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

[walkingdeadgirl]

I see this much more clearly as a compassionate, hospice type situation, rather than a "killing".

They are allowing the fetus to die, not killing it, IMO. It is "terminally ill" for lack of a better example. They are simply not prolonging the inevitable. I believe this is a compassionate and ethical thing to do.

You said this much more eloquently than I could. Thank you.

 

[jjenny]

Because the mother is brain dead. A heart transplant is medical intervention to save someone's life. You can't cure dead. This woman is dead. If she had never been hooked up to machines like some Frankenstein experiment, the fetus would have died when she died. You said it yourself..."all kinds of problems that we fix". This isn't one of those cases.

Mother is dead. Fetus isn't. If she wasn't hooked up to machines, fetus would have died with her. But so what? If doctors didn't give someone like Dick Cheney a heart transplant, he would have died too. Did nature ever intend for us to take heart from one person and give it to another? Somehow I doubt it.

 

[jjenny]

Respectfully snipped...

I could not agree more with all of this, especially the last paragraph.

A case by case basis after every test possible to see how the fetus is developing and also taking into consideration how the family feels.

The family should always have a say...

Which family member gets to decide? They don't always agree.

 

[alliemay]

Is she also on a feeding tube?

 

[hambirg]

Well, The Judge went with the definition of deceased and viable, even though that section of then law does not apply to Marlise because she didn't have a written Advance Medical Directive. Someone is going to have to explain that to me further. How that section can apply in this case when it doesn't apply, idk.

For those thinking this was a win as to the choice of parents and loved ones. It's not. The judge specifically stated that there were no constitutional issues here. So now if a pregnant woman in the state of Texas suffers brain death at 23 weeks and 6 days, even if the fetus is perfectly healthy and normal, even if her husband or the father and her family are begging to keep her on life support just a little bit longer so the baby can be born, the answer will be no. The hospital MUST terminate life support at any time before 24 weeks (legal definition of viable.)

IMHO, I don't necessarily think this judge did the wrong thing. I am SOOOO thankful that he said he won't consider any constitutional arguments here. The translation of that is that the husband/family DO NOT have absolute rights. The State does have an interest in the potential life. No man has a constitutional right to terminate a woman's pregnancy.

But I think he was somewhat lazy in going with "viable." Viable within the legal definition just means 24 weeks of gestation. It does not reflect, in any way, the condition of the fetus. I do think the condition of THIS fetus played a part in the judge's decision. IMHO, he should have had the balls to address the "futility" issue. But he didn't. It was convenient for him to go with "viable."

So now husbands and families will have no choice in the matter if the pregnant woman happens to be declared dead before 24 weeks. I think it really should come down to futility. Apparently, no one wants to touch that issue. IMHO. . the real question should be, are we protecting a potential life or are we prolonging it's death? It seems that no court wants to step up to that issue. That would be dependent on the circumstances of each case. Easier for courts to draw an arbitrary line in the sand at 24 weeks.

 

[Karmady]

Well, The Judge went with the definition of deceased and viable, even though that section of then law does not apply to Marlise because she didn't have a written Advance Medical Directive. Someone is going to have to explain that to me further. How that section can apply in this case when it doesn't apply, idk.

For those thinking this was a win as to the choice of parents and loved ones. It's not. The judge specifically stated that there were no constitutional issues here. So now if a pregnant woman in the state of Texas suffers brain death at 23 weeks and 6 days, even if the fetus is perfectly healthy and normal, even if her husband or the father and her family are begging to keep her on life support just a little bit longer so the baby can be born, the answer will be no. The hospital MUST terminate life support at any time before 24 weeks (legal definition of viable.)

IMHO, I don't necessarily think this judge did the wrong thing. I am SOOOO thankful that he said he won't consider any constitutional arguments here. The translation of that is that the husband/family DO not have absolute rights. The State does have an interest in the potential life. No man has a constitutional right to terminate a woman's pregnancy.

But I think he was somewhat lazy in going with "viable." Viable withing the legal definition just means 24 weeks of gestation. It does not reflect, in any way, the condition of the fetus. I do think the condition of THIS fetus played a part in the judge's decision. IMHO, he should have had the balls to address the "futility" issue. But he didn't. It was convenient for him to go with "viable."

