the sources, Grillo ruled that McMath was legally dead, based on the testimony of CHO doctors and the independent expert. He extended the restraining order to give time for appeals. NorthBySouthBaranof (talk) 01:56, 3 March 2014 (UTC)

THAnk-you! i especially like the way that you put separate events separate even-as they happened on the same date(s). makes it very much more understandable. A previous version of this article had a three event timeline, (this is better)--and it really helps the reader see exactly how the case transpired. Really nice job. I think that it could use some bullets and maybe something to re-indicate same date events like a star or line?24.0.133.234 (talk) 02:11, 3 March 2014 (UTC)

I nominate using the section under the main content as a section titled "timeline" or something like that. There is a way to name the cites so that they will not double and multiple post in the references section. (by using cite title or name?).............I do have a slight prob. with something like January 8, although it is a good secondary source, and something that article readers probably want to know, (so it is probably good for the TL)--but we want to be really careful about adding further health reports that are family facebook updates and the like--(not really verifiable). Maybe adding McMath's family reports that...?24.0.133.234 (talk) 02:22, 3 March 2014 (UTC)

This timeline is great. Thanks Ca2james I also really like how NorthBySouthBaranof divided the main article into 3 sections and formatted the references into columns. --BoboMeowCat (talk) 02:32, 3 March 2014 (UTC)

Or slapping it on a timeline template?24.0.133.234 (talk) 03:12, 3 March 2014 (UTC)

You're all welcome. Please bear in mind that these are just my notes and don't include things like Judge Grillo's statements. The references may also not be perfect and there may be better ones out there; these are just what I found. It was a very complicated situation. I was going to write this all out as sentences but then I figured that you all are much better at that than me. I'm better at editing things than I am at coming up with things in the first place :) . I just hope that all of this information will be useful.

I think references can be named with < ref name=blah > and then recalled that way.

I also love the sections that NorthBySouthBaranof added, too - I think they break up the article and make it flow better. 03:22, 3 March 2014 (UTC)

I think if we're going to include timeline in the article it needs to be clarified a little more. Maybe rephrasing “family upset” as “family gave press conference stating such and such" etc. --BoboMeowCat (talk) 17:30, 3 March 2014 (UTC)

Ummm, 24.0.133.234 (talk),..... while I appreciate that you want to include this timeline in the article, I meant for it to be used as a starting point, not to be put in as-is! The language is nowhere near encyclopedic or necessarily neutral as these were just my notes that I thought I'd share with you all. The phrasing definitely needs to be re-worked; we can't just say that the family was upset, for example, as BoboMeowCat (talk) pointed out. Personally, I'd rather see the timeline taken out until the language is improved but since I didn't put it in, I won't take it out. Ca2james (talk) 17:52, 3 March 2014 (UTC)

Removed timeline. I agree with [Special:Contributions/24.0.133.234|24.0.133.234]] that it makes a useful addition to the article, but it's still in draft form so removed pending rewrite. --BoboMeowCat (talk) 18:09, 3 March 2014 (UTC)

Timeline should be out essentially per WP:IINFO and WP:NOTNEWS. What it is at this point is just a list of news articles and primary sources on the case that have little bearing on the long-term impact of this case (presuming there will be any). Wikipedia is not a news aggregator, nor a repository of links to relevant topics. We're an encyclopedia, and so should summarize what's relevant about the topic, as stated in the published sources, and discuss the important points of the specific case. —/Mendaliv/^2¢/_Δ's/ 18:21, 3 March 2014 (UTC)

OOps sorry. This case needs a timeline, especially of the court dates and filings with other landmarks in the situation (as it currently is). The reason why I put it in article I was trying to fix some punctuation errors with it, but then realized that I would be messing with someone's post on a Talk Page. SORRY I thought it was good to go almost.24.0.133.234 (talk) 22:55, 3 March 2014 (UTC)

If you want to work on some text that isn't finished, you should do it in the sandbox on your user page rather than putting it into a live, published article and editing it after the fact. Funcrunch (talk) 23:07, 3 March 2014 (UTC)

Yep. But the funny thing was that I was going to uppercase the "H" in the word hospital which started a sentence, when I realized that i did not want to mess with the talk page, but when I reloaded the mistake that I had seen was gone. So i really didn't edit the TL at all, just moved it and added a section for it.

