The tragic case of Jahi McMath, a thirteen-year-old California girl who was declared brain-dead three days after complications ensued from a tonsillectomy, has spawned a bevy of newspaper and internet articles penned by or including interviews of noted bioethicists. Examples include an essay by Art Caplan, head of the Division of Bioethics at New York University Langone Medical Center in New York City; commentary by Robert Veatch, Professor of Medical Ethics at the Kennedy Institute of Ethics at Georgetown University in Washington, D.C.; and an interview of John Di Camillo, Staff Ethicist at the National Catholic Bioethics Center in Washington, D.C. Unsurprisingly, no libertarian bioethical evaluations of this incident have been published. As I am a libertarian with a special interest in bioethics, it is my duty to fill this philosophical vacuum. The humanistic void I relinquish to William Shakespeare, from Romeo and Juliet:

Death lies on her, like an untimely frost
Upon the sweetest flower of all the field.

A Wikepedia entry summarizes the case: “Jahi McMath was a 13-year-old girl who suffered irreversible brain death from post-operative complications from medical procedures aimed at relieving symptoms from sleep apnea. … McMath was admitted to Children’s Hospital Oakland on December 9, 2013 … . After the surgeries were performed, McMath was conscious and recovering … . She was later moved to the ICU before she … went into cardiac arrest. … On December 12, 2013 she was declared brain-dead by doctors … and her family was informed that … she was legally dead and that life support systems would be removed. After the family petitioned Alameda Country Superior Court, Judge Evelio Grillo approved an independent second opinion. Paul Graham Fisher, the chief of child neurology at Stanford University, was appointed … and reaffirmed the diagnosis of brain death. The family appealed … to force the hospital to continue life support measures until other arrangements could be made … . … Alameda County Superior Court granted an extension to keep McMath on a ventilator until January 7, 2014, but refused the family attorney’s request for hospital staff to insert tracheostomy and feeding tubes. On January 5, 2014, Children’s Hospital released Jahi McMath’s body to the Alameda Country coroner, which then released her body to the custody of her mother … .”

As the key libertarian issue in any bioethical scenario is the property rights dispute, the question that must be answered in the McMath case is the following: The ownership of which scarce resource(s) was in contention? The scarce resource was not the body of Jahi McMath because, legally, parents are the owners of a child’s body when a child dies AND there were no attempts by the hospital or State to seize custody of Jahi’s body from the parents.

So, which scarce resource(s) was the dispute about? The brouhaha in this case was the ownership of life-support equipment [the ventilator, medications, and all other supplies the Children’s Hospital & Research Center staff were utilizing to maintain the circulatory and respiratory functions of Jahi’s body AND additional life-support equipment (tracheostomy and feeding tube appliances) the parents demanded the hospital staff add to Jahi’s body]. The conflict was the fact that the parents wanted to wrest from the hospital the ultimate decision-making authority (ownership) about the use of this equipment.

How was this situation resolved? Via a State-mediated settlement, the hospital staff agreed to not remove (but not add to) the life-support equipment already in place until the family was able to arrange transport to another medical facility that agreed to provide the medical services the parents desired. Was this a satisfactory libertarian conclusion? Yes and no. Yes, because the parents maintained control of their scarce resource (Jahi’s body) AND the hospital maintained control of its scarce resources (the life-support equipment). No, because the means the family and the hospital utilized to obtain the end was not libertarian (both enlisted the assistance of the California State legal system in the process).

In the final analysis, the Jahi McMath tragedy raised fundamental bioethical issues. A libertarian analysis of her case concludes the ends were libertarian but the means were not. Libertarian bioethics recognizes that disentanglement of property rights disputes solves nearly all bioethics conundrums.