So now husbands and families will have no choice in the matter if the pregnant woman happens to be declared dead before 24 weeks. I think it really should come down to futility. Apparently, no one wants to touch that issue. IMHO. . the real question should be, are we protecting a potential life or are we prolonging it's death? It seems that no court wants to step up to that issue.

I didn't see the ruling that way, but maybe I was just going with my preconceived idea about how it would go. As I read the Order, he read the definition of death under the determination of death act together with the statute requiring the hospital to keep a pregnant patient on life support and found that she's legally dead, ergo not a patient. What am I missing?

I agree with your statement about the effect of the decision regardless, though.

 

[jjenny]

I didn't see the ruling that way, but maybe I was just going with my preconceived idea about how it would go. As I read the Order, he read the definition of death under the determination of death act together with the statute requiring the hospital to keep a pregnant patient on life support and found that she's legally dead, ergo not a patient. What am I missing?

I agree with your statement about the effect of the decision regardless, though.

I don't think the ruling means the hospital must remove pregnant brain dead "non-patient" from life support. It just means the hospital can remove pregnant brain dead "non-patient" from life support. Against wishes of the family, even if the fetus is perfectly normal.
Knowing how hospitals like to save money, I am concenred that is going to happen.
Apparently Mr. Munoz's lawyer thinks that is what should happen, based on what she said.

 

[alwaysonmymind]

WFAA News 8 just reported the family needs time to say goodbye. Marlise won't be taken off of life support today.


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[BeginnersLuck]

Well, The Judge went with the definition of deceased and viable, even though that section of then law does not apply to Marlise because she didn't have a written Advance Medical Directive. Someone is going to have to explain that to me further. How that section can apply in this case when it doesn't apply, idk.
For those thinking this was a win as to the choice of parents and loved ones. It's not. The judge specifically stated that there were no constitutional issues here. So now if a pregnant woman in the state of Texas suffers brain death at 23 weeks and 6 days, even if the fetus is perfectly healthy and normal, even if her husband or the father and her family are begging to keep her on life support just a little bit longer so the baby can be born, the answer will be no. The hospital MUST terminate life support at any time before 24 weeks (legal definition of viable.)

IMHO, I don't necessarily think this judge did the wrong thing. I am SOOOO thankful that he said he won't consider any constitutional arguments here. The translation of that is that the husband/family DO NOT have absolute rights. The State does have an interest in the potential life. No man has a constitutional right to terminate a woman's pregnancy.

But I think he was somewhat lazy in going with "viable." Viable withing the legal definition just means 24 weeks of gestation. It does not reflect, in any way, the condition of the fetus. I do think the condition of THIS fetus played a part in the judge's decision. IMHO, he should have had the balls to address the "futility" issue. But he didn't. It was convenient for him to go with "viable."

So now husbands and families will have no choice in the matter if the pregnant woman happens to be declared dead before 24 weeks. I think it really should come down to futility. Apparently, no one wants to touch that issue. IMHO. . the real question should be, are we protecting a potential life or are we prolonging it's death? It seems that no court wants to step up to that issue. That would be dependent on the circumstances of each case. Easier for courts to draw an arbitrary line in the sand at 24 weeks.

Here is the judges ruling. There wasn't anything at all addressed as far a viability of the fetus.

http://thaddeuspope.com/images/MUNOZ_202053415-Judges-Order-on-Munoz-Matter.pdf

There was only one law ruled on and that was that Mrs. Munoz was legally dead and therefore not a patient.

 

[hambirg]

I didn't see the ruling that way, but maybe I was just going with my preconceived idea about how it would go. As I read the Order, he read the definition of death under the determination of death act together with the statute requiring the hospital to keep a pregnant patient on life support and found that she's legally dead, ergo not a patient. What am I missing?

I agree with your statement about the effect of the decision regardless, though.

If you read the Advance Medical Directive Act. . .the section that deals with "patient, " the same section that was argued in this case, specifically addresses written advance medical directives. If you scroll through the Act to the section dealing with Power of Medical Attorney, it never addresses or defines "patient." The term used is "primary."

 

[Karmady]

Here is the judges ruling. There wasn't anything at all addressed as far a viability of the fetus.

http://thaddeuspope.com/images/MUNOZ_202053415-Judges-Order-on-Munoz-Matter.pdf

There was only one law ruled on and that was that Mrs. Munoz was legally dead and therefore not a patient.

