Health
Was football player Terrance Howard really dead? His parents didn’t think so.
From LifeSiteNews
The Uniform Determination of Death Act (UDDA) states that there must be an irreversible cessation of all functions of the entire brain for a declaration of brain death. The way doctors currently diagnose brain death does not comply with the law under the UDDA.
North Carolina Central University football player Terrance Howard died recently after a car accident reportedly left him “brain dead.” But his family disputed this diagnosis and requested that their son be transferred to another facility for treatment of his brain injury, leading to conflict with Terrance’s doctors and hospital. According to News One, his parents claimed that Atrium Health Carolinas Medical Center wanted to kill their son for his organs, and accused doctors of snickering and laughing while refusing to help him. His father, Anthony Allen, told News One that the hospital removed Terrance from life support against his family’s wishes and forcibly ejected his family from his room. The family posted videos on social media of apparent police officers entering Terrance’s hospital room, and said that the hospital threatened them with criminal action for trespassing.
If these allegations are true, the Howard family has every right to be outraged at the disrespectful treatment they received at Atrium Health. Especially now, as the legitimacy of brain death is coming under increasing scrutiny, it is outrageous that hospitals and doctors continue being so heavy-handed. The National Catholic Bioethics Center (NCBC), formerly a staunch supporter of “brain death,” released a statement in April 2024, saying:
Events in the last several months have revealed a decisive breakdown in a shared understanding of brain death (death by neurological criteria) which has been critical in shaping the ethical practice of organ transplantation. At stake now is whether clinicians, potential organ donors, and society can agree on what it means to be dead before vital organs are procured.
The NCBC statement was prompted by the newest brain death guideline which explicitly allows people with partial brain function to be declared brain dead. But the Uniform Determination of Death Act (UDDA) states that there must be an irreversible cessation of all functions of the entire brain for a declaration of brain death. The way doctors currently diagnose brain death does not comply with the law under the UDDA.
Terrance Howard’s story is reminiscent of the mistreatment of another Black teenager, Jahi McMath. In 2013, Jahi was a quiet, cautious teenager with sleep apnea who underwent a tonsillectomy and palate reconstruction to improve her airflow while sleeping. An hour after the surgery, she started spitting up blood. Her parents requested repeatedly to see a doctor without success. Her mother, Nailah Winkfield, said, “No one was listening to us, and I can’t prove it, but I really feel in my heart: if Jahi was a little white girl, I feel we would have gotten a little more help and attention.”
Jahi continued to bleed until she had a cardiac arrest just after midnight. She was pulseless for ten minutes during her “code blue” resuscitation. Two days later, her electroencephalogram (EEG) was flatline, and it was clear that Jahi had suffered a severe brain injury which was worsening. But rather than treating these findings aggressively, her doctors proceeded toward a diagnosis of brain death. Three days after her surgery, her parents were informed that their daughter was “dead” and that Jahi could now become an organ donor. The family was stunned. How could Jahi be dead? She was warm, she was moving occasionally, and her heart was still beating. As a Christian, Nailah believed her daughter’s spirit remained in her body as long as her heart continued to beat. While the family sought medical and legal assistance, Children’s Hospital Oakland doubled down, refusing to feed Jahi for three weeks. The hospital finally agreed to release Jahi to the county coroner for a death certificate, following which her family would be responsible for her.
On January 3, 2014, Jahi received a death certificate from California, listing her cause of death as “Pending Investigation.” Why was the hospital so adamant about insisting Jahi was dead, even to the point of issuing a death certificate? Possibly because California’s Medical Injury Compensation Reform Act limits noneconomic damages to $250,000. If Jahi was “dead,” the hospital and its malpractice insurer would only be liable for $250,000. But if Jahi was alive, there would be no limit to the amount her family could claim for her ongoing care.
After Jahi was transferred to New Jersey, the only US state with a religious exemption to a diagnosis of brain death, she began to improve. After noticing that Jahi’s heart rate would decrease at the sound of her mother’s voice, the family began asking her to respond to commands, and videoed her correct responses. Jahi went through puberty and began to menstruate — something not seen in corpses! By August 2014 she was stable enough to move into her mother’s apartment for continuing care. Subsequently Jahi was examined by two neurologists (Dr. Calixto Machado and Dr. D. Alan Shewmon) who found that she had definitely improved: she no longer met the criteria for brain death and was in a minimally conscious state. Jahi continued responding to her family in a meaningful way until her death in June 2018 from complications of liver failure.
How could Jahi McMath, who was declared brain dead by three doctors, who failed three apnea tests, and who had four flatline EEGs and a radioisotope scan showing no intracranial blood flow, go on to recover neurologic function? Very likely, due to a condition called Global Ischemic Penumbra, or GIP. Like every other organ, the brain shuts down its function when its blood flow is reduced in order to conserve energy. At 70 percent of normal blood flow, the brain’s neurological functioning is reduced, and at a 50 percent reduction the EEG becomes flatline. But tissue damage doesn’t begin until blood flow to the brain drops below 20 percent of normal for several hours. GIP is a term doctors use to refer to that interval when the brain’s blood flow is between 20 and 50 percent of normal. During GIP the brain will not respond to neurological testing and has no electrical activity on EEG, but still has enough blood flow to maintain tissue viability — meaning that recovery is still possible. During GIP, a person will appear “brain dead” using the current medical guidelines and testing, but with continuing care they could potentially improve.
