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

[K_Z]

With all due respect to the miracle preemie survivors - that is not what this particular case is about. I'd love to see the focus remain on the actual circumstances in this case.

Respectfully snipped.

Agreed. All of the miracle preemie survivor stories posted here are not comparable in any way to the situation with Marlise Munoz. None of the miracle preemie survivors had a mom who had:

- Unwitnessed cardiac arrest and prolonged "down" time of unknown duration

- Huge pulmonary embolism, complicating efforts to oxygenate the patient

**A pulmonary embolism prevents blood from circulating to the lungs from the heart. The amount of ventilation and percentage of oxygen delivered during resuscitation doesn't matter, if blood can't GET TO the lung tissue. And the longer this situation occurs, the more acidotic the mother becomes. Acidosis prevents oxygen from both binding normally, and releasing at the tissue level normally. Both Marlise AND her fetus were profoundly deprived of oxygen during the prolonged resuscitation and down time.

- Prolonged resuscitation, with multiple arrests and resuscitative efforts, including electricity and potent drugs

- Concluding in brain death

- Non-viable, profoundly undeveloped fetus at 14 weeks

This entire situation, IMO, is an unregulated, unsupervised, unethical experiment in fetal maturation in a post- resuscitation situation that resulted in brain death of the host. It's reminiscent of the of the horrific medical experiments from WWII, IMO.

It is beyond my comprehension how any rational person can perceive this situation as a reasonable, compassionate, or loving effort to bring an unfortunate and disadvantaged fetus to term.

IMO, it is absolute folly to compare "normal" non-brain dead mothers who delivered viable preemies and micro-preemies, with the situation created in Texas by misguided doctors and politicians with the body of Marlise Munoz.

Has anyone even considered that if this experiment results in a fetus brought to viability and delivered, and then dies, the husband is then saddled BY THE STATE OF TEXAS with yet additional financial burden??

A non-viable "miscarriage" is considered to be a hospital specimen, and is not required to be buried or cremated in the same way as a viable person. Typically, the lab disposes of the tissue in the same way as any biological specimen, unless the family makes other arrangements.

A viable fetus delivered who then dies will need to have final disposition. IN ADDITION to the body of Marlise, which will be taken off support after the fetus is delivered by C-section. And in some cemeteries and jurisdictions, co-mingling remains in one casket is not permitted.

Layer after layer of emotional, social, moral, ethical, and financial burden is being heaped on this husband and family by the State of Texas, IMO. I hope the attorney they hired is a very good one, and can begin to help them right some of these profound wrongs. IMO.

 

[faw720]

Thank you K Z for posting some medical FACTS.

You know, I've even worried about how the trauma of this situation is also affecting the attending doctors. They are forbidden by law from practicing medicine in a responsible & compassionate manner. I think there is a good possibility that at least some of them feel that they are are being forced into prolonging the baby's suffering.

 

[faw720]

Protestors both pro & con gathered at JPS Hospital on Sunday.

http://www.wfaa.com/news/health/Fat...rotests-at-Fort-Worth-hospital-239843571.html

 

[K_Z]

A couple additional thoughts.

As we debate whether this is fetal experimentation, or some kind of compassionate, legitimate health care, think about what it takes to develop a robust body of scientific and medical knowledge.

There is essentially no body of knowledge about substantial fetal gestation from early 2nd trimester in brain dead mothers who have suffered prolonged cardiac arrest and achieved cardiac resuscitation. So, how do we add to the body of scientific and medical knowledge to determine if what we are doing is beneficial? And how do we define beneficial?

Imagine the outcry among animal rights supporters if large scale brain death experimentation on pregnant mammals were to be proposed. Let's take several hundred large mammals, inseminate them to produce an early pregnancy, then induce brain death from various causes. And then study the effects of various treatments on the brain dead hosts to see what the effects would be on the offspring. This would not "brief well" to most of the American public, IMO. Likewise, unregulated opportunistic fetal experimentation is profoundly misguided, IMO. There is this little happy fairy tale fantasy many people have of this fetus becoming a relatively healthy child, and skipping off to his or her first day of kindergarten in 5 years. The odds against that happening are astronomical.

This isn't a profoundly disabled child that is already born, that we have an ethical and moral mandate to care for. This is, IMO, intentionally engaging in an unstudied, unregulated process loosely defined as some kind of medical care, that is extremely likely to produce a profoundly disabled term fetus. That is massively unethical, IMO.

The other question to ask, is why is the father NOW seeking legal representation, instead of seeking injunctions back in November?

