TX - pregnant wife unresponsive on life support, husband hopes to fulfill her wishes

[K_Z]

I think if they stop life support, of course the fetus will not be able to live because it will not be connected to a life source from the mother, it is not a viable fetus and the baby is horribly deformed and with a host of other issues besides. So I really can;t see how the baby could survive once life support is ended.

K_Z? can you explain to us?

Sorry I had to miss the discussion around the hearing time. (Life gets in the way sometimes!) Reading backwards to catch up.

I think you explained this well. Less than 22-24 weeks, a fetus cannot exist outside the mother's body.

Under "good" circumstances, the first evidence of "viability" is really determined by which doc or resident is on call, and whether or not they can pass a 2 or 2.5 ETT (endotracheal tube), the smallest available, to resuscitate the neonate. (And that is just the beginning.)

Tracheal intubation - Wikipedia, the free encyclopedia

Under most circumstances, that means the neonate has to be 22-24 weeks gestation. That gestational age is not absolute, because each fetus varies in their size and physiological circumstances. A 22-24 weeker that was gestating in a normal pregnancy may be larger than a 22-24 weeker in a difficult pregnancy, but the difficult pregnancy baby may have some adaptations from being under stress that the 22-24 weeker from the normal pregnancy did not.

I see a lot of posts that toss around "viability" as if it were some kind of absolute. As if "23 weeks is certain death, and 24 weeks is guaranteed life". There are 28 weekers and 36 weekers and 42 weekers that aren't "viable" due to their particular unfortunate set of circumstances. The number of weeks gestation is just a beginning point. You have to take into account all of the known facts about the fetus, the gestation, the preganacy, and the circumstances leading to the extreme prematurity.

One of the unfortunate things about success in medical care is that as we become more successful in different areas, the public tends to become complacent, and generalize those outcomes as guarantees, or standards. Surgery and anesthesia is safer now than ever before, but there are still unknowns, and complications that can occur. A C-section is major abdominal surgery, but most people think of it as a minor procedure, and elective C-sections are at an all time high world wide. The same with preemie care. Everyone knows a preemie that survived incredible odds and now is a functional person in society, if not an Olympic athlete or a CEO. The truth is that a 22-24 weeker is only really BARELY viable. We save a few, but many more die of various complications of extreme prematurity. You never hear about those stories. NEC for instance, kills a lot of preemies. But you never hear people talk about it. It's invisible unless you know someone with a neonate who had it.

Necrotizing enterocolitis - Wikipedia, the free encyclopedia

Someone wondered if "the hospital" might dash in and try to do a c section before the Monday deadline, because the fetus is "viable". Gosh, that would be incredibly unwise, and open up a whole new area for litigation. I think the neonate would surely die, probably within hours at best. I don't think anyone credible thinks it's a wise decision to do a C-section to deliver a profoundly abnormal 22 weeker. All that would do is heap misery upon misery for everyone. No one thinks this fetus has a chance at life outside the womb. It's very, very sad. But the time for science experiments is over now. IMO. I'm glad the precedent has been set that dead is dead, and not a "patient". That should be helpful in the future.

I'm glad (and extremely surprised!) that the judge ruled as he did. But I wonder if the hospital will acquiesce so easily. Monday at 5 pm is a long way away. I hope they don't file injunctions, but sadly, I think it's a real possibility. They have a lot on the line in this case. They were just told they made a horribly wrong decision. They may have to try to fight it. IDK. I hope not.

 

[walkingdeadgirl]

Thinking about this poor man and the rest of this woman's family having to suffer daily, looking at her dead body, grieving without end, unable to put her to rest...is just making me sick. And thankful that I don't live in Texas.

 

[walkingdeadgirl]

So sorry little baby.....sorry your mommy isn't able to fight for your life. I believe she would if she could. Perfect or not, you deserve a chance to live. I'm so sad that so many have fought so hard to make sure you will never have that chance. So sad.

I'm pretty sure by having her dead body hooked up to machines, the mother of the fetus is continuing to provide it with life.

Without the intervention of technology and men, this fetus would have passed away naturally with its mother, as nature clearly intended. What is sad is that now it is alone instead of with its mother, horribly deformed because it was never meant to be at this stage, and still people are fighting against nature, arrogant enough to think that we know better than Life.

 

[gitana1]

So sorry little baby.....sorry your mommy isn't able to fight for your life. I believe she would if she could. Perfect or not, you deserve a chance to live. I'm so sad that so many have fought so hard to make sure you will never have that chance. So sad.

Awww, Amster. I want to say that I really respect your feelings about this and I think you are courageous to voice your feelings in a forum in which most people feel differently. Hugs to you and God bless you, Amster.

