Hospital keeps pregnant, brain-dead woman alive, contrary to husband’s wishes

Fascinating, and sad, story out of Texas.  A man is suing a hospital in order to force them to take his pregnant wife off of life support.

Erick Munoz found his wife Marlise unconscious in their home on November 26, 2013. She was immediately put on life support, where she remains to this day.  At the time, Marlise was 14 weeks pregnant.

The woman is brain dead, and her husband’s lawyers say that under Texas law, Marlise is legally dead.  They also say that Marlise made clear to her husband, prior to falling ill, that she would not want to have life support continued in this type of situation. The husband and her parents want the hospital to remove life support.

The hospital, on the other hand, says that they are required to continue treatment to a “pregnant patient” under Texas law. Here’s the law in question:

Sec. 166.049. PREGNANT PATIENTS. A person may not withdraw or withhold life-sustaining treatment [procedures] under this subchapter from a pregnant patient.

The husband’s lawyer respond that the law applies to living patients, not dead ones.  Interestingly, both Erick and Marlise Munoz are paramedics, so they’re not unaware of medical decision making.

Complicating things further, the condition of the fetus, according to AP, is “unclear.”

There are a number of interesting questions here:

1. Could the couple have sought an abortion under Texas law at 14 weeks of pregnancy? (More on that below.) If so, then isn’t that really what the husband has been asking for, and as the person in charge of his wife’s medical decisions, did he not have the right to request this immediately?  And the same question applies to the age of the fetus now.

2. Would the wife have wanted to terminate the pregnancy under these conditions?  It’s one thing to say that she indicated she would not like to be kept artificially alive if brain dead.  But I doubt the couple had a discussion about being brain dead and pregnant.  Let’s assume they didn’t have that discussion, for argument’s sake.  Does that change things?  Does that make her consent about being on life support less applicable to the current situation?

What’s also interesting is that under the official state of Texas DNR (do not resuscitate) advanced medical directives, the form is void if the patient is pregnant – I found a Texas DNR online, here’s what it says:

AUTOMATIC REVOCATION: An OOH-DNR Order is automatically revoked for a person known to be pregnant or in the case of unnatural or suspicious circumstances.

The Munoz’ did not have a DRN.  But this does seem to suggest that under Texas law, if you’re pregnant, you don’t get to remove life support.  But again, the husband’s legal team is arguing that the woman is dead, and that the law did not anticipate applying to dead people.  But is that really true?  Isn’t this exactly the type of situation that a DNR applies to, where someone suffers a catastrophic illness and cannot recover and/or is brain-dead?

And I found a bit more about Texas abortion law from an earlier article about this couple:

Then you have the uncertain legal standing of the fetus. On the one hand, Supreme Court precedent dictates that a woman has a constitutional right to an abortion pre-viability (Texas recently moved its threshold to 20 weeks), meaning it’s not considered a person under the law, meaning that, at 14 weeks, Munoz’ fetus wasn’t legally considered a person. On the other, Texas laws suggest otherwise, including the aforementioned advanced-directives rule and criminal statutes that treat the death of a fetus at any stage of development as murder.

The analysis seems correct.  You can’t tell a couple that under Texas law they can abort a fetus at 14 weeks, but if they try to remove life support from the mother, and thus terminate the fetus at 14 weeks, they can’t because it’s illegal to terminate a fetus at 14 weeks.  Either the family has the right to terminate the fetus at 14 weeks or they don’t.  It looks like the Texas legislature, whether intentionally or not (likely intentionally), tried to find a way to further undercut the right to choose.

And to make things even more complicated, the county-operated hospital in question is located in a conservative part of Texas, and the hospital banned abortions on its premises in 1988.  Thus raising the issue of how much leeway we should give hospitals on a myriad of issues.  As this case shows, you can’t always choose what hospital you end up in, certainly during an emergency. So when hospitals limit choices, it puts real people in danger of losing their rights.

