FORT WORTH - A judge on Friday ordered a Texas hospital to remove life support from a pregnant, braindead woman whose family had argued she would not want to be kept in that condition.
Judge R. H. Wallace Jr. issued the ruling in the case of Marlise Munoz. John Peter Smith Hospital in Fort Worth has been keeping Munoz on life support against her family’s wishes. The judge gave the hospital until 5 p.m. Monday to remove life support.
Munoz was 14 weeks pregnant when her husband found her unconscious Nov. 26, possibly due to a blood clot. Both the hospital and the family agree the fetus could not be born alive at this point.
But the hospital had not pronounced her dead and continued to treat her over the objections of both Erick Munoz and her parents, who sat together in court Friday.
“Mrs. Munoz is dead,” Wallace said in issuing his ruling, adding that meant the hospital was misapplying a state law that prohibits the removal of life-sustaining treatment from a pregnant patient.
Larry Thompson, a state’s attorney representing the public hospital, had told the judge the hospital had a legal responsibility to protect the fetus.
“There is a life involved, and the life is the unborn child,” Thompson said.
Erick Munoz said he and his wife are paramedics and both had previously made it clear they didn’t want lifesupport in this type of situation. Her parents agreed.
Jessica Hall Janicek and Heather King, Erick Munoz’s attorneys, accused the hospital of conducting a “science experiment” and warned of the dangerous precedent her case could set, raising the specter of special intensive care units for brain-dead women carrying babies.
“There is an infant and a dead person serving as a dysfunctional incubator,” King said.
Attorneys for the family declined to say what the next steps were, pending a potential appeal from the hospital.
The hospital said in a statement Friday that it “appreciates the potential impact of the consequences of the order on all parties involved” and was deciding whether to appeal.
Hospital officials have said they were bound by a state law prohibiting withdrawal of treatment from a pregnant patient. Several experts have said the hospital is misapplying the law because Marlise Munoz would be considered legally and medically dead.
“Marlise Munoz is dead, and she gave clear instructions to her husband and family - Marlise was not to remain on any type of artificial ‘life sustaining treatment,’ ventilators or the like,” the lawsuit said. “There is no reason JPS should be allowed to continue treatment on Marlise Munoz’s dead body, and this Court should order JPS to immediately discontinue such.”
The case has raised questions about end-of-life careand whether a pregnant woman who is considered legally and medically dead should be kept on life support for the sake of a fetus. It also has gripped attention on both sides of the abortion debate, with anti-abortion groups arguing Munoz’s fetus deserves a chance to be born.
Earlier this week, Erick Munoz’s attorneys said the fetus, now believed to be at about 22 weeks’ gestation, is “distinctly abnormal.” The attorneys said they based that statement on medical records they received from the hospital.
Not much is known about fetal survival when mothers suffer brain death during pregnancy. German doctors who searched for such cases found 30 of them in nearly 30 years, according to an article published in the journal BMC Medicine in 2010.
Those mothers were further along in pregnancy - 22 weeks on average - when brain death occurred. Birth results were available for 19 cases. In 12, a viable child was born. Follow-up results were available for six, all of whom developed normally.
In refusing to take Marlise Munoz off life support, the hospital has cited a provision of the Texas Advance Directives Act that reads: “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.”
Experts, including two who helped draft the legislation, said a brain-dead patient’s case wouldn’t be covered by the law.
Front Section, Pages 7 on 01/25/2014