The Hospital will not (due to HIPPA) release information on how the fetus is developing, but the doctors and the family certainly know. If I were them, I would have sought out the best and brightest perinatal specialists to advise me on what is the most likely outcome. The fetus is now 20+ weeks. Plenty mature to make inferences as to how healthy or how damaged it is. A 20+ week fetus should have variability, and be very active, demonstrating sleep/ wake cycles, swallowing motions, etc.

I think the husband seeking representation at this particular point in time potentially signals a very poor, very disturbing prognosis in the fetus. JMO.

 

[faw720]

Respectfully snipped.

I hope the attorney they hired is a very good one, and can begin to help them right some of these profound wrongs. IMO.

I've done a bit of research on the law firm of Koons Fuller. Their office in Tarrant Co. is located in Southlake, a very very upscale location. I'm assuming that they are reputable & successful or they would not be located there. They also have offices in Plano, Denton, Dallas, & Houston so they should have access to a lot of expertise.

We can only hope.

 

[Gardenlady]

It continues to astound me that this woman's wishes can be ignored by the state. That her next-of-kin's wishes can be ignored. The protests that "when she said she didn't want to be kept alive like this she didn't know she was pregnant" are also disturbing, because it presumes that a grown woman is unable to grasp or fully think out her decision. It assumes, in other words, that adult women are too stupid, incapable of taking into consideration all the possibilities, and so lawmakers must make the decision for her.

This woman has now become nothing more than an incubator for a possible child that she will not even be present to care for. It is nightmarish in the extreme that this can be done legally, but unsurprising given attacks in the past year or two against womens' medical autonomy in the state of Texas.

If this were my relative, I'd unplug her, or otherwise allow her body to shut down - and damn the legal ramifications.

 

[Elley Mae]

With all due respect to the miracle preemie survivors - that is not what this particular case is about. I'd love to see the focus remain on the actual circumstances in this case.

The wishes of the mother and, with her legally dead, the father, are being controlled now by the state of Texas. Perhaps we should all put ourselves in their shoes and consider the consequences - whatever they may be. I sure as HE77 don't want my state determining what is best for me and my family.

http://www.dallasnews.com/news/metr...ant-fort-worth-woman-kept-on-life-support.ece

Texas law states that if a person on life support is declared irreversibly brain-dead by a physician, the person is considered legally dead.

Former Sen. Ray Farabee, D-Wichita Falls, wrote that definition of death in 1979. Farabee also wrote the Texas Natural Death Act, now known as the Advance Directives Act, in 1977. He modeled the law after California’s Natural Death Act, which included the provision regarding pregnant patients.

The law states that if a woman is pregnant, an advanced directive “shall have no force or effect during the course” of the pregnancy. The language was amended over time, but the provision remained intact.

Rep. Garnet Coleman, a Houston Democrat who worked to amend the act in 1999, said the wording about pregnant patients is ambiguous.

“The general counsel of any large organization can say, ‘We don’t know how it’s defined so we’re going to err on the side of caution,’” he said. “We didn’t contemplate that, and we left it too vague.”

http://thinkprogress.org/health/2014/01/10/3146331/texas-family-sue-life-support/


The hospital is citing a decades-old state law that states, “A person may not withdraw or withhold life-sustaining treatment… from a pregnant patient.” Texas is one of 12 states that invalidate women’s end-of-life wishes if she is pregnant.

http://www.centerwomenpolicy.org/pr...lProxyStatutesMeganGreeneandLeslieR.Wolfe.pdf

Automatic Invalidation of A Pregnant Woman’s Advance Directive :Currently, 12 state statutes (Alabama, Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, South Carolina,Texas, Utah, Washington, and Wisconsin) automatically invalidate a woman’s advance directive if she is pregnant
, as compared to 22 states with such provisions at the time of the Center’s 1992 report.

 

[hambirg]

I haven't read this entire thread, but I've popped in here and there.

To me the issue comes down to the fact that the ONLY person that has the right to terminate a pregnancy is the pregnant woman, within certain guidelines of the law. So that means, the father can't, the doctors can't, etc. Unfortunately she is not here to tell us her choice. It seems as if she intended to carry the baby to term while she was still alive. I also understand that she didn't want to be kept alive on machines. Unfortunately there is a lot of gray area there. No one can assume that she intended to terminate the pregnancy in this case. We simply don't know what her choice would be if she was able to tell us.

It seems to be a legal issue within the state of Texas if a woman chose to have a directive that states, if she finds herself in this situation, that she would choose to terminate the pregnancy if she was still within the legal time frame for that to happen. That's a valid issue, but it is not the case here, IMHO.

 

[faw720]

I am wondering about something. What if the attending physicians had no legal restrictions? How would they have proceeded, using their medical knowledge only, if Marlise & the fetus were their spouse & fetus? If one or more of the physicians were a female, what would she want done to preserve the life of her fetus?

No doubt they knew early on that they had a critical situation on their hands & consulted with hospital administrators, who in turn consulted with their attorneys who advised they had legal problems in the state of Texas.

Sorry, I can't provide a link (I lost it & can't find it again), but there was an USA Today article that quoted Eric Munoz as saying he was being "mostly kept in the dark" about the condition of the fetus or the hospital's future plans for the fetus. The hospital told him a decision MIGHT be made at week 24.

 

[Elley Mae]

The next important date is the beginning of February. That's when doctors will test to see how viable Marlise's fetus is, and they’ll also be able to see if she can sustain the child.

http://www.freep.com/article/20140109/NEWS07/301090061/pregnant-daughter-life-support

 

[faw720]

The next important date is the beginning of February. That's when doctors will test to see how viable Marlise's fetus is, and they’ll also be able to see if she can sustain the child.

http://www.freep.com/article/20140109/NEWS07/301090061/pregnant-daughter-life-support

Since I'm not a medical professional, I cannot attest to this being fact. I was reading various articles on the 13 year old California girl who is also brain dead. A doctor is quoted as saying that even though she is on life support, her body will eventually begin to decompose because she is brain dead. If this indeed a medical fact, that is even more sorrow ahead for Munoz family, as I assume the same thing would happen to Marlise. The hospital will, at some point, be forced to either deliver an extremely premature fetus or let it decompose along with Marlise.

So sad for the Munoz family. God bless them!

 

[NevadaMom]

I haven't read this entire thread, but I've popped in here and there.

To me the issue comes down to the fact that the ONLY person that has the right to terminate a pregnancy is the pregnant woman, within certain guidelines of the law. So that means, the father can't, the doctors can't, etc. Unfortunately she is not here to tell us her choice. It seems as if she intended to carry the baby to term while she was still alive. I also understand that she didn't want to be kept alive on machines. Unfortunately there is a lot of gray area there. No one can assume that she intended to terminate the pregnancy in this case. We simply don't know what her choice would be if she was able to tell us.

It seems to be a legal issue within the state of Texas if a woman chose to have a directive that states, if she finds herself in this situation, that she would choose to terminate the pregnancy if she was still within the legal time frame for that to happen. That's a valid issue, but it is not the case here, IMHO.

Since she's legally brain dead by all accounts her husband (the father) should be able to say that he wants an "abortion"*. A dead person has no legal standing to make choices, and when a person is still alive yet unable to make medical choices for themselves that falls upon the person they gave power of attorney to. In this case it would be her husband more than likely, or her parents as the "next of kin", and they all seem to be in agreement that using her as a host for a fetus is not what is wanted.

“It’s not a matter of pro-choice and pro-life,” Munoz’s mother says. “It’s about a matter of our daughter’s wishes not being honored by the state of Texas.”

http://www.salon.com/2014/01/08/whe...xas_denies_brain_dead_pregnant_womans_rights/


* - It would not be a surgical procedure as is normally done I don't imagine. It would be a matter of just removing the support from the mother.

 

[hambirg]

Since she's legally brain dead by all accounts her husband (the father) should be able to say that he wants an "abortion"*. A dead person has no legal standing to make choices, and when a person is still alive yet unable to make medical choices for themselves that falls upon the person they gave power of attorney to. In this case it would be her husband more than likely, or her parents as the "next of kin", and they all seem to be in agreement that using her as a host for a fetus is not what is wanted.

“It’s not a matter of pro-choice and pro-life,” Munoz’s mother says. “It’s about a matter of our daughter’s wishes not being honored by the state of Texas.”

http://www.salon.com/2014/01/08/whe...xas_denies_brain_dead_pregnant_womans_rights/


* - It would not be a surgical procedure as is normally done I don't imagine. It would be a matter of just removing the support from the mother.

BBM

See, that's the thing. I don't believe he has that right. Men have not been granted that right. I do agree that if she had a directive stating her wishes specifically, then the law in Texas could be challenged. But that's not the case here is it?

 

[NevadaMom]

BBM

See, that's the thing. I don't believe he has that right. Men have not been granted that right. I do agree that if she had a directive stating her wishes specifically, then the law in Texas could be challenged. But that's not the case here is it?

She's dead and will never be able to have an opinion, and the husband likely has power of attorney giving him the right to make medical decisions for her. So why should the state have more say than the person whom she trusted her final wishes to? He's also the other genetic half of the fetus, of the two people on the face of the planet who should have the final say he's the only one left living. He also has medical training and knows what the potential outcome will be.

