The family of Marlise Machado Munoz is preparing a legal challenge against a Texas hospital that is forcing them to keep Munoz on life support because she’s pregnant, even though she has been pronounced brain dead and the grieving family wants to say their goodbyes. An attorney who specializes in family law confirmed to the Star-Telegram that litigation will be filed soon, but declined to give more details in order to protect the strategy in the upcoming legal fight.
Munoz was pronounced brain dead in November after losing consciousness unexpectedly. She was 14 weeks pregnant at the time. Munoz’s family members say she would never want to be kept alive by a machine — but hospital officials are still preventing them from removing Munoz from a ventilator. The hospital is citing a decades-old state law that states, “A person may not withdraw or withhold life-sustaining treatment… from a pregnant patient.” Texas is one of 12 states that invalidate women’s end-of-life wishes if she is pregnant.
In Munoz’s case, the hospital could actually be applying the law incorrectly.
“I think the Texas law cannot apply to the dead,” Art Caplan, the director of medical ethics at New York University’s Langone Medical Center, explained to the Star-Telegram. “I think the hospital is wrong to insist that it does.”
The issue at hand results from a misunderstanding of the medical definition of death. As theNew York Times notes, it’s important to make the distinction between individuals who are “brain dead” — like Munoz — and individuals who are in a “persistent vegetative state.” The most high-profile battles over life support, like the one that centered on Terri Schiavo, involved people who were in vegetative states. That means they could breathe on their own; although they may have been severely brain damaged, they weren’t considered to be brain dead.
Brain death, on the other hand, is one of the two medical definitions of death. In all 50 states, once a person is declared to be brain dead, they are considered to be deceased. In every state except for New York and New Jersey, hospitals don’t need to consult families to decide how to terminate care after a brain death diagnosis.
Laurence McCullough, a professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine, told USA Today that there shouldn’t be any ethical issues about providing care to someone who is brain dead because that patient is now a corpse. Most medical professionals actually believe it is highly unethical to keep a brain dead person hooked up to ventilators or feeding tubes, because medical interventions shouldn’t be performed on a dead body.
Even when an individual is brain dead, their heart may remain beating. That can give the illusion of life. In another high-profile controversy currently swirling around this area of medical practice, the family of 13-year-old Jahi McMath is fighting to keep her hooked up to life support even though she is brain dead, because they say her body functions prove she is still alive. But that heartbeat is only temporary. With ventilation, the heart can continue to beat for up to a week even without brain function. With more aggressive intervention, it could keep beating for months after brain death. It’s confusing to receive a death certificate for someone whose heart is still beating, but doctors ultimately say that it doesn’t change the fact that they’re not alive any longer.
NYU’s Caplan believes that when it comes to both Munoz and McMath, the cases have been handled very badly. “They’re giving the impression that dead people can come back to life,” he explained. Caplan encouraged the Munoz family to sue over the hospital’s interpretation of Texas law.