I’m curious if the family tried to have Marlise moved to another hospital, one that’s more amenable to their wishes, and whether the current hospital could say or do anything to stop them from moving her.  It’s none of the hospital’s business why or where I move my family member, providing the family member is well enough to be moved (and it’s not like Marlise’s condition is going to get any worse – though perhaps the hospital would allege that the move would be too dangerous for the fetus).

As an aside, I’ve been unable to find any news stories explaining why the family is against keeping Marlise on life support only until the child can be born.  If it were my child, and my spouse died, I suspect I’d do everything I could to save the child/fetus.  One story did mention that while the doctors found a heartbeat for the fetus, they don’t know how long it might have gone without oxygen while the mother was unconscious.  So perhaps the family is concerned that the fetus likely has severe brain damage, and that’s a legitimate concern.  This may not be relevant to the legal question – either they get to make the decision or they don’t – but as a human interest story, which this is, it would seem an obvious question that the media failed to ask.

What do you think?  In view of the facts, and questions, I raise above, is this solely the husband’s decision?

(I’m told that in order to better see my Facebook posts in your feed, you need to “follow” me.)

Follow me on Twitter: @aravosis | @americablog | @americabloggay | Facebook | Instagram | Google+ | LinkedIn. John Aravosis is the Executive Editor of AMERICAblog, which he founded in 2004. He has a joint law degree (JD) and masters in Foreign Service from Georgetown; and has worked in the US Senate, World Bank, Children's Defense Fund, the United Nations Development Programme, and as a stringer for the Economist. He is a frequent TV pundit, having appeared on the O'Reilly Factor, Hardball, World News Tonight, Nightline, AM Joy & Reliable Sources, among others. John lives in Washington, DC. .

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  • LaSargenta

    As far as the idea of transferring to another hospital: In theory that would be straightforward; however, I have encountered a couple of anecdotes (yes, not data, just ‘people I know’) who disagreed with their standard of care and what the doctors were forcing them to do and they left their hospitals and went to others. Both of these people are women, both were pregnant, both received visits from CPS *and* police for endangering a fetus even though they gave birth to healthy babies elsewhere. One was going to be forced to have a caesarian section (major surgery, best avoided, amazingly common in the USA…probably because it results in huge invoices…and healing from it is prone to complications and severely interferes with the nursing — imagine having a big, healing incision on your abdomen and trying to hold a baby against there while they nurse), the other was being treated like crap and accused of drug use — we all suspected it was because she’s not well-off (to say the least) and lived off-grid (in a very cozy, functioning house, tyvm) and was a latter-day hippie.

    Transferring to another hospital for diabetes or heart treatments and tranferring to another hospital when there’s OMG IT’S A BAAAAAAAAAAAAAYYYYYYYYBEEEEEEEEEEE involved are two completely separate things.

  • Jewel Markess

    Read the comment below ” “To add insult to injury, Gila Medical Center attempted repeatedly to
    bill Mr. Eckert for the sadistic and medical malpractice inflicted upon
    him against his will.” — this is why the hospital is keeping this up. He has another child, and he is getting billed for the millions of dollars, he isn’t allowed to bury his wife, when there is very little chance the baby will survive. Her parents are with him on that. You are a hypocrite.

  • Jewel Markess

    The fetus has a heart beat because the mother is on a ventilator and has a heart beat. It’s a mechanical function. It doesn’t mean the fetus has a functioning brain.

  • Jewel Markess

    Who is paying for it? It must cost over a million dollars to maintain her. No insurance pays for dead people. So if you were the one presented with this type of bill, would you still want to keep your dead loved one when there is a good chance the baby is brain dead? She was without oxygen for over an hour. As to “people ready to love this baby” – where will these people be if the baby is severely brain damaged. Oh, and will these people pay the medical bills this baby has already occurred? You are so quick to judge and to take someone else’s baby – as long as it doesn’t cost you anything and the baby is healthy (which is unlikely).