And Mendaliv the links are not really a list of links, they are references for a chronological, and geographical--(when it comes to courts jurisdiction), list of events which occurred in the case itself which were also reported in secondary sources. Local court-Federal Court, cases which were reported-on but later dropped, statements related to the TRO, and then asking for other mandates.............it gets pretty confusing pretty easily, especially when an unofficial death certificate was mentioned with a date of Dec. 12-(when Jahi was first declared legally brain-dead)...and that was not done until January (back-dated according to Cali. health statutes). ........even-if it has to be collapsed, the TL is an asset to the topic. If there are more legal actions or even many more, there is a way to COLLAPSE? it into timeline before release from hospital and timeline after, or however would break it up better.24.0.133.234 (talk) 23:36, 3 March 2014 (UTC)

I disagree that the article needs a timeline I don't think a timeline is an asset to the article. I think the most important relevent dates and events can be covered quite succinctly in prose. A detailed summary or timeline of every filing and result isn't needed to convey what happened, as per Mendaliv's comment above. Ca2james (talk) 03:49, 4 March 2014 (UTC)

@24.0.133.234:, the problem is it's duplicative of content elsewhere in the article. Moreover, who cares? What does this actually add to the article? Is there something significant about the dates, the spacing between them, or something like that? While I agree that mentioning dates to an extent is informative, there's simply no clear benefit to including a timeline format that is merely a list of headlines with links to articles. Even if it's not intended to be a list of links, it has the same effect, and fails WP:NOTNEWS in the same manner. Furthermore, there are issues of undue weight in giving equal prominence to certain events listed in the timeline. Finally, and this is said with the utmost respect to all involved who have clearly put in a lot of time considering this issue, we're talking about events that largely took place only three and four months ago. I am frankly not even convinced this subject merits an article at all, let alone paragraph after paragraph of text that merely parrots what's in mass media reports. —/Mendaliv/^2¢/_Δ's/ 04:36, 4 March 2014 (UTC)

Byrne discussion

We should not be giving any weight to a discussion by a person who according to the sources decided what her condition was even before seeing her, and who did not give an official evaluation to the court. This seems like coatracking an opinion into the article. Yobol (talk) 21:38, 5 March 2014 (UTC)

Byrne was requested by the family for the brain death determination and that request denied. The court documents from the family include statements from Byrne as he later saw her (see timeline section). Including Byrne's involvement in case was part of the NPOV requests of user 24.0.133.234 who requested help regarding concerns this article was previously not neutral.--BoboMeowCat (talk) 21:54, 5 March 2014 (UTC)

It speaks WORSE for Byrne that he decided what condition she was in before he saw her (seriously, who trusts a doctor that gives the diagnosis prior to examining the patient?). Nevertheless, his opinion is tangential at best as his opinion was not considered by the court, as the sources show. Disturbingly, we quote the doctor who the court did not want to hear from, but do not quote the independent expert DID want to hear from. This is troubling, as it appears to be POV pushing by those who agree with Byrne, rather than a neutral documenting of the facts surrounding the case. Yobol (talk) 21:59, 5 March 2014 (UTC)

The court did hear from this doctor, just not for the brain death determination, but either way, we are not trying to "speak worse" of Dr. Byrne or speak well of him either, but rather present this whole case from NPOV. Fact that Byrne said this before seeing her, is both accurate and speaks both to his personal bias and to his minority argument regarding brain death believed by the McMath family and their supporters. --BoboMeowCat (talk) 22:14, 5 March 2014 (UTC)

Also, findings of Dr. Fisher are prominently included. Sure, not in quote form, as such quotes would be too technical for WP, but detailed as follows: "Fisher examined McMath and affirmed the diagnosis of brain death, reporting that she had no activity on an electroencephalogram, no blood flow to the brain and did not breathe when removed from mechanical ventilation, all of which are standard clinical indications of total brain death.[20][21] On December 24, 2013, Judge Grillo ruled that McMath was legally dead, basing his decision on the medical evidence presented by physicians from Children's Hospital Oakland and from independent expert Paul Fisher." --BoboMeowCat (talk) 22:31, 5 March 2014 (UTC)

Let's see what other state. Did the court request Byrne's evaluation, because certainly they requested Fisher's, as the court appointed independent evaluation. Byrne's quote is disproportionate to their role in the case, as far as I can tell, it is being pushed by those who agree with Byrne's position, rather than his actual role here, which appears only to be that the family really, really wanted his opinion because they already knew what it would be before he even examined her. Yobol (talk) 22:57, 5 March 2014 (UTC)

