Jahi McMath still hooked to machines 1 year later

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Jahi McMath case
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Jahi McMath still hooked to machines 1 year later
A photograph of 13-year-old Jahi McMath is seen on a necklace in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep their daughter on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
Oakland, Calif, USA. 23rd Dec, 2013. Nailah Winkfield, center, mother of Jahi McMath, receives hugs and support from family and friends in front of Children's Hospital Oakland in Oakland, Calif., on Monday, Dec. 23, 2013. © Susan Tripp Pollard/Bay Area News Group/MCT/Alamy Live News
Oakland, CA, USA . 05th Jan, 2014. The exterior of Children's Hospital Oakland on January 5, 2014 in Oakland, California. The hospital is currently involved in a legal battle over Jahi McMath, a 13-year-old girl who became brain dead after complications from surgery to remove her tonsils. The hospital has declared McMath dead and want to remove her from the ventilator keeping her alive and her family has sued to prevent the move. © Kristoffer Tripplaar/Alamy Live News
Oakland, CA, USA . 05th Jan, 2014. The exterior of Children's Hospital Oakland on January 5, 2014 in Oakland, California. The hospital is currently involved in a legal battle over Jahi McMath, a 13-year-old girl who became brain dead after complications from surgery to remove her tonsils. The hospital has declared McMath dead and want to remove her from the ventilator keeping her alive and her family has sued to prevent the move. © Kristoffer Tripplaar/Alamy Live News
(L-R) Jahi McMath's uncle Omari Sealy, grandmother Sandra Chatman and family attorney Chris Dolan react after speaking with the media outside Children's Hospital and Research Center in Oakland, California, December 30, 2013. The family of 13-year-old Jahi, who was declared brain dead after complications from a tonsillectomy won an 11th-hour court order on Monday requiring doctors to keep her connected to a breathing machine for at least another week, relatives said. Jahi's mother Nailah Winkfield and uncle told reporters that a court has issued an injunction barring Children's Hospital in Oakland from removing the girl from a ventilator without her family's consent before January 7. REUTERS/Norbert von der Groeben (UNITED STATES - Tags: HEALTH SOCIETY)
Oakland Children's Hospital spokesperson Sam Singer speaks with the media at the U.S. District Courthouse for a settlement conference in Oakland, California, January 3, 2014. Relatives of a California girl declared brain dead after complications from a tonsillectomy want her moved to a long-term care facility, but face resistance from the hospital where she is due to be disconnected from a breathing machine on Monday. Under the latest court order in the case, doctors at Children's Hospital and Research Center in Oakland are barred from taking 13-year-old Jahi McMath off a ventilator without her family's consent before 5 p.m. local time on Jan. 7, relatives and hospital officials said. REUTERS/Beck Diefenbach (UNITED STATES - Tags: SOCIETY HEALTH)
Nailah Winkfield, the mother of Jahi McMath, along with Jahi's uncle Omari Sealy (R), speak with the media outside Children's Hospital and Research Center in Oakland, California, December 30, 2013. The family of 13-year-old Jahi McMath, who was declared brain dead after complications from a tonsillectomy won an 11th-hour court order on Monday requiring doctors to keep her connected to a breathing machine for at least another week, relatives said. The mother and uncle of Jahi told reporters that a court has issued an injunction barring Children's Hospital in Oakland from removing the girl from a ventilator without her family's consent before January 7. REUTERS/Norbert von der Groeben (UNITED STATES - Tags: HEALTH SOCIETY)
(L-R) Sandra Chatman, grandmother of 13-year-old Jahi McMath, attorney Christopher Dolan and Omari Sealey, uncle of McMath, embrace each other after a court hearing in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep her on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine tonsillectomy procedure. REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
Christopher Dolan, attorney representing the family of 13-year-old Jahi McMath, wipes his eyes as a judge announces his ruling on McMath in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep her on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine tonsillectomy procedure. REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
Nailah Winkfield, mother of Jahi McMath, sits with her husband, Martin Winkfield, left, while attending a court hearing to discuss the treatment of 13-year-old daughter Jahi McMath in Oakland, Calif., on Monday, Dec. 23, 2013. Jahi remains on a ventilator at Children's Hospital Oakland after suffering tragic complications during surgery. (Kristopher Skinner/Bay Area News Group/MCT)
Dr. Paul Fisher, chief of pediatric neurology at Lucile Packard Children's Hospital, testifies during a court hearing on 13-year-old Jahi McMath in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep their daughter on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine tonsillectomy procedure. REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
Martin Winkfield (L), stepfather of 13-year-old Jahi McMath, and Sandra Chatman, grandmother of McMath, sit in the court room during a court hearing in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep their daughter on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine tonsillectomy procedure. REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
(L-R) Family members Omari Sealey and Sandra Chatman, together with attorney Christopher Dolan, smile as they speak to members of the media after a court hearing on 13-year-old Jahi McMath in Oakland, California December 24, 2013. A judge on Tuesday denied the McMath family's petition to keep her on ventilator at the Children's Hospital Oakland past December 30 after doctors declared her brain dead following a routine tonsillectomy procedure. REUTERS/Stephen Lam (UNITED STATES - Tags: HEALTH CRIME LAW)
Nailah Winkfield, mother of Jahi McMath, speaks to the media outside Children's Hospital and Research Center in Oakland, California, December 30, 2013. The family of 13-year-old Jahi McMath, who was declared brain dead after complications from a tonsillectomy won an 11th-hour court order on Monday requiring doctors to keep her connected to a breathing machine for at least another week, relatives said. Jahi's mother and uncle Omari Sealy told reporters that a court has issued an injunction barring Children's Hospital in Oakland from removing the girl from a ventilator without her family's consent before January 7. REUTERS/Norbert von der Groeben (UNITED STATES - Tags: HEALTH SOCIETY)
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A year ago, 13-year-old Jahi McMath underwent a tonsillectomy and tissue removal at Children's Hospital in Oakland, California, to treat sleep apnea. The girl suffered massive bleeding, had a heart attack and was declared brain dead Dec. 12.

