Come on, Texas. Really?

I’ve written before about my connection to that most unique state, Texas. Today’s post sadly isn’t one which fills me with state pride.

Since seeing the tragic news a few days ago about Marlise Munoz, a 33-year-old brain dead woman who is forcibly being kept alive to serve, quite bluntly, as an incubator, has me speechless. Ms Munoz by all accounts is unable to live without full life support and will not recover. Her husband and parents want to take her off of life support and have wished to do so since learning that there is no brain stem activity. She herself had previously said that she did not want to be kept alive in a vegetative state. So, why is she now on life support against the wishes of her family and her own living will?

She was 14-weeks pregnant when she collapsed.

In Texas, life-sustaining treatment can not be withdrawn or withheld from a pregnant woman regardless of how far along she is in her pregnancy. As of 2012, similar strict laws surrounding end-of-life care for pregnant women existed in 12 states in the US, according to a 2012 study by the Centre for Women Policy Studies. (These states are Alabama, Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, South Carolina, Texas, Utah, Washington, and Wisconsin.) Thus, even if an advance directive exists stipulating that a woman does not wish to remain on life support if she is considered brain dead, the state has the right to keep her on life-sustaining support if she is pregnant. Her wishes for a dignified death are unimportant and she is essentially rendered an incubator. This is precisely what has happened to Ms Munoz.

Had she been further along in her pregnancy, I might find this more understandable. But, she was still in her first trimester when she was classified as ‘legally’ dead. She suffered from a lack of oxygen for an extended period of time, which most likely also affected the foetus. But, nevermind that.

What really gets me is the medical bills. Since it is the hospital’s decision to keep Ms Munoz on life support , you would think that the costs would fall on the administration. No. The bills will ultimately go to her family. With an average cost of US$4004 per day, already the bill is quite steep (~US$170 000 already at least). And, that’s just for the intensive care unit bill. But, this does not necessarily include the costs of the ambulance, emergency room and other various services and service providers, specialists, etc. undoubtedly used since she first collapsed on 26 November. All of these add to that already hefty bill and in the absence of a national healthcare system. For what?

My understanding is that, currently, the hospital is waiting until the foetus has developed further to determine if they will keep Ms Munoz on life support further and what additional actions they will take. Should tests reveal that the foetus is brain dead, what next? Who will be responsible for providing long-term care to that foetus/infant? The family? Or the hospital? Or the state of Texas?

Without delving into the pro-life / pro-choice debate, this case in particular fills me with sadness for the family of Ms Munoz, but also for Ms Munoz herself. Her dignity as a human and as a woman specifically has been diminished so greatly. She expressed her wishes to not be put on life support should she lose brain function. Her wishes have been ignored completely all for the sake of a foetus which may or may not survive to birth, and may or may not itself be brain dead.

In the words of her father, she is a ‘host’ at this point, not a woman or a mother. In cases like this, it’s hard to see that women are valued within society as anything but incubators when the rights of a foetus are placed so clearly above those of the mother. And, if we can fight so fiercely for the well-being of a foetus before it enters the world, why do we not then provide that same level of care and concern for the child it becomes?

Clearly, medical technology has advanced at an amazing rate, so much so that the ethics of our options have not completely sunk in and we have yet to philosophically ponder let alone come up with solutions / answers which work for all of us given our varied beliefs and moral compasses. Yet, I would hope that we would at the very least put the dignity of an individual, especially when spelled out when one is capable of still making such decisions, above all else.

For now, my thoughts are with the Munoz family. Suffering such a loss is bad enough. Having to relive it each and every day in such a viscous, callous and myopic way is unthinkable. May they be able to finally and definitively grieve sooner rather than later.

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