A photo of Jahi McMath shown at her funeral service at Acts Full Gospel Church in Oakland, Calif. AP Photo/Jeff Chiu
California teenager Jahi McMath, who suffered catastrophic brain injury as a result of a routine tonsil surgery, died on June 22, 2018.
Her death came after four years of her family fighting in court to continue her care in California. Eventually, they moved her to a facility in New Jersey, a state that accommodates religious views that don’t recognize brain death.
Much of the popular discussion in the case centered on the family’s refusal to accept the diagnosis of brain death. However, as a philosopher who writes on bioethics and race, I believe an underappreciated aspect of the discussion was the role of race – both in how the medical personnel dealt with the family and how the family interpreted their interactions with the medical establishment.
The surgery and outcome
On Dec. 9, 2013, the 13-year-old McMath entered Children’s Hospital and Research Center in Oakland, California, for what should have been a routine tonsillectomy. The young girl was, according to her mother’s account, frightened that something would go wrong. Her mother reassured McMath that she would be okay.
McMath’s post-surgical complications began about an hour after her surgery. A nurse provided a bin to catch the blood that McMath had begun spitting up. Although the nurses indicated to the family that some post-surgical bleeding was normal, two hours later, McMath’s blood filled two plastic bins and the bandages packing her nose were saturated with blood. Her hospital gown was also covered in blood.
According to the family, four and a half hours passed before a physician saw her, despite the family’s repeated pleas for intervention. The hospital has maintained that they can not discuss Jahi’s case in detail because of privacy laws. Bleeding complications, though rare, can occur after tonsillectomy because tonsils are near arteries.
As a result of the immense blood loss, McMath’s heart stopped and her brain was deprived of oxygen. Three days later, on Dec. 12, 2013, the medical staff at Children’s Hospital declared McMath brain dead. Hospital personnel encouraged the family to withdraw life support and donate her organs.
McMath’s family refused to accept the diagnosis, and a court battle to keep McMath on life support ensued.
A judge in California initially ruled that McMath could remain on life support until Jan. 7, 2014. However, the Alameda County coroner issued a death certificate anyway.
A 2015 photo of Jahi McMath is shown on a video screen next to her uncle Timothy Whisenton. AP Photo/Jeff Chiu, File
Philosopher Jeffrey P. Bishop, who holds the chair of health care ethics at Saint Louis University, writing in Harvard Divinity School bulletin noted the ethical oddities of the case. In California, once two physicians confirm brain death, the patient is legally dead. The body is then technically released to the coroner before being released to the family so that they can make arrangements. In the case of McMath, she was still in the hospital and on a ventilator when these procedures kicked in.
From the beginning, the case was tangled up with all sorts of questions regarding the nature and diagnosis of brain death. Although there are long-established criteria, how brain death is determined in practice can vary. These differences in practices can contribute to confusion, particularly among the lay public, about brain death.
Her family rejected the brain death diagnosis alleging the hospital had a conflict of interest and simply wanted McMath’s organs.
Revisiting a history of medical racism
Rather than dismiss the family’s concerns as paranoid or ignorant, it is important to understand the historical realities faced by black patients in their encounters with the U.S. medical system.
There is a long historical record of using African-Americans for medical experimentation. For example, medical experimentation performed by J. Marion Sims, “the father of modern gynecology,” highlights the medical establishment’s disregard for black people.
Sims, who began conducting his gynecological experiments in the 1840s, is credited with developing a surgical procedure to repair vesicovaginal fistula, a hole that develops between the vaginal wall and the bladder, resulting in incontinence. However, Sims achieved his success by experimenting on enslaved women, often without anesthesia.
Sims wasn’t the only one. During the 19th century, medical schools used both enslaved and free black people, often without their consent, to teach their white medical students anatomy, disease progression and diagnosis. This practice continued after slavery.
Additionally, the graves of African-Americans were robbed and their bodies disinterred so that medical students could use black bodies as cadavers. Aware of these practices, African-American communities were deeply suspicious of local medical schools and unsure whether the medical personnel were actually “treating” them or merely “experimenting” on them.