    “As an aside, I’ve been unable to find any news stories explaining why the family is against keeping Marlise on life support only until the child can be born.”
    I read that Marlise and her husband, both being EMT’s, had decided against life-support for themselves. He says he is honoring her wishes but did the subject come up again, after she already had a baby and was pregnant again? Regardless, she did not become his property after they married. Likewise the baby, a separate human being with separate DNA, is not his property either. The State of Texas should make the baby a ward of court giving the family the right to adopt if they change their mind. There are people ready to love this baby, even if (which I doubt) the baby is disabled. (see my note 6″ before). The Black Pro-Life Coalition are holding a vigil outside the hospital. African Americans, are keenly aware of the implications for rule by those who think humans can be owned.


    The baby has had a heart beat and would have been sustained as long as oxygen was in the woman’s circulation. A young woman like that could have had a heartbeat that was imperceptible on the scene unless the father had a cardiac monitor in his possession. On another site I mentioned that I personally took care of a woman whose body held a viable child. A Christian medical transport team, at no charge, life-flighted the woman’s body to a major medical center, where at 28 weeks the baby was born by c-section. Several months later the grandparents brought the lively and sociable boy back to see us. We (most of the nurses were pro-choice) were all overjoyed to see him.
    Though I have heard many discussions among medical people regarding life-support, I never heard the “but what if I’m pregnant?” scenario brought up. Mr. Munoz and extended family are overwrought and should not be making decisions about the baby who was a separate human since conception with all the genetic information that will be present in his maturity. If he has male genitalia it is clear he is not part of the woman’s body. Nothing can hurt her now. It is the mental health of the family that is suffering. The pro-choice people rushed to the side of these poor people because THEY ARE AFRAID THE BABY WILL BE DECLARED, BY LAW, A HUMAN BEING.

  • K_L_Carten

    The hospital would HAVE to eat the cost. If she isn’t insured because she is dead, and the husband and her family wants the plug pulled. The hospital said no we won’t pull the plug. My first thought is, I WOULDN’T pay it was the hospitals choice to continue life support. Just love those republicans, where less govt means the exact opposite especially if it’s dealing with someone’s sex life or a fetus. Once the kid is born, its all about personal responsibility and the only handout is for the rich or corps.

  • lynchie

    Well I think it is a given that we continue to pay more and more for content on line. Soon you will pay extra for anything someone deems x rated or filtering the news as they do on the network channels. We lost control of our government the “government for the people by the people” horseshit is gone for ever. Some 20 something can ban you from a site or limit your access all in the name of making some other asshole a little richer.

  • Drew2u

    Depends on what your ISP lets you see, according to the new rules of the internet now that Net Neutrality is dead.
    I have no realistic hope that people are going to get angry about it and are fine with segregated internet content as controlled by not you, not the websites, but by your provider.

  • I feel the same way. I’d eliminate probably 95% of the channels on the list, starting with Faux News, home shopping, and every single Christian faith channel.

    Honestly though, after a couple days now, I find I prefer WeatherNation. I tune in, I get a comprehensive nationwide weather report in 10-20 minutes tops.

  • lynchie

    You can probably get the same information on Youtube which doesn;’t cost anything.

  • lynchie

    Actually the replacement weather service is just the weather which the Weather Channel used to be now they are Coast Guard Reality, naming every winter storm and scaring the bejezzus out of the elderly. I am a direct tv subscriber and dont have a problem with losing them and getting a real weather service as a replacement. What I would like is to pick the channels i want to watch and just pay for them, I don’t need the 8 to 10 full time religious “send in your money” channels or the local channels abc, cbs etc.

  • lilyannerose

    Been trying to backtrack for the article I read a few days ago specifically naming one of the right to lifer fanatics being on the hospital board and he’s turned this case into something compatible to his own right to life agenda. As the father is not sure for how long the wife was without oxygen I’m sure this is just a real nightmare for him. Undoubtedly the insult to injury will be when he gets presented with a hospital bill. Don’t know why they haven’t had her transferred to another hospital where time of death will be called and this nightmare ended.

  • annatopia

    i’ve been following this story closely as this is happening in my county. texas law actually does not require that marlise be kept alive, because the law only applies to living persons. the hospital is mis-interpreting the statute. if a patient is dead the hospital has no right/obligation to continue artificial life support. marlise has been declared dead; that is the crux of the issue and the family’s lawyer is right. the husband is supported by her family, who insist that marlise would not have wanted to be kept alive artificially. they were both in the medical field and her wishes were clear.

    this is just a very tragic case. as to the fetus, you are right when you state that it is probably irrevocably damaged. the hospital in this case is forcing this family to endure unbelievable pain. i can only imagine how heart wrenching it must be to want to bury your spouse and not be able to, and beyond that, to potentially have a baby born that will either be severely handicapped or destined to die shortly after birth. i can’t believe the hospital is forcing this family into this situation. it must be agonizing. and i don’t judge them for whatever decision they want to make. this is a private matter that is being turned into an issue because the hospital is mis-interpreting the statute. just a tragedy all around.

  • Caroline Abbott

    If she is indeed dead (and brain dead is dead), her body is necrosing. Tissues are decaying, even as the respirator and administered nutrition/hydration are supplied to her corpse. A fetus might be able to sustain growth for a short period under this situation, but not for the weeks remaining before it becomes viable.

    It is unethical to continue medical measures when a person dies. Has Texas a law against mutilating or desecrating a corpse?

  • I agree……………

  • Whitewitch

    Perfectly stated and I could even “hear” the affection in your post of the love you have for this task. If only all of us could embrace the world in such a clear and focused way. Well said StraightnotNarrow!

  • And if Mrs. Munoz was up and walking around, pregnant, they’d also just as happily let her starve.

  • Whitewitch

    Hi SkippyFlipjack, this is a great opportunity for all of us to have this discussion with our companions. After a few weeks, ask her to write down what she would like. I am counting my my husband to do for me the same, oh gosh I would be tortured if I had to lay still for any length of time without a book or some amusement…and my husband knows it. I am taking this opportunity to put everything in writing, so that my husband know exactly what I want. His beliefs are different than mine, I believe he would be okay with me on support so he could visit regularly, and I know that he does not want his plug-pulled, so we have agree to do what the other one would like done…irrespective or our own beliefs. It is hard conversation – but a good one to have. You are a good hubby to be concerned.

  • There is that, too, and I agree. My wife and I both know where our durable power of attorney and DNR paperwork is located at all times.

  • Whitewitch

    Will is the word to use here. Insurance ceases when a body is declared dead, and who else is there to pay?

  • Whitewitch

    I so totally what to upvote you Karmanot, but I can not because it is sooo horribly true and sad.

  • Whitewitch

    The most important detail is that this husband and wife made a pact, that pact is a sacred commitment to most couples, that pact was to not keep a deceased person on support.

    The fetus is out of play here, it is not sentient, it is not even alive, outside its host, it would cease. It is really about the pact between two people who clearly loved each other.

    My husband and I have such a pact – I believe he will follow through, even though he does not believe it is the right decision, he will because it is my decision. Mine….as it is Mrs. Munoz’s.

  • Drew2u

    Yeah, the doc went over everything with me when I went in freaking out because there was a lump in my throat. They gave me a quote on the price and I said, “Nope!”
    I just recently got my 4 wisdom teeth pulled and am recuperating from that, so yeah, I’m familiar with the risk forms. I took no gas for my teeth because when I can afford to go in for the throat-surgery, I didn’t want to use up my Nos insurance for the year.