Byrne's position significant to case. If McMath family didn’t believe his opinion, there’d be no case, no argument, no story. IP editor who introduced Byrne did appear to agree with it, while other editors didn't. I don't as much agree with Byrne's position, as I agree it significant to Jahi McMath case. Anyway, we attempted to neutrally present Byrne’s opinion in the context you describe it, in that it did appear family requested his opinion knowing very well what it would be in advance. Court denied Byrne's opinion as part of brain death determination but considered it as part of decision to maintain life support allowing time to arrange transfer. --BoboMeowCat (talk) 23:29, 5 March 2014 (UTC)

As I already said above in the original dr Byrne section, his opinion has no place in the article. The family wanted her kept on the ventilator before he ever came along. The text is WP:UNDUE and WP:COATRACK and must be removed. — Preceding unsigned comment added by Ca2james (talk • contribs) 04:18, 6 March 2014 (UTC)

If most editors want it out, I don't strongly object, but I don't agree it's [WP:COATRACK]], because it's a quote directly about Jahi, and not one of Byrne's general anti-braindeath, anti-organ donation quotes. I think it adds to the side IP 24 complained was missing, but in an honest/neutral way. Also, Mendaliv apparently didn't think it was coatrack, as he already trimmed all that stuff out (which I think was good because in attempt to balance all that stuff, more coatrack kept getting added and was becoming a mess and after it was out we finally ended up with a version it seemed everyone could accept). Anyway, who added that quote from Byrne in the first place? It wasn't me. I think it might have been NorthbySouthBaranof, who definitely didn't strike me as a Byrne supporter. --BoboMeowCat (talk) 04:42, 6 March 2014 (UTC)

Quotations don't always add to an article. Especially in light of the fact that what Byrne says is probably a fringe opinion, we needn't give it too much presence in the article. I might suggest trimming the quotation itself, or even just summarizing his point in a few words, which is all it really needs. Be careful about relying too much on primary sources for how you shape this article as well. These include interviews, and drawing conclusions based on quotations may be a form of unpublished synthesis. Just go by what the secondary sources say. And also be careful about taking WP:FRINGE too far and applying it in such a way that WP:NPOV or WP:BLP is violated. —/Mendaliv/^2¢/_Δ's/ 09:01, 6 March 2014 (UTC)

Deleted quote. Replaced with brief mention of Bryne’s testimony in court documents during appeal to summarizes his point in a few words.--BoboMeowCat (talk) 13:09, 6 March 2014 (UTC)

Thank you. I'm fine with the replacement text. Ca2james (talk) 15:46, 6 March 2014 (UTC)

I added a small note regarding the movements - I think if we mention Byrne's statement about them, we need to mention that those movements are biologically outside the brain path and are consistent with brain death. NorthBySouthBaranof (talk) 21:19, 6 March 2014 (UTC)

According to the ref it was part of his court testimony. http://www.nbcbayarea.com/news/local/Catholic-Organization-Says-Jahi-McMath-With-Jesus-Christ-239314591.html Either way, I’m not that attached to the word “testified” but think should be clear these statements were in court documents because otherwise it doesn’t make sense the hospital is responding to these statements, so changed to “stated in court documents”. The statement you added about reflex movements works for me.--BoboMeowCat (talk) 14:11, 7 March 2014 (UTC)

I agree that "testified" doesn't belong here but "stated in court documents" works for me. Thanks. Ca2james (talk) 16:52, 7 March 2014 (UTC)

Edit warring on death date and verb tenses

Folks, whatever anyone's opinion is on the situation, the fact is that the coroner issued a death certificate dated December 12, 2013. It makes sense to me to include that in the article as Jahi's death date. If we keep going back and forth on whether Jahi "is" or "was" it's going to make this page lose credibility. — Preceding unsigned comment added by Funcrunch (talk • contribs) 16:53, 9 January 2014 (UTC)

It's a controversial topic since many people (myself not included) believe she's still alive. I'm not sure how to best solve this, but I say that the vast majority of verifiable credible references say she's deceased, thus we should go with that. -- Bob drobbs (talk) 21:58, 9 January 2014 (UTC)

