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杰希·麦克马思病例:神经科医生的观点。

The Case of Jahi McMath: A Neurologist's View.

出版信息

Hastings Cent Rep. 2018 Nov;48 Suppl 4:S74-S76. doi: 10.1002/hast.962.

DOI:10.1002/hast.962
PMID:30584850
Abstract

From the start, I followed the case of Jahi McMath with great interest. In December 2013, she clearly fulfilled the diagnostic criteria for brain death. As a neurologist with a special interest in chronic brain death, I was not surprised that, after she was flown to New Jersey, where she became statutorily resurrected and was treated as a comatose patient, Jahi's condition quickly improved. In 2014, her family reported that she sometimes responded to simple motor commands. I shared the general skepticism regarding these reports, assuming that the family was in denial and was misinterpreting spinal myoclonus (a rapid, involuntary twitch generated by the spinal cord) as volitional. The family had noticed that when Jahi's heart rate was above eighty beats per minute, she was more likely to respond, as though the heart rate reflected some sort of inner level of arousal. So they began to make video recordings. I have been privileged to be entrusted with copies of these recordings, forty-eight of which proved suitable for assessing alleged responsiveness. All have been certified by a forensic video expert as unaltered. The first thing that struck me was that the great majority of the alleged responses were not spinal myoclonus. In fact, they did not resemble any type of spontaneous, involuntary movement described in patients paralyzed from high spinal cord lesions.

摘要

从一开始,我就非常关注 Jahi McMath 的病例。2013 年 12 月,她显然符合脑死亡的诊断标准。作为一名对慢性脑死亡特别感兴趣的神经科医生,我并不惊讶的是,在她被空运到新泽西州后,她在那里被法定复活,并被视为昏迷患者,Jahi 的病情迅速好转。2014 年,她的家人报告说,她有时会对简单的运动命令做出反应。我对这些报告持普遍的怀疑态度,认为家属否认现实,并将脊髓肌阵挛(由脊髓产生的快速、无意识抽搐)误解为自主运动。家属注意到,当 Jahi 的心率超过每分钟 80 次时,她更有可能做出反应,好像心率反映了某种内在的觉醒水平。于是他们开始制作视频记录。我有幸被委托复制这些记录,其中 48 份被证明适合评估所谓的反应能力。所有记录都经过法医视频专家认证,未被篡改。首先引起我注意的是,绝大多数所谓的反应都不是脊髓肌阵挛。事实上,它们与任何类型的自发、无意识运动都不相似,这些运动在因高脊髓损伤而瘫痪的患者中都有描述。

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The Case of Jahi McMath: A Neurologist's View.杰希·麦克马思病例:神经科医生的观点。
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