  • Whitewitch

    As an aside, I’ve been unable to find any news stories explaining why the family is against keeping Marlise on life support only until the child can be born. If it were my child, and my spouse died, I suspect I’d do everything I could to save the child/fetus.

    It is NOT your fetus (this is not a child by any measure), nor your wife/companion, John. What goes into his decision making is NONE of our business. His wife is NOT an incubator, here to serve only as a hatchery for children. I can think of nothing more HORRIFIC than having a dead woman used as a hatchery. That is one horrible slippery slope that you can read about in a Handmaidens Tale, and which I would grieve to see become reality.

    As an aside, John, I am a mother, a woman, and have taken other children into my home to help raise and love…children are wonderful….as a woman who considers herself an “Earth Mother”, I would be horrified if my husband keep my DEAD body going to hatch a fetus.

    I have such strong feelings about this – that I had to really think about this post, that said the bottom line is that It is the loving husband, of this departed woman, who gets to make the decision. I suspect that it is beyond hard for the husband….and sad, really really sad.

  • Drew2u

    They had one of their shows dedicated to how the plant regulates its temperature and it was fascinating – that acid rain eats into rocks but the acid-part stays on the minerals, leeched from the H2O, and isn’t cycled back into the water/air.

  • docsterx

    Exactly. Those who want to do anything to keep the Munoz fetus alive would happily let it starve just after it took its first breath. And they are leading the troop that is screaming over the money spent on the Jahi McMath case, even though what ever insurance the family had probably stopped all coverage as soon as she was declared brain dead. I think that’s why her family ran a funding campaign to get enough money to transfer her body to the current “hospital.”

  • Drew2u

    Oh I don’t disagree. I just don’t have the health insurance to afford it. I priced it for out-of-pocket payment before and it’s cheaper for me to fly to Europe for a week and get it done over there than to have it done at the closest clinic, 20 miles away.

  • Drew2u

    I’m using the battle between DirecTV and Weather Channel as an example of what could happen with websites. Want access to eBay or Amazon? Well since they’re blacked out, you’ll have to switch providers or purchase a more expensive internet package.

    As for TWC its self, it’s the only station that’s covering climate change and it’s impacts.

  • docsterx

    I’ve heard some possible reports from people who allegedly were in the unit where Jahi McMath was recovering post-op. If true, some of the complications may have been caused by the family itself. Though it is impossible to say just based on what the family and their attorney have said. The hospital is not officially releasing any information. So there may have been problems with the surgery or post-op period attributable to the staff or the actions of the family.

    Even though all surgeries do have risks, I believe that Jahi McMath had more than just her tonsils and adenoids out. Her surgery was more extensive than that. Also, there may have been additional complications because of her weight. Your doctor would go over the risks for you before any surgery.

  • Doubly ironic is the fact those on the side of spending millions to keep this one body alive are the same who would insist on no health insurance or medical care for the indigent — and who also complain about the supposed tyranny of the government interfering with people’s most personal decisions.

    But then again, for the reactionary conservatives, when it comes to regulating sexuality and women’s bodies, any notion of personal liberty goes right out the window.

  • Actually, I checked out the replacement station, WeatherNation, and it’s not bad. Nothing but weather reports.

  • ‘Can’? I’m sure the hospital will. Mr. Munoz is looking at inevitable medical-bill bankruptcy.

  • docsterx

    I posted a link to a paper above. Yes, some fetuses have apparently developed normally in brain dead women. But there was no long-term follow up to see how “normal” they may have been at a later date.