Dr. D. Alan Shewmon, one of the world’s leading authorities on brain death, describes GIP this way:
This [GIP] is not a hypothesis but a mathematical necessity. The clinically relevant question is therefore not whether GIP occurs but how long it might last. If, in some patients, it could last more than a few hours, then it would be a supreme mimicker of brain death by bedside clinical examination, yet the non-function (or at least some of it) would be in principle reversible.
Dr. Cicero Coimbra first described GIP in 1999, but in the never-ending quest for transplantable organs, his work has been largely ignored. There is absolutely no medical or moral certainty in a brain death diagnosis, and people need to be made aware of this. “Brain dead” people are very ill, and their prognosis may be death, but they deserve to be treated aggressively until they either recover or succumb to natural death. Unfortunately, as the family of Terrance Howard seems to have experienced, doctors are continuing to use a brain death guideline that ignores the reality of GIP and does not comply with brain death law under the UDDA.
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.
David Clinton
Involuntary confinement is currently enjoying serious reconsideration
Sometimes a quick look is all it takes to convince me that a particular government initiative has gone off the rails. The federal government’s recent decision to shut down their electric vehicle subsidy program does feel like a vindication of my previous claim that subsidies don’t actually increase EV sales.
But no matter how hard I look at some other programs – and no matter how awful I think they are – coming up with better alternatives of my own isn’t at all straightforward. A case in point is contemporary strategies for managing urban homeless shelters. The problem is obvious: people suffering from mental illnesses, addictions, and poverty desperately need assistance with shelter and immediate care.
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Ideally, shelters should provide integration with local healthcare, social, and employment infrastructure to make it easier for clients to get back on their feet. But integration isn’t cost-free. Because many shelters serve people suffering from serious mental illnesses, neighbors have to worry about being subjected to dangerous and criminal behavior.
Apparently, City of Toronto policy now requires their staff to obscure from public view the purchase and preparation of new shelter locations. The obvious logic driving the policy is the desire to avoid push back from neighbors worried about the impact such a facility could have.
As much as we might regret the not-in-my-back-yard (NIMBY) attitude the city is trying to circumvent, the neighbors do have a point. Would I want to raise my children on a block littered with used syringes and regularly visited by high-as-a-kite – and often violent – substance abusers? Would I be excited about an overnight 25 percent drop in the value of my home? To be honest, I could easily see myself fighting fiercely to prevent such a facility opening anywhere near where I live.
On the other hand, we can’t very well abandon the homeless. They need a warm place to go along with access to resources necessary for moving ahead with their lives.
One alternative to dorm-like shelters where client concentration can amplify the negative impacts of disturbed behavior is “housing first” models. The goal is to provide clients with immediate and unconditional access to their own apartments regardless of health or behaviour warnings. The thinking is that other issues can only be properly addressed from the foundation of stable housing.
Such models have been tried in many places around the world over the years. Canada’s federal government, for example, ran their Housing First program between 2009 and 2013. That was replaced in 2014 with the Homelessness Partnering Strategy which, in 2019 was followed by Reaching Home.
There have been some successes, particularly in small communities. But one look at the disaster that is San Francisco will demonstrate that the model doesn’t scale well. The sad fact is that Canada’s emergency shelters are still as common as ever: serving as many as 11,000 people a night just in Toronto. Some individuals might have benefited from the Home First-type programs, but they haven’t had a measurable impact on the problem itself.
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Where does the money to cover those programs come from? According to their 2023 Financial Report, the City of Toronto spent $1.1 billion on social housing, of which $504 million came in funding transfers from other levels of government. Now we probably have to be careful to distinguish between a range of programs that could be included in those “social housing” figures. But it’s probably safe to assume that they included an awful lot of funding directed at the homeless.
So money is available, but is there another way to spend it that doesn’t involve harming residential neighborhoods?
To ask the question is to answer it. Why not create homeless shelters in non-residential areas?
Right off the top I’ll acknowledge that there’s no guarantee these ideas would work and they’re certainly not perfect. But we already know that the current system isn’t ideal and there’s no indication that it’s bringing us any closer to solving the underlying problems. So why not take a step back and at least talk about alternatives?
Good government is about finding a smart balance between bad options.
Put bluntly, by “non-residential neighborhood shelters” I mean “client warehouses”. That is, constructing or converting facilities in commercial, industrial, or rural areas for dorm-like housing. Naturally, there would be medical, social, and guidance resources available on-site, and frequent shuttle services back and forth to urban hubs.
If some of this sounds suspiciously like the forced institutionalization of people suffering from dangerous mental health conditions that existing until the 1970s, that’s not an accident. The terrible abuses that existed in some of those institutions were replaced by different kinds of suffering, not to mention growing street crime. But shutting down the institutions themselves didn’t solve anything. Involuntary confinement is currently enjoying serious reconsideration.