By all legal standards she is deceased and has been since December 12th. Towards the best interest of factual accuracy we have no choice but to go with the legal POV until it changes. 69.246.141.209 (talk) 19:50, 10 January 2014 (UTC)

Legally dead but is she grammatically dead? In this case it may be necessary to just have the edit-war appear in article? is/was, date of "legal" death/ , and so on. Using "was" instead of "is" is grammatically awkward and I think incorrect. A (noun) "is"-not was. The subject of the article "is"-not was if you want the subject to agree with the context, and although the child "was" declared "legally" dead, until she has "actually" died, there are too many political overtones to this.24.0.133.234 (talk) 00:57, 18 February 2014 (UTC)

Legally dead is actually dead. This is not a political statement, this is the decision of the coroner. There has been no reversal to the coroner's declaration of death, and no legal judgment that says that Jahi McMath is anything other than dead. Funcrunch (talk) 01:43, 18 February 2014 (UTC)

I don't know if it is appropriate for this article to elaborate on exactly what legally dead but on life support, and technically dead means, but from the way that I understand it, the legal definition of "brain death", was created by Drs at Harvard in order to facilitate removing organs from a person being kept alive on machines, which in reality is what caused the death of such people. By declaring a person "legally" brain-dead, this ending of one person's life by removing their organs, (which were only being kept functioning on machines to make them available for transplant)--would not be subject to criminal, and moral objections which were brought up by family members of the donors, recipients, and members of the transplant operation. In cases like Jahi's, a diagnoses of brain-death can be used to remove or refuse life support, but there are questions and different legal, ethical, religious...views on the subject. Why is only one view being pushed on Wikipedia? (that a person being kept alive on life support after being declared brain-dead is "dead"). Wikipedia should be able to reflect the uncertainties involved with this case for the main reason that WP will likely be used as a resource for people researching this case. The article, edit-warring etc. does a disservice to WP users by refusing to acknowledge the questions that have been raised, and only providing one side to a contentious issue. Readers are aware that there are political and ethical questions here and for WP editors to get heavy-handed and maintain this "legally brain-dead" position when readers already know that it has been disputed, looks like propaganda and censorship to me.24.0.133.234 (talk) 02:59, 18 February 2014 (UTC)

The article absolutely acknowledges that questions has been raised. If McMath's death weren't questioned there would be no point to the article's existence. However, this article is also presenting the facts of the case and the fact is that the coroner issued a death certificate dated December 12, 2013. There has been no evidence presented by any reliable source to dispute that that date was the date that McMath died. Funcrunch (talk) 03:04, 18 February 2014 (UTC)

The evidence is that as far as we know, her body is continuing to function with the help of life-support. If she were physically deceased, her body would die/deteriorate/decay and life-support or machines would not be able to sustain cardiac and the other functions that are apparently being assisted. This is an ongoing learning issue and it is only fair to WP users to present the correct facts without getting into editing wars to support one-sided agendas. You have maintained that a coroner declared the child "dead", that is not in dispute. What is disputed is how the material is presented in that article, and what exactly is meant by brain death in this case. By the way, the people who have been misdiagnosed as brain-dead have helped advance the diagnoses by highlighting the mistakes that were made-showing medicine what NOT to do and/or what additional steps will lead to a correct diagnoses. Even though the girl has been declared brain-dead, her physical body is alive until some time after her heart stops. There is a lot of confusion about this case because of the legal issues. Her body is being kept alive, but her brain has been declared dead. I think that the article needs to reflect those facts. It would help to add some good medical journal references,specifically pointing-out that a body can "die" while on life-support, but that Jahi's body has not done that yet as far as we know. Also there are journal/professional references that show that brain dead patients have "physically lived" for over 30 years in a "brain dead" (not coma, not vegetative state as the article currently suggests with that propaganda-like section) condition, but that their bodies have been relatively healthy but I'm too tired for that right now. Legally dead-legally brain dead-no argument, but she is physically alive and that needs to be addressed and it keeps getting censored-out of the article.24.0.133.234 (talk) 03:35, 18 February 2014 (UTC)

There has been no evidence presented in any reliable source that McMath was still alive as of December 12, 2013. Furthermore, there has been no evidence presented in any reliable source of what condition her body is in since the coroner released her body to the family on January 5, 2014. If you have any such evidence feel free to add it, with citations, to the article. In the meantime, as I posted on your talk page in response to your message, I have sought editor assistance in resolving this dispute. Funcrunch (talk) 03:47, 18 February 2014 (UTC)

