Judge orders end to life-support for 'brain-dead' Texas woman

A Texas judge has ordered hospital authorities to remove life-support devices from Marlise Muñoz, a pregnant woman who has been declared 'brain-dead.' It's an important test of laws written to protect unborn children.

Tom Fox/The Dallas Morning News/AP
Afton Brown shows her support for the family of Marlise Muñoz in Ft. Worth, Texas, after Judge R.H. Wallace ordered John Peter Smith Hospital to declare the pregnant woman dead and withdraw life support by 5 p.m. Monday.

In the latest turn in a tragic case involving end-of-life treatment, state laws designed to protect unborn children, and the wishes of families, a judge in Texas has ordered an end to life-support procedures for a pregnant woman medical authorities have declared to be ‘brain-dead.’

In his ruling Friday, Judge R.H. Wallace told John Peter Smith Hospital in Ft. Worth that it had until 5 p.m. Monday to remove the ventilator and other devices from the body of Marlise Muñoz.

This is what Mrs. Muñoz’s husband and other family members have been seeking.

Both the hospital and the family agree that Mrs.  Muñoz meets the criteria to be considered brain-dead – which means she is dead both medically and under Texas law – and that the fetus could not be born alive this early in pregnancy.

Mr. Muñoz contends that while his wife had not signed a medical directive, she would not have wanted to be kept in this condition. His attorneys have said medical records show the fetus is "distinctly abnormal."

While the hospital agrees that Mrs. Muñoz is no longer medically alive, officials there say they have a legal duty to protect the fetus under the Texas Advance Directives Act, which prohibits withdrawal of life-sustaining treatment from a pregnant patient.

In his ruling, Judge Wallace asserts that the hospital is misapplying the law since Mrs. Muñoz is deceased and can no longer be considered pregnant.

“This is a tragic and very difficult case,” Wallace told a packed courtroom in Fort Worth, according to the Star-Telegram newspaper in Ft. Worth. “I’m as prepared to make a ruling as I will ever be.”

Attorneys for the hospital have not said whether or not they will appeal the judge’s order. In a statement Friday, the hospital said: "JPS Health Network appreciates the potential impact of the consequences of the order on all parties involved and will be consulting with the Tarrant County District Attorney's office."

Right-to-life and antiabortion groups are following the case closely.

“The decision fails to recognize the interests of the unborn child, who is a separate patient,” the Texas Alliance for Life in Austin said in a statement. “We believe the intent of the legislature, as expressed numerous places in Texas law, is to protect the lives of unborn children to the greatest extent possible.”

Abortion rights groups have been weighing in as well.

"This terrible tragedy has shown that there are consequences when politicians interfere in the personal medical decisions of families," Heather Busby, executive director of NARAL Pro-Choice Texas, said in a statement. "According to the Center for Women Policy Studies, 12 state statutes automatically invalidate a woman's advanced directive if she is pregnant, ignoring a woman's legal rights. These laws must be brought in line so that the rights guaranteed to all are afforded to all."

But for the most part, advocates on both sides have emphasized compassion for the family of a young woman representing personal tragedy as well as sharply-divided political, legal, and social opinions about end-of-life treatment and the unborn.

Gov. Rick Perry’s office called the case “tragic” and said his prayers are with the family. “This was a matter for the court,” his spokeswoman Lucy Nashed said, as reported by the Star-Telegram

Attorney General Greg Abbott issued a statement saying: “This is a heartbreaking tragedy for the entire Muñoz family and our thoughts and prayers will remain with them during this difficult time. Texas strives to protect both families and human life, and we will continue to work toward that end.”

Erick and Marlise Muñoz, both trained paramedics, had been expecting their second child.

“Since my wife’s death on Nov. 26, 2013, I have had to endure the pain of watching my wife’s dead body be treated as if she were alive,” Erick Muñoz said in an affidavit filed with the court on Thursday. “As her husband, I wish every day she was alive, but I am positive that my wife has passed away for many reasons.”

This report includes material from the Associated Press.

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