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Wednesday, January 8, 2014

27

On the Brain-Dead Texas Woman Being Kept Alive to Gestate a Fetus

The (redesignedNew York Times on an unforgivable human rights story from my home state:

The diagnosis was crushing and irrevocable. At 33, Marlise Munoz was brain-dead after collapsing on her kitchen floor in November from what appeared to be a blood clot in her lungs.

But as her parents and her husband prepared to say their final goodbyes in the intensive care unit at John Peter Smith Hospital here and to honor her wish not to be left on life support, they were stunned when a doctor told them the hospital was not going to comply with their instructions. Mrs. Munoz was 14 weeks pregnant, the doctor said, and Texas is one of more than two dozen states that prohibit, with varying degrees of strictness, medical officials from cutting off life support to a pregnant patient.

There is some confusion over whether the law applies to brain-dead patients as well as patients in a coma or vegetative state, but additional "confusion" stems from the fact that the hospital has also "declined to comment" on Munoz's condition. I'm shivering with rage! From Munoz's parents:

“It’s not a matter of pro-choice and pro-life,” said Mrs. Munoz’s mother, Lynne Machado, 60. “It’s about a matter of our daughter’s wishes not being honored by the state of Texas.” Mrs. Munoz’s father, Ernest Machado, 60, a former police officer and an Air Force veteran, put it even more bluntly. “All she is is a host for a fetus,” he said on Tuesday.

A spokesperson for the hospital said, “Every day, we have patients and families who must make difficult decisions. Our position remains the same. We follow the law.”

At least 31 states have adopted laws restricting the ability of doctors to end life support for terminally ill pregnant women, regardless of the wishes of the patient or the family, according to a 2012 report from the Center for Women Policy Studies in Washington. Texas is among 12 of those states with the most restrictive such laws, which require that life-support measures continue no matter how far along the pregnancy is.

Legal and ethical experts, meanwhile, said they were puzzled by the conflicting accounts of her condition. Brain death, an absence of neurological activity, can be readily determined, they said. It is legally death, even if other bodily functions can be maintained.

Texas: Not Doing Great.

[NYTimes]



27 Comments / Post A Comment

supernintendochalmers

I read about this policy recently but it's quite shocking to hear about it being applied to a 14-week fetus. That's barely at the stage when it's safe to start telling people you're pregnant, right? It can't be healthy for a baby to be grown in someone who's vegetative for most of their development. And then to know that this child is coming into the world with no mother... This is just so tragic all around.

Blushingflwr

@supernintendochalmers There's also the problem that since the mother was deprived of oxygen, the fetus may well have been too. And that in brain death, the rest of the body will start to follow. So we have no idea what kind of long-term damage the fetus has already suffered/may suffer in the future.

Kenneth Higgs@facebook

@supernintendochalmers & @Blushingflwr:
Numerous patients who were diagnosed as “brain dead” with “no hope of recovery” have spontaneously revived, proving the doctors wrong. http://www.OrganFacts.net/notdead/
Let this woman stay on life support and let her unborn baby have a chance to live.

Blushingflwr

@supernintendochalmers It's not up to me, or you, or the state of Texas to make the decision. I'm not her next of kin. I'm guessing neither are you. The state certainly isn't. She made a decision, she discussed it with her next of kin, and her wishes are being ignored. This is an egregious example of the state deciding that a woman's primary function is childbearing, regardless of her feelings on the matter.

Jill_Tata

Took my breath away…@k

stuffisthings

Great -- we're one step closer to the Matrix-style human fetus farm that Jesus called for in the Bible. Good work team.

Rock and Roll Ken Doll

@stuffisthings
This is my favorite joke of yours since Guantanamo Pumpkin Spice.

City_Dater

Leaving aside the most rage-inducing part of this -- keeping this poor woman's body alive against her wishes and her family's -- will this hospital and the Jackass State of Texas be paying for this experiment in gestation, or will their final horrifying insult be billing this grieving family for anything not covered by insurance?

pinniped

@City_Dater And I'm confused about legal custody, too; will the husband or parents automatically have to take on this child they did not ask for?

This is so heartbreaking.

Rock and Roll Ken Doll

I guess whoever has custody could put the child up for adoption? As for who pays, perhaps Marlise Munoz would be covered under Medicaid (I assume a brain-dead person has no assets or income)? Just brainstorming possible answers.

commanderbanana

@City_Dater Texas does not pay - and keeping a brain-dead person breathing on a ventilator in a hospital costs about 4k PER DAY.

When/if the baby's born, it will likely have severe brain damage as well, since it would have been deprived of oxygen for as long as the mother was.

There really are just no words - I mean, I don't see how anyone can read this and still be in denial that in Texas, women's bodies are considered property of the state.

keristars

@commanderbanana
OH MY GOD THAT IS HORRIFYING.
So horrifying that I was compelled to spell out omg and do it all in caps instead of being lazy. Like, I had an idea that mostly dead + pregnant = bad news for fetus (can it even grow independently, since it's basically completely tied to the mother's body at this point, like a parasite?), but to ALSO cost $4K PER DAY that the state isn't going to pick up, even though they're the ones forcing the hospital to keep the body on a ventilator and such... I would be shocked if the insurance company picked up the tab, too.