Few examples of the abuse of African-Americans in medical experimentation loom larger than the Tuskegee syphilis experiment – a 40-year-long study of disease progression of syphilis in 600 men in the Tuskegee, Alabama, area that began in 1932. The study was sponsored by the U.S. Public Health Service.
None of the 399 men who had syphilis were ever told of their diagnosis. Nor were these men or their partners treated with penicillin once penicillin became the standard treatment for syphilis in 1945. In 1997, President Bill Clinton issued a formal apology on behalf of the U.S. government to the eight remaining survivors of the Tuskegee experiment.
President Bill Clinton apologizes to black men whose syphilis went untreated by government doctors. AP Photo/Doug Mills
One presidential apology, however, could not erase the sense of mistrust that many African-Americans feel toward health care institutions.
And the medical injustice continues: There are wide gaps in outcomes between whites and African-Americans in a variety of diseases. For example, the American Cancer Society reports that, of all the racial and ethnic groups in the U.S., African-Americans, are more likely to die from most cancers.
Lower quality of care?
African-Americans also report lower quality of health care and greater dissatisfaction with the care they receive. In addtion, they are significantly more likely to report experiencing racial discrimination and negative attitudes by health care personnel than non-Hispanic whites.
Medical mistrust and the resulting dissatisfaction have been connected to patient anxiety, as well as lower engagement in health care decision-making between patient and provider.
This mistrust makes African-Americans less likely to use the health care system. Along with other factors, such as limited insurance status and greater geographic distance from health care providers, it contributes to disparate health outcomes.
It is against this backdrop that one must understand the McMath family’s skepticism regarding both her treatment and diagnosis.
“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.”
Nailah Winkfield, the mother of Jahi McMath, speaks next to husband Martin Winkfield during funeral services for Jahi. AP Photo/Jeff Chiu
Sadly, Winkfield is not alone in her suspicions.
It is possible that the ultimate outcome might still have been tragic. Even with the most attentive care, McMath might have died. However, the family feeling that the medical team did not do all that they could have done for their loved one, and that this, for them, was a function of race, needlessly inflicted additional injury.
Now this may not be for everyone, but for me these are 10 non-negotiables that have led me to a pretty awesome relationship. I know some of you will immediately notice I didn’t put “faith” as a bullet point, but sometimes I think we spend more time looking for superficial religious clues than we do for signs of character and integrity. Yes, he needs to be a man who has faith in God, but the quality of his faith is more likely to be found in how he treats you and others rather than the church he attends. So, check out these 10 tips for finding a good guy, then let us know if you agree — or disagree.
1. He Was a Good Guy When You Met Him
Now ladies, please read this twice. You cannot make a bad boy a good boy no matter how hard you try. Every time you tell yourself that lie you should slap yourself and read this article. No, but seriously, stop trying. Please! Your happiness depends on it. Have you ever looked up and said what on earth am I doing here? I should have, would have, could have …! I’d bet my 401K that it had something to do with a guy … a bad guy.
2. His Kindness Holds Up Under Pressure
It’s easy to be a nice guy when you get your way, but the ultimate test comes when you have a right to “go there.” However a man treats the people around him, he will eventually treat you. You don’t want a man that is just nice to you, or disrespects other women but treats you differently. As soon as you tell him no, you’ll be on the bad end of his personality. Easy things to observe: how he deals with an aggressive stranger, how he deals with a family member he doesn’t get along with. How does his personality hold up when he disagrees with you?
3. He Offers to Help Others When There’s Nothing in It for Him
This is the best selfishness indicator. Does he help people simply because they need help, or does he look for ‘I Owe You’s’? When he does a nice gesture for you, does he expect you to return the favor? His motivation should be based solely on a desire to make you happy.
4. He Feels Honored to Be with You
So many men attempt to make women feel that they are lucky to be with them, but this should definitely be the other way around. I know some men would contest that statement, but it’s true. Honor me and I will honor you. When two good people get together, no ones needs are unmet; you both reciprocate equally. His manhood isn’t diminished by telling you how beautiful, intelligent, and strong you are – that’s what he loves about you.
