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

  • #221
I don't assume she felt that way. That's my own analogy.

But we don't need to assume at all what her wishes were. We have the testimony of her husband and parents as to what her wishes were - that she would not want to be kept alive this way.

We accept testimony about things like this all the time. Why suddenly is this different? Wy are we treating women differently, simply because they have a uterus that might have an embryo or fetus in it?

JMO, because the fact of the matter is that many women feel differently and make different decisions depending on whether there is a baby involved or not. I would, anyway. Normally I would prefer to die with dignity and not artificially ventilated if there is no hope of meaningful recovery. But if I was pregnant I would put my baby's life ahead of my right to die without ventilators and say, to he!! with my dignity, please do anything you can to save my baby. I had a cancer scare during one of my pregnancies and I had it all thought out. I would normally have wanted all the treatments the doctors recommended as soon as possible but I had decided that I would delay anything that could harm the baby.

I realize not everybody is me but I think I'm probably not the only one who thinks like that. It is possible that MM would want the same things anyway and her husband might be right that she'd prefer to disconnect the ventilator, never mind what happens to the baby. Perhaps she would be particularly worried for her baby and that's why she'd like to disconnect the ventilator, to save her baby the suffering.


But it's possible that all the families don't know what their loved ones want either unless they have made a point of discussing the end of life decisions while pregnant and while not pregnant. Mine didn't... I didn't want to talk about it, it was too scary.

The only way for anybody to know for sure what we want after we are incapacitated is for us to put it in writing beforehand. There's no way to take all the different contingencies into account but it would be easy enough for the advance directives of fertile women to add a rider, "if I'm pregnant, please disregard the above and try to save my baby if possible? yes/no/maybe in some circumstances/let the father of my baby know the facts and the prognosis and decide what he wants to do".
 
  • #222
Just found this little tidbit.


http://www.star-telegram.com/2014/0...-and-the-politics.html?storylink=addthis&rh=1

snipped

Had Muñoz been in a different city or state when she collapsed with no brain function Nov. 26, she might have been allowed to die, perhaps after an abortion to end what was then a 14-week pregnancy.

But at county-operated John Peter Smith Hospital in conservative Tarrant County, Texas, abortions were banned in 1988.

snipped

But a Dallas-based Baylor Health Care System ethicist who helped write the law has disagreed with JPS’s interpretation.

Dr. Robert L. Fine told The Associated Press that if Muñoz is brain-dead, she’s not an ill “patient,” she’s legally dead.

How you die depends where you live.
 
  • #223
tumblr_mz51cnTApo1r6s4fvo1_500.jpg

http://big.assets.huffingtonpost.com/LifeSupport_0.png

http://www.huffingtonpost.com/2014/01/08/pregnant-living-will-_n_4562964.html
comments are interesting.
http://www.centerwomenpolicy.org/pr...lProxyStatutesMeganGreeneandLeslieR.Wolfe.pdf
 
  • #224
She did not have a WRITTEN advance directive. At 33, why would she?

IMO, because none of us, no matter our age, are guaranteed a long life. There are too many tragic things that can happen every day whether it is for a physical reason like Marlise, an accident, or a terrorist attack. The only thing about life that is certain is that it is uncertain.
 
  • #225
And one last question - why the need to see it in writing? Do folks think that not only her husband, but her parents as well, are all conspiring to go against her wishes? Wy would they all do this?

And this is disregarding the fact that even if it were in writing, it wouldn't matter. The state of Texas thinks it knows better about what to do with women's bodies at the end of their lives if they're pregnant.

I understand what you are saying. But, it has to be in writing because it HAS to be her choice. Absence of it being in writing, it would be left to power of attorney. . .and terminating a pregnancy, by legal definition, is not a right that can be assigned to anyone else besides the pregnant woman.

I agree that IF Marlise had put it in writing that their would be a constitutional issue there. However, she was in her second trimester and Roe v Wade is pretty clear on the states powers after the first trimester. Read some of the decisions dealing with these issues.
 
  • #226
I understand what you are saying. But, it has to be in writing because it HAS to be her choice. Absence of it being in writing, it would be left to power of attorney. . .and terminating a pregnancy, by legal definition, is not a right that can be assigned to anyone else besides the pregnant woman.

I agree that IF Marlise had put it in writing that their would be a constitutional issue there. However, she was in her second trimester and Roe v Wade is pretty clear on the states powers after the first trimester. Read some of the decisions dealing with these issues.

Apart from the legalities, I think it's simply kinder to the next of kin to have this stuff in writing. If the worst happens, the family will be in a terrible crisis and their decision making capabilities are not always the clearest, with sadness, despair, guilt, hope, etc. warring inside. It will save the family in crisis some heartache at least if they have a clear written proof of what the loved one wanted and don't have to quarrel among themselves or spend a lot of time, perhaps the rest of their lives, wondering if they made the right decision. You know, "Am I doing the right thing? Is this what she wanted? I remember she once said... Do I really remember that conversation? What if I misunderstood her? What if she didn't really mean it? What if she changed her mind? What if there is still hope? What should we do? But she said if she was in a coma. She didn't say pregnant and in coma. What would she do if she was me and I was her? What if this was a mistake?" And so on.
 
