Advance Health Care Directives likely would have helped poor Marlise Munoz.
Brain Death and Pregnancy - the Marlise Munoz Story
Thirty-three year old Texan, Marlise Munoz, who was kept alive by a ventilator for over a month in John Peter Smith Hospital, was taken off of life support on January 26, 2014. In November, she collapsed at home as the result of what doctors believe to be a pulmonary embolism. While Marlise's husband, Erick, administered CPR until emergency responders arrived, Marlise tragically, suffered brain death. Marlise, who is an EMT herself, reportedly told her family that she would never want to be kept alive by a ventilator. It would seem that her wishes are clear, despite the fact that she never executed a living will or other advance directive. However, doctors refused to take Marlise off of the ventilator. Why? Marlise was pregnant and, according to the hospital's interpretation of Texas' law on advance directives, a pregnant woman cannot taken off of life support.
Unfortunately, Marlise became one of extraordinarily few individuals to suffer the unique situation of being brain dead and pregnant. Like the case of Jahi McMath discussed in a previous blog, there was no question that Marlise's brain was no longer functioning. In accordance with the definition set forth in the Uniform Determination of Death Act, Marlise had suffered "irreversible cessation of all functions of the entire brain, including the brain stem" and, as such, is dead. The debate in Marlise's case, unlike the debate in Jahi's case, was not whether she is alive or dead. The debate was this: Even if Marlise is legally dead, can she be kept alive because she is pregnant?
The statute relied on by the hospital to keep Marlise on a ventilator is a provision of the Texas Advance Directives Act, which states the following:
"Section 166.049. PREGNANT PATIENTS. A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient."
The hospital argued that this provision prevents them from withdrawing or withholding life sustaining treatment (i.e.: a ventilator) from an individual who is pregnant.