  • docsterx

    I think that it’s very bizarre that both Texas and the hospital would be so willing to use a dead body as an incubator for a fetus. Especially in light of the fact that both the (now deceased) woman and her husband want the life support (which is an oxymoron in this case) terminated. Additionally, the hospital is presupposing that the fetus is still viable. That may or may not be the case after the anoxic episode that caused Marlise’s death. There is a study that shows that some fetuses of brain dead women can survive and be delivered. In the study, about 2/3s were successfully delivered. Some had congenital problems and none was followed very long. So for anyone to make a statement that the fetus is, or is not, definitely viable, just isn’t supported by evidence. What may happen is that the cadaver is supported for several more weeks, then a C-section is done to deliver the fetus. Then, if the delivered fetus needs extensive care (almost certainly a stay in a Neonatal ICU) and perhaps much more treratment, who will be responsible for the fees? I’m assuming that, since Mrs. Munoz has been declared brain dead that no insurance company will be paying any money for any of her care after she was declared dead. Will the hospital write off the debt? Will Texas, in the form of its taxpayers, pay for it?

    John cites Texas law; Sec. 166.049. PREGNANT PATIENTS. A person may not withdraw or withhold
    life-sustaining treatment [procedures] under this subchapter from a
    pregnant patient. I agree that this doesn’t apply here. Marlise isn’t a pregnant patient. Patients are living. Marlise is, very sadly, deceased and as such, is not covered under this law.

    The same holds for this: AUTOMATIC REVOCATION: An OOH-DNR Order is automatically revoked for a person known to be pregnant or in the case of unnatural or suspicious
    circumstances. Marlise is no longer a person, she is dead. And, since she has been pronounced dead a DNR order is irrelevant. DNR means “Do Not Resuscitate.” Corpses aren’t eligible for resuscitation and by definition, cannot be resuscitated.

    I think that the coroner’s office needs to be consulted for its opinion (as it was in the case of Jahi McMath (below)). As a cadaver, what happens to Marlise’s body is up to the coroner. Also, I agree that the husband needs to try to get the body moved out of the hospital. I’m sure that the hospital will try to block the move, but I think that a transfer can be undertaken without undo risk to the fetus.

    No one has mentioned whether or not Marlise is an organ donor. If she is, based on her physiological condition, and what the coroner’s office decides, she may be able to serve as as donor and thereby help a few other people. My guess is, that the longer she is maintained in her current condition, the less likely it will be that her organs can be used for transplant.

    As to why her husband is willing to terminate the pregnancy, I can only guess. But, since they both were paramedics and both have DNR orders, I think that it’s a matter of respect. When a family member entrusts her spouse with this task, she assumes that he will carry it out. She will, of course, not be able to be active in having support removed. She trusts him that he will follow her wishes. He may feel that the promise that he made to his spouse is of primary importance to him. Indeed, it may be the very last gift that he can give her.

    I agree with Straightnotnarrow below, this decision, to terminate support is something that the lady and her husband have decided mutually. Her physicians and the hospital need to support them and carry out those wished. To do otherwise is unethical and repulsive.

    (You may want to contrast what’s going on here re: brain death and what’s going on in the Jahi McMath atrocity in California ( )

  • I get that there’s an ethical/moral debate to be had here, but there’s one detail missing from the account: If Mrs. Munoz was unconscious and in a state of cardiac arrest long enough to suffer brain death, in all likelihood the fetus — being rather more delicate — is also probably damaged irrevocably.

    That’s the reason the family wants to terminate life support. It’s not some cruel throwaway or casual decision on their part, but they were advised by the doctors that the chances of a healthy baby are next to nil.

    The tragic irony is Texas law will require that millions of dollars be spent — which Mr. Munoz certainly does not have — to keep this brain-dead body functioning, until the almost inevitable miscarriage or life-threatening infection happens (the usual results in these instances) — yet they refused to expand Medicaid coverage and have banned funding for the family planning clinics which could help thousands of other women have healthy pregnancies.

  • PeteWa

    how is this fetus going to survive in a body that no longer produces hormones to keep the gastric systems, immune functions and the kidney running for more than a week?
    not to mention the various hormones associated with pregnancy itself.

    they’re going to have to have that husk hooked up to a dialysis machine and pumped full of hormones and antibiotics, fighting an insane battle against the inevitable by not allowing nature to follow its course.
    it is truly sickening the way they are treating a human body like a slab of meat only sort-of good for incubating a bunch of cells.

