Erick
and Marlise Munoz, both paramedics in Tarrant County, Texas, had talked a lot
about end-of-life decisions, including the importance of do-not-resuscitate
orders. So when doctors put her on life support after suffering a suspected
pulmonary embolism last month, her husband says, he knew her wishes.
Marlise,
33, had lost a brother years before and told her husband she never wanted to be
kept alive by machines, he says.
But
Marlise is pregnant, and Texas state law puts the rights of a fetus over the
wishes of its mother. The baby Marlise is carrying is now closer to 18 weeks,
but Munoz says doctors have no idea what effects the oxygen deprivation Marlise
has suffered will have if the baby is delivered.
"It's hard to reach the point
where you wish your wife's body would stop," Munoz, also in his 30s, told ABC News' Dallas-Fort Worth affiliate WFAA-TV.
"They
don't know how long the baby was without nutrients and oxygen," he said.
"But I'm aware what challenges I might face ahead."
Marlise,
who with her husband has a 1-year-old son, has been on life support at John
Peter Smith Hospital in Fort Worth since Nov. 26, when Munoz found her
collapsed on the living room floor. He performed CPR and then called 911. She
never regained consciousness and her husband says she is now "simply a
shell."
But
the fetus still has a normal heartbeat.
Munoz
told ABC News that he knows his desire to end his wife's life support is
unpopular with many people
Family
lawyers have said it will be difficult to convince a Texas judge to grant an
injunction or restraining order to put the mother's wishes ahead of her child.
Munoz
said that although he and his wife had intended to sign a do-not-resuscitate
order, or DNR forms, they had not done so before she fell ill.
Texas
law states this on pregnant patients: "A person may not withdraw or
withhold life-sustaining treatment under this subchapter from a pregnant
patient."
And
on DNR forms, under the Health and Safety Code, it reads, "I understand
under Texas law this directive has no effect if I have been diagnosed as
pregnant."
Hospital
officials would not speak directly about the Munoz case, but told ABC News:
"We have families every day that face really difficult decisions when it
comes to the care of their loved ones and we would have the same response. We
follow the law."
Art L. Caplan,
director of the medical ethics division at NYU's Langone Medical Center, said that at 18 weeks, the fetus is
not viable, but could be kept alive and delivered by cesarean at 24 to 28
weeks.
"We
don't know if these babies have been healthy," he said. "We tend to
see that these babies are born, then it's the end of the headline. ... We don't
know the impact of life support on fetal development and the wife being robbed
of oxygen. ... It could be a huge challenge for the fetus."
Caplan
said several other states, like Texas, have riders that void living wills when
women are pregnant. But most legal cases favor the rights of the mother.
"The
basic moral principle with the individual is you do not have to give them care
they do not want," he said. "The principle has been established again
and again throughout legal cases in the United States."
The most notable right-to-die case
was that of Terry Schiavo, a brain-dead Florida woman whose family fought
to keep her alive.
But her husband eventually won a
court order in 2005 to withdraw her feeding tube and Schiavo died at the age of 41.
ABC
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