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Old 12-24-2013, 09:38 AM  
dirk digler dirk digler is offline
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Moral Dilemma: Wife is brain dead but pregnant

Interesting story and I am not sure what the right answer is though I tend to side with the wishes of the person over the state. I don't know...

Quote:
http://www.cnn.com/2013/12/23/health...html?hpt=hp_t2

Erick Munoz wants to see his wife's wish fulfilled this holiday season, but it's one that carries ethical and legal challenges: To be taken off of life support. Marlise Munoz, 33, is in serious condition in the intensive care unit at John Peter Smith Hospital in Fort Worth, Texas, hospital officials said.

She is unconscious and on a ventilator, her husband told CNN affiliate WFAA, but she wouldn't have wanted her life sustained by a machine.
"We talked about it. We're both paramedics," he told WFAA. "We've seen things out in the field. We both knew that we both didn't want to be on life support."

Complicating an already difficult situation is that Munoz is also pregnant, about 18 weeks along, WFAA reported. Texas state law prohibits withdrawing or withholding life-sustaining treatment from a pregnant patient, regardless of her wishes.

Patients can indicate their future wishes about medical treatment, in the event that they are unable to communicate them, through forms called advance directives. But in Texas, under the Health and Safety Code, such a form includes the provision "I understand that under Texas law this Directive has no effect if I have been diagnosed as pregnant."

Erick Munoz told WFAA doctors said his wife may have suffered a pulmonary embolism, which happens when blood clots travel to the lungs from elsewhere in the body. They do not know how long the baby went without nutrients and oxygen.

The hospital would not release specific details about Marlise Munoz's condition, but officials said the hospital would follow Texas law regarding care during pregnancy.

"We have a responsibility as a good corporate citizen here in Tarrant County to also provide the highest quality care we can for all of our patients," said J.R. Labbe, vice president of communications and community affairs for JPS Health Network, in a statement.

"But at all times, we will follow the law as it is applicable to health care in the state of Texas. And state law here says you cannot withhold or withdraw life sustaining treatment for a pregnant patient. It's that clear."

The husband and wife, both paramedics in the Tarrant County area, have a 14-month-old son named Mateo.

Erick Munoz and Marlise Munoz's mother did not immediately respond to requests for comment from CNN.

Erick Munoz found his wife unconscious on November 26, around 2 a.m. He performed CPR on her and then called 911, WFAA reported.

Since that day, the pregnant woman has been on life support, her husband said. Tests have shown that the fetus has a normal heart beat, he said. At 24 weeks, doctors may know more about when the fetus can be taken out, Munoz's family told WFAA. Doctors have also discussed the possibility of taking the fetus to full term.

He told WFAA that his wife had said she would not want to be kept alive by machine, and said he has reached "the point where you wish that your wife's body would stop."

Munoz wears his wife's pink and blue bracelets on his wrist, WFAA reported. Her wedding ring is on his pinkie.

When Munoz walks in the door, he said his son Mateo is waiting for his mother to show up.

"You can see it in his eyes," Munoz said.
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Old 12-24-2013, 12:14 PM   #31
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Quote:
Originally Posted by blaise View Post
That's skirting around his statement, though. According to him the choice would be his and he could pull the plug regardless of whether they could deliver.
Not that any father would, but the point is that it isn't just as simple as, 'His choice." Unless of course you believe he should be able to pull the plug on her whether 2 months pregnant or 8 months.
There should be a timetable on it but not some general law that says you can't because the person is pregnant. She could be 2 weeks pregnant so he would have to keep her alive for a very long time. I would be in favor of making the limit like 20 weeks, like they do for late term abortion or when they can determine if the baby is brain dead or not.
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Old 12-24-2013, 04:24 PM   #32
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What a sad situation. I wonder, if the husband just waited until he was alone and then pulled the plug himself, would they charge him with murder? Double murder?

Probably would.

My thoughts and prayers are with the family.
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Old 12-24-2013, 10:35 PM   #33
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If the wife is already 'gone', then what's the issue really? Sure, she may have given general consent, but if you asked a mother if she would mind her body being kept alive by machines to give the baby a better chance, wouldn't all mothers say yes?

I bet you could make a legal argument that her AND agreement applied only to her own life, and that she neither could have foreseen this circumstance nor could it be presumed that she would want the baby to go with her.

It seems a bit... Off, that the husband would want to shut them both off, doesn't it? Does anyone else find that to be rather unseemly...?

Last edited by Cochise; 12-24-2013 at 10:55 PM..
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Old 12-24-2013, 10:42 PM   #34
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Originally Posted by Garcia Bronco View Post
I don't think there is a right answer here other than it's no one's choice but the family.

God Bless and prayers for this family.
This. 50 years ago this probably wouldn't even have been discussed, both would have passed.

What a tough but very personal choice.

I hate that someone can tell another person what's right/best for them.

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Old 12-25-2013, 12:24 AM   #35
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Originally Posted by Katipan View Post
They are pretty amazing with how early they can deliver babies these days but the developmental risks are just so huge. Think they really like making it to 6 months which isn't too far away for her. And if they're going 2 months would 2 more on top of that be too unreasonable to ask?

All around sad and it appears I should have yet another qualifying conversation with my family.
The age of viability is 22 to 26 weeks. That being said the percentage of survival obviously increases significantly with each passing week.
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Old 12-25-2013, 12:33 AM   #36
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Old 12-25-2013, 01:04 AM   #37
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Quote:
Originally Posted by Hoopsdoc View Post
What a sad situation. I wonder, if the husband just waited until he was alone and then pulled the plug himself, would they charge him with murder? Double murder?

Probably would.

