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A Medical Judgment
Monday, November 10, 2008

THE PROGNOSIS for 12-year-old Motl Brody was never good. Diagnosed with a highly malignant brain tumor this year, Motl's parents, Eluzer and Miriam Brody, brought the boy to Washington from Brooklyn, N.Y., for what they hoped would be a miracle. In June, Motl underwent surgery at the top-flight Children's National Medical Center. He has not awakened since.

Not long after the surgery, physicians at Children's explained to Motl's parents that there was nothing else medically they could do help the boy fight the cancer or ward off death. Because Children's is an acute-care center, they urged the Brodys to take Motl home or move him to a facility where he could receive appropriate end-of-life care. Hospital staff members worked for months to try to find a suitable place for Motl, but the Brodys balked.

Observant Orthodox Jews, they believe that every effort must be made to preserve and prolong life. The kinds of facilities and hospice programs that at one point would have accepted Motl do not allow heroic measures to save a terminally ill patient. The Brodys also resisted taking Motl home or transferring him because such travel could prove fatal.

Last week, Motl was pronounced brain-dead by his doctors. According to court documents, he is unable to breathe on his own without the help of a ventilator, and his heart continues to beat only because of a trio of drugs. Children's has now gone to court seeking a judge's declaration that its physicians acted properly under District law in declaring Motl legally dead. Such a determination would allow the hospital to disconnect medical equipment from Motl's body. The Brodys are fighting back, arguing that their son is not dead under their rabbi's interpretation of Jewish law, which says that only cessation of a heartbeat and breathing constitutes death. The hospital would be in violation of the Religious Freedom Restoration Act, the Brodys argue, if it set aside their religious beliefs and denied Motl further care.

The loss of a child is one of life's unbearable tragedies, and most parents would go to unimaginable lengths to save their own. But what the Brodys have demanded of Children's Hospital is not life-saving treatment. Through their refusal to act, they have, instead, essentially coerced medical professionals into ignoring their own best judgments about Motl's condition and appropriate treatment.

A D.C. Superior Court judge was scheduled to hear the matter today, but Children's asked for a postponement until Wednesday to allow for a last chance to speak directly with the Brodys, who, the hospital claims, have not been at their son's bedside since late July. This is a decent and wise gesture, even though the law appears to favor the hospital. The two sides should try to reach an accommodation that both respects the Brodys' faith and their plight while protecting the hospital's legitimate need to make -- and carry out -- its independent judgment. Failure to reach such an accommodation would only compound this tragedy for both sides.


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