  • #227
So far no court date has been set so that makes me wonder. Please trust me when I say I am not ordinarily a paranoid person. More than once I've had a "friend" who totally betrayed me & I didn't have a clue until the "hammer fell". It is in my nature to be trusting. You would think after 75 years, I would know better.

Here's what I'm wondering about. If a court date is not set within the next few days, I suspect the hospital & the court are just in a stalling mode. If that is the case, they can hold out until the 24th week of pregnancy. They can then deliver the baby. If it's dead, they can then say "We've done all we could. We've resorted to heroic measures & it didn't work." If the baby is seriously disabled, they can say the same thing. Forget the fact that the baby is suffering terribly & so is the Munoz family. That is just superfluous "collateral damage". This scenario would leave the hospital blameless & & free the judge from making an unpopular decision. Let's face it, the judge's decision will be unpopular regardless of whatever that decision might be. Since I'm not a medical professional, I don't know what the percentages are that the baby will be able to have anything resembling a normal life free of any pain & suffering. Perhaps K Z has an educated opinion on this.

I hope my idea is unfounded paranoia. Guess we just have to wait to find out. I just don't trust politics!
 
  • #228
  • #229
Well, that's a horrifying map. :ohoh:
 
  • #230
  • #231
  • #232
So far no court date has been set so that makes me wonder. Please trust me when I say I am not ordinarily a paranoid person. More than once I've had a "friend" who totally betrayed me & I didn't have a clue until the "hammer fell". It is in my nature to be trusting. You would think after 75 years, I would know better.

Here's what I'm wondering about. If a court date is not set within the next few days, I suspect the hospital & the court are just in a stalling mode. If that is the case, they can hold out until the 24th week of pregnancy. They can then deliver the baby. If it's dead, they can then say "We've done all we could. We've resorted to heroic measures & it didn't work." If the baby is seriously disabled, they can say the same thing. Forget the fact that the baby is suffering terribly & so is the Munoz family. That is just superfluous "collateral damage". This scenario would leave the hospital blameless & & free the judge from making an unpopular decision. Let's face it, the judge's decision will be unpopular regardless of whatever that decision might be. Since I'm not a medical professional, I don't know what the percentages are that the baby will be able to have anything resembling a normal life free of any pain & suffering. Perhaps K Z has an educated opinion on this.

I hope my idea is unfounded paranoia. Guess we just have to wait to find out. I just don't trust politics!

I agree with your distrust of politics. I've considered this will not even get resolved before the 2014 election for Governor of Texas. Rick Perry is not running so the Attorney General of Texas Greg Abbott (pro-life) is one party's candidate and State Senator Wendy Davis (pro-choice) is the other party's candidate and its sad to think the election is going to be a one issue election, but early indications look like it will be.

http://www.politicususa.com/2014/01...endy-davis-soar-gop-opponent-fundraising.html
 
  • #233
Let's try this link again about the judge recuses herself.

http://www.wfaa.com/news/local/judg...e-support-case-recuses-herself-240643781.html

Ok, this link works!! Sorry for my initial flub!

I'm anxious to know if this judge gives a reason for recusing herself.
MOO, legitimate & non legitimate reasons could be:

1. She is related to the Munoz family or one of the physicians, nurses, or administrators on the staff of the hospital, or is good friends of one of them

2. She has pre-determined what she believes the decision should be

3. She knows, that by law, she would have to rule in favor of the Munoz family & this would be contrary to her moral beliefs

4. She is up for re-election this year & doesn't want to take the political heat because of any decision she might make.

5. She has been instructed by the 'powers that be' to 'stall'

I still have a very strong feeling that this is NOT about the fetus/baby or the Munoz family but that it simply a case of politics at it's worst.
 
  • #234
This case is a conundrum. There is a lot to learn here, and I think it will inspire changes.

Very sad for the woman, the father and the baby.

I have a medical question:
does the fact that the baby has a heart beat mean that its brain is working? Or could it also be brain dead?
 
  • #235
First, the judge is entitled to recluse herself. It's like someone exercising their right to remain silent. I don't hold that against her. I wouldn't want to decide this case either. It's a lose/lose situation for her.

What I want to make VERY clear here is, that legally, if you are arguing that this family has the right to have Marlise removed from life support, you are actually arguing AGAINST a woman's right to choose an abortion. That is simply the facts. You canNOT argue that this family has the right to remove her from life support without saying that the right to an abortion can be assigned to someone other than the pregnant woman. The very definition of an abortion does apply here. Anything that terminates her pregnancy is defined, by law, as an abortion.

I don't know about anybody else, BUT I am okie dokie with telling THIS family " I am so sorry, but she should have put it in writing. .. too bad. . .so sad," than redefining who gets to choose an abortion.

Can you seriously imagine if the the courts determine that the right to an abortion is assignable?!

"Hey honey, let's get married. But first you have to sign this pre-nup where you sign away your reproductive rights to me."

