Texas Law is Keeping a Tarrant County Paramedic From Letting His Pregnant Wife Die

Categories: Healthcare
Erick Munoz wasn't trying to set off a debate about abortion or end-of-life care. He just wanted to comply with the wishes of his wife, who is on life support at JPS Hospital in Fort Worth after suffering an apparent pulmonary embolism two days before Thanksgiving. But because his wife, Marlise Munoz, was 14 weeks pregnant when she went into the hospital, and because Texas law requires doctors to keep a patient alive if she is pregnant, and because Munoz's plight was featured on the news, an overheated national debate was inevitable.

Hats off to WFAA reporter Jobin Panicker, who managed to fold two of the most divisive issues of our time into one tragic package and for revealing a heretofore obscure provision of Texas law governing advance directives.

The relevant portion reads, in full:

Sec. 166.049. PREGNANT PATIENTS. A person may not withdraw or withhold life-sustaining treatment [procedures] under this subchapter from a pregnant patient.

Even if the woman signed a do-not-resuscitate order, it's no good so long as there's a fetus in her womb. This is spelled out clearly in the state-mandated language of Texas DNRs.

I understand that under Texas law this directive has no effect if I have been diagnosed as pregnant.

Marlise Munoz hadn't signed a DNR order, but she had frank discussions with her family about end-of-life care. Both she and Erick are paramedics, who are regularly confronted with people whose lives have been cut short. Four years ago, after her brother died, Marlise declared she never wanted to be kept alive by a machine, Panicker reports.

That's her fate until one of two things happen, according to Dr. Robert Fine, a medical ethicist at Baylor Hospital. The fetus could reach viability, at which point the baby could be removed by c-section, allowing the Marlise's final wishes to be carried out. Or, the fetus could die inside the womb, allowing the same outcome.

"Thankfully, in my experience cases like this are rare," Fine wrote to Unfair Park in an email. "Somewhat related, we have had a few cases over the years at Baylor in which the pregnant mother was not merely comatose, but actually met all the criteria for brain death, but rather than withdraw all organ support (the patient is dead so we don't call it life support), the organ support was maintained to allow the fetus to reach viability at which point delivery occurred and organ support was halted."

Good Morning America talked to a medical ethicist at NYU who said that Texas is among a handful of states that include pregnancy riders on DNR forms but that the measure is ethically dubious.

"The basic moral principle with the individual is you do not have to give them care they do not want," he said. "The principle has been established again and again throughout legal cases in the United States."

But lawmakers in Texas have never cared much for letting the rights of a mother outweigh those of a fetus. While the Supreme Court has set fetal viability, traditionally defined as 23-24 weeks, as the limit for abortion, the legislature this year passed a 20-week abortion ban. It also likes to slip fetal personhood into other portions of Texas law. Murder a pregnant woman in Texas, and you'll be charged with two counts of homicide, not just one. So it is with end-of-life care.

Send your story tips to the author, Eric Nicholson.

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39 comments
christopher168
christopher168

One wonders what Munoz might end up being subjected to if the baby is born severely handicapped and can’t exist on it’s own? Would it be correct to have this man subjected to ongoing medical bills in perpuitity? 


Shouldn't we look at both sides, and stop putting one's personal agenda about pro or not pro life to this. Look at the odds that are against this baby right now and this man’s rights also....


http://scallywagandvagabond.com/2013/12/erick-munoz-wants-wife-life-support-even-means-unborn-baby-will-die/

Montemalone
Montemalone topcommenter

This is tragic, but now there's to be a kid with NO MOTHER mandated by the republican state government. Is the state going to be this kids mother?

njdefltx
njdefltx

I do not see any reference to 14 months in the article.  There are a couple references to 14 weeks.  Why all the comments regarding 14 months?

ozonelarryb
ozonelarryb

All these rights for feti, but the moment that kid walks i to a school, the Constitugion is suspended, and Tshirts are policed relentessly.

We are a lunatic society.

mcreed80
mcreed80

What is she giving birth to?  A camel?  Sheesh ...14 months pregnant. 

t.knapp1
t.knapp1

Another reason this state sucks


finnmf89
finnmf89

This could have been a hard hitting story if it had been written well. Seriously, fourteen months pregnant? You end with if you kill a oreganant woman in Texas you get two counts of manslaughter? This is such a pitiful article on what could have been interesting. How about spend more time focusing on the rights of an individual being taken from them because the rights of someone is not even a person yet trumps theirs. How about the fact that pregnancy on life support is extremely dangerous for mother AND child as the infant has very low chances of surviving or being born healthily. DO needs a do over.

pak152
pak152

'But because his wife, Marlise Munoz, was 14 months pregnant'

14 months! normal pregnancy is but 9 months, someone call the Guinness book of records

Myrna.Minkoff-Katz
Myrna.Minkoff-Katz topcommenter

Laws that interfere with a person's basic life decisions need to be repealed; not championed, as they are by the far right moral police.  

NewsDog
NewsDog

Eric, 14 MONTHS pregnant??  are you a DISD grad? 

RWilliams
RWilliams

If this poor woman is 14 months pregnant (paragraph one), the situation should resolve itself very-very soon.

tay82
tay82

@christopher168And if this had not happened what would he have done if that child had been born handicapped??? Healthy babies have been born from these conditions.

tay82
tay82

@MontemaloneThe child has a father. That should be sufficient . Unfortunately father does not want child.

lolotehe
lolotehe

@bvckvs Texas is on the cutting edge of axolotl tank technology.

ruddski
ruddski

Ask the kid in twenty years how much Texas sucks.

ruddski
ruddski

If the woman is on life support, but both she and her husband prefer her death to that, why would there be concern about her survival?

Here, it's the mans right to choose being violated, since he'll be the one punished by the birth of a dependent, and there's no victims group for male reproductive rights that I'm aware of. He's stuck with the kid.

Tom434
Tom434

@oakclifftownie JPS is owned by the Tarrant County Hospital District, so unless she has health insurance, which probably will not pay to keep her on life support, the taxpayors of Tarrant county.

ruddski
ruddski

@Myrna.Minkoff-Katz

"Laws that interfere with a person's basic life decisions need to be repealed; not championed, as they are by the Obama administration."

Fixed

leftocenter
leftocenter

Eric finally fixed it, thank goodness!  It added hilarity to an un-funny story.

observist
observist topcommenter

@ruddski I might be confusing you with Holman, but aren't you anti-abortion?

pak152
pak152

@Myrna.Minkoff-Katz@pak152maybe if you got a better night's sleep you wouldn't be yawning, but get yourself some Red Bull or a good cup of joe and the yawning should be obviated.

ScottsMerkin
ScottsMerkin topcommenter

@Tom434 @oakclifftownie I bet WylieH is gald she didnt have this happen at DFW as they would have shipped her to Parkland and Dallas county would be on the hook

rrrosco
rrrosco

@ruddskiGood to see you've discovered quotation marks, but must you troll up another thread with your irrelevance?  Blaming President Obama for pulmonary embolisms?  I'll wait while you look that up...So let's get this straight, libertarian pseudo christians pass anti-abortion laws that create human brood chambers, and you blame President Obama. That's some insightful stuff.  How bout Benghazi causes cancer! (has more snap) or The I.R.S. is the #1 cause of heart disease! Yawn...  

ruddski
ruddski

He pulled a Martin Bashir

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