Two Months Too Late

It was November of last year that the case first made the headlines. A Texas woman, Marlise Munoz, was found by her husband in their family home collapsed on the kitchen floor and not responding. A paramedic, he was able to get her heart started again, and she was rushed to John Peter Smith Hospital. Sadly, it became clear early on that Munoz had been without oxygen for far too long. She had collapsed after suffering from a blood clot in the lungs, starving her body and brain of the air it needed to survive. Despite the help of respirators, Marlise was clinically brain dead.

Her family was rightfully devastated, but prepared to say their farewells. Husband Erick and Marlise had discussed the issue of life support before, and both agreed that they wouldn’t want to be kept alive by machines. The decision was made, Erick’s wife was to be taken off the life support after he and her parents were given time to say goodbye. Then, a doctor told them it wasn’t going to happen. Marlise, it turns out, was fourteen weeks pregnant, and under Texas state law, this made it illegal for the hospital to remove her from life support, until such a time the fetus was viable for cesarean section.

The legal debate began. The law in question refers to the issue of terminally-ill women: those in comas, or vegetative states, and nearing death. Mrs. Munoz, on the other hand, was legally dead, and clinical brain death – a complete lack of neurological activity – constitutes death under the law. Beyond this, the fetus suffered the sameoxygen deprivation as Mrs. Munoz, for just as long. Despite this, doctors were hesitant, wanting to wait to determine the health of the fetus.

On Friday, however, a Texas state district judge ordered that the hospital remove Munoz from life support, justifying the decision by saying that the state law did not apply to the brain-dead and therefore legally dead Marlise Munoz. Although the hospital considered appealing the decision, they instead complied, only for it to come to light later that the fetus they had claimed to be protecting never had been viable, and would not have survived to term.

Although Marlise Munoz and her unborn child have finally been put to rest, it can be argued justice has not been served. She may not have suffered as she was brain dead upon arrival at the John Peter Smith, long before being put on the life support machines, but what her about her family? Through a misinterpretation of state law, a hospital was allowed to drag out an already tragic and devastating experience for over two months.

And for what? Quite possibly, profit. The machines, care, and processes needed for life-support are extensive, and expensive. Thousands of dollars a day have been adding up since the Munoz case broke headlines, and now, with a judge finally ordering peace for the family, the question of the bill arises. John Peter Smith Hospital has even stated that their financial department will look at the situation at a later time.Depending on what that means, even now this tragic ordeal may not be over for the Munoz family.

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3 Responses to Two Months Too Late

  1. zoneofsubduction says:

    As the old saw goes: ‘The devil’s in the details’ and so they are here as well.

    States have differing definitions, State Statutes, legal requirements of medical ‘Do Not Resuscitate’ [DNR] orders, medical protocols, and even of death itself. So, what appears to be straightforward in theory or in third party analysis, can be a convoluted mess in actual application.

    This was taken from the Center for Women Policy Studies – Reproductive Laws for the 21st
    Century Papers – August 2012

    “Automatic Invalidation of A Pregnant Woman’s Advance Directive:
    Currently,12 state statutes (Alabama, Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, South Carolina,Texas, Utah, Washington, and Wisconsin) automatically invalidate a woman’s advance
    directive if she is pregnant, as compared to 22 states with such provisions at the time of the
    Center’s 1992 report. These are the most restrictive of the pregnancy exclusion statutes, stating
    that, regardless of the progression of the pregnancy, a woman must remain on life – sustaining
    treatment until she gives birth.”

    http://www.centerwomenpolicy.org/programs/health/statepolicy/documents/REPRO_PregnancyExclusionsinStateLivingWillandMedicalProxyStatutesMeganGreeneandLeslieR.Wolfe.pdf

    According to a Southern Methodist University associate law professor, Thomas Mayo, J.D., who consulted on this State statute and helped draft it, he stated the following: “It never would have occurred to us that anything in the statute applied to anyone who was dead,” Mayo said in an interview. “The statute was meant for making treatment decisions for patients with terminal or irreversible conditions.”

    http://www.star-telegram.com/2014/01/23/5509944/texas-law-didnt-anticipate-dead.html?rh=1#storylink=cpy

    Even legal professionals with extensive and years of experience cannot foresee every eventuality or circumstance.

    This issue was a substantive legal one, not of economics.

  2. jenny9213 says:

    The ordeal the family Munoz had to live through is certainly painful and to know that it may not be over due to the bills is unfortunate. I do agree, that the hospital may have lengthened the circumstance for profit and that the Munoz is held responsible for paying the bills when the fault of lengthening this ordeal wasn’t theirs. It doesn’t matter that it was lengthened due to an unforeseen situation because the decision wasn’t made by them to keep her on life support.

  3. dalienthus says:

    Thank you for this blog post. I was really hoping that someone would bring up a life support issue. When ever you have to make this decision it can have horrible, lasting effects on their loved ones. I personally had to deal with a situation where the law restricted an end to a miserable existance. My Grandfather had increasing health issues for years until he was permanently hospitalized. I spent most days out of the week going to sit with him. Every time I came he would say that he was ready and wanted to the suffering to stop. Then one day I was told that he was about to die. Through various health complications he ended up choking on his own blood. According to the law they only removed enough of the blood to keep him from drowning. I had to sit with him for twelve hours as he kept spewing blood all over his face and chest until finally his withered frame gave in and he drowned. Ever since Jack Kavorkian tested medical boundaries, it has been apparent that the US is long over due for a policy overhaul. In situations like these it makes me wonder who it is that is defining what exactly is ‘quality of life’ and how do we find it.

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