In Texas (of course) the long, sad saga of Marlise Muñoz, who died in late November but was being kept alive because she was pregnant (with a 22 week-old fetus with hydrocephaly and heart problems that is “not viable”) has finally been decided by judge. After two months of legal wrangling, barring further appeal, she will be taken off life support, something her family wanted two days after she collapsed at home and showed no brain activity after being treated at the hospital.
The hospital, which was represented in court by the Tarrant County district attorney, believed that state law required them to protect the fetus. They were probably right–I imagine the intent of the Republicans in the Texas Legislature was to make sure that much pain and suffering was visited upon anyone who dared interfere with fetal rights, the only rights that are nearly as important as gun rights. I hope that Erick Muñoz, her husband and father of their toddler son, has good insurance to pay for two months in intensive care, not to mention the procedures (including a tracheotomy) for which he refused consent but were performed anyway.
The only surprising thing about this case is that John Boehner didn’t bring Congress back into session to pass a law requiring Texas to keep Marlise on life support.
Schlemizel
The is very good (though very sad) news for the family. But like the previous case the stories will soon be circulating about how the fetus was perfect and it would have been fine if the cult of death had not intervened. From a macro level it would have been better to lose the case & have the fetus be delivered dead and badly deformed. But that would have been added horror for her poor family who have already suffered enough. Plus, if past experience shows future trends he is in for harassment from the nutters already
Betty Cracker
Here’s how the dead-women-are-holy-incubators site framed the ruling:
Those sick, twisted fucks are utterly bereft of decency.
Punchy
Repubs: get the gubbmint outta my health care….unless theres a fetus involved. Then get the gubbmint involved in others’ health care!
amk
Don’t celebrate too early. The idjit judge has given up to monday evening. boner and his texas troglodytes will think of something over the weekend.
JPL
What a sad story but it does highlight what limited government means to Republicans. The family of Marlise Munoz suffered enough when she died and should not have had to fight the state of TX, in order to have her buried.
RIP
Many of those who supported keeping the fetus alive, also believe in fetal pain. How do they justify those feelings now after discovering the fetus was not viable.
Amir Khalid
What happens with the law itself, now that its cruel potential consequences have been exposed? Is anyone working to get it amended to avoid such a thing from happening again?
Elizabelle
Such a sad, sad case. Marlise was 14 weeks pregnant when she collapsed, perhaps of a blood clot in her lung. She was an EMT, and had probably seen some terrible injuries and medical cases.
I could see keeping a pregnant woman on life support, IF the fetus was viable or very close to it (or term) AND the family requested the life support.
But a law that interferes at such an early stage of pregnancy, when it is unknown if the fetus was without oxygen during a crucial developmental stage? And who was going to bear the costs of the care of a terribly damaged infant, if it ever came to that? They going to stick the family/father with that?
I hope (and think) the hospital will write off the care and not charge the family a cent beyond the first two days of care.
This was haunting, from the husband/father’s affidavit (via NYTimes):
mellowjohn
@Betty Cracker:
i clicked thru hoping to make a snarky comment. quelle surprise, they don’t allow comments.
and after reading the article, i couldn’t agree more with you: what a bunch of sick, twisted fucks!
The Dangerman
I doubt the insurance will pay for services rendered after death of the mother; the Hospital will have to sue the Father (another loser) or eat the cost (which, of course, just gets passed along).
c u n d gulag
If he gets a bill, he ought to refuse to pay it, and forward it to the Texas State Legislature and Gov. Good-hair/No-brain.
Republicans:
Let this be a lesson to all of you libidinous sluts!
If you schtupp – married or not! – all you are is the vessel for bringing to term the Captain’s, your Lord and Master’s, fetus.
Sick, sick, fucks, the whole lot of them!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Gin & Tonic
If they performed surgical procedures on her without her husband’s consent, I have a hard time seeing how they can bill him for them (and make it stick, I guess.) Obviously IANAL. It’s one thing if you’re performing emergency surgery to keep someone alive before you can get next of kin’s consent, but if they had time to ask him for consent and he refused, that seems to be on them.
Schlemizel
@Amir Khalid:
This is Texas, if anyone is doing anything about the law it is to find a way to prevent a judge finding a reason to overrule them in the future. There are some very sick sick fucks in that part of the country
Elizabelle
Texas has to be careful how it rewrites its legislation, and I hope that it does.
What of the case where a pregnant woman is fatally injured in a car crash, very near term, and her family (and lets say they and she are on Medicaid) wants life support to sustain the viable or very nearly viable child’s life? Do you declare them moochers and save yourself the expense? One hopes not (and probably not, given that a sacred fetus is involved).
If they don’t want the child, which medical experts confirm is just about viable and apparently healthy, does the state intervene at a very late stage of pregnancy? Viability is getting earlier and earlier. At what point does an almost or clearly viable fetus have a claim to protection of the state?
What of a case where a pregnant woman is murdered by the father’s child (happens more than you like to think) once the fetus is very close to viability and still apparently healthy? Father says he doesn’t want the child; mother’s family says she was set on motherhood and would want the child saved.
You want families to have real options here; don’t want it in the state’s hands, but sometimes the state can be a protector …
Also — the horrible case of Jahi McMath, a San Diego, CA area 13 year old who died of surgical complications before Christmas and her mother/family have insisted she remain on life support, awaiting a miracle. They had a real struggle with the hospital, which declared her dead on December 13th or so. Body was finally released to the coroner, and family has arranged life support at some unknown facility. Lots of gruesome stories about how the late Jahi’s body is faring at this stage.
You don’t always want the family making decisions like that….
Life always outruns the legal system, especially with the technology available today.
Boudica
As an aside, my understanding that the fetus is not viable refers to the fact that it is less than 24 weeks along (when a fetus may possibly live separate from the mother), not because it has defects.
Gin & Tonic
@Boudica: From the linked article: “She said medical records indicate that the fetus, at 22 weeks and 5 days into the pregnancy, is deformed and suffers from hydrocephalus, or excessive fluid on the brain.”
Tokyokie
Wendy Davis has had a tough week, but I think a lot of that will largely forgotten should she quickly and loudly decry the onerous results of the legislation the Legislature passed last session. And considering that Greg Abbott supported it and Davis was its most vocal opponent, she’s in a perfect position to do so. I hope she can get Erick Muñoz to cut commercials for her.
BTW, Marlise was in the county hospital and that was the entity arguing that Texas law made it illegal for it to withdraw life-support from a brain-dead pregnant woman. And as a branch of the local government applying its misinterpretation of state law in contravention of the wishes of the family, sending the Muñoz family the bill for two months of ICU care will be a tough sell legally.
Professor
But this week, I understand, the state of Texas killed a man on death row. He was once a beautiful, much loved foetus. Why didn’t the pro-life godbotherers protest to save his life?
Cassidy
@Gin & Tonic: They’ll bill him anyway. That’s what they do.
Elizabelle
Interesting article about the McMath, Schiavo, and Munoz cases, from USA Today. Very well balanced.
Good backgrounder on the McMath case, if you’ve not followed that one.
Per USA Today, Laurence McCullough is a professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine in Houston. Arthur Caplan is head of the division of bioethics at NYU Langone Medical Center in New York City.
Villago Delenda Est
@Professor:
Once you’re out of the birth canal, you’re on your own, kid.
It’s never been about life, or babies. It’s always been about slut shaming.
Botsplainer
I have some doubts on whether insurance will pay on something that the company may deem medically unnecessary. The bill is undoubtedly around the half million dollar mark now, and as I understand, the general counsel for the hospital is a right to life nut job.
West of the Cascades
One of the things that is going to make me angry when this sad story reappears in a year or so, when the family’s lawsuit against the hospital (and, I hope, the Tarrant County DA’s office) for violating Marlise Muñoz’s civil rights (by denying her advance directive wishes), is that the hospital and DA’s office likely have a complete defense that “we can’t have been violating the civil rights of someone who was dead.” So these assholes who kept a legally-dead woman functioning as an incubator will probably escape liability for their true crime.
I’d have hope, though, that Mr. Muñoz might be able to get a court to order that he does not have to pay for the hospital-mandated medical treatment because it was unnecessary and inappropriate for someone who was legally dead shortly after she arrived at the hospital.
Elizabelle
@Tokyokie:
I think this case will incense families, as it becomes widely known.
The Terry Schiavo case did not help Republicans at all, beyond their right to life of the fetus constituents. I remember the Republicans I know being horrified that they might not get to make a life and death decision for their wives or family members, that the state could intervene. Senator Bill Frist diagnosing a comatose patient while standing on the Senate floor did not go over well at all with my GOP friends and [extended] family.
No way that Texas hospital tries to stick the family with the bill, beyond the point where Marlise was declared brain dead. And maybe all of it, as a gesture of compassion and to allay the suffering everyone has already endured.
Skerry
The original judge in the case recused herself last week after it was revealed that the hospital’s general counsel was also the treasurer for the judge’s re-election campaign.
pat
I assume there will be an autopsy that will also investigate the fetus.
Villago Delenda Est
@Botsplainer:
Then s/he should pay for all this.
Fucking forced birth assholes.
SarahT
Have beeen hoping for a post on this ruling. Thank you, DPM.
Elizabelle
From that USA Today story. Ethicists criticize treatment of teen, Texas patient.
“According to the Uniform Determination of Death Act, adopted by most states …” I wonder if Texas follows the UDDA, or if their “pro-pregnancy” legislation adapts it to cover the case of dead pregnant women …
Betty Cracker
@mellowjohn: I wish I hadn’t read the screed I linked above. It makes me so angry. I get that this is a controversial issue. What I don’t understand — what is unconscionable — is their demonization of Mr. Muñoz. They are lower than whale shit.
Tokyokie
@Elizabelle: I certainly hope that’s the case. Texas voters need to ask themselves, which is worse, a candidate who claimed to have been a single mom at 19, when she didn’t become one until 21, or a candidate who wholeheartedly supports such pernicious and draconian legislation? I’m a Texas voter (actually a constituent of Wendy Davis), and I know how I come down on this matter. I think this case (and Davis’ prominent opposition to the legislation), combined with backlash by women (mostly) against what they perceive as unfair treatment of Davis, could well mean a net gain for her.
JPL
@Betty Cracker: Keeping the fetus alive, if as some believe, can feel pain, amounts to torture. That was probably not mentioned.
aimai
@Elizabelle: What if? Ridiculous. Texas hospitals cut actual, living, women off life support when they are awake and aware because of cost. They cut babies off of life support when it costs too much. The entire fantasy that there are sufficient pregnant-on-life-support women to require a separate law governing their treatment is weird and pathological. You either extend to everyone the same rights to care without respect to cost or you don’t.
aimai
@Elizabelle: Oh, yeah, no.
I would predict exactly the opposite. They will attempt to stick the insurance company, and then the husband, with the costs because they will never, ever, acknowledge the “suffering everyone has already endured.”
scav
Given advances of medical technology, will the Moral Texans ™ soon be full-throatedly approving madatory life support of all dead wimminz with fertile eggs in case their lord and masters might decide they need some ova in order to have issue? And, given the movement toward having to have parental approval for abortions even from grown-up wimminz, I guess feminin egg vats can be tied to live support so that gramma and grampy can get their cuddle object too.
ETA let alone if some random judge wants to make a point.
Boudica
@Gin & Tonic: I know the fetus has deformities…just saying that’s not what “non-viable” is referring to.
Elizabelle
@aimai:
We will find out, in time.
Rafer Janders
Unfortunately, I believe that when this law was passed in the 1990s the Texas Legislature was still majority Democrat. Very conservative Democrats, to be sure, and some of those folks are Republican now, but we can’t put all the blame on the GOP. It’s Texas itself.
Elizabelle
NYTimes on January 7, Pregnant, and Forced to Stay on Life Support. Informative re legal background of the Texas law. Well worth a click.
Mudge
@aimai: Of course they will. The comment above that once Marlise died, the “life-support” continuation became an experiment may allow the insurance companies to avoid payment for such experimental procedures. The situation regarding billing the husband, who forbade the life support, is anybody’s guess. In many ways the law was an unfunded mandate. There appear to be no state funds to support the medical costs associated with enforcing this law. I am sure the State of Texas will provide funds to lawyers involved in this mess.
JoyfulA
I’m sympathetic to the family of the girl who died after a tonsillectomy. According to the initial stories, the hospital treatment was a case study in “how to get a patient to sue a hospital,” with being ignored at the nurses’ station when they said she was bleeding profusely to brusque doctors to general lack of humanity. I figure the family concluded that the staff didn’t care about the girl and that they couldn’t be trusted. Now they’re locked into their defensive posture.
Elizabelle
Link for report by Center for Women Policy Studies, from NYTimes story.
Pregnancy Exclusions in State Living Will and Medical Proxy Statutes
http://www.centerwomenpolicy.org/programs/health/statepolicy/documents/REPRO_PregnancyExclusionsinStateLivingWillandMedicalProxyStatutesMeganGreeneandLeslieR.Wolfe.pdf
See what protections your state offers you, your family, or just the fetus.
What’s Washington state doing lumped in with that crew? And the well-educated women in Wisconsin are in for a rude shock. Good news is it’s a class of 12 states, down from 22 initially.
We can’t all be Maryland, regrettably, which seems to have a pretty good policy.
And from a real quick skim, some states mandate on “viability”, but not on actual health status of the fetus.
So a family could both (a) lose a much-loved woman, and (b) get stuck — automatically — with a grievously malformed or damaged infant to raise/support.
Mike G
@Elizabelle:
There’s another word for this: money. My experience of working for hospitals is that many administrators will do anything for revenue, ethics be damned. Somebody sniffed a desperate family they could milk for money.
Elizabelle
@JoyfulA:
Yeah, the Jahi McMath story is heartbreaking. It’s not clear the actual risk of the surgery was well-explained to the family either.
And, because Jahi was a black teenager, I’ve seen some beyond ugly comments on the case.
Elizabelle
@Mike G:
The McMath family at present does not have much money. Maybe the facility expects to seize whatever funds Jahi’s family is awarded in a malpractice suit. “Some say” Jahi’s been transported out of California.
Horribly sad case all around. He said, she said throughout, and a dead young girl.
Keith G
Seriously? To be thusly surprised would entail not having much understanding of what Boehner’s priorities are.
elm
My suspicion in the Jahi McMath case is that the family is getting very bad advice from someone whose interests aren’t in line with the family’s.
I haven’t read anything that says that directly, but from reading in between the lines, somebody is feeding them false hope, and that’s horrible.
It could be a quack doctor looking to sell a quack theory, or an attorney hoping to skim off part of a large malpractice suit, or maybe a political hopeful who sees an angle for demagoging the issue.
Whatever is actually happening there, it’s terribly sad and really does break my heart.
Ken
There’s still time. E-mail your Republican representatives and demand that they step in. For bonus points, use the phrases “remind people what the Republican party stands for” and “don’t let this become another Terry Schiavo case”.
elm
@Keith G:
I feel bad for chuckling about anything to do with this story, but this one did get me.
And you’re right, I think Orange John isn’t about to disturb his typical weekend plans over something like this.
CaseyL
@Elizabelle:
Washington is one of those states? Holy hell!
… I looked up the statute. RCW 70.122.030. The pregnancy exception isn’t even in the main wording of the statute; it’s just one line in the model language form at the end of the statute. Fuckers.
ETA: @elm: They’re getting “advice” from an organization that was heavily involved in the Schiavo case. So, yes, they are getting very bad advice.
ruemara
@Boudica: Holy shit, what do you need? The fetus is encephalitic, has brain development abnormalities, was without oxygen for an unknown amount of time, is so deformed physically that they can’t even tell what gender it’s supposed to be. If it was viable out of the womb, it would not be for long and any survival would require even more expensive surgery and medical care for whatever portion of time it ‘lived’. This would be on top of the nearly 100k a day ICU care the mother has been forced into.
I linked to this story a couple of days ago. Every woman should be concerned about laws like this. We’re not incubators and to be denied a dignified death like this, even once our end plans are made clear-disgusting.
Matt
I hope he sends the bills to “Texas Right To Life”‘s offices. Seems only fair that they should ante up the cash if they love fetuses so much more than people.
PurpleGirl
Depending on how long the mother has been without oxygen, not only her brain but the fetus’s brain may well be damaged beyond an ability to be functional. I guess the legislators don’t know much about biology/medicine. The fetus could theoretically be viable and have a good body but be crippled by a non-functional brain. And yes, disgustedly, there would be no help for the family to pay for the upkeep of such a child. Damn godbotherers.
a hip hop artist from Idaho (fka Bella Q)
Worse (if possible)
(emphasis added)
From the link above.
Marlis
@ruemaga: Boudica is correct. The question of viability is not related to the question of deformities. The judge requested confirmation that the fetus was not viable in the legal sense under Texas abortion law; the judge noted that since the fetus was not viable, Munoz (or, in this case, her husband) had the legal right to terminate the pregnancy. It was a factor in the decision.
Aleta
I know that logic doesn’t matter much to those who agitate for the ‘feelings’ of a fetus (and their own feelings) to be given more importance than the self-determination of a woman. But even on their own emotional terms, condemning a fetus to be forced to mechanically ‘live’ inside its dead mother is a horrific torture. Unless actual life has no meaning to them.
Mnemosyne
@a hip hop artist from Idaho (fka Bella Q):
Huh. Sounds like someone at the insurance company may have clued them in about the futility of trying to get reimbursed for unauthorized human experimentation.
I’ve been following this story and it’s pretty much horrifying from beginning to end. I feel especially sorry for the husband, who’s being harassed by forced birthers with implications that he must have abused his wife (because pregnant women never get blood clots, amirite?) or that he somehow wants to “kill his baby.” Fucking assholes.
JLJ
“On Nov. 28, the hospital agreed that she “met the clinical criteria for brain death” but refused to remove her from life support because she was 14 weeks pregnant.”
They also refused to pronounce her dead at the time of death.
The court order: http://www.scribd.com/doc/202053415/Judges-Order-on-Munoz-Matter
The woman has been dead for almost 2 months and the hospital knew and knows that. Now the judge is ordering the hospital to pronounce her dead. How do they get away with refusing to pronounce her dead for 2 months? WTF? It’s malpractice and fraud on top of being cruel, callous, and disgusting.
I’m also just amazed at how grotesque the “pro-life” cult of fetus worshipers has become. The hate hurled at the husband in some of the comments on articles about this is just vile and always accompanied by a statement of the commenter’s Christian righteousness.
Nutella
@a hip hop artist from Idaho (fka Bella Q):
There is no child in this case, born or ‘unborn’. There’s a fetus and a corpse.
Neither of those are people and therefore neither of those have any rights, to medical treatment or anything else, because they are not people.
Are there laws in Texas against desecrating a corpse? Because that’s what the hospital did.
It’s tragic that Mr Muñoz has to deal with all this awful political posturing when he’s got enough troubles dealing with the death of his wife.
a hip hop artist from Idaho (fka Bella Q)
@Nutella:
That’s among the things that are so ghastly about this. I cannot fathom the horror Mr. Munoz faces. There is not a tort award available (even in a state without “tort reform” limits) that could compensate him for what Texas and this hospital have done to the entire family. Its a shanda.
Boudica
@ruemara: I am not for keeping the woman on life support. She should have been removed back in November. I was just pointing out a semantic misunderstanding.
Elizabelle
Popping this in as a coda to the sad story of the Munoz family:
Incidentally, that Texas hospital said “uncle.”
They will not fight Friday’s judge’s ruling that Marlise Munoz is dead, legally and medically, and that her family has the right to have her removed from life support.
She takes with her a fetus at 23 weeks of development, with grave abnormalities. John Peter Smith Hospital in Fort Worth had forced her to remain on life support these past 8 weeks, on a misreading of Texas law that ignores a woman’s advance directive, when pregnant.
Rest in peace, and may Erik Munoz and Marlise’s parents and loved ones have peace in which to grieve. They were courageous in fighting for her rights, and their own.
JLJ
Yes. Rest in peace.
Marlise’s family’s last memories of her now include the past two months of obscenity. I hope the hospital doesn’t continue to pile on by billing her husband for the hospital’s “mistaken” interpretation of the law.