Pregnant Texas woman removed from life support

Michael Cook
31 January 2014
Reproduced with Permission
BioEdge

Texas woman Marlise Muñoz was disconnected from life support last Sunday. All cardiac function ceased within a few minutes. Her body was released to her family, ending a nation-wide debate over reproductive rights, brain death, and advance directives.

On November 26, 33-year-old Mrs Muñoz collapsed after a clot in her lungs. The John Peter Smith Hospital in Fort Worth diagnosed brain death but also found that she was 14 weeks pregnant. It thereupon refused to remove her from life support, against her husband's wishes. It cited a Texas law which says that "life-sustaining treatment" must be maintained if a patient is pregnant, even if an advance directive exists or her relatives oppose it. The hospital planned to keep Mrs Muñoz on life support until her child was viable, deliver it with a Caesarean section, and then remove her from life support.

But the hospital finally relented when Mr Muñoz filed a lawsuit. "In fact, Marlise cannot possibly be a 'pregnant patient' - Marlise is dead," the suit says. "To further conduct surgical procedures on a deceased body is nothing short of outrageous." Her husband also alleged that the baby was not viable; it was said to be badly deformed and suffering from hydrocephalus.

This complex situation generated a storm of controversy. Was the Texas law unjust? Feminists said Yes. Was the Texas law being misinterpreted? Legal experts differed. Should a woman be used as an incubator? Feminists said, No. Should a dead body be used as an incubator? Her family thought that this did not show respect to Marlise Muñoz. Should a baby's right to life be ignored? Pro-life groups said, No.

Was it possible for the woman to give birth to a healthy baby? Surprisingly, this question was not often posed. If the fate of the baby was mentioned in the media, the focus was on its alleged deformities. However, surprising as it may seem, there have been a small number of documented cases of brain-dead women who have given birth to viable children. A 2010 study by German doctors examined 30 cases of brain-dead pregnant women between 1982 and 2010. Twelve viable children were born and survived infancy.

In fact, at the same time as Americans were debating whether to remove Marlise Muñoz from life support and to allow her child to die, Italians witnessed the birth of a healthy child from a brain-dead mother. Carolina Sepe, 25, was shot in the head by a deranged neighbour when she was 10 weeks pregnant (he killed her father and grandmother). She survived for another 17 weeks and passed away in early January.

The case also raised the thorny question of whether Marlise Muñoz was really dead, even if she fulfilled all the criteria for brain death. A few neurologists say that if the body is functioning as an integrated whole, the person is not dead - because the person is not the brain.

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