Officials at John Peter Smith Hospital argue that they are keeping Munoz’s body alive because doing otherwise would violate a state law that bars medical officials from removing a pregnant patient from life support. The law, which was passed in the late 1980s and upheld in court a decade later, holds that life support will continue in such cases regardless of how advanced the pregnancy is.
And, perhaps, regardless of the overall viability of the fetus. Doctors had said that they would have to wait to determine what, if any, fetal damage had occurred as a result of Munoz’s collapse; it was estimated that she was unconscious for an hour before her husband found her, which means that the fetus was deprived of oxygen for at least that long. There are also the medical challenges associated with a brain-dead body gestating a fetus—which sounds like a sentence that can only be applied to a character in a science-fiction or horror story, not to a woman living in the United States in the 21st century.
Earlier this week, tests revealed serious fetal abnormalities, including hydrocephalus, deformed lower extremities and a possible problem with the fetus’ heart. And late yesterday afternoon, a judge ordered the hospital to remove Munoz from life support by 5 pm Monday afternoon. The hospital has the right to appeal; whether it will do so remains to be seen at this time. One would hope that the court decision will do what medical science could not—provide the final evidence needed for the hospital to let Munoz and her unborn child pass away with the dignity and respect they should have been afforded seven weeks ago.
But that might be giving too much credit to the hospital, whose interpretation of the law has baffled some medical ethicists. And when looking at their decisions and statements, it’s worth noting that the hospital’s lead attorney has been described as an “anti-choice crusader.” In the 1980s the attorney, Neal Adams, advocated barring hospital employees from performing abortions at all; currently, he is on the board of an anti-choice organization.
This is not a case about abortion. And personal beliefs do not automatically influence professional behavior. But Adams’ views are germane to this discussion because it is impossible to ignore the specter of anti-choice, anti-woman sentiment that pervades the Texas law, which demonstrates the extent to which the state regards women as incubators whose own rights are secondary to the interests of a fetus.
The law denies women the same rights as men to make decisions regarding their end-of-life care, and allows the state government to overrule a woman’s ability to make her own healthcare choices. Yet that same government all too often lacks the interest, will or resources to assist families in raising children, much less children born to brain-dead mothers. And the hospital has not discussed any support that it will offer Munoz’s family in the case that the fetus is delivered alive.
Given Texas’s aggressively anti-choice behavior over the past year, it would be easy to say that these actions just demonstrate the perspective of one state. But such laws exist in over half the states in this country, although they vary in their wording and strictness. While Texas’s law falls on the stricter end of the spectrum, the knowledge that so many state governments put a pregnant woman’s wishes secondary to political interest in a fetus is chilling.
Nothing about what happened to Marlise Munoz makes any sense: her sudden death, the end of a wanted pregnancy or the refusal of the hospital to honor either her wishes or the identical ones of her next of kin. But the hospital, at least, can be held accountable for the role it has played in compounding this family’s trauma; and the state should be held accountable as well. As Mrs. Munoz’s father asked in an interview earlier this month, “All she is is a host for a fetus … What business did [the state] have delving into these areas? Why are they practicing medicine up in Austin?”
Sarah Erdreich is the author of Generation Roe: Inside the Future of the Pro-Choice Movement. She lives in Washington, D.C. with her family.
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