"Congratulations! You got the job. But part of the terms of your employment is that you have to sign this waiver where we get to choose for you. We don't like abortion so you CAN'T have one/ OR we don't want our employees to have families so you MUST have an abortion. Don't like it? You don't have to work here."

MOO. . .NO friggin thank you! :gasp:
 
  • #236
This case is a conundrum. There is a lot to learn here, and I think it will inspire changes.

Very sad for the woman, the father and the baby.

I have a medical question:
does the fact that the baby has a heart beat mean that its brain is working? Or could it also be brain dead?

Baby could be brain dead even with the heart beating. It's getting oxygen from the mother, which is getting it from the ventillator. If it's brain dead it would be just dead after birth, unless somebody attaches it to its own ventillator.
But hospital can do tests to check what shape the baby is in.
By the way the abortion would already be illegal in TX at the gestation period the fetus is in now (on the recently passed law that prohibits abortion after 20 weeks gestation).
 
  • #237
  • #238
Why I believe this case is politically motivated fetal experimentation:

- If one believes Marlise is "still" deserving of personhood rights, her expressed wishes are being intentionally being disregarded by the interpretation of the laws in Texas. That is not informed consent, it is State coercion. And hijacking of her "personhood" rights to self determination. The state of TX doesn't care if she wrote her wishes down, or not. Merely because she has a uterus, the State of TX has determined that she cannot have decision making rights over her own body.

-If Marlise retains "personhood" rights, she has not consented to what is being done with her body, nor has she consented to what is being done to her fetus.

-Marlise's legal decision maker, her husband, has been disregarded and replaced by the state of TX as Marlise's decision maker. He has not consented to what is being done to his wife's body, or consented to what is being done to the fetus she was carrying at the time of her death.

- The decisions about maintaining the host body have not taken into account medical information about the fetus, nor the circumstances of the host mother's death, nor the stage of development of the fetus at the time that the decision was taken to maintain Marlise's body as a involuntary host. The profound arrogance and paternalism of the TX law says that ONE day pregnant is enough to invalidate any advanced directives or expressed wishes.

- Medical science cannot predict with ANY certainty what the short term, or long term outcome of this experimental gestation will have on the fetus. There is no body of knowledge to guide decision making. There are 30 anecdotal cases in the past 30 years, and some of the earliest ones which are not robustly validated. There are no clinical studies, outcome criteria, best practices guidelines, or research protocols for this experimental gestation. There is no institutional review board approval for this experimental gestation. There is no ethics committee involvement in the decision making for either this deceased woman, nor her unfortunate fetus.

- The overwhelming circumstances of the duration and conditions of the decedent's oxygen deprivation add enormous uncertainty as to the potential outcomes for this early second trimester fetus. There are no protocols, or collective body of knowledge, to guide clinical decision making. But it doesn't take a rocket scientist to predict that the circumstances of Marlise's hypoxia and cardiac arrest (multiple arrests, from EM's reports) will not have a positive effect on the developing fetus. The overwhelming likelihood is that IF the fetus lives to viability, it will be damaged neurologically to probably a very severe degree. This was NOT a witnessed arrest, with prompt restoration of oxygenation and circulation. This was a very, very prolonged hypoxic insult, compounded by ventilation perfusion mismatch from the embolism. There is NO physiological reason to believe that this fetus is "okay." And we don't know what the condition of the fetus is at this point, because it is confidential. All we know is that the heart is beating.

- There is no identified funding for this experimental gestation. Private insurance will not pay for donor care, once death is declared.

- Once undertaken, there are no identified circumstances allowable by state law to withdraw host support, save cardiac arrest of the fetus.

Basically, they are just "winging it", and hoping for the "best". (However they would define "best".) That is magical thinking, IMO. It is not the scientific practice of educated, moral, ethical professionals, IMO. It is opportunistic abuse of a fetus, IMO.

These are professionals and administrators who have been, IMO, willingly sucked into the vortex of abortion politics, magical thinking, and ignorance, and are willing to play "God" in a very childlike way with a dead woman's body, and a non-viable fetus.

It all boils down to a mentality of , "Let's do this thing, and just see what happens!" This is not a 6th grade science project. But the hospital, and the politicians are acting like it is. IMO.
 
  • #239
Condition of fetus is only confidential as far as the hospital is concerned. Father can release any information he sees fit. Or he could give hospital permission to talk about condition of the fetus/his wife (which he has not done).
I don't think he knows anything about condition of the fetus because hospital hasn't run the tests yet.
It plans to do so in early February.
It also has until February to respond to the lawsuit.
By that time fetus is going to be at 24 weeks gestation which is considered the age of viability.
If it's brain dead then it's going to be easy-they can turn off life support. But what if it's not?
I understand by law the brain dead person is legally dead. But how can it not be taken into account if this brain dead person is pregnant?
 
  • #240
I'd be willing to bet that they ultrasound the fetus at least once a day. They have a TON of information already. I'd bet they have done an MRI.

A 20 weeker is still too small to keep it on the external fetal heart monitor 24/7....unless it isn't moving around at all.
 

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