Declared dead on December 12th, released from hospital almost a month later. Are you suggesting that she was physically dead during that month that we are certain that her body was at the hospital? No. That is what the article needs to clarify. That her body was physically alive, not dead. If her body was dead no life support could have kept it out of the morgue for almost a month-could it?24.0.133.234 (talk) 03:56, 18 February 2014 (UTC)

I am not only suggesting but asserting that based on all available evidence, Jahi McMath died on December 12. Her body was kept on a ventilator which enabled her heart to keep beating, but she was not "physically alive" after that date. I am not going to dispute this point with you further; I will await the input of other editors. Funcrunch (talk) 04:08, 18 February 2014 (UTC)

I hope that someone else can add to this too. I don't really want to dispute it with you either, because it looks like we have drawn the opposite conclusion here and i know that I am not qualified to convince you since I came to this article as a user lol to answer some of the questions that I had about this exact issue. Hopefully I will have time to find my references, but even with what I have seen about this there has been a lot of confusion. Not so much about brain-death, although I'm tending to look at that as more of a legal definition, but the clarification needs to be concerning physical death. And I will agree that we don't know her current condition, or after she was released from the hospital. Since she was declared legally dead I guess that child protection services can't legally intervene either. But it is my understanding that nothing except maybe freezing will keep a body from ceasing to function if it is physically dead.24.0.133.234 (talk) 04:57, 18 February 2014 (UTC)

I wanted to address as many of your concerns as possible; I hope this information helps clear things up for you. I've included some links to references and I hope I've done that right as I haven't done much Wikipedia editing at all.

Jahi's body has been receiving mechanical ventilation which, in essence, forces oxygen into the lungs and removes carbon dioxide . This, in turn, forces the heart to beat, which then circulates blood throughout her body. Her heart cannot beat without the mechanical assistance of the ventilator because her brain has died and does not signal the heart to beat.

Modern medical technology is amazing. We have the power to mechanically force almost every system in the body to work - except for the brain, that is. If the brain dies we have no way to restart it; all we can do is mechanically animate the rest of the body. If the entire brain is confirmed dead and the body cannot function on its own, logically the body is dead. Note that her brain was pronounced dead by several separate doctors who administered the required tests (pdf). There's a good bunch of blog posts by this doctor on Jahi and brain death that I recommend reading, starting with the FAQ: .

Her brain has almost certainly decomposed due to a lack of oxygen and her body has been deteriorating. It was deteriorating before she left the hospital (pdf). This deterioration is clear in pictures: her skin has a grey cast and appears loose.

Finally, I think it was mentioned earlier that brain death was developed just for organ transplants. This is not true - see ref

References

https://www.nhlbi.nih.gov/health/health-topics/topics/vent/

http://www.thaddeuspope.com/images/CHO_-_Physician_Decls.pdf

http://docbastard.blogspot.ca/2014/01/jahi-mcmath-faq.html

http://sprocket-trials.blogspot.ca/2014/01/jahi-mcmath-merely-dead-or-really-most.html

http://media.nbcbayarea.com/documents/HeidiFlori.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652772/?report=classic

Ca2james (talk) 16:00, 18 February 2014 (UTC)

Note to editors: This article is now listed at the BLP noticeboard. Funcrunch (talk) 16:37, 18 February 2014 (UTC)

Thank-you for posting those references and addressing the problem. I finally forced myself to read the report that supposedly refutes the fact that the legal definition of brain death was developed as an ad hoc response to vital organ transplants which end the life of someone who is brain dead. Not sure that it supports that premise. I am already familiar with most of the other sources listed, and frankly, they appear mostly biased towards one-side of the issue, especially the blogs and the comments contained in the blogs but they do have some good questions and answers about brain death and the issues involved. There are also links and references available which are more neutral, but which lean towards answering the question-(is Jahi McMath physically dead?)-which in my opinion would say "No."
What I am asking for is a compromise in the grammar used in this particular article-not to redefine brain death. The fact that the term brain-death requires that the word (brain) be added to (death) leaves the option of some OTHER, or even "plain" death open, at least in a grammatical sense of things. It is not the job of Wikipedia to conform to euphemisms.It was even pointed-out in one of the sources referenced that "life support" cannot be maintained on a "dead" body, proving that the body is not dead. I say let's mince words here, use the correct medical terms, and the traditional terms for death as well. At least as long as the subject of the article is still "alive" in the way that people understand/define biologically "living". This is a special case, and the political and other questions should not be forced on this particular article to commit one way or the other.
I don't think that anyone wants to omit or dispute whether or not the child has been declared brain-dead, or even legally dead, but there are objection towards portraying a living human being as a "corpse" which the tone of the article currently maintains, and which is objectionable for many reasons, not the least of that it it is factually not correct.
24.0.133.234 (talk) 00:14, 19 February 2014 (UTC)

