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

[Softail]

Jobin Panicker ‏@jobinpnews 5m
Family of #MarliseMunoz tells me they will be in the courtroom today. @wfaachannel8


When I saw this tweet, all I could think was DUH! :doh:

 

[Morag]

I wonder if he'd be so keen to push for her (and the child's) life to be terminated if he could be assured, 100%, that the child would be born healthy? (ie: he doesn't want to raise a handicapped child).

Maybe he's even said this, I don't know.

He's not pushing-your word-for her life to be terminated. Her life is already over.

 

[faw720]

Here is an article I've never seen before. It outlines the thoughts of a medical ethicist, Jeffery Spike, who was involved in a somewhat similar situation.

Sorry for all the ads & junk that pops up with any Star-Telegram link, but if you keep clicking you will eventually be able to read the article.





http://www.star-telegram.com/2014/01/23/5509465/very-few-medical-precedents-in.html

 

[alwaysonmymind]

Advanced directives don't apply when someone is brain dead. Texas law says they are legally dead. If someone is on a vent and they are brain dead, then the vent is removed. The family is not asked if the vent can be removed. The persons advanced directives don't apply in brain death or make a difference in the removal of support in someone that is brain dead.

And therein lies the rub....

It applies when you're pregnant in Texas.


Sent from my iPhone using Tapatalk

 

[gitana1]

And therein lies the rub....

It applies when you're pregnant in Texas.


Sent from my iPhone using Tapatalk

Well, we don't know that. The hopspital believes it does as does the District Attorney's office who are representing the hospital. But the court is going to likely determine whether a brain dead person is a "patient" and thus whether the law applies.

 

[Softail]

Jobin Panicker ‏@jobinpnews 5m
At least 30 people are here waiting outside the courtroom. Hearing to start in over an hour. #MarliseMunoz

 

[gitana1]

In a lawsuit trying to force the hospital to cut off those machines so they can bury her, Erick Munoz contends doctors told him his wife "had lost all activity in her brain stem" and an accompanying chart stated that she was "brain dead."
In an affidavit filed Thursday in court, Erick Munoz said little to him now is recognizable about Marlise. Her bones crack when her stiff limbs move. Her usual scent has been replaced by the "smell of death." And her once lively eyes have become "soulless."
"Over these past two months, nothing about my wife indicates she is alive," Erick Munoz said. "... What sits in front of me is a deteriorating body."


The family's attorneys more recently said that Marlise's fetus "is distinctly abnormal," suffering from hydrocephalus and "deformed to the extent that the gender cannot be determined." http://www.cnn.com/2014/01/24/health/pregnant-brain-dead-woman-texas/index.html?hpt=hp_t1

Oh geez.

 

[K_Z]

For anyone wanting to stay on top of today's court hearing scheduled for 3:15 pm CST, here are 3 links that you might want to follow.

http://www.star-telegram.com

http://www.wfaa.com

http://www.nbcdfw.com

Our first evening newscast is at 4pm CST. There is another newscast at 5 pm CST & I will be listening to both. I will report anything I hear as soon as I hear it. Very often we hear the news on TV before a link is ever posted, but I will also provide the links as they become available.

On the really, really, remote chance that the judge somehow has an enlightenment, and rules that MM is not a "patient" and can be removed from the ventilator "immediately", I strongly suspect the hospital attorney/s already have prepared a request for an emergency injunction or appeal (not sure what it's called) to prevent the removal of the vent.

As in the Jahi McMath case, I do hope the Judge requires an independent neurologist to examine MM's body and confirm the diagnosis of irreversible brain death (not an OB GYN, or an internist, or intensivist, or cardiologist, etc). I think that's essential, at this point-- to bring in someone from outside of the hospital hierarchy, to lend some impartiality. And this neurologist should have no identifiable connections to any pro life groups or pro life politicians, OR pro choice groups, for maximum transparency. A professional with impeccable credentials, who will make decisions based on scientific and medical findings, and not emotion, religion, and politics.

