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It’s a personal not a political decision-Why the Munoz case matters

January 8, 2014 By jconway

Many here have probably read the gut wrenching story out of this morning’s Times concerning a woman who has lost brain function and whose husband and extended family have lost the rights they assumed they had under the law to remove life support. The reason?

She was also an expected mother. In Texas, if there is any chance the fetus could reach viability, they cannot ‘pull the plug’.

as her parents and her husband prepared to say their final goodbyes in the intensive care unit at John Peter Smith Hospital here and to honor her wish not to be left on life support, they were stunned when a doctor told them the hospital was not going to comply with their instructions. Mrs. Munoz was 14 weeks pregnant, the doctor said, and Texas is one of more than two dozen states that prohibit, with varying degrees of strictness, medical officials from cutting off life support to a pregnant patient.

To draw the inevitable comparison to the Teri Schiavo case it is interesting that a law, the one that ostensibly gave the next of kin the right to make this decision in that case, one even the right to life crowd wanted left with the family, is now preventing a family from making a decision that it feels is in the best interests of it’s daughter. In Texas, neither the family nor the husband has the rights we have been accustomed to seeing families maintain in these questions. But the hospital and the state has arbitrarily kept her alive.

As her husband and parents said:

“It’s not a matter of pro-choice and pro-life,” said Mrs. Munoz’s mother, Lynne Machado, 60. “It’s about a matter of our daughter’s wishes not being honored by the state of Texas.”

Mrs. Munoz’s father, Ernest Machado, 60, a former police officer and an Air Force veteran, put it even more bluntly. “All she is is a host for a fetus,” he said on Tuesday. “I get angry with the state. What business did they have delving into these areas? Why are they practicing medicine up in Austin?”

There may or may not be a legal case going forward. But this is the kind of stuff Wendy Davis was trying to stop, and this is the kind of case that can galvanize fence sitters. As many of you know, I have long supported Roe v Wade but have had my own private doubts about the morality of elective abortion. I still do, but I also know that I would never want to be in the shoes of this family, having the state interfere and prevent them from making the best healthcare decisions for their incapacitated daughter. Similarly, I would never want to be in the shoes of an expected mother facing the dilemma so many are facing in states across the union. I still oppose federal funding, and favor some reasonable restrictions, but this law in Texas and the hundreds of others in statehouses across the country, are unreasonable and end up causing as much emotional pain as the pain they claim to prevent.

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Comments

  1. Christopher says

    January 8, 2014 at 6:25 pm

    If the mother has the legal right to terminate a pregnancy at 14 weeks, and the mother’s condition requires that her medical decisions be turned over to family, then it stands to reason that the family now possesses the same legal right to make a decision which would have the effect of terminating the pregnancy. Besides, can a fetus even develop normally given the mother’s condition?

    • jconway says

      January 8, 2014 at 7:09 pm

      In this instance I guess they are arguing that the doctors would in effect, be allowing the fetus to die by allowing the mother to die, even if that was what the family wanted.

      Here is a neat breakdown of the degree of severity for similar laws in other states. FWIW MA does not have a statute clarifying the law in this instance. NH and RI are neighboring states that have a viability standard that is based on the likelihood that the fetus would survive outside the womb. That could be a fair standard, though I am not sure the mechanism for how that determination is made.

      There is also a lot of chatter that the administrator might be misinterpreting the law. From the article:

      Arthur L. Caplan, director of medical ethics at NYU Langone Medical Center in Manhattan, agreed. “The Texas Legislature can’t require doctors to do the impossible and try to treat someone who’s dead,” Mr. Caplan said. “I don’t think they intended this statute the way the hospital is interpreting it.”

      Critics of the hospital’s actions also note that the fetus has not reached the point of viability outside the womb and that Ms. Munoz would have a constitutional right to an abortion.

      From the other portions of the article it seems that the fetus was likely brain dead itself due to oxygen depravation.

      she had been due to give birth in mid-May, but the hospital’s plans for the fetus — as well as its health and viability — remain unknown. Mr. Machado said he had been told by the hospital’s medical team that his daughter might have gone an hour or longer without breathing before her husband woke and discovered her, a situation he believes has seriously impaired the fetus.

      Hard to argue it isn’t the family’s call and not the state’s. As someone preparing to get married within the next year and have children in 3-5 years these are issues I am starting to take very seriously. I am glad to be living in a state that would allow that decision to be mine and mine alone.

      • Christopher says

        January 8, 2014 at 7:14 pm

        …if the fetus were already viable. Then maybe there could be a way to deliver the fetus live and transfer it to an incubater before taking the mother off life support. However, I find the argument that it will later become viable weak. Of course most 14-week-old fetuses will later become viable, but we have the option to abort at that stage even so.

  2. mike_cote says

    January 8, 2014 at 7:13 pm

    It frames this as though people on the left would be cheering on this person’s death.

    I also think it is an insult to the person that was Teri Schiavo, before the NRC turned her into a ReThuglican Talking Point.

