Will Doctors Force Brain Dead Mother to be Kept Alive as an Incubator?

I saw this story on AC360 this evening:

It is both a tragic and morbidly fascinating situation. A 14-weeks pregnant Marlise Munoz collapsed on the floor of her home in November after a suspected pulmonary embolism. Munoz was declared brain dead shortly after at John Peter Smith Hospital in Fort Worth, Texas.

Munoz wished not to be kept on life support, but as her husband Erick and family prepared to say their final goodbyes, her doctors told them that they would not comply with her wishes. You see, the state of Texas prohibits the removal of life support from pregnant patients.

Now, more than a month later, the doctors and hospital are keeping Munoz’s body alive in order to comply with their understanding of Texas law.

The legal and ethical questions here are complicated, and that is to say nothing about the pain and suffering Munoz’s husband and family are experiencing. Legally, there are two definitions of death: cardio respiratory death and brain death. For example, a person who is in a coma or a vegetative state can be kept alive through life support systems and is not legally dead. However, when all brain function stops – as is reportedly the case with Mrs. Munoz – even if the body can be kept alive through artificial means, the person is legally dead.

The Texas law, passed in 1989 and amended in 1999 says that “life-sustaining treatment” cannot be withheld or withdrawn from a pregnant patient. Some medical and bioethics experts claim that the hospital is misinterpreting the law. Thomas W. Mayo, a bioethics and health law expert from the Southern Methodist University school of law said, “If she is dead, I don’t see how she can be a patient, and I don’t see how we can be talking about treatment options for her.”

Additionally, Arthur L. Caplan, director of medical ethics at NYU Langone Medical School stated, “the Texas Legislature can’t require doctors to do the impossible and try to treat someone who’s dead. I don’t think they intended this statute the way the hospital is interpreting it.”

Here we are. Did the Texas legislature intend that a dead pregnant woman should be kept alive to serve as an incubator for a 20-week old fetus?

Anti-abortion activists have supported the decision of the hospital. And there may be a point to be made that Mrs. Munoz’s wish to be taken off life support was not considering the possibility that she would be pregnant.

More ethical questions arise if and when Mrs. Munoz is artifically kept alive past the point of fetal viability. I generally think that the point of fetal viability is an appropriate place to start considering the rights of the unborn in addition to the rights of the mother.

Meanwhile, Mrs. Munoz’s husband and family are in limbo.

Further reading:

  1. Pregnant, and Forced to Stay on Life Support – from the New York Times
  2. Texas Life Support Battle Pits State Law Against Pregnant Woman’s Earlier Wishes – from CBS News
  3. Take Pregnant Woman Off Ventilator? – from CNN Opinion
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