I also hope that an independent perinatal specialist from outside the hospital is ordered to examine the fetus and make a report to the court, too. Even if we never hear about it. I am very bothered by the air of secrecy surrounding EM's access to information about his wife's body, and the condition of the fetus. IMO, the hospital sees him only as an obstacle, because he isn't going along lockstep with their extremist plans.

I feel so sorry for EM and MM's parents. They have conducted themselves with dignity and decorum at every stage of this fiasco. They have not pandered to the public, when they very easily could have. My heart goes out to them for the harsh judgments and nasty words aimed at them. I wonder how EM will be able to go back to work-- there are so many activist pro life people who hate this man, that I really worry for his safety. The activist prolife extremists are well known to resort to violence when passions are inflamed, and I worry for this man, his toddler, and MM's parents. It is so unfair. None of this is their doing.

 

[oh_gal]

But that is clearly not the case. He has medical training, and he understood quite well the ramifications of hypoxia on the fetus. From my own personal experiences those who work in the medical field generally understand the gravity of medical situations without having to be told. I think holding out false hope - not unlike in the Jahi McMath case - is far more detrimental to the mental health of the family.

:moo:

I am not really sure what the "case" is. That's why I was wondering.

My question wasn't about him hoping against hope that the baby will be born healthy. I was wondering (out loud, so to speak), if he would wish to carry on with the pregnancy if he could be assured the baby would be negatively unaffected due to the lack of oxygen.

I see him as not wanting to raise a possibly handicapped child. But if he knew, beyond a shadow of a doubt, the child would be born healthy, would he choose to continue the pregnancy.

I guess it's a rhetorical question.

 

[oh_gal]

He's not pushing-your word-for her life to be terminated. Her life is already over.

For the pregnancy to be continued, then.

Did you really not understand what I wrote, or are you just splitting hairs for the sake of splitting hairs?

 

[oh_gal]

Even if he is, he isn't alone.
Not everybody wants to raise a handicapped child.
If mother were alive, she'd have an option of terminating pregnancy after finding out about severe deformities.
Even after 20 weeks gestation.

No, that's true. And I wrote that in my OP (which I then took out) because I didn't want to offend anyone. It's so hard to know who will be offended by what you write.

 

[gitana1]

Oh, I wish we could try not to politicize this issue. We have lovely and kind pro-life and pro-choice people on websleuths who do not deserve to be offended for their beliefs.

Also, I have not seen anyone threatening this man or his family, although of course there probably are some nuts out there doing that, but the overwhelming response in Texas and everywhere appears to be support for this man and his right to follow his wife's wishes and/or to make those decisions as her husband.

 

[K_Z]

Oh geez.

Yeah. It's tough to read.

Her hemodynamics are probably so unstable she can't be turned much, or have range of motion in her limbs. I'm guessing she is just positioned in a 30 degree left lateral tilt position, to lift the uterus off the great vessels as much as possible, and moved as little as possible, so that her blood pressure remains sort of stable.

The attorneys alluded to the fetal imaging as being difficult due to the immobility of her body-- MM's body can't autoregulate her BP and vascular resistance, and probably less and less as time goes on and she becomes more refractory to pressors. When they move or turn her, I suspect her BP drops like a rock. I'd be surprised if they can maintain her systolic BP at or above 100. That is the bare minimum for halfway decent uteroplacental perfusion. I'm guessing that hypotension is a constant battle

 

[Softail]

Omar Villafranca ‏@OmarVillafranca 4m
A few folks w/signs outside Tarrant Co Court for #MarliseMunoz case. @cbsnewspath pic.twitter.com/nvruC6ruG0

 

[gitana1]

Yeah. It's tough to read.