    • jconway says

      January 8, 2014 at 7:50 pm

      In one instance we had the right to lifers mainly cheering on the rights of a family to make this decision as opposed to a husband, and now we have a family and husband on one side, ostensibly the side the Teri advocates would be supporting, but now the state is preventing them from making that decision.

      I thought I was very careful in the comments to articulate what I was saying, but since you point out how the headline could be considered offensive or non constructive I will edit it accordingly. This is a case deserving of attention, and one I think can be used to articulate the common sense at the core of the pro-choice position-mainly let the individuals affected by the decision make the decision.

      • jconway says

        January 8, 2014 at 7:55 pm

        Let me know if you still found it offensive, I am sincere in wanting a respectful conversation nationwide about this issue and think it has a powerful way of connecting to people that may not have thought about this issue or had knee jerk opinions about it.

        • mike_cote says

          January 8, 2014 at 9:14 pm

          While I appreciate that in the original, you expressed concern about the title being provocative, I appreciate the edit.

          I agree that this should not be decided by the state but by the family, I would not want to see this devolve into “The Left is Rooting for Death” type disrespectful back and forth as has happened here before. I will not provide a link to the previous bitter exchange, but will relay the code word of “Philadelphia” as the basis for my concern.

          Again, thank you.

  3. power-wheels says

    January 9, 2014 at 10:01 am

    that the hospital is misinterpreting the law. As mentioned in the article, the law talks about “life sustaining measures.” But here the patient is already brain dead. Doesn’t that mean there is no life to maintain?

    It seems similarly to me that jconway is starting the wrong discussion when he talks about a family making healthcare decisions for an incapacitated woman. The typical Roe/abortion issues involve a woman’s right to make healthcare decisions regarding her own body vs. the government’s right to set policies to protect an unborn fetus. This case does not involve a woman’s healthcare. This case weighs a family’s rights to make decisions regarding the treatment of a relative’s dead body vs. the government’s right to set policies to protect an unborn fetus. Certainly still a very serious issue with many difficult permutations, but very different factors to weigh.

    • jconway says

      January 9, 2014 at 12:38 pm

      But I think a lot of fence sitters were sympathetic to Teri’s family since they thought their daughter could be in that situation, and we saw polls showing an uptick in anti-abortion respondents after that. I would argue here the extrapolation would be, I want to make that decision on my daughter’s behalf and not have the state tell me what to do. That leads logically to-if I were/am a woman, I would want to make that decision myself. That’s the way I examine it.

      I think Martin Sheen summed up my own views rather succinctly:

      I don’t think abortion is a good idea. I personally am opposed to abortion, but I will not judge anybody else’s right in that regard because I am not a woman and I could never face the actual reality of it.

      • power-wheels says

        January 9, 2014 at 1:12 pm

        But this situation is completely different than Terri Schiavo. Terri was no doubt alive, but her quality of life was severely compromised and she was unable to make decisions regarding her healthcare. This woman is dead. There are no more decisions to be made regarding her “healthcare. ” At least, I’ve never heard of decisions made regarding a dead body (organ donation, autopsy, cremation, burial, etc) described as healthcare decisions on behalf of the deceased.

        Assuming that the hospital is properly applying TX law (which I don’t believe they are based on my limited reading about this situation), the question is one of weighing a state’s ability to protect an unborn fetus with a family’s right to make decisions regarding a relative’s dead body. There are no more healthcare decisions to be made.

        • jconway says

          January 9, 2014 at 2:02 pm

          But they share similar political narratives.

          I clearly erred in bringing her up since it brought us down the wrong rabbit hole, but my point was simply-the same people defending a family’s rights to make end of life decision are now defending a state from stopping exactly that. I was pointing out their hypocrisy in making her a martyr.

          I am saying can anyone, even a self identifying pro-lifer, reading this not feel for the family and want their wishes to be honored? That is why it’s a powerful case and one that could really get a lot of midly pro-life people to start examining the reprecussions of the policies they vote for.

          • power-wheels says

            January 9, 2014 at 2:43 pm

            If a pro-life individual believes that an unborn fetus is more important than a woman’s right to choose to terminate a pregnancy, then you think that the same individual might believe that a family’s ability to make decisions regarding the treatment of the dead body of a relative is more important than a fetus? It’s certainly an awful and heartbreaking situation that a 33 year old pregnant woman, mother, wife, and daughter passed away. But I just can’t see many pro-life individuals reevaluating their beliefs. I don’t know, maybe I’m wrong but I just don’t see it.

          • fenway49 says

            January 9, 2014 at 3:39 pm

            In the Schiavo case, I don’t recall the conservatives “defending a family’s rights to make make end of life decision” so much as supporting, between two competing “families” (the husband and the parents), the side that happened to be reaching the decision the conservatives wanted on the merits.

            It remains to be seen how many “mild” anti-abortion people will think this is a bridge too far, and how many will not.

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