IMO I hope the family takes this up the courts and gets laws that permit this to happen changed. Like I said before it's a slippery slope, and states meddling in uteruses is unacceptable.

 

[hambirg]

She's dead and will never be able to have an opinion, and the husband likely has power of attorney giving him the right to make medical decisions for her. So why should the state have more say than the person whom she trusted her final wishes to? He's also the other genetic half of the fetus, of the two people on the face of the planet who should have the final say he's the only one left living. He also has medical training and knows what the potential outcome will be.

IMO I hope the family takes this up the courts and gets laws that permit this to happen changed. Like I said before it's a slippery slope, and states meddling in uteruses is unacceptable.

Because men do not have the right to terminate a pregnancy. I hate to even go down that road. It is solely the right of the pregnant woman. Since this pregnant woman is now deceased and can no longer make that choice, then the choice can't be made. That's my point.

I thoroughly agree that if she had a written directive stating her wishes and addressing what her wishes were if she were pregnant, then I think the Texas law can be challenged. I understand the issues in that case. But that isn't the case here. We have to go by the husbands word. And he doesn't get to say whether or not a woman's pregnancy is terminated or not. . .even if it is his child and the woman is deceased.

ETA- If we start arguing that he has the right to terminate her pregnancy, than we inadvertently undermine the entire legal foundation that Roe v Wade is based upon.

 

[faw720]

Because men do not have the right to terminate a pregnancy. I hate to even go down that road. It is solely the right of the pregnant woman. Since this pregnant woman is now deceased and can no longer make that choice, then the choice can't be made. That's my point.

I thoroughly agree that if she had a written directive stating her wishes and addressing what her wishes were if she were pregnant, then I think the Texas law can be challenged. I understand the issues in that case. But that isn't the case here. We have to go by the husbands word. And he doesn't get to say whether or not a woman's pregnancy is terminated or not. . .even if it is his child and the woman is deceased.

ETA- If we start arguing that he has the right to terminate her pregnancy, than we inadvertently undermine the entire legal foundation that Roe v Wade is based upon.

If nothing else, this situation should be a wake-up call for couples everywhere. They should discuss what they would want done if they were in the same situation as the Munoz family. If poor Erick had only waited a couple of hours to call 911 they wouldn't have the problem they now are faced with. Naturally, he was hoping for a positive outcome & help for his wife. But now, we all know that isn't always the case. There's only so much medical science can do & then we are left with the state playing God.

BTW, I am not unfamiliar with being called upon to make a difficult decision. I had medical power of attorney from my 93 year old uncle who had no children. He was in a nursing home & was hospitalized numerous times with heart failure. Each time the hospital would get him stabilized, send him back to the nursing home, & he would suffer some more. He was subjected to continuous agony many times. One night they called & said he was having a heart attack & asked what I wanted them to do. I told them to make him as comfortable as humanly possible & let him go. He passed away in a very short time. God was ready for him & he was way past ready to go. It was NOT an easy decision, but I am at peace with my decision. God does not intend us to live forever & he calls some home earlier than others.

 

[NevadaMom]

Because men do not have the right to terminate a pregnancy. I hate to even go down that road. It is solely the right of the pregnant woman. Since this pregnant woman is now deceased and can no longer make that choice, then the choice can't be made. That's my point.

I thoroughly agree that if she had a written directive stating her wishes and addressing what her wishes were if she were pregnant, then I think the Texas law can be challenged. I understand the issues in that case. But that isn't the case here. We have to go by the husbands word. And he doesn't get to say whether or not a woman's pregnancy is terminated or not. . .even if it is his child and the woman is deceased.

ETA- If we start arguing that he has the right to terminate her pregnancy, than we inadvertently undermine the entire legal foundation that Roe v Wade is based upon.

It's clear we are not going to agree on this, but as someone with a uterus if I tell my husband - the person who has legal medical power of attorney - what my wishes are I would expect he would ensure that they are carried out. I trust him to do what is right by me, and what is best for the emotional well being of my entire family. I think that's pretty much what this boils down to - respecting the wishes she had to never be kept alive by artificial means.

Also it would not be a surgical procedure abortion. It would simply be unplugging the "life support" and letting her body go.

One final question, it's been mentioned that people do choose to abort a pregnancy when it's discovered that the child would have serious health issues. Why is the father potentially being saddled with that and not permitted to have a say? Using the "a woman's rights" argument is invalid in this situation because she is no longer alive. Instead there's now this waiting game to see if the fetus was impacted and if it will even be viable outside the womb, and how much longer they can make her body hold out as an incubator.