Techinically, there were two laws, read together. The Determination of Death Act, and the one you're referring to. They're both cited in the Order.

jmo

 

[hambirg]

Here is the judges ruling. There wasn't anything at all addressed as far a viability of the fetus.

http://thaddeuspope.com/images/MUNOZ_202053415-Judges-Order-on-Munoz-Matter.pdf

There was only one law ruled on and that was that Mrs. Munoz was legally dead and therefore not a patient.

Yes, I thoroughly understand that. BUT the section argued is under the written Advance Medical Directive clause, which is a written document. That's NOT what Marlise had. Please read the entire code. Marlise's case falls under the medical power of attorney sections. "Patient" is not a term under that section. The term used there is "primary."

 

[Karmady]

If you read the Advance Medical Directive Act. . .the section that deals with "patient, " the same section that was argued in this case, specifically addresses written advance medical directives. If you scroll through the Act to the section dealing with Power of Medical Attorney, it never addresses or defines "patient." The term used is "primary."

Right. My understanding is that the Court looked to the UDDA to define patient based on the language of the AMDA referring to a patient as someone who is receiving life-sustaining treatment (paraphrasing that last bit), i.e., you can't receive life-sustaining treatment (be a patient under the AMDA) if you're dead under the UDD.


jmo

 

[hambirg]

I don't think the ruling means the hospital must remove pregnant brain dead "non-patient" from life support. It just means the hospital can remove pregnant brain dead "non-patient" from life support. Against wishes of the family, even if the fetus is perfectly normal.
Knowing how hospitals like to save money, I am concenred that is going to happen.
Apparently Mr. Munoz's lawyer thinks that is what should happen, based on what she said.

Well, these cases are rare. How in practicality do you think a hospital is going to determine what they should do? A woman is deceased and if it's before 24 weeks, than the fetus is not viable and they should terminate any life support.

 

[jjenny]

My understanding is if that fetus was already viable, it's well being would have to be considered. Since it's not yet, it is as if it didn't exist.
So since Mrs. Munoz is dead, she isn't a patient, and when life support is turned off, fetus will die with her.

 

[jjenny]

Well, these cases are rare. How in practicality do you think a hospital is going to determine what they should do? A woman is deceased and if it's before 24 weeks, than the fetus is not viable and they should terminate any life support.

I agree with you. The law says they should terminate life support. I don't think it means they must terminate life support.
But end result will obviously be the same.
Without considering wishes of the family and condition of the fetus, hospitals should terminate life support for brain dead pregnant women if fetus is not yet viable.

 

[Karmady]

Hambirg, I just searched the Advance Directive Act, and I'm only seeing the word "primary" come up once in the definition of attending physician. Am I looking at the wrong thing?

 

[hambirg]

Hambirg, I just searched the Advance Directive Act, and I'm only seeing the word "primary" come up once in the definition of attending physician. Am I looking at the wrong thing?

Hang on, let me find it.

 

[hambirg]

Here is the entire code. http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.166.htm

Please note this section that applies here. . .

SUBCHAPTER D. MEDICAL POWER OF ATTORNEY

Sec. 166.151. DEFINITIONS. In this subchapter:
(1) "Adult" means a person 18 years of age or older or a person under 18 years of age who has had the disabilities of minority removed.
(2) "Agent" means an adult to whom authority to make health care decisions is delegated under a medical power of attorney.
(3) "Health care provider" means an individual or facility licensed, certified, or otherwise authorized to administer health care, for profit or otherwise, in the ordinary course of business or professional practice and includes a physician.
(4) "Principal" means an adult who has executed a medical power of attorney.
(5) "Residential care provider" means an individual or facility licensed, certified,. . .

(1) according to the agent's knowledge of the principal's wishes, including the principal's religious and moral beliefs; or
(2) if the agent does not know the principal's wishes, according to the agent's assessment of the principal's best interests.
(f) Notwithstanding any other provision of this subchapter, an agent may not consent to:
(1) voluntary inpatient mental health services;
(2) convulsive treatment;
(3) psychosurgery;
(4) abortion; or
(5) neglect of the principal through the omission of care primarily intended to provide for the comfort of the principal.

ETA. .sorry. . I meant "principal" and not "primary." No where does it address "patient."

 

[CHERIE.T]

WFAA News 8 just reported the family needs time to say goodbye. Marlise won't be taken off of life support today.


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aomm, thanks for the update.
I'm not surprised even after yesterday's hearing that the family needs time to say goodbye.