  • docsterx

    Thanks, Straightnotnarrow. Clearly stated and beautifully expressed.

  • Monoceros Forth

    Yep. Right-wingers are full of boundless love for everyone, so long as the “everyone” is someone either already dead, or not yet alive, or who never existed in the first place.

  • Pregnant, brain dead, and helpless—the perfect Tea Party wifey.

  • usagi

    Surgery always has risks, up to and including death. So does walking out your front door (or even walking into your bathroom or kitchen–look at the home accident stats; those things are deathtraps).
    If it is medically recommended that you get the things out, have them taken out. Your quality of life will go up dramatically. I wish I’d had mine done sooner than I did.

  • There’s no doubt in my mind that the hospital will try and bill the husband. Trying to make the victim pay for their malfeasance is the standard go-to for all for-profit hospitals.

  • I do enjoy the shows they have on strange weather events. And they usually cut to all, or mostly, weather coverage if there’s severe weather warnings in an area.

  • Well, re: the Weather Channel — ya have to admit that over the last several years, they’ve become less and less about simply providing weather news and reports and more about stupid weather-related reality shows.

    “OMG, it’s a tornado on someone’s shaky smartphone video… from five years ago!”

  • jasper

    If Mrs. Munoz was not breathing for some time, chances are that the foetus was deprived of oxygen. It has, in all likelihood, suffered severe brain damage.

  • Hue-Man

    That was the SECOND thing I thought of, particularly with Becca’s item on the New Mexico police story: “To add insult to injury, Gila Medical Center attempted repeatedly to
    bill Mr. Eckert for the sadistic and medical malpractice inflicted upon
    him against his will.” If the hospital is billing the patient, they are in an obvious conflict of interest. (If I were the insurance adjuster, I’d deny all claims: “We don’t pay for medical care of dead people.”)

    My first thought was how horrible it would be to see your loved one clinically dead, lying there for another 5 months with the medical apparatus needed to keep blood moving around her corpse.

  • SkippyFlipjack

    Good points. I guess I’m just a little sensitive to these personal stories turning into big policy battles, and I’ve heard a similar angle taken by concern-trollish pro-lifers and was a little sensitive to it. Like, “If *I* were them, I’d WANT that baby! I can’t think of ANY reason why THEY wouldn’t WANT to keep it!” Well, pro-lifer, they’re not you, and it’s their decision. Or should be.

    I know someone who last year faced the prospect of being a single mom w/ twins, one of whom was found in utero to have a severe genetic disease. She had to decide whether to keep one or both to term. If the media caught wind of the story it would have fed a national debate on which everyone would have had an opinion, but it was really a very hard and entirely personal decision, period.

    Most of us don’t know what we’d do in this situation. My wife is adamant about not being kept alive through artificial means, but she would go through anything for having kids, and those two things would be in conflict here. I would want to do what she wished, but wouldn’t really know what that was. It would be an incredibly tough time, and the idea that Texas should be deciding the issue for this family is just obscene.

  • goulo

    WHO? :)

  • Monoceros Forth

    Digby has written a couple of interesting and provocative pieces on this subject, placing the Munoz case in the context of a larger attempt to demote the personhood of expectant mothers in the name of protecting the foetus’s “rights”:

  • Drew2u

    OT: I did the math for a tonsillectomy and adenoidectomy and it’d cost me far less to fly to Ireland for a week (9 days total) and get the procedure done than it would be for me to pay out-of-pocket at a clinic 20 miles away (the closest clinic to me).

  • Correct me if I’m wrong, but isn’t she being kept alive also in opposition to her own wishes?

    Personally, I don’t think it’s a hard question. If she doesn’t ant to be kept alive, she shouldn’t be, regardless of the pregnancy.

  • Excellent observations.