 

[faw720]

Here is a link to a similar situation, in Texas no less. In this instance we have a 25 week pregnant woman with the flu. Doctors told the husband they had to either take the baby by C-section or risk loosing both mother & child. The husband authorized the C-section & a baby was delivered that only lived 5 days.

http://www.wfaa.com/news/health/flu...ling-Influenza-Loses-her-Child-240002331.html

Why the difference???????????

 

[kincaid]

ETA- If we start arguing that he has the right to terminate her pregnancy, than we inadvertently undermine the entire legal foundation that Roe v Wade is based upon.

I know this isn't the popular opinion but part of me feels like not doing everything to try to save the baby is going against the mother's right to choose. At 14 weeks, the mother clearly wanted this baby and had made a decision to go thru with the pregnancy. It's not really about what the husband or her family wants. Abortion decisions are a mother's right, no one else's. I'm not sure I agree with doctors or family members deciding to terminate a pregnancy that the mother clearly wanted, even if she is brain dead.

 

[hambirg]

If nothing else, this situation should be a wake-up call for couples everywhere. They should discuss what they would want done if they were in the same situation as the Munoz family. If poor Erick had only waited a couple of hours to call 911 they wouldn't have the problem they now are faced with. Naturally, he was hoping for a positive outcome & help for his wife. But now, we all know that isn't always the case. There's only so much medical science can do & then we are left with the state playing God.

BTW, I am not unfamiliar with being called upon to make a difficult decision. I had medical power of attorney from my 93 year old uncle who had no children. He was in a nursing home & was hospitalized numerous times with heart failure. Each time the hospital would get him stabilized, send him back to the nursing home, & he would suffer some more. He was subjected to continuous agony many times. One night they called & said he was having a heart attack & asked what I wanted them to do. I told them to make him as comfortable as humanly possible & let him go. He passed away in a very short time. God was ready for him & he was way past ready to go. It was NOT an easy decision, but I am at peace with my decision. God does not intend us to live forever & he calls some home earlier than others.

I absolutely agree! It's not an easy situation, or one even most young couples would consider. But her wishes have to be known. . .in writing. Btw. . .I'm sorry about your uncle. I know first hand how difficult these decisions can be. You did the right thing. :hug:

It's clear we are not going to agree on this, but as someone with a uterus if I tell my husband - the person who has legal medical power of attorney - what my wishes are I would expect he would ensure that they are carried out. I trust him to do what is right by me, and what is best for the emotional well being of my entire family. I think that's pretty much what this boils down to - respecting the wishes she had to never be kept alive by artificial means.

Also it would not be a surgical procedure abortion. It would simply be unplugging the "life support" and letting her body go.

One final question, it's been mentioned that people do choose to abort a pregnancy when it's discovered that the child would have serious health issues. Why is the father potentially being saddled with that and not permitted to have a say? Using the "a woman's rights" argument is invalid in this situation because she is no longer alive. Instead there's now this waiting game to see if the fetus was impacted and if it will even be viable outside the womb, and how much longer they can make her body hold out as an incubator.

Again, it has to be IN WRITING, exactly what her wishes were. If it was, I would understand the legal ramifications. But it wasn't. Her husband does NOT have the right, per the Supreme Court of the United States, to terminate her pregnancy. He just doesn't! And if we want to start going down that street, men having a say in whether a woman has an abortion or not, regardless of the method, then we are opening a can of worms. It undermines the entire legal foundation that legal abortion is based upon. Just playing devil's advocate, but what if he never wanted the pregnancy but it was her wish to have the baby? She is not here to tell us her intentions. She never bothered to put her intentions in writing. We can not just assume what he says is what she wanted. His word and his wants mean nada. He does not have the right to an abortion, regardless of the situation. Your're right. We are not going to agree on this. I do not believe, without her written consent, that he gets to choose whether or not to terminate her pregnancy. That right is solely her's. . .and the whole legal basis of her right to an abortion is is based upon the fact that ONLY she has the right to choose. Take that away, and she doesn't have the right to choose anymore.

I know this isn't the popular opinion but part of me feels like not doing everything to try to save the baby is going against the mother's right to choose. At 14 weeks, the mother clearly wanted this baby and had made a decision to go thru with the pregnancy. It's not really about what the husband or her family wants. Abortion decisions are a mother's right, no one else's. I'm not sure I agree with doctors or family members deciding to terminate a pregnancy that the mother clearly wanted, even if she is brain dead.

Exactly! ITA! They have NO say. And since she didn't put her intentions in writing, no assumptions can be made.