Against her wishes, woman stays on life support

Happy 2014 blog readers! If you’re reading this from the Midwest, I hope you’ve stayed warm and cozy inside during this past week of snow and subzero temperatures. I was really hoping to blog about ethics and the snow, but no particularly interesting topic came to mind. Snow is white, cold, and makes it difficult to get to work. Done. So what’s the first topic of 2014 you ask? Bioethics.

While scanning the New York Times Wednesday, I read a thought-provoking article with the intriguing headline “Pregnant, and Forced to Stay on Life Support”.

Erick Munoz standing next to a photo of himself, Marlise,
and their son Mateo (Star-Telegram/Ron T. Ennis)

Marlise Munoz, a 33-year-old mother living in Fort Worth, TX died this past November after collapsing on her kitchen floor from a blood clot in her lungs. When her husband found her, she was rushed to a local hospital where she was pronounced brain-dead, but kept alive by machines in the intensive care unit. Her family prepared to say their goodbyes, keeping in mind Marlise’s wishes to not be kept on life support if in this situation. I can't imagine their confusion then, when a doctor came into the room and told them that she would continue to stay on life support in compliance with Texas law. Marlise was 14-weeks pregnant.

Under Texas law, a person cannot withdraw or withhold “life-sustaining treatment” from a pregnant patient. But according to the article, there is a difference from being brain-dead (as Marlise was declared) and being in a vegetative state. Brain-dead means that there is no neurological activity, but the organs can be maintained through breathing tubes, whereas brain activity still exists for patients in a coma. Brain-dead is legally dead, and therefore the hospital deciding to keep Marlise alive does not apply to Texas law.

This all brings into question end-of-life care. For the parents of Marlise, Mr. and Mrs. Machado, this is prolonging their agony. I picture them sitting next to their dead daughter whose chest continues to go up and down as oxygen is pumped into her body but whose skin is cold and lifeless. If the hospital continues to support their statement that Marlise is brain-dead, then they have misinterpreted Texas law and must abide by the family’s wishes. This treatment may be causing irreparable damages to the family psychologically.

If this fetus were to go through a full term, and brought from Marlise’s body as a healthy child, would it not be a blessing for the family? Mr. Munoz (Marlise’s husband) is a 26-year-old firefighter working full time and taking care of his 15-month-old son as a single father. Does his situation factor into your opinion of what should happen to the mother or the fetus?

This is a great topic for debate. Is the Texas hospital stepping out of bounds? Should the parents agree to their daughter’s wishes? Would Marlise’s wishes be different if she knew she would die while pregnant? With advanced medical technology, we need to be having these conversations as a member of a family, as a voter or a policy maker to ensure we have the end-of-life care we desire, while easing the pain of the loved ones we leave behind.