"Life support" is actually medically called "mechanical ventilation" and several people writing in the main-stream media have expressed a desire to change the "life support" terminology so as to avoid confusion.

Jahi is not alive in any medical way and there is absolutely no credible medical or legal dispute about that. The article is factually correct. Ca2james (talk) 15:27, 19 February 2014 (UTC)

Also. It is my understanding that Jahi McMath's diagnoses could be changed at this point, or even at the point where she was released from the hospital to something called, "chronic brain death", as opposed to "brain death"-the latter which implies an imminent complete demise/physical no-coming-back-(or whatever anyone wants to call "death" as we know it). "Chronic brain death", is apparently what happens when a person diagnosed with brain death, goes on past the immediate few days that the "brain dead" do not survive. There have been cases of chronically brain dead patients being maintained for decades and those people were not considered to be or referred-to as "corpses"/deceased, until all bodily functions had ended. In this case the legal actions do make it interesting and are part of the story of Jahi McMath-(belongs in the article)--but that still doesn't mean that Wikipedia has to take one side or the other in regards to whether or not, or to what degree of "dead" she is or was on the last known date of her condition.24.0.133.234 (talk) 00:40, 19 February 2014 (UTC)

The coroner has issued a death certificate. There is no coming back. This is not a vegetative state or a coma or anything like it. She had zero brain activity, a flatline EEG. Under American law, brain death is death. We can note the fringe view that she is not dead, but we are not required to give that view equal time/equal space/equal credence. By all mainstream criteria, Jahi is dead. NorthBySouthBaranof (talk) 05:39, 19 February 2014 (UTC)

Brain death is final and irreversible and Jahi's condition and diagnosis will not change. Your terminology suggestions have no basis in medical or legal literature and therefore have no place in a Wikipedia article. I think you're arguing issues that are larger than this case and more properly belong in a discussion of brain death and medical ethics. Ca2james (talk) 15:27, 19 February 2014 (UTC)

Here is a medical terminology reference regarding "Chronic Brain Death"-just so you know that it is not my terminology. Please note that over 200 other articles have cited that one. https://www.neurology.org/content/51/6/1538.short 24.0.133.234 (talk) 20:20, 24 February 2014 (UTC)

Also after this article was published in Neurobiology, there were some strong opposing comments/correspondence but I cannot open that at this point. www.neurology.org/content/53/6/1369.short?sid=fcfa8a95-2079-400a-a2d8-407c48347f9724.0.133.234 (talk) 20:44, 24 February 2014 (UTC)

I don't really know where to put this, so sorry if it is not in the right place. About the "Harvard" 1968 landmark and discussed here brain-death topic, this reference from Pubmed has some more information and a review of the review that disputed whether or not organ-donation had anything to do with it. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574564/#Sec2title I agree that the McMath case article has about zero to do with organ or transplant topics EXCEPT for the origins and crossing-of terms pertaining to the brain-dead condition of donors. Which i really think should be avoided in this article. And, i also believe that this (incorrect in a LOT of instances)cross-referencing of different terms used regarding, death, brain-death in particular, and organ transplants and recovery, are part of the problem. The transplant industry uses terms related to the brain-dead, that just do not fit here, but they have been used here. In the glossary of the transplant profession, the only living donor is someone who remains living and recovers from the donation, the rest are varyingly classified as "cadavers", even-though they are not "corpses"-as traditionally defined. I'm not arguing with what the transplant professionals use as highly-specialized tools to define their job, but I am arguing that it is their industry jargon and terminology, and that to use those same terms in basically unrelated instances, is not the job of WP, or anyone else, including medicine for anyone who is not involved with organ transplant.(and I am actually excluding irreversible brain-death, since there is a use for that term in medicine, up until if/when they decide to change it again)24.0.133.234 (talk) 05:18, 10 March 2014 (UTC)