And then to know that if the fetus grows long enough to become viable, it's most likely going to be super damaged from this... Isn't 20 weeks the cut-off for those super restrictive laws that are trying to undermine Roe v. Wade?

MrsTeacherFace

@City_Dater Yes, 20 weeks is the new cut off in Texas, which is another reason this situation makes NO SENSE. Come on Texas.

commanderbanana

@City_Dater I'm actually really surprised this article didn't mention it - the first article I read about this was linked in Feministing and they did mention that Texas is under no obligation to pay for her care and the cost. I would think that is a not unimportant consideration.
Assuming the baby reaches term and is born alive, the family may be able to file a wrongful-birth suit against the hospital, if Texas even allows that kind of thing (California had one successful wrongful-birth suit before changing the laws so that they could't be brought in court).

I have many and varied reasons for not wanting to have children, but I will say one of the big reasons is the idea of losing bodily autonomy for nine months and losing complete physical control over my body and what is done to it when I deliver (and anyone who thinks I'm being hyperbolic is more than welcome to Google cases of forced Caesarians or instances where women were actually arrested and forced to undergo a C-section after trying to decline them).

Anyway, I am so incredibly horrified for this family and the ordeal they're going through. It's sickening.

harebell

@City_Dater
I could be wrong, but I believe that technically Marlise Munoz is the person accruing debt by being treated by the hospital, so the bills will be in her name. And while you can collect money from a dead person's estate, you can't make inheritors be responsible for a dead person's debt once the assets of the estate are gone. So anything in Marlise Munoz's own name would be wiped out, but it would not be legal to hold the husband or parents liable for the costs. What happens with joint-owned stuff, I don't know, but they would not be liable for her debt -- the hospital would just have to swallow those costs.

hungrybee

I get real bummed every time I realize that Margaret Atwood is probably a prophet.

lunaesque

They're not even keeping the mother's body alive. They have a dead body in which they are circulating blood in a heretofore never before attempted experiment comparable to the kind of experiments on human life that took place in Germany during WWII (no, this is not an exaggeration). This is so disgustingly creepy, it makes my skin crawl. I feel for the family and the fetus, which does not have much of a chance of growing into a normal baby. The physicians involved in the "care" of this dead body should lose their liscences to practice medicine. They are professionals and know better. "First, do no harm."

peculiarity

I don't know why we're all upset. I thought "The Handmaid's Tale" was an excellent book.

Wait, this is for realz? ::crawls in corner and sobs::

bowtiesarecool

I had no idea that so many states invalidate advance directives and DNRs in the case of pregnancy before I read this. It is so terrifying and horrifying and WRONG.

I feel strongly about death and dying and control over the degree of medical intervention experienced, and the fact that if I am unlucky enough to be in an accident/get sick/experience a cardiovascular event while pregnant means that my wishes mean NOTHING makes me ill. That's even more horrifying than all of the restrictions around birth control and termination, which were already pretty horrifying.

Are any 'Pinners familiar with any organizations working against these kinds of provisions? Because I want to give them my money.

commanderbanana

@bowtiesarecool This is a little-known wrinkle in state law. Planned Parenthood and NARAL support protecting women's bodily autonomy in a general sense; but I don't know if they specifically campaign against things like this.

I would say your best bet is to consistently vote for lawmakers who don't support these laws in state and local elections. If your state has one of these statues, you can contact your state legislature and let them know that you disagree with it and won't vote for anyone who supports them.

Other than that, I think drawing attention to these laws before something like what's happening in Texas happens is the most important thing.

stonefruit

I have all kinds of thoughts and warring opinions about end of life decisions and how they intersect with disability, but the facts here seem pretty stark: she had an advance directive, and the state is straight-up ignoring that because she happens to be pregnant.

It's disgusting and terrifying and makes me want to punch someone.

bowtiesarecool

@stonefruit I had no idea that SO MANY states invalidate advance directives automatically in the case of pregnancy. You literally have no right to refuse (or have you designated agent refuse for you) life-preserving medical treatment if you are pregnant in a third of the US. Probably more if we're measuring by geography. Oh my god. Oh my god. That is my worst nightmare.

stonefruit

@bowtiesarecool I mean, after the Terry Schiavo thing happened, I saw so many people take really hard looks at their lives and decide to write their own advance directives, and I thought: wonderful. So much less trauma and horrible family stress at a moment when unity should be paramount, I am all in favor!

And now there are the women in Texas - and in one-third of the US, apparently! - whose advance directives are nullified because of anti-choice laws. So like - what was the point of having them at all? Why offer such an illusory choice?

It just feels so hopeless.

bowtiesarecool

@stonefruit Yeah, I feel really strongly about advance directives and end of life planning in general.

But hey, they're worthwhile! Unless you're pregnant. Then you're not a person and you don't get to have rights and things. But we already knew that from the umpty billion other examples of this fuckery.

Blushingflwr

@bowtiesarecool I was really happy to learn that in MD, if you make an advance directive, there is a subsection for if you are pregnant, and you can make the same choices or different ones as if you are not pregnant.

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