Treating a woman as an incubator

ERICK MUNOZ would like to let his wife Marlise die in peace. But the state of Texas is determined to make her live out her last days as a human incubator.

Marlise suffered a suspected pulmonary embolism on November 26 that left her brain-dead, despite attempts to resuscitate her. Her husband says she would not have wanted to be kept alive on a ventilator. Working as paramedics, the couple had discussed such a scenario many times--especially after Marlise's brother died several years ago. "It's our decision that we didn't want to live in that condition," Erick Munoz told the Houston Chronicle.

But because Marlise Munnoz was 14 weeks pregnant at the time she became brain-dead, John Peter Smith Hospital in Fort Worth, Texas, is refusing to follow her wishes or those of her husband and remove her from a ventilator. The hospital claims a Texas law prohibits it from following such a family directive when a pregnancy is involved.

The Texas Advance Directives Act states, "A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." The hospital is interpreting the law to mean that it cannot (or will not) legally allow Marlise to die in peace.

But several experts--including two who helped draft the law--told the Houston Chronicle that the hospital was twisting the meaning of the law. "This patient is neither terminally nor irreversibly ill," said Dr. Robert Fine, clinical director of the office of clinical ethics and palliative care for Baylor Health Care System. "Under Texas law, this patient is legally dead."

Arthur L. Caplan, director of medical ethics at NYU Langone Medical Center in Manhattan, told the New York Times, "The Texas legislature can't require doctors to do the impossible and try to treat someone who's dead. I don't think they intended this statute the way the hospital is interpreting it."

Additionally, it's unclear how long the fetus may have been deprived of oxygen and if it suffered irreversible damage--if it can even come to term.

"That poor fetus had the same lack of oxygen, the same electric shocks, the same chemicals that got her heart going again," Marlise's father, Ernest Machado, told DallasNews.com. "For all we know, it's in the same condition that Marlise is in."

Now, Erick Munoz has been left to care for the couple's toddler son while trying to make John Peter Smith Hospital respect his wife's wishes. "I don't agree with this law...I don't," he told WFAA Channel 8. "It's hard to reach the point where you wish your wife's body would stop."

THERE IS a possibility that Erick Munoz could obtain a restraining order against the hospital to allow his wife's wishes to be carried out. But according to WFAA, "most [legal experts] say it would be difficult to find a Texas judge to grant it. They say it's unlikely a mother's wishes would be allowed to override a child's potential."

And that is precisely what makes this case such an ugly illustration of the way abortion politics are playing out in Texas and across the U.S.: The wishes of actual women and their families are held hostage to the "potential" of a fetus.

Were she alive, Marlise Munoz would have the absolute right to an abortion--though abortion restrictions in Texas would certainly make exercising that choice difficult--given that the fetus is not viable outside the womb. As Katherine Taylor, a lawyer and bioethicist at Drexel University in Philadelphia, explained to the New York Times: "These laws essentially deny women rights that are given others to direct their health care in advance and determine how they want to die. The law can make a woman stay alive to gestate the fetus."

Texas, which recently enacted some of the most draconian abortion restrictions in the U.S., is not alone in its approach to the end-of-life decisions of pregnant women. While cases like that of Marlise Munoz are rare, as ThinkProgress wrote, "According to a 2012 report from the Center for Women Policy Studies, Texas is one of 12 states that automatically invalidate women's end-of-life wishes if she is pregnant. Those state laws ensure that 'regardless of the progression of the pregnancy, a woman must remain on life-sustaining treatment until she gives birth.'"

Under such laws, the suffering of women and their families becomes less important than the state forcing a pregnancy to term. As Slate.com's Amanda Marcotte noted:

Mandating that pregnant women stay on life support regardless of their wishes is a neat and easy way to establish the claim that the state has an interest in fetal life, even at the earliest stages, that overrides a pregnant woman's basic human rights. After all, brain death during pregnancy is incredibly rare, making these laws more symbolic in nature than pragmatic. If your goal is to legally enshrine the notion that pregnant women are incubators first and humans second, keeping their bodies alive to grow babies long after their minds are gone is a perfect way to do it.

Of course, rare doesn't mean impossible, as Marlise Munoz's family is discovering.

"All she is a host for a fetus," Ernest Machado told the New York Times. "I get angry with the state. What business did they have delving into these areas?"

Incredibly, since Erick Munoz went public with the situation his wife and family are dealing with, he has been subjected to a flood of anti-choice hate. According to DallasNews.com's Jacquielynn Floyd, "Some of the posted comments were vicious, accusing Erick Munoz--a grief-stricken father and husband--of wanting to 'pull the plug' and 'get rid' of his wife and baby. Others--strangers who don't know these people--claim Marlise 'might wake up' or cling to slim odds that the oxygen-deprived fetus might be miraculously healthy."

Meanwhile, the Munoz family is suffering every day that Marlise is forced to stay alive on machines. "This isn't about pro-life or pro-choice," Ernest Machado explained. "We want to say goodbye. We want to let them rest."