My thoughts and prayers are with the family.
sup, hootie?
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Old 12-25-2013, 08:34 AM   #38
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Quote:
Originally Posted by Cochise View Post
If the wife is already 'gone', then what's the issue really? Sure, she may have given general consent, but if you asked a mother if she would mind her body being kept alive by machines to give the baby a better chance, wouldn't all mothers say yes?

I bet you could make a legal argument that her AND agreement applied only to her own life, and that she neither could have foreseen this circumstance nor could it be presumed that she would want the baby to go with her.

It seems a bit... Off, that the husband would want to shut them both off, doesn't it? Does anyone else find that to be rather unseemly...?

Unseemly as well as something terribly convenient. If you have no moral compass then choosing the easy way is not an issue. There is no consideration for the baby and giving it up for adoption if the father, or more accurate if he really would kill the baby, sperm donor?
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Old 12-25-2013, 08:43 AM   #39
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Originally Posted by dirk digler View Post
baby\fetus.
You are correct that fetus in latin means child.
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Old 12-25-2013, 08:52 AM   #40
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Quote:
Originally Posted by Cochise View Post
If the wife is already 'gone', then what's the issue really? Sure, she may have given general consent, but if you asked a mother if she would mind her body being kept alive by machines to give the baby a better chance, wouldn't all mothers say yes?

I bet you could make a legal argument that her AND agreement applied only to her own life, and that she neither could have foreseen this circumstance nor could it be presumed that she would want the baby to go with her.

It seems a bit... Off, that the husband would want to shut them both off, doesn't it? Does anyone else find that to be rather unseemly...?
Quote:
Originally Posted by HonestChieffan View Post
Unseemly as well as something terribly convenient. If you have no moral compass then choosing the easy way is not an issue. There is no consideration for the baby and giving it up for adoption if the father, or more accurate if he really would kill the baby, sperm donor?
Yep !! You guys both nailed it.
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Old 12-25-2013, 08:55 AM   #41
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Oh btw, no moral dilemma for me. Use the technology God has blessed man with to preserve life until the baby is safe to take from the womb. The mother is already with Jesus. What's the moral issue ??
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Old 12-25-2013, 09:08 AM   #42
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Oh btw, no moral dilemma for me. Use the technology God has blessed man with to preserve life until the baby is safe to take from the womb. The mother is already with Jesus. What's the moral issue ??
There are several moral issues and not everyone believes like you believe. Alot of people didn't think Terri Schiavo should have had her feeding tube removed so that is one issue. The other is the fetus and whether or not it is alive or dead. It has a heartbeat but that doesn't mean it is alive. Third and as Cochise and hcf thought it is unseemly to not give the fetus a chance, is that anymore unseemly than using this dead woman's body as an incubator for a few months?

Oh btw Merry Christmas shrink and hcf.
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Old 12-25-2013, 09:09 AM   #43
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Originally Posted by Chiefshrink View Post
Oh btw, no moral dilemma for me. Use the technology God has blessed man with to preserve life until the baby is safe to take from the womb. The mother is already with Jesus. What's the moral issue ??
What a terrible situation. I feel bad for the guy. I do find it rather arrogant of you to presume you know their beliefs and her standing with your God. How do you know she had not fallen out of grace and therefore is doomed to eternal torture. What if she was Muslim, Jewish or a believer the countless other religions~
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Old 12-25-2013, 09:15 AM   #44
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Originally Posted by dirk digler View Post
There are several moral issues and not everyone believes like you believe. Alot of people didn't think Terri Schiavo should have had her feeding tube removed so that is one issue. The other is the fetus and whether or not it is alive or dead. It has a heartbeat but that doesn't mean it is alive. Third and as Cochise and hcf thought it is unseemly to not give the fetus a chance, is that anymore unseemly than using this dead woman's body as an incubator for a few months?

Oh btw Merry Christmas shrink and hcf.
Dont confuse Terri Shaivo with this case. It would be a similar issue although not exactly the same if it was not confounded by the existence of the baby.

One could argue that the mother in this state is completing the effort to create a life she began and her journey will come to a close she the baby is born. To assume otherwise is to think that while alive this lady wanted to have an abortion to kill the baby and just didn't have time so "we" should kill it for her.



Her body is not dead, she has been ruled brain dead. But she continues to nurture her baby. People find declaring dead so easy when it fits a narrative.


I don't feel thats in anyway in my power, ability or moral upbringing to do.
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Old 12-25-2013, 09:40 AM   #45
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Quote:
Originally Posted by HonestChieffan View Post
Dont confuse Terri Shaivo with this case. It would be a similar issue although not exactly the same if it was not confounded by the existence of the baby.

One could argue that the mother in this state is completing the effort to create a life she began and her journey will come to a close she the baby is born. To assume otherwise is to think that while alive this lady wanted to have an abortion to kill the baby and just didn't have time so "we" should kill it for her.



Her body is not dead, she has been ruled brain dead. But she continues to nurture her baby. People find declaring dead so easy when it fits a narrative.


I don't feel thats in anyway in my power, ability or moral upbringing to do.
You make a good point about the mother and I doubt she would want to abort her baby. But would she also want to carry a dead baby with her? I would suspect not.

I will add there was a case in Europe a few years ago where a woman suffered a brain aneursym that was 25 weeks pregnant. They kept her alive for 2 days, injected her with a bunch of steroids and delivered the baby. The baby was fine and when they pulled the plug she died immediately after. But there is a huge difference IMO between a 14 week old fetus and one 25 weeks along with the fact this current case she was unconscious for an extended period of time. I guess we will find out though and I do hope there is a good outcome out of all of this, I really do.
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