Her family battled to keep her on a ventilator and to have breathing and feeding tubes surgically inserted. Under a court agreement, the family and the hospital agreed that Jahi's mother, Nailah Winkfield, could remove her from the hospital if she took responsibility for the girl's care.

A year later, Jahi remains on a ventilator and hooked to feeding tubes, and her case has ignited a debate over the definition of brain death. Here's a look at the latest:

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Q: Why does her family want to keep her on a ventilator?

A: Jahi's relatives say their religious beliefs dictate that as long as her heart is beating, Jahi is alive and deserves long-term care. In October, the family released videos of the girl showing her foot and hand appearing to move in response to her mother's commands.

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Q: Is there any scientific basis for the family's belief that Jahi is responsive and could recover?

A: Nancy Berlinger, a bioethicist with The Hastings Center, a nonpartisan research institute devoted to health and medical issues, says Jahi's body is only being maintained by machines. Others contend the family is confusing any movements with an involuntary muscle reflex sometimes seen in brain-dead patients- the so-called "Lazarus effect."

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Q: Is this case different from other high-profile instances where families have gone to court over prolonging medical intervention?

A: A Florida woman named Terry Schiavo often is associated with end-of-life legal fights. Schiavo collapsed at her home when she was 26 years old and was on life support from 1990 to 2005. Multiple doctors diagnosed her as being in a persistent vegetative state, but her parents refused to accept that. Schiavo maintained signs of limited brain activity and was able to breathe without a ventilator. Jahi is different in that doctors say her heart would stop beating if she were removed from a breaching machine because her brain stem is not functioning. The lengthy and costly campaign by her family to keep the girl's heart beating is rare.

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Q: What do other experts say?

A: Philip DeFina, chief executive of the International Brain Research Foundation, said researchers found electrical activity after conducting a brain scan of Jahi. DeFina also said blood is flowing to her brain, which remains intact despite predictions that it should have "liquefied" by now. Other experts remain skeptical and are calling for further testing by independent sources. David Magnus, director of the Stanford Center for Biomedical Ethics has said there is no evidence that patients who are brain dead can ever recover. Still, he said it's somewhat surprising her body has lasted as long as it has and that some patients can live for years on ventilators.

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Q: Where is Jahi now and where does legal action surrounding her case now stand?

A: The family says she is in a "home environment" in New Jersey with her mother and stepfather and is cared for around the clock. Unlike California, New Jersey law allows families to reject a declaration of brain death on religious grounds and allows brain-dead patients to remain connected to ventilators. In October, the family's lawyer Christopher Dolan sought an unprecedented court ruling to revoke the death certificate, arguing that new tests show Jahi has brain activity. He later withdrew his request for a court hearing, telling the judge he wanted time for the court-appointed doctor and his own medical experts to confer. No new court date has been scheduled.

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