 

[Fairy1]

I'm pretty sure by having her dead body hooked up to machines, the mother of the fetus is continuing to provide it with life.

Without the intervention of technology and men, this fetus would have passed away naturally with its mother, as nature clearly intended. What is sad is that now it is alone instead of with its mother, horribly deformed because it was never meant to be at this stage, and still people are fighting against nature, arrogant enough to think that we know better than Life.

The fetus is still with its Mother. Hopefully, they will be allowed to pass through this world and rest in peace, together.

 

[RT51]

This "viable" thing gets to me.

A healthy child born at 24 weeks still has hard chance of surviving: brain bleeds, resulting in in brain damage, just to mention one.

A child born at 24 weeks with multiple deformities, has even a lesser chance of survival. So why continue the incubator for this child to have to suffer more after birth. Yes, some things can be fixed with surgery, but how much pain will this child go through, and will it really help the child have a happier, comfortable life?

I really hope this doesn't get dragged on too much longer.

 

[walkingdeadgirl]

The fetus is still with its Mother. Hopefully, they will be allowed to pass through this world and rest in peace, together.

Depending on a person's view of soul occupation, perhaps.

I agree. Hopefully they will be together and loved. And there will be unicorns.

 

[walkingdeadgirl]

This "viable" thing gets to me.

A healthy child born at 24 weeks still has hard chance of surviving: brain bleeds, resulting in in brain damage, just to mention one.

A child born at 24 weeks with multiple deformities, has even a lesser chance of survival. So why continue the incubator for this child to have to suffer more after birth. Yes, some things can be fixed with surgery, but how much pain will this child go through, and will it really help the child have a happier, comfortable life?

I really hope this doesn't get dragged on too much longer.

I kind of feel like the hospital has too much invested at this point to just agree with the judge and back off. They've been torturing this family since the fetus was 14 weeks old, fighting tooth and nail. I think they will dig in and continue, unfortunately.

 

[jjenny]

This "viable" thing gets to me.

A healthy child born at 24 weeks still has hard chance of surviving: brain bleeds, resulting in in brain damage, just to mention one.

A child born at 24 weeks with multiple deformities, has even a lesser chance of survival. So why continue the incubator for this child to have to suffer more after birth. Yes, some things can be fixed with surgery, but how much pain will this child go through, and will it really help the child have a happier, comfortable life?

I really hope this doesn't get dragged on too much longer.

Fetus doesn't have to be removed at 24 weeks. 24 weeks it's the age the fetus is considered viable. There was a recent case where brain dead woman was able to carry a fetus to 32 weeks from 15 weeks.
Of course Munoz fetus would still be abnormal at 32 weeks.

 

[jjenny]

I'm pretty sure by having her dead body hooked up to machines, the mother of the fetus is continuing to provide it with life.

Without the intervention of technology and men, this fetus would have passed away naturally with its mother, as nature clearly intended. What is sad is that now it is alone instead of with its mother, horribly deformed because it was never meant to be at this stage, and still people are fighting against nature, arrogant enough to think that we know better than Life.

Yes, the fetus would have passed naturally but so would someone who needs a heart transplant. I am not sure why nature intened for this fetus to die as opposed to people with all kind of problems that we fix through medical intervention. Should we stop treating everybody because that is what nature wants?

 

[Fairy1]

Depending on a person's view of soul occupation, perhaps.

I agree. Hopefully they will be together and loved. And there will be unicorns.

Nothing to do with "soul occupation." The fetus is still within its Mother. They both should be allowed to pass without medical intervention, at this point.

They are together and they are loved. Not sure what the unicorn reference is about, but to each his own.

 

[Fairy1]

Yes, the fetus would have passed naturally but so would someone who needs a heart transplant. I am not sure why nature intened for this fetus to die as opposed to people with all kind of problems that we fix through medical intervention. Should we stop treating everybody because that is what nature wants?

Sometimes, yes. If someone has been "down" for a long period of time, it's not always best to "bring them back." IMO.

 

[liltexans]

Thinking about this poor man and the rest of this woman's family having to suffer daily, looking at her dead body, grieving without end, unable to put her to rest...is just making me sick. And thankful that I don't live in Texas.

It's not just Texas. There are many states that have laws preventing a woman's advance directive from being followed if the woman is pregnant. This same horrifying situation could easily happen in another state.

 

[gitana1]

Yes, the fetus would have passed naturally but so would someone who needs a heart transplant. I am not sure why nature intened for this fetus to die as opposed to people with all kind of problems that we fix through medical intervention. Should we stop treating everybody because that is what nature wants?