  • Well, sometimes we have to engage in discussions even if they’re not convenient :) I posted this to get an honest discussion going about this topic, and I think the question is an obvious one, and a lot of times, but not answering obvious questions, you help the other guy because you look guilty. It’s something I’ve often felt on gay issues – address the hard question up front, don’t run from it.

  • Oh that’s a very interesting question, regarding who’s paying for this. I hadn’t even thought of that. I wonder if the hospital can still come after the husband for payment for all of this. Wow.

  • rextrek

    hmmm, and whom is PAYING for this ???????? Taxpayers? His Insurance company? WHOM?

  • Henson

    It seems like it would be extremely hard to financially afford a second child after keeping the (dead) mother on life support for several months, and then having to deal with the baby’s own medical complications post-birth.

  • SkippyFlipjack

    As an aside, I’ve been unable to find any news stories explaining why the family is against keeping Marlise on life support only until the child can be born. If it were my child, and my spouse died, I suspect I’d do everything I could to save the child/fetus.

    They already have one child; tough being a single parent with two. The second one was only 14 weeks when the woman died, so it’s got a long ways to go until viability, and is facing extremely long odds. That’s a lot of stress for the family and a long time to keep a dead woman “alive” as a baby-holding vessel, a woman who didn’t want such measures in place. They want closure and healing, not a nightmare scenario that’s unlikely to be successful. I can totally understand their reasoning.

  • Straightnotnarrow

    I have a few thoughts on this topic, informed by my practice in Emergency Medicine. The surrogate decision maker (in this case the husband) trumps all. No piece of paper, policy, or legislation should stand in the way of that. I often role play with family members at the bedside in situations like this and ask, “If the patient could somehow be sitting here with us, and seeing this, what would they tell me as the treating physician to do.” If the answer is, “Stop this, I wouldn’t want this for me or for my family to see me like this,” I thank the family and tell them that I will take the steps necessary to make their loved one comfortable and respect those wishes. DNAR (DNR/DNI, no code, etc) orders, living wills, and the like are nice to have, however, in the end this is human life and requires a human to human interaction to make informed decisions.

    A hospital in Galway Ireland (my native soil) is currently embroiled along with the nation after the death of a women from sepsis. She died in no small part because she was denied a surgical abortion after a missed miscarriage. The deceased foetus served as a nidus for infection and she died from overwhelming sepsis. This hospital in TX would do the same based on this law and their stated policy. To suggest that the “Doctors’ hands are tied” because of existing hospital policy and state law is ludicrous. This is a core ethic in medicine, Primum non nocere. There is real and present harm in prolonging the suffering of this body, this family, and likely this foetus by extending the patient’s life. This violates the four pillars of medical ethics: Justice, Autonomy, Beneficence, and Non-maleficence. There are legal channels and ethical review boards at any hospital and her treating physician has an obligation to stand up for her patient.

    “But for the grace of God goes us.” I say this often to my wife when I get home and have had to deal with these issues. Guiding families through what we can, what we cannot, and what we should do is a challenge, one that I enjoy and look forward to. It gives me an opportunity to be there at the worst moment, and to shine some light to guide the survivors with. Her physicians need to reevaluate what is right here and act based on ethical principles. Mrs Munoz’s hospital seems to have washed its hands, declaring the situation to be out of their control. Shame on them.

  • bejammin075

    Would it even be possible for a fetus to develop properly for another 25 weeks or so in a brain-dead, completely sedentary mother? It seems like there would be huge risks and uncertainty. Is there any precedent?

  • Drew2u

    I have to get a tonsillectomy and an adenoidectomy at some point so the recent story of the girl who became brain-dead due to a botched tonsillectomy has me kind of nervous. Speaking of which, I’ve yet to hear back about my health insurance through the ACA, so I should call them today.

    Also, have you seen the Weather Channel is no longer on DirectTV? Good thing the internet is open to all.

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