5. He Inspires You to Be a Better You
His goals, achievements, and motivations encourage you to stay on track with your God-given destiny. He doesn’t hesitate to encourage you when you are down. You are proud of him, and he is equally proud of you. He challenges you to overcome your insecurities instead of giving more reasons for you to be insecure.
6. He’s Not in Competition With You
Do you feel like you have to prove yourself to him in order to earn his respect? Does he get jealous when men recognize your beauty? Some relationships can feel more like a competition than a mutual support system; you compete over careers, intelligence, or even physical fitness. Don’t let your competitive nature convince you that this endurance test is worth winning. A good relationship is not a competition; it’s a partnership.
7. He Has Personal Ambition
It’s far too easy to get distracted by income when looking for a good man. Many men have become pros at the illusion of security. The truth is, a wealthy man can lose his money and a poor man can stumble across a fortune. The best way to avoid superficiality and navigate these choppy waters is to make sure the guy has passion and a plan. You also may want to check his motivations; a good man will feel his destiny driving him, and will know that God has given him that vision. The proverb tells us, “Where there is no vision, the people perish.” Consider this sound advice for romantic relationships as well. How can someone who is going nowhere and doing nothing inspire you to be anything? Usually, those men are only professionals at destroying confidence.
8. He’ll Do Something Just Because You Want to Do It
Let’s face it; sometimes we are selfish, and that’s okay. Sometimes he’ll want his way and you should give it to him. Why? Because he has treated you like a prize and he deserves it. The same goes for us ladies. We all know relationships are give and take, but unfortunately often when it’s time to give there’s often some person WITHOUT a significant other that is telling us not to. A good man could care less about peer pressure; he knows what he has and knows you deserve to have your way sometimes.
9. He’s Confident in Who He Is
You don’t want a man that constantly needs encouragement or is preoccupied with proving himself to everyone he knows. By this point he should have resolved the major issues (if any) of his past. If he’s still “complicated,” wait until you find something simple, because your relationship deserves peace! A good guy knew who he was before he met you.
10. You’re Happy!
I saved the best for last. One of the greatest indicators that we often ignore is our happiness and our peace. If you argue all the time, or you feel like things will get better in time, he isn’t the right guy for you. This is a hard pill to swallow, but it’s good medicine! Besides, what’s the point if you’re not happy? There are a lot of things in your life that you can’t control, but when it comes to a relationship this should not be one of them. Do yourself a favor and not only find yourself a good guy, but find the good guy that makes you happy.
We all make excuses and exceptions, but I would encourage all you single ladies to consider your past relationships and see if there’s a trend. It’s never too late to elevate your standards.
It makes a certain kind of sense that some white evangelicals voted for Trump instead of Hillary Clinton in the general election because they objected to Clinton on abortion and other issues. It does not, however, make sense that many of these same voters supported Trump as early as the primaries when there were experienced evangelical candidates still in the race.
How did this realignment happen in American religion and politics? Or is it even a realignment?
John Fea has recently written the book Believe Me: The Evangelical Road to Donald Trump, which takes a deeper look at how this fits into nearly two centuries of white evangelicals’ history. Fea, a historian at Messiah College, traces it to three things: fear, power and nostalgia.
Religion News Service interviewed Fea about the book. His responses follow.
San Diego, California, USA – May 27, 2016: An African American woman holds high a sign reading “We are all women” at an anti-Trump protest outside a Trump rally in San Diego.
Of the three elements you highlight, you start with fear, saying that white evangelicals’ embrace of Donald Trump stems out of their long history of being afraid of certain kinds of change. So did you see his victory coming?
No. Frankly, I was so caught up in the moment myself that I kind of lost my historical sensibility for a month or two. It wasn’t until the emotions died down that as a historian I began to see the pattern, the continuity. This is not new.
At every moment of social, cultural or demographic change in history, there have been Americans who have felt threatened, and have responded with fear. Almost every time that happens, evangelicals seem to be at the forefront of the backlash to change. For example, when Catholic immigrants start arriving in the country in the 1840s and ’50s, it’s evangelical Christians who are fearful about a change taking place in their Protestant nation. Or when slaves rebel in the 19th-century South, there becomes this great fear of slave rebellions, which prompts evangelicals to promote slavery in their writings.
So white evangelicals see Trump as a strongman who will protect them from their fears? He seemed very adept at stoking those very fears.
It’s not that the other GOP candidates didn’t also appeal to fears. Ted Cruz was one of the biggest fearmongers that there was. But somehow Trump managed to convince voters that he was stronger and better at protecting them than these other candidates.
I think this gets at why evangelicals turned to Trump when there were other, more traditional Christian conservative candidates in the race, like Cruz or Marco Rubio or Ben Carson.
Your second point is that white evangelicals have bought into the idea that the only way to have an impact on the culture is to seize upon worldly power. What were the roads not taken? What else could they have done instead?
The history of American evangelicals appealing to political power is a relatively new history, maybe going back to the late 1970s and 1980s with the rise of the Christian right. I argued in “Was America Founded as a Christian Nation?“ that evangelicals had been in power in America up until the 1960s in terms of determining what would be America’s cultural symbols, understanding of marriage, and position on other social issues. It’s not until those traditional values become challenged in the 1960s that evangelicals begin this new strategy of pursuing political power as a way to reclaim the culture.
Since the 1960s, there have also been some evangelical approaches to politics that are unrelated, or do not call for the pursuit of political power, like James Davidson Hunter’s idea of “faithful presence” or Michael Gerson’s call for evangelicals to learn more from Catholic social theory. Or there are Dutch Reformed people who are followers of Abraham Kuyper, who did not advocate seizing political power in the way the Christian right wants to do. And since the early 1970s, people on the evangelical left, like Jim Wallis and Ron Sider, have called for a different kind of evangelical power. But the right refuses to adopt any of these models, and has instead built their entire political philosophy on changing the culture by trying to elect leaders who will follow their agenda.
Your third point is that white evangelicals voted for Trump because of nostalgia. “Make America Great Again” is a slogan custom-built for white people, men especially. For the rest of us, the past really wasn’t so great.
I think a lot of people, when they hear “Make America Great Again,” tend to focus on the word “great.” But as a historian, I’m immediately attracted to the word “again.”
If white evangelicals are going to embrace that slogan, I think they at least have to articulate: When was America great? What golden age do they want to return to? The 1980s? The 1950s? So as a historian, I want to think more critically about the phrase “Make America Great Again.” First identify which period they mean, and then look at the period in more depth. Who was benefiting in that period, and who was not included?
Race is at the heart of this. I ask my African-American friends, “What is the best time in American history to live?” and they say, “Right now!” No African-Americans want to go back to a previous era.
You’ve coined the phrase “court evangelicals” to describe religious leaders like Robert Jeffress and Paula White who have cozied up to Trump. What do you mean?
I was struck by the fact that Trump created an evangelical advisory council, which he did not do for any other religious group. When religious leaders invest in political power in that way, it becomes very difficult for them to speak with a prophetic voice to the political leader they are hoping is going to champion their views.
So as I watched many of these evangelical ministers visiting the White House for photo ops with the president, then sharing these photos on Twitter and boasting about the “unprecedented access” that they had to the president, all of this reminded me as a historian of the Renaissance-era priests and other courtiers who came to the king’s throne to flatter him and praise his greatness. They did not speak any kind of prophetic critique to the king — they were there for selfish reasons, to get in his good graces. So I worry when evangelical ministers like Paula White, Jerry Falwell Jr. and Robert Jeffress praise Trump as the most Christian president we’ve ever had. This has the potential of weakening their credibility among people who may actually need to hear the good news of the gospel, the good news of Jesus Christ.
Finally, you dedicate your book to the 19 percent of white evangelicals who did not vote for Trump. What do you want to say to them with this book?
I dedicate the book to the 19 percent not because they’re my primary audience, but because they seem to have seen through Trump. They’ve made a decision that Trump is not good — not just for the nation, but also for the church. So I hope the book might provide some history and arguments that the 19 percent can offer to their evangelical friends who did vote for Donald Trump and are having second thoughts, or are at least open to further evidence and dialogue. But my main audience, I think, is those evangelicals who voted for Trump who are open to reason and evidence and historical arguments that may suggest electing Trump was a bad idea.
