Marlise Muñoz being kept alive despite family wishes, controversy

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Marlise Muñoz has been declared brain dead.

Despite family and personal wishes, Marlise Muñoz is being kept alive on life support. (Courtesy)

Marlise Muñoz was 33-years-old when her husband found her lying unconscious on their kitchen floor in the middle of the night back in November of 2013. She was taken to John Peter Smith Hospital in Fort Worth, “where doctors informed Erick that Marlise had lost all activity in her brain stem, and was for all purposes brain dead,” according to a civil court petition filed Tuesday in Tarrant County. Since then, Marlise has been kept on life support in the hospital–against her family’s wishes–in the hopes she might still be able to deliver the child she was carrying.

The decision of the hospital has caused significant emotional turmoil within Muñoz’s family; it was well-known among family members the young wife and mother-to-be had stated she never wanted to be kept alive on a machine. Despite having made those sentiments clear to hospital staff, John Peter Smith medical staff has kept Marlise Muñoz’s body functioning for more than seven weeks.

According to the hospital, the family’s wishes can be overridden in this situation because of the Texas Advance Directives Act, which says in part: “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.”

The Los Angeles Times reports Erick Muñoz, Marlise’s husband, as well as her parents and several medical and legal experts agree that the state law doesn’t apply on the grounds that Marlise is not a “patient” because she can be legally classified as dead. The family and their council cite previous brain-injury cases where legal death was defined as the “irreversible cessation of all functions of the entire brain, including the brain stem.”

For Muñoz’s family, the questionable health of the fetus at the center of the controversy is not cause enough for such prolonged life support.

“That poor fetus had the same lack of oxygen, the same electric shocks, the same chemicals that got her heart going again,” Marlise’s father, Ernest Machado, told Dallas News. “For all we know, it’s in the same condition that Marlise is in. All we want is to let her rest, to let her go to sleep. What they’re (the hospital staff) doing serves no purpose.”

In a final attempt to carry out Marlise’s wishes, her husband and family have brought a lawsuit against John Peter Smith Hospital.

“Erick Muñoz vehemently opposes any further medical treatment to be undertaken on the deceased body of his wife,” read the lawsuit filed Tuesday in Tarrant County, Texas. “The Fourteenth Amendment provides that no State shall ‘deprive any person of life, liberty or property, without due process of law; the principle that a competent person has a constitutionally protected liberty interest in making decisions regarding their own body began at common law.”

The suit further states keeping Marlise Muñoz on life support violates the 14th Amendment of Texas law and can be proven by Section 671.001 of the Texas Health and Safety Code that states:

“(a) A person is dead when, according to ordinary standards of medical practice, there is irreversible cessation of the person’s spontaneous respiratory and circulatory functions…

(b) If artificial means of support preclude a determination that a person’s spontaneous respiratory and circulatory functions have ceased, the person is dead when, in the announced opinion of a physician, according to ordinary standards of medical practice, there is irreversible cessation of all spontaneous brain function. Death occurs when the relevant functions cease.”

Could a living will have helped Marlise Muñoz?

Some individuals have raised the question about how a living will, or an Advanced Directive, would have affected the Marlise Muñoz situation. According to CNN, in Texas, even a living will wouldn’t have changed the outcome of this sad story.

Pregnancy can by a difficult time.

For pregnant women, a living will can be overridden by state laws. (Shutterstock)

Fives states in the country allow women to have what are known as living wills–legal documents that indicate a woman’s wishes regarding her own body if she is unable to communicate at the time a medical decision or otherwise needs to be made. In those five states, Advanced Directive documents are considered “law” regarding what a pregnant woman’s wishes are with her body.

Unfortunately, the vast majority of states retain the power to override living wills in certain situations. For example, in more than 30 states, a living will denying life support will be overridden if the fetus is considered “viable,” meaning it has a chance to be born healthy regardless of the mother’s state of health. In this situation, as is the case in Texas, the mother will be kept alive by all means possible, even if she is in excruciating pain.

For this reason it is important for anyone with an Advanced Directive to know their state laws. The National Cancer Institute indicates living wills may dictate:

  • The use of life-sustaining equipment (such as dialysis machines, ventilators, and respirators).
  • “Do not resuscitate” (DNR) orders; that is, instructions not to use cardiopulmonary resuscitation (CPR) if breathing or heartbeat stops.
  • Artificial hydration and nutrition (tube feeding).
  • Withholding food and fluids.
  • Organ and tissue donation.

But living wills are no guarantee those wishes will be carried out. In some states, a living will at best will make a stronger case should a medical situation like that of Marlise Munoz go to court.

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