Clients would face some isolation and inconvenience, and the risk of institutional abuses can’t be ignored. But those could be outweighed by the positives. For one thing, a larger client population makes it possible to properly separate families and healthy individuals facing short-term poverty from the mentally ill or abusive. It would also allow for more resource concentration than community-based models. That might mean dedicated law enforcement and medical staff rather than reliance on the 9-1-1 system.
It would also be possible to build positive pathways into the system, so making good progress in the rural facility could earn clients the right to move to in-town transition locations.
This won’t be the last word spoken on this topic. But we’re living with a system that’s clearly failing to properly serve both the homeless and people living around them. It would be hard to justify ignoring alternatives.
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Health
Canadian media might not be able to ignore new studies on harmful gender transitions for minors
From LifeSiteNews
When the UK National Health Service’s bombshell Cass Review condemning gender “transition” for minors was published, virtually the entire Canadian press engaged in a voluntary blackout.
Unless you were reading an alternative news source, an international news source, or the National Post, it was as if Cass Review — and its findings — had simply never existed. Many media outlets did not run a single story; the state-funded CBC ran precisely one, and it was a laughable hatchet job claiming that the massive study was “biased.” They did not interview a single person associated with the research.
The Canadian press has functioned for years as a propaganda arm for the transgender movement, even as the gender ideology house of cards topples in in the U.S. and the UK, where there have been genuinely robust debates informed by scientific evidence rather than ideology. Thus, I wonder how they will deal with new studies by Canadian researchers that reach many of the same conclusions.
As Sharon Kirkey of the National Post reported. “The evidence surrounding the use of puberty blockers and cross-sex hormones in children and teens identifying as transgender is of such low certainty it’s impossible to conclude whether the drugs help or harm, Canadian researchers are reporting.” The research was funded by the Society for Evidence-based Gender Medicine (SEGM) and McMaster University, considered to one of Canada’s top institutions of higher hearing, and published this week in the journal Archives of Disease in Childhood.
“There’s not enough reliable information,” said Chan Kulatunga-Moruzi, one of the authors of the two new reviews. “We really don’t have enough evidence to say that these procedures are beneficial. Few studies have looked at physical harm, so we have really no evidence of harm as well. There’s not a lot that we can say with certainty, based on the evidence.” (Here, I would note that there are now thousands of testimonies of detransitioners testifying to the harm that sex-change “treatments” have caused them, but this is a remarkable admission nonetheless.)
The researchers conclude that doctors should approach these “treatments” with extreme care, clearly communicating with parents and children and — notably — checking “whose values they are prioritizing” if they should decide to prescribe cross-sex hormones or puberty blockers. As Kirkey put it with devastating understatement: “Originally considered fully reversible, concerns are emerging about potential long-term or irreversible effects, the Canadian team wrote … Questions have been raised about the effects of fertility or what impact, if any, they might have on brain development.”
The researchers painstakingly went through the available evidence on both cross-sex hormones and puberty blockers (Kirkey irritatingly refers to them as “gender-affirming hormones”) for those up to 26 years old. To analyze the evidence, they “graded” it “using a scoring system co-developed by Dr. Gordon Guyatt, a celebrated McMaster University scientist who coined the phrase evidence-based medicine.” As Kirkey reported:
After screening 6,736 titles and abstracts involving puberty blockers, only 10 studies were included in their review. While children who received puberty blockers compared to those who don’t score higher on “global function” — quality of life, and general physical and psychological wellbeing — the evidence was of “very low certainty.” Very low, meaning researchers have “very little confidence in the effect estimate” and that the true effect “is likely to be substantially different from the estimate of effect.”
It gets worse. The research also debunked the perpetually asserted claim utilized by trans activists and their political allies to enforce their agenda: that these drugs are necessary to prevent depression and suicidal ideation. According to the researchers: “We are very uncertain about the causal effect of the (drugs) on depression. Most studies provided very low certainty of evidence about the outcomes of interest; thus, we cannot exclude the possibility of benefit or harm.” Again, despite the careful understatement, this is devastating: Thousands of children have been subjected to these treatments on the premise that they prevent harm and are harmless.
Indeed, the second review, which analyzed 24 studies, reached the similar conclusion of “very low confirmatory evidence of substantive change” not just in depression or health overall but even in gender dysphoria itself. As Kirkey noted: “Many studies suffered from missing data, small sample sizes, or lacked a comparison group.” The researchers concluded: “Since the current best evidence, including our systematic review and meta-analysis, is predominantly very low quality, clinicians must clearly communicate this evidence to patients and caregivers. Treatment decisions should consider the lack of moderate- and high-quality evidence, uncertainty about the effects of puberty blockers and patient’s values and preferences.”
Imagine for a moment that you are a teen or young person who started these treatments after having been told, with utter, aggressive confidence, by counselors, psychiatrists, and doctors that they were both harmless and necessary — that they could even save your life. Imagine being a parent who subjected your child to these treatments, convinced by “experts” that this was the best thing you could do to love your son or daughter. I have written these words too many times to count: This is a medical scandal of unprecedented proportions in this century, and those that perpetrated it must be held accountable.
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