Choosing Death, Choosing Life: did being distinctly abnormal make a difference?- part 1

Husband of pregnant woman wants her off life support

By Elizabeth Landau, CNN
updated 4:11 PM EST, Tue December 24, 2013

(CNN) -- Erick Munoz wants to see his wife's wish fulfilled this holiday season, but it's one that carries ethical and legal challenges: To be taken off of life support.

Marlise Munoz, 33, is in serious condition in the intensive care unit at John Peter Smith Hospital in Fort Worth, Texas, hospital officials said. She is unconscious and on a ventilator, her husband told CNN affiliate WFAA, but she wouldn't have wanted her life sustained by a machine.

"We talked about it. We're both paramedics," he told WFAA. "We've seen things out in the field. We both knew that we both didn't want to be on life support."

Complicating an already difficult situation is that Munoz is also pregnant, about 18 weeks along, WFAA reported. Texas state law prohibits withdrawing or withholding life-sustaining treatment from a pregnant patient, regardless of her wishes.

 

Man wants pregnant wife off life support

 

Patients can indicate their future wishes about medical treatment, in the event that they are unable to communicate them, through forms called advance directives. But in Texas, under the Health and Safety Code, such a form includes the provision "I understand that under Texas law this Directive has no effect if I have been diagnosed as pregnant."

Erick Munoz told WFAA doctors said his wife may have suffered a pulmonary embolism, which happens when blood clots travel to the lungs from elsewhere in the body. They do not know how long the baby went without nutrients and oxygen.

The hospital would not release specific details about Marlise Munoz's condition, but officials said the hospital would follow Texas law regarding care during pregnancy.

 

"We have a responsibility as a good corporate citizen here in Tarrant County to also provide the highest quality care we can for all of our patients," said J.R. Labbe, vice president of communications and community affairs for JPS Health Network, in a statement.

"But at all times, we will follow the law as it is applicable to health care in the state of Texas. And state law here says you cannot withhold or withdraw life sustaining treatment for a pregnant patient. It's that clear."

The husband and wife, both paramedics in the Tarrant County area, have a 14-month-old son named Mateo.

Erick Munoz and Marlise Munoz's mother did not immediately respond to requests for comment from CNN.

Erick Munoz found his wife unconscious on November 26, around 2 a.m. He performed CPR on her and then called 911, WFAA reported.

Since that day, the pregnant woman has been on life support, her husband said. Tests have shown that the fetus has a normal heart beat, he said. At 24 weeks, doctors may know more about when the fetus can be taken out, Munoz's family told WFAA. Doctors have also discussed the possibility of taking the fetus to full term.

He told WFAA that his wife had said she would not want to be kept alive by machine, and said he has reached "the point where you wish that your wife's body would stop."

Munoz wears his wife's pink and blue bracelets on his wrist, WFAA reported. Her wedding ring is on his pinkie.

When Munoz walks in the door, he said his son Mateo is waiting for his mother to show up.

"You can see it in his eyes," Munoz said.

 

Brain-dead Texas woman taken off ventilator
http://www.cnn.com/video/data/2.0/video/bestoftv/2014/01/27/newday-valencia-tx-mom-off-of-life-support.cnn.html

From Caleb Hellerman. Jason Morris and Matt Smith, CNN

updated 7:26 AM EST, Mon January 27, 2014

 

Fort Worth, Texas (CNN) -- A wrenching court fight -- about who is alive, who is dead and how the presence of a fetus changes the equation -- came to an end Sunday when a brain-dead, pregnant Texas woman was taken off a ventilator.

The devices that had kept Marlise Munoz's heart and lungs working for two months were switched off about 11:30 a.m. Sunday, her family's attorneys announced.

"May Marlise Munoz finally rest in peace, and her family find the strength to complete what has been an unbearably long and arduous journey," the lawyers, Heather King and Jessica Janicek, said in a written statement.

Munoz was 14 weeks pregnant with the couple's second child when her husband found her unconscious on their kitchen floor November 26. Though doctors had pronounced her brain dead and her family had said she did not want to have machines keep her body alive, officials at John Peter Smith Hospital in Fort Worth had said state law required them to maintain life-sustaining treatment for a pregnant patient.

Attorneys: Fetus was 'distinctly abnormal'

Sunday's announcement came two days after a judge in Fort Worth ordered the hospital to remove any artificial means of life support from Munoz by 5 p.m. Monday. Earlier Sunday, the hospital said it intended to comply with that order.

"The past eight weeks have been difficult for the Munoz family, the caregivers and the entire Tarrant County community, which found itself involved in a sad situation," a hospital statement said. "JPS Health Network has followed what we believed were the demands of a state statute."

The hospital acknowledged Friday that Munoz, 33, had been brain dead since November 28 and that the fetus she carried was not viable. Her husband, Erick Munoz, had argued that sustaining her body artificially amounted to "the cruel and obscene mutilation of a deceased body" against her wishes and those of her family.

Marlise Munoz didn't leave any written directives regarding end-of-life care, but her husband and other family members said she had told them she didn't want machines to keep her blood pumping.

The ethics of life support

In an affidavit filed Thursday in court, Erick Munoz said little to him was recognizable about his wife. 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."

The hospital's position drew support from demonstrators outside the hospital, some of whom held signs last week that read "God stands for life" and "Praying for Baby Munoz and family." But others countered with placards bearing messages like "Let Marlise rest in peace" and "Respect Marlise's wishes."