Health
Hospital wants to pull the plug on inhumanely neglected 23-year-old woman who is not brain dead
From LifeSiteNews
Montefiore Hospital in Brooklyn is neglecting Amber Ebanks, but experts who have seen the student say her body is functioning and that she could improve with proper treatment.
Amber Ebanks, a 23-year-old Jamaican business student, drove herself to Montefiore Hospital in the Bronx for elective surgery on July 30. But her procedure went awry, leading to an intraoperative stroke and brain swelling that worsened over time. Now, her family is fighting for Amber’s life while the hospital wants to pull the plug.
In February, Amber was found to have a ruptured arteriovenous malformation (AVM), a tangle of abnormal arteries and veins in her brain. Thankfully, after the rupture she was able to return to life as normal. Her doctors recommended that she undergo an embolization procedure to clot off the abnormal blood vessels in her brain in hopes of preventing further rupturing and brain damage. Unfortunately, during the embolization procedure, one of the major arteries supplying blood to Amber’s brain was unintentionally occluded, and her procedure was also complicated by a type of bleeding around the brain called a subarachnoid hemorrhage. Thus, she was taken to the ICU, placed in a medically induced coma, and treated for brain swelling.
Just 10 days later, on August 9, her doctors declared her to be “brain dead.” But there were problems with this diagnosis. The Determination of Death statute in New York and the Uniform Determination of Death Act (UDDA) both state:
“An individual who has sustained either:
- irreversible cessation of circulatory and respiratory functions; or
- irreversible cessation of all functions of the entire brain, including the brain stem, is dead.”
Amber Ebanks meets neither the first nor the second of these criteria. Her circulatory and respiratory functions continue: her heart is still beating, and her lungs are absorbing oxygen and releasing carbon dioxide. And she does not have the irreversible cessation of all functions of her brain, since she is maintaining her own body temperature, which is a brain function.
Moreover, the new 2023 American Academy of Neurology brain death guideline indicates that metabolic derangements such as high serum sodium levels may confound a brain death evaluation. According to Dr. Paul Byrne, Amber’s sodium levels were very high prior to her brain death determination, with readings over 160meq/L (normal sodium levels range from 135-145 meq/L). Not only can high sodium levels cause abnormal brain functioning, but they can also cause blood vessels in the brain to rupture, causing more brain bleeding – the very problems that Amber’s doctors should be interested in preventing. Also, even though high levels of carbon dioxide are known to exacerbate brain swelling, her doctors have not been checking these levels or adjusting her ventilator settings to prevent such derangements.
In addition to her ongoing heart, lung, and brain functions, Amber has continuing liver and kidney function. And presumably she still has digestive function, even though the hospital has been refusing to feed her since she came in for her surgery on July 30th. A patient cannot be expected to improve neurologically without nutrition.
Not only is Montefiore Hospital refusing to feed Amber, it’s refusing to provide her with basic wound care and hygiene. When Dr. Byrne, a board-certified pediatrician and neonatologist and brain death expert, flew to New York to see Amber this past week, Amber’s sister Kay showed him a maggot she had removed from her sister’s hair. Referring to hospital personnel, Kay Ebanks said in an ABC News article, “They are some of the cruelest people I have ever known.” Most of Amber’s family lives in Jamaica, and her father has been struggling to get a visa in order to come and see his daughter. Meanwhile, the hospital actually suggested that family members say goodbye to her over the phone.
Dr. Byrne and Dr. Thomas M. Zabiega, a board-certified psychiatrist and neurologist, have both evaluated Amber’s case. They have submitted sworn affidavits that Amber Ebanks is alive, and believe that she has decreased blood flow to her brain causing a quietness of the brain known as Global Ischemic Penumbra (GIP). During GIP, the brain shuts down its function to save energy, but the brain tissue itself remains viable. Drs. Byrne and Zabiega recommend additional time and treatment such as adjusting Amber’s sodium and carbon dioxide levels and treating hormonal deficiencies. They have testified that with proper medical treatments she is likely to continue to live and may obtain limited to full recovery of brain functions, even possibly recovering consciousness.
And there are other health care professionals who are willing to help Amber heal. A long-term care facility on Long Island called New Beginnings has agreed to care for Ebanks for as long as her family would like. “Everybody needs hope. You can’t just give up. Can’t just take them off life support when she needs more time,” New Beginnings founder Allyson Scerri said.
Nevertheless, doctors at Montefiore Hospital are adamant that Amber is “brain dead” and want to disconnect her from her ventilator over the objections of her family. Despite the testimony of qualified doctors and experts, the judge assigned to her case is requiring that a New York-licensed physician be found to evaluate Amber and give testimony about her condition. Until then, Amber remains unfed, uncared for, and neglected in an American hospital, to the point of her sister having to remove vermin from her hair.
Amber Ebanks is very much alive despite receiving little to no ongoing treatment to assist with the healing of her brain. She does not meet the medical or legal criteria for death. All she needs are proper ventilator therapy, a balancing of her fluids and electrolytes, nutrition via a feeding tube, and hormonal replacement: treatments that are commonplace in medicine today. It is shameful that her family has had to beg for these treatments and even go to court to try to force the hospital to provide them.
Heidi Klessig, MD is a retired anesthesiologist and pain management specialist who writes and speaks on the ethics of organ harvesting and transplantation. She is the author of “The Brain Death Fallacy” and her work may be found at respectforhumanlife.com.
Alberta
Early Success: 33 Nurse Practitioners already working independently across Alberta
Nurse practitioners expand primary care access |
The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.
Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.
“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”
To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.
With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.
“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”
“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”
“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”
The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.
Quick facts
- Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
- Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
- Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
- For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
- There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
- Data from the Nurse Practitioner Primary Care Program show:
- Nine applicants plan to work on First Nations reserves or Metis Settlements.
- Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
- Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
- Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.
Related information
Addictions
BC Addictions Expert Questions Ties Between Safer Supply Advocates and For-Profit Companies
By Liam Hunt
Canada’s safer supply programs are “selling people down the river,” says a leading medical expert in British Columbia. Dr. Julian Somers, director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University, says that despite the thin evidence in support of these experimental programs, the BC government has aggressively expanded them—and retaliated against dissenting researchers.
Somers also, controversially, raises questions about doctors and former health officials who appear to have gravitated toward businesses involved in these programs. He notes that these connections warrant closer scrutiny to ensure public policies remain free from undue industry influence.
Safer supply programs claim to reduce overdoses and deaths by distributing free addictive drugs—typically 8-milligram tablets of hydromorphone, an opioid as potent as heroin—to dissuade addicts from accessing riskier street substances. Yet, a growing number of doctors say these programs are deeply misguided—and widely defrauded.
Ultimately, Somers argues, safer supply is exacerbating the country’s addiction crisis.
Somers opposed safer supply at its inception and openly criticized its nationwide expansion in 2020. He believes these programs perpetuate drug use and societal disconnection and fail to encourage users to make the mental and social changes needed to beat addiction. Worse yet, the safer supply movement seems rife with double standards that devalue the lives of poorer drug users. While working professionals are provided generous supports that prioritize recovery, disadvantaged Canadians are given “ineffective yet profitable” interventions, such as safer supply, that “convey no expectation that stopping substance use or overcoming addiction is a desirable or important goal.”
To better understand addiction, Somers created the Inter-Ministry Evaluation Database (IMED) in 2004, which, for the first time in BC’s history, connected disparate information—i.e. hospitalizations, incarceration rates—about vulnerable populations.
Throughout its existence, health experts used IMED’s data to create dozens of research projects and papers. It allowed Somers to conduct a multi-million-dollar randomized control trial (the “Vancouver at Home” study) that showed that scattering vulnerable people into regular apartments throughout the city, rather than warehousing them in a few buildings, leads to better outcomes at no additional cost.
In early 2021, Somers presented recommendations drawn from his analysis of the IMED to several leading officials in the B.C. government. He says that these officials gave a frosty reception to his ideas, which prioritized employment, rehabilitation, and social integration over easy access to drugs. Shortly afterwards, the government ordered him to immediately and permanently delete the IMED’s ministerial data.
Somers describes the order as a “devastating act of retaliation” and says that losing access to the IMED effectively ended his career as a researcher. “My lab can no longer do the research we were doing,” he noted, adding that public funding now goes exclusively toward projects sympathetic to safer supply. The B.C. government has since denied that its order was politically motivated.
In early 2022, the government of Alberta commissioned a team of researchers, led by Somers, to investigate the evidence base behind safer supply. They found that there was no empirical proof that the experiment works, and that harm reduction researchers often advocated for safer supply within their studies even if their data did not support such recommendations.
Somers says that, after these findings were published, his team was subjected to a smear campaign that was partially organized by the British Columbia Centre on Substance Use (BCCSU), a powerful pro-safer supply research organization with close ties to the B.C. government. The BCCSU has been instrumental in the expansion of safer supply and has produced studies and protocols in support of it, sometimes at the behest of the provincial government.
Somers is also concerned about the connections between some of safer supply’s key proponents and for-profit drug companies.
He notes that the BCCSU’s founding executive director, Dr. Evan Wood, became Chief Medical Officer at Numinus Wellness, a publicly traded psychedelic company, in 2020. Similarly, Dr. Perry Kendall, who also served as a BCCSU executive director, went on to found Fair Price Pharma, a now-defunct for-profit company that specializes in providing pharmaceutical heroin to high-risk drug users, the following year.
While these connections are not necessarily unethical, they do raise important questions about whether there is enough industry regulation to minimize potential conflicts of interest, whether they be real or perceived.
The BCCSU was also recently criticized in an editorial by Canadian Affairs, which noted that the organization had received funding from companies such as Shoppers Drug Mart and Tilray (a cannabis company). The editorial argued that influential addiction research organizations should not receive drug industry funding and reported that Alberta founded its own counterpart to the BCCSU in August, known as the Canadian Centre of Recovery Excellence, which is legally prohibited from accepting such sponsorships.
Already, private interests are betting on the likely expansion of safer supply programs. For instance, Safe Supply Streaming Co., a publicly traded venture capital firm, has advertised to potential investors that B.C.’s safer supply system could create a multi-billion-dollar annual market.
Somers believes that Canada needs more transparency regarding how for-profit companies may be directly or indirectly influencing policy makers: “We need to know exactly, to the dollar, how much of [harm reduction researchers’] operating budget is flowing from industry sources.”
Editor’s note: This story is published in syndication with Break The Needle and Western Standard.
The Bureau is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Dr. Julian M. Somers is director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University. He was Director of the UBC Psychology Clinic, and past president of the BC Psychological Association. Liam Hunt is a contributing author to the Centre For Responsible Drug Policy in partnership with the Macdonald-Laurier Institute.
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