That's a good point. However, isn't the let nature take it's course argument with humans really about technology prolonging the lives of terminal people who are suffering or enabling catastrophically ill or disabled fetuses and babies be born and live but suffer when nature would not have allowed them to live otherwise?

I think it comes down to people's individual beliefs about the meaning of life, the value of life and whether suffering plays a part in the value of life, right? And for those who feel intense suffering with no remedy defeats the meaning of life or diminishes its value, technology should not be used to force such lives to be prolonged.

 

[Karmady]

That's a good point. However, isn't the let nature take it's course argument with humans really about technology prolonging the lives of terminal people who are suffering or enabling catastrophically ill or disabled fetuses and babies be born and live but suffer when nature would not have allowed them to live otherwise?

I think it comes down to people's individual beliefs about the meaning of life, the value of life and whether suffering plays a part in the value of life, right? And for those who feel intense suffering with no remedy defeats the meaning of life or diminishes its value, technology should not be used to force such lives to be prolonged.

Right. And there will always be those who disagree. What is the value of a disabled life? What is suffering? What is suffering so intolerable that life should be ended? Who makes that decision? I think the answers are so myriad that we can almost never reach concensus. Particularly wrt a fetus whose suffering upon birth and life can only be anticipated but not known. A dilemma for the ages imo

 

[K_Z]

One thing of interest to me. Our local nbcdfw station conducted a poll via online or telephone response. They were asking for people to vote if they approved or did not approve of the judge's decision. Now I realize that this is not exactly a scientific poll, but here are the results. 91% responded that the judge made the correct decision & 9% said that he did not make the correct decision.

I don't know how to do a poll here, but it would be interesting to see.

Great suggestion! I put up a poll, to see what Websleuthers think.

Poll: Marlise Munoz Case: Did the judge make the right decision? - Websleuths Crime Sleuthing Community

 

[jjenny]

Right. And there will always be those who disagree. What is the value of a disabled life? What is suffering? What is suffering so intolerable that life should be ended? Who makes that decision? I think the answers are so myriad that we can almost never reach concensus. Particularly wrt a fetus whose suffering upon birth and life can only be anticipated but not known. A dilemma for the ages imo

If mother were alive and found out fetus was abnormal, she could decide whether to terminate the pregnancy or not.
With her dead, should it be up to the father? Or an assumption of what she would have wanted?
Or it doesn't matter since she is dead? And if she is legally dead, so is the fetus (regardless of what state the fetus is in, as long as it's not yet viable). Judge seems to have ruled that way.
We could easily end up with a case like McMath's, where hospital wants to turn off life support from pregnant non-patient, while family wants otherwise.

 

[Karmady]

If mother were alive and found out fetus was abnormal, she could decide whether to terminate the pregnancy or not.
With her dead, should it be up to the father? Or an assumption of what she would have wanted?
Or it doesn't matter since she is dead? And if she is legally dead, so is the fetus (regardless of what state the fetus is in, as long as it's not yet viable). Judge seems to rule that way.

That's a good question. So if a mother now anticipates this eventuality and specifically says she wants to be kept on life support until the baby can be born, what then? The law, as construed by the court today only addresses the opposite circumstance. Can the mother make such a decision, in advance, and have it be honored by a hospital, her family, etc? Seems to me, not.

Like I said--a dilemma for the ages, imo.

 

[jjenny]

That's a good question. So if a mother now anticipates this eventuality and specifically says she wants to be kept on life support until the baby can be born, what then? The law, as construed by the court today only addresses the opposite circumstance. Can the mother make such a decision, in advance, and have it be honored by a hospital, her family, etc? Seems to me, not.

Like I said--a dilemma for the ages, imo.

The way the law is, no. Hospital doesn't have to honor a directive of someone who wants to remain on life support after brain death.
Brain dead is legally dead. Fetus that is not yet viable is considered then dead as well. Even if it's perfectly normally developing and could become viable in a short time.
I don't think that makes for a very good law.

 

[Fairy1]

If mother were alive and found out fetus was abnormal, she could decide whether to terminate the pregnancy or not.
With her dead, should it be up to the father? Or an assumption of what she would have wanted?
Or it doesn't matter since she is dead? And if she is legally dead, so is the fetus (regardless of what state the fetus is in, as long as it's not yet viable). Judge seems to have ruled that way.
We could easily end up with a case like McMath's, where hospital wants to turn off life support from pregnant non-patient, while family wants otherwise.

The bottom line in this case is that it never mattered what Marlise may or may not have wanted. That's what bothers me. That a woman who was alive and productive and loved was reduced to nothing more than an incubator. That should matter to all women, no matter where we are in the stages of life. She didn't matter to them.

She matters to me.