Her hemodynamics are probably so unstable she can't be turned much, or have range of motion in her limbs. I'm guessing she is just positioned in a 30 degree left lateral tilt position, to lift the uterus off the great vessels as much as possible, and moved as little as possible, so that her blood pressure remains sort of stable.

The attorneys alluded to the fetal imaging as being difficult due to the immobility of her body-- MM's body can't autoregulate her BP and vascular resistance, and probably less and less as time goes on and she becomes more refractory to pressors. When they move or turn her, I suspect her BP drops like a rock. I'd be surprised if they can maintain her systolic BP at or above 100. That is the bare minimum for halfway decent uteroplacental perfusion. I'm guessing that hypotension is a constant battle

Help me with layman's terms!! I'm a dummy over here!

 

[K_Z]

Oh, I wish we could try not to politicize this issue. We have lovely and kind pro-life and pro-choice people on websleuths who do not deserve to be offended for their beliefs.

Also, I have not seen anyone threatening this man or his family, although of course there probably are some nuts out there doing that, but the overwhelming response in Texas and everywhere appears to be support for this man and his right to follow his wife's wishes and/or to make those decisions as her husband.

My concern isn't the reasonable people who hold beliefs, but the unstable ones. The ones who go off the rails and commit violence. And they are out there.

No one here is threatening the family, but the comments on other sites are very "unkind" to EM and MM's parents. It's worrying.

 

[gitana1]

My concern isn't the reasonable people who hold beliefs, but the unstable ones. The ones who go off the rails and commit violence. And they are out there.

No one here is threatening the family, but the comments on other sites are very "unkind" to EM and MM's parents. It's worrying.

I haven't seen any threats anywhere. My objection is to using an epithet following the term "activist pro life...".

 

[K_Z]

Help me with layman's terms!! I'm a dummy over here!

Oh, I am sorry! I thought I did?

MM's body, because of the brain death, and the demands of the pregnancy, is very vulnerable to wild swings in blood pressure.

Systolic BP (the mother's top number) is very important to make sure the placenta is well perfused (has good circulation). She may also have some infarcts (dead spots) in the tangle of blood vessels that make up a placenta.

That leads to chronic insufficiency. The fetus likely has had very compromised circulation (not enough, and not under enough pressure) to the placenta since MM collapsed.

Hope that helps.

(That's how I feel when I see all the legal latin terms, and I took 2 years of latin!)

 

[popsicle]

My concern isn't the reasonable people who hold beliefs, but the unstable ones. The ones who go off the rails and commit violence. And they are out there.

No one here is threatening the family, but the comments on other sites are very "unkind" to EM and MM's parents. It's worrying.

I agree.

Strong opinions on both sides of debate

The strong feelings about the next chapter for Marlise Munoz and her unborn child were on display Thursday outside the Fort Worth hospital.
Some held signs reading "God stands for life" and "Praying for Baby Munoz and family," believing that doing whatever is necessary for the unborn child's sake was imperative.

The opposite view was represented by those toting placards with messages like "Let Marlise rest in peace" and "Respect Marlise's wishes."

http://www.cnn.com/2014/01/24/health/pregnant-brain-dead-woman-texas/index.html?hpt=hp_t1

 

[gitana1]

Oh, I am sorry! I thought I did?

MM's body, because of the brain death, and the demands of the pregnancy, is very vulnerable to wild swings in blood pressure.

Systolic BP (the mother's top number) is very important to make sure the placenta is well perfused (has good circulation). She may also have some infarcts (dead spots) in the tangle of blood vessels that make up a placenta.

That leads to chronic insufficiency. The fetus likely has had very compromised circulation (not enough, and not under enough pressure) to the placenta since MM collapsed.

Hope that helps.

(That's how I feel when I see all the legal latin terms, and I took 2 years of latin!)

Thanks, it did. So how can the fetus be kept stable. I mean how is her body a good incubator for the baby? At the early stage of her pregnancy, is it even possible for her body to be kept going long enough to allow for the formation of a viable fetus?