I've been following the two cases in the national news that deal with brain death but for differing reasons. The California case involving of the family of Jahi McGrath illustrates one set of issues and the Texas case involving the husband and family of Marlise Munoz involves another set of issues. In both cases the situations and decisions are heartbreaking and the heart break compounded because of legal fights over state laws.
In the McGrath case, the family decided not to accept the medical decision of brain death for their daughter and finally obtained court permission to have their daughter's body discharged to their care so they could obtain continued mechanical life support for Jahi in another medical facility. For this to happen they had to first get a death certificate from the county and present this to the coroner's office who then gave them a permission slip to retrieve Jahi from Children's Hospital Oakland. This is not that unusual in California because State Law makