Erick Munoz wants his wife now in an intensive care unit to be taken off life-support. The state of Texas does not.
Texas — and the Fort Worth hospital where Marlise Munoz is being kept on machines — should honor his wishes.
Munoz’ wife Marlise was 14 weeks pregnant when, without any warning last November 26th, her husband found her on the kitchen floor around 2 a.m. unconscious and unresponsive, her face blue from lack of oxygen. Doctors suspect that a blood clot traveled to her lungs and blocked air flow, leaving her unconscious, unresponsive and on life support at at Fort Worth’s John Peter Smith Hospital.
When it comes to medical care for the very ill, Erick and Marlise are experts. Both had worked as paramedics in Texas, and Marlise lost her brother tragically four years ago. Given that loss and what they knew first-hand could happen to those who are resuscitated but very sick they had many serious, in-depth conversations about what to do if the worst happened to them.
“We were all on the same page,” Marlise’s mom, Lynne Machado, told NBC News. “None of us want to be on life support.”
The state of Texas honors those choices, but with one exception. Texas state law Section 166.049 governing “Pregnant Patients” says, “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." That is a very bad, overly broad restriction of individual freedom.
Remember Marlise’s fetus was not viable when she fell seriously ill. And that fetus is not viable today. Still, the Texas law does not make any exceptions regarding viability or survivability. Erick is deeply concerned that the fetus won’t make it or may have been seriously harmed as a result of his wife’s embolism. He wants her wishes honored despite her pregnancy.
Why the legislature of Texas has any right to get involved in the care of Marlise Munoz when her wishes are so well informed and so clear is not self-evident. Even in their desire to protect fetal life the way the law has been written forces care in situations where the fetus is either not able to live or may be severely impaired. That restriction is far too strong given the clarity of this family’s wishes.
The hospital is unwilling to stop care and face the potential wrath of the Texas legislature.
“We follow the state law on this," said J.R. Labbe, vice president of communication and community affairs for JPS Health Network. "We cannot withdraw or withhold life-sustaining treatment from a pregnant patient."
But legislators ought not have a role at the bedside in this case. Erick Munoz has enough to deal with in trying to manage the loss of his wife and their fetus. He knows his wife’s wishes as well as anyone could. He deserves to have her wishes honored.
Arthur Caplan is the head of the Division of Medical Ethics at NYU Langone Medical Center.