TX - pregnant wife unresponsive on life support, husband hopes to fulfill her wishes

[hambirg]

You keep saying that but it's just seriously not the case. There has not been one recorded case of a brain dead pregnant mother whose family wants the baby, but the hospital pulled the plug or threatened to do so. Not. One. And that's because if the family determines that the pregnancy should continue and the child be given a chance to be born, it is no longer a case of futile life support.

Further, even if the totally improbable happened, and some crazy hospital stated they were going to disconnect support against the family's wishes and terminate the pregnancy, the public outcry would be so incredible, and it would be seriously easy for the family to go to court and get an injunction.

This is just not a reasonable concern, in my legal opinion. We do not live in communist China or Nazi Germany where the authorities can force people to have abortions. In our country, as we can all easily see, it is not the right to carry a baby that is threatened. It's the right not to.

I respect your posts, but this judge's decision had nothing to do with what you are claiming. He never addressed familial rights, or the 14th amendment. If the woman is dead and the fetus is not at or past 24 weeks, she is not a patient and the state has no interest in the potential life of the fetus.

What this judge decided is that the statute doesn't apply because Marlise is dead and not a "patient." Period. He did address that the State has an interest in an unborn fetus, but in the eyes of the law, that interest only applies to fetuses that are at or past 24 weeks gestation.

The Texas legislature can simply go change the wording and nothing will have changed. A family wanting to keep their deceased loved one alive for a fetus under 24 weeks will have to go the route of the McMath family. If they can't find a facility that will take their loved one they are SOL.

This was not a win for familial rights.

ETA- Who is claiming this has anything to do with Marlise's right to not terminate her pregnancy. She NEVER chose to terminate it. Not in life, not after death.

 

[K_Z]

I wonder if it is plausible that Judge Wallace ruled the way he did, to PREVENT appeals, and a constitutional challenge?

Because if I think about this case "beyond" MM and her family, I can really see that as his "best" option for preserving the status quo WRT prolife interests and agendas in Texas law.

The Munoz family has a ruling they are happy with, which is accordance with TX law.....and Wallace's ruling does not threaten any of the existing "gains" for the prolife movement. (Escalating appeals.)

I believe that if he had ruled to continue MM on life support, the case would have likely reached the SCOTUS. (But not quickly.....over years.)

But then, with a 5/4 split on the SCOTUS, conservatives to democrats, I wonder why there would be worry about these issues reaching SCOTUS? Why wouldn't the prolife movement WANT these issues to reach the SCOTUS? Isn't that a big goal?

Perhaps Kennedy is too much of a worry which way he might go, since he has disappointed conservatives in this area in the past?

 

[faw720]

I wonder if it is plausible that Judge Wallace ruled the way he did, to PREVENT appeals, and a constitutional challenge?

Because if I think about this case "beyond" MM and her family, I can really see that as his "best" option for preserving the status quo WRT prolife interests and agendas in Texas law.

The Munoz family has a ruling they are happy with, which is accordance with TX law.....and Wallace's ruling does not threaten any of the existing "gains" for the prolife movement. (Escalating appeals.)

I believe that if he had ruled to continue MM on life support, the case would have likely reached the SCOTUS. (But not quickly.....over years.)

But then, with a 5/4 split on the SCOTUS, conservatives to democrats, I wonder why there would be worry about these issues reaching SCOTUS? Why wouldn't the prolife movement WANT these issues to reach the SCOTUS? Isn't that a big goal?

Perhaps Kennedy is too much of a worry which way he might go, since he has disappointed conservatives in this area in the past?

This is a very interesting idea. Considering his background, Judge Wallace's ruling puzzles me. I would have bet my last dollar that he would have ruled in favor of the hospital. As I've already stated up post, I believe he consulted with various legal experts before issuing his decision. One of our local tv commentators made the statement that when Wallace entered the court room he said, "I'm as ready as I'll ever be". This indicates to me that he was not happy with the verdict that he felt compelled to give.

 

[Ladylub]

And what if the family doesn't have insurance or can't even come close to affording the treatment?

eta: I think the vast majority of people would fall into at least the latter category. Probably at least 90% if not more.

With or without insurance it would be hard to pay for a brain dead incubator. Many people are sitting around sick and not able to afford the medical care they need. Lets say we change laws to force brain dead women to stay hooked up to a machine till the baby is viable who pays for it then? Someone has to pay the hospital for the baby's care.

 

[BeginnersLuck]

With or without insurance it would be hard to pay for a brain dead incubator. Many people are sitting around sick and not able to afford the medical care they need. Lets say we change laws to force brain dead women to stay hooked up to a machine till the baby is viable who pays for it then? Someone has to pay the hospital for the baby's care.

People with insurance get denied coverage for care due to a variety of reasons such as it being not medically necessary. Insurance does not pay for experimental drugs or treatments for instance.

There is no medical necessity in keeping a BD person on a vent.

Prolonged gestation of a fetus in a BD body is experimental in nature.

If a person has insurance they can always be billed and see if it's paid or not. Not all things are covered though for obvious reason.

Consider this scenario. They pass a law saying that if a pregnant woman is brain dead, she should be kept on support until the fetus is viable outside of the womb. Hospitals would then have to do a pregnancy test on all BD females before withdrawal of support no matter if they were a week pregnant or not. No heartbeat can be detected at this stage. No one has ever prolonged delivery of a fetus at this early of a stage of pregnancy when BD occurred. Keeping a deteriorating body on prolonged support for the fetus to become viable is insane. The baby is living is a cesspool of slow decomp.

It would be a ridiculous law that would affect the rights of the brain dead patients and their families. It would be considered research and unethical. Research can only be approved of by the patient or family. The brain death law would have to be changed to exclude pregnant patients. Then there would be issues of ethics and laws surrounding experimental research. I don't think any laws can force any type of experimental treatment. Dangerous territory when this starts happening.

If a BD patient is pregnant and family wants to continue care against doctors wishes, no insurance is compelled to pay for experiments. It would fall back on the family. If someone doesn't have insurance to begin with, regardless of type of medical care given, it falls back on the patient and family.

 

[K_Z]

Consider this scenario. They pass a law saying that if a pregnant woman is brain dead, she should be kept on support until the fetus is viable outside of the womb. Hospitals would then have to do a pregnancy test on all BD females before withdrawal of support no matter if they were a week pregnant or not. No heartbeat can be detected at this stage. No one has ever prolonged delivery of a fetus at this early of a stage of pregnancy when BD occurred. Keeping a deteriorating body on prolonged support for the fetus to become viable is insane. The baby is living is a cesspool of slow decomp.

Respectfully snipped.

And to take that hypothetical law even further, could there be criminal charges for manslaughter if "someone" didn't diagnose a pregnancy before treatment was withdrawn?

Civil suits for "failing to maintain a fetus to viability" if the fetus dies. "Wrongful death" suits?

What if a woman was awaiting embryo transfer from assisted reproduction, and becomes brain dead? Are we compelled to "use" her body as a vessel (or "organ donor") to attempt to gestate these "living persons without a womb?"

I agree, it's all ridiculous. The stuff of Brave New World, complete with decanting jars. Not every egg is fertilized. Not every fertilized egg becomes a viable fetus, or a living baby. And it is unethical and immoral to force unregulated, unconsented, un-funded, un-studied, experimental treatment on anyone, living or dead. IMO.

I'm all about ethical, regulated scientific research to increase our abilities and our understanding of what is possible. But IMO, the prolife movement is very hypocritical when it comes to actually doing ethical research to further their message and their positions.

I've often wondered why they don't set up a privately funded "institute" to conduct animal studies, and develop protocols, for example? That would be doing the HARD work to scientifically demonstrate evidence for their positions. Once they persuade the scientific world that something like early fetal gestation in brain dead hosts is not only possible, but likely to repeatedly have good outcomes using "their" protocols, it would be an easier "sell" to the general public, and legislators. Right?

But instead, what we have is a VERY few purely anecdotal cases around the world, conducted in a completely non-scientific, "opportunistic" experimental manner. That is not a rigorous cohort of index cases to hang policies on, IMO. A real scientist would probably say that there isn't even enough data in those anecdotal cases to make a competent and compelling argument for moving forward with animal model studies at this point. IMO.

 

[faw720]

Consider this scenario. They pass a law saying that if a pregnant woman is brain dead, she should be kept on support until the fetus is viable outside of the womb. Hospitals would then have to do a pregnancy test on all BD females before withdrawal of support no matter if they were a week pregnant or not. No heartbeat can be detected at this stage. No one has ever prolonged delivery of a fetus at this early of a stage of pregnancy when BD occurred. Keeping a deteriorating body on prolonged support for the fetus to become viable is insane. The baby is living is a cesspool of slow decomp.

It would be a ridiculous law that would affect the rights of the brain dead patients and their families. It would be considered research and unethical. Research can only be approved of by the patient or family. The brain death law would have to be changed to exclude pregnant patients. Then treatment.issu Dangerous territory when this starts happening.there would be es of ethics and laws surrounding experimental research. I don't think any laws can force any type of experimental

Yes, the Nazis conducted medical experiments on humans. Subsequent war crimes trials ruled that those experiments were criminal in nature. Saddam Hussein experimented on humans using chemical weapons. In both instances the perpetrators were punished accordingly.

Science has advanced to such a point that many things are scientifically possible. As of yet ethics, the law, & human decency have not caught up with science.

 

[faw720]

There an awful lot of people who believe it is cruel to experiment on animals. IMO, some of those same people probably don't have a problem experimenting on humans, living or dead.

We live in a very strange world.

 

[alliemay]

I think autopsy's are experiments after the person passes. We learn how the person died.
I wonder if one has been completed on the mother yet. Not sure, but my friend died at 48 years old and they did one. For months we wondered what had happened to her. She fell off her computer chair with no one near her and died. I was told by her husband that it's standard procedure to do autopsy's when a person dies at a young age. I don't know if it's like that in every state.

 

[BeginnersLuck]

I think autopsy's are experiments after the person passes. We learn how the person died.
I wonder is one has been completed on the mother yet. Not sure, but my friend died at 48 years old and they did one. For months we wondered what had happened to her. She fell off her computer chair with no one near her and died. I was told by her husband that it's standard procedure to do autopsy's when a person dies at a young age. I don't know if it's like that in every state.

MOO but I think an autopsy was performed.

 

[faw720]

I think autopsy's are experiments after the person passes. We learn how the person died.
I wonder if one has been completed on the mother yet. Not sure, but my friend died at 48 years old and they did one. For months we wondered what had happened to her. She fell off her computer chair with no one near her and died. I was told by her husband that it's standard procedure to do autopsy's when a person dies at a young age. I don't know if it's like that in every state.

I think, but do not know for sure, in Texas an autopsy is required only for an unattended, criminally suspicious, or violent death. This is my interpretation of Texas law, link up post. Of course, the family could have requested one. I think requirements vary by state, but this is JMO.

 

[nrdsb4]

I think, but do not know for sure, in Texas an autopsy is required only for an unattended, criminally suspicious, or violent death. This is my interpretation of Texas law, link up post. Of course, the family could have requested one. I think requirements vary by state, but this is JMO.

By Texas law,(CCP art. 49.25), the Medical Examiner is required to determine the cause and manner of death in all cases of accident, homicide, suicide, and undetermined death. In cases of natural death, when the person is NOT under a doctor's care, or the person passes away in less than 24 hours after admission to a hospital, the Medical Examiner must be notified, as an autopsy may be required.

https://www.harriscountytx.gov/ifs/faq.aspx#ctl00_ContentPlaceHolder1_SectionViewer1_section163

 

[Karmady]

With or without insurance it would be hard to pay for a brain dead incubator. Many people are sitting around sick and not able to afford the medical care they need. Lets say we change laws to force brain dead women to stay hooked up to a machine till the baby is viable who pays for it then? Someone has to pay the hospital for the baby's care.

That's my point. Your post suggested that if the family could pay, have at it. Personally, I don't have a problem with that. But I think there are a lot of people who would -- discrimination based on "socioeconomic status," whose life is worth more, etc. Check the Jahi McMath thread for that argument. jmo

 

[Ladylub]

That's my point. Your post suggested that if the family could pay, have at it. Personally, I don't have a problem with that. But I think there are a lot of people who would -- discrimination based on "socioeconomic status," whose life is worth more, etc. Check the Jahi McMath thread for that argument. jmo

So who should pay for these people to stay hooked to machines when family can not afford? Like or not things cost money.

I do not find that it is discriminating against anyone by saying if you cant afford this you cant have it especially when its something like being brain dead and no hope. If a woman is pregnant when she is declared brain dead and the family wants to keep life going till the baby is viable then they should pay the bill even if it takes till the child is grown and has children of his/her own.

 

[Karmady]

So who should pay for these people to stay hooked to machines when family can not afford? Like or not things cost money.

I do not find that it is discriminating against anyone by saying if you cant afford this you cant have it especially when its something like being brain dead and no hope. If a woman is pregnant when she is declared brain dead and the family wants to keep life going till the baby is viable then they should pay the bill even if it takes till the child is grown and has children of his/her own.

I think you missed the part of my post where I said, personally, I'm fine with the family being able to pay for it or not. lol But there are a LOT of other people who would disagree. They will argue that it's unfair for a person to be able to pay for long-term medical intervention, but that a person who can't afford it is SOL. Especially when there's a baby involved. Is the life of the baby whose family can't afford it less worthy of saving then the life of a baby whose family has the money? etc. etc. That would be a ch*tstorm extraordinaire, imo.

 

[wendiesan]

Yes, the Nazis conducted medical experiments on humans. Subsequent war crimes trials ruled that those experiments were criminal in nature. Saddam Hussein experimented on humans using chemical weapons. In both instances the perpetrators were punished accordingly.

Science has advanced to such a point that many things are scientifically possible. As of yet ethics, the law, & human decency have not caught up with science.

Just because something can be done does not mean that it should be done. JMO.

 

[Steft50]

I think, but do not know for sure, in Texas an autopsy is required only for an unattended, criminally suspicious, or violent death. This is my interpretation of Texas law, link up post. Of course, the family could have requested one. I think requirements vary by state, but this is JMO.

I think it depends on the circumstances. My mom died unattended in Texas but due to her chronic illness the decision was left to us-and we knew she didn't want one. Our wishes were honored and no autopsy was done.

 

[nrdsb4]

I think it depends on the circumstances. My mom died unattended in Texas but due to her chronic illness the decision was left to us-and we knew she didn't want one. Our wishes were honored and no autopsy was done.

As I linked in post 1332, there can be additional circumstances where a ME would mandate an autopsy. One I personally was always aware of is if a patient died within 24 hours of a hospital admission; we always called the ME in those cases. Often the ME declined the case, but certainly many times we were required to release the body for autopsy.

 

[wendiesan]

I think the discussion begun in this thread might be very relevant to a situation going on in Victoria, BC.

On December 28th, Robyn Bensonm who was 22 weeks pregnant, suffered a brain hemorrhage. A C-section has been scheduled for the end of February (if all goes as hoped) at the 34th week of the pregnancy.

In this case, the hospital, IIRC, presented the possibility of trying to bring the fetus to viability if that was in accord with what the mother would have wanted. Her husband, family, and friends agreed that Robyn would have wanted the doctors to try. Again, this brings up the importance of having directives in writing, as has been discussed up-thread.

http://globalnews.ca/news/1125347/p...-b-c-woman-kept-alive-until-baby-can-be-born/

(The article refers to the Heidelberg study posted upthread and to Marlise Munoz.)


http://news.nationalpost.com/2014/0...usband-hoping-for-their-sons-healthy-arrival/

http://globalnews.ca/news/1130112/a...in-dead-b-c-woman-kept-alive-until-baby-born/

Dr. Randy Wax, section chief of critical care at Oshawa, Ont.’s Lakeridge Health, hospital head for organ donation, was asked to comment on the chances for the C-section to be successful and the baby's potential survival. Since Robyn depends on critical care for 24 hours every day, doctors are forcing functions normally governed by the brain.

'...“The body isn’t meant to function for prolonged periods of time after the brain is dead,” Wax said. If she encounters pneumonia or a lung infection, it means bad news for the baby and the duo’s doctors. If there are sudden complications or, in a worst case scenario, her heart stops beating, doctors would have little time to respond to help her baby, Wax said...'

Very bitter sweet for the father (who has named the baby), since he knows that the day after his son is born, he must say good-bye to his wife.

Mods please snip if this post goes against the rules. Thanks.

 

[al66pine]

As I linked in post 1332, there can be additional circumstances where a ME would mandate an autopsy. One I personally was always aware of is if a patient died within 24 hours of a hospital admission; we always called the ME in those cases. Often the ME declined the case, but certainly many times we were required to release the body for autopsy.

BBM

Hello, nrdbs4,
"...patient died within 24 hours of a hospital admission..."
triggering notice to ME seems pretty straightforward.
As a longtime (former) home office employee in another field (investments), I'm always interested in how 'legal' req'mts work in policy & actual practice in other industries.

Are you speaking from experience in US?
Or anyone w direct pt. care position or med fac admin position.
Experience in the last few yrs, or waaaaay long ago?

Do you recall if hosp had explicit written policy.
Mainly, who within hosp was responsible -- floor nurse, supervising nurse, chief of nursing? Attending doc, admitting doc, ER doc? Admin-type personnel? (Obviously I may not have med terms right here)

How was notice to ME made? Phone? Fax? email?
How was notice to ME documented, esp if by phone.
Where recorded? Nursing notes? Doctor-entries in pt chart?
If ME's response not written (fax, email), how documented at your/hosp end? Where recorded?

I imagine any facility, med or non-med, may have technical reqmts slip between the cracks, esp if employees are overworked and underpaid.

Back to the Munoz situation specifically, I wonder -
Was she declared BD within 24 hr of admission?
Did she meet another TX parameter for notice to ME?

Hoping for healing and comfort to Mr. Munoz and all involved.
And thank you to all health care ppl, who post and benefit the med-ignorant like me.
Thx in adv. :seeya: