When is a person legally dead? One family’s fight to keep their daughter alive comes to a close this month

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A lengthy legal battle on whether a Brampton woman can be taken off life support will come to a close this month with a landmark legal decision over who gets to decide what death is.

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Taquisha McKitty, 27, has been on life support since September when she went into cardiac arrest following a drug overdose. She was declared neurologically dead by doctors and her death certificate was issued on Sept. 20.

In the nine months since then, her family has been in court arguing that she is alive, and that to pull the plug would go against her Christian beliefs about when life ends.

Now the McKitty family’s lawyer, Hugh Scher, says a ruling from a Brampton Superior Court is imminent — and the decision could influence how doctors, coroners and families approach the idea of death altogether.

“It raises a serious question as to what is death in Ontario and in Canada. There is no statutory legal definition,” said Scher on Metro Morning Tuesday. “We’re hopeful this case will provide some guidance.”

‘No doubt’ she’s biologically alive: lawyer

Scher and the McKitty family say that beyond breathing and having a heartbeat, Taquisha shows other signs of life — like moving her legs — that prove she’s still biologically alive.

“She eats, she drinks, her organs function,” said Scher, comparing her to “many other people with a severe neurological impairment.”

Also to be determined is the question of how McKitty’s faith should factor in, with Scher making the case that individual wishes and values should be taken into account when deciding death.

That line of thinking bears a strong resemblance to another one of Scher’s cases, which also has yet to be decided: Shalom Ouanounou, a now deceased 25-year-old.

Ouanounou’s family fought to keep him on life support indefinitely after he was declared brain dead on the grounds of his belief in a Jewish law that stipulates death is when the heart stops beating.

2nd GTA case still awaiting decision

Though his heart stopped in March, making him dead in the eyes of his family, Ouanounou’s case will continue to be considered, and could likely be influenced by the decision in the McKitty case, said Scher in March. 

Shalom Ouanounou, 25, was a Seneca College student who was described by his family as devoutly religious. (Submitted by Hugh Scher)

Of course, many doctors see the issue quite differently, arguing that brain death has been a widely accepted medical standard since the late 1960s.

In November, Dr. Blair Bigham wrote that the heart has a “cruise control” function and can beat close to indefinitely if a respirator is used. He argued that by keeping McKitty and Ouanounou on life support, the grieving process for their families had been put on pause.

“Changing the definition of death won’t bring these two back to life,” he wrote.

The question of resources

Kerry Bowman, a bioethicist from the University of Toronto, said on Metro Morning that McKitty and Ouanounou’s cases raise important questions about the limits of cultural acceptance.

Patients hooked up indefinitely also raise thorny questions about the allocation of resources.

If they are hooked up to a respirator, “in most cases, they are in a critical care bed, in an intensive care unit,” he said.

Though individual lives shouldn’t be viewed in monetary terms, Bowman said, he believes the country needs to have a “mature conversation on the ethics of resource allocation” in medicine. 

Similar concerns were raised in Ouanounou’s case, with doctors pointing out that hundreds of thousands of dollars of care and extreme medical interventions — including the use of drugs already in short supply in the hospital system — were extended to someone whom the hospital considered to be dead.

Organ donation is also put into question, said Bowman, believing that if the definition of death becomes murky, “this could erode people’s fundamental faith in the organ donation system.”

Scher believes that the decision in the McKitty case, already delayed, will be released next week.

http://www.cbc.ca/news/canada/toronto/taquisha-mckitty-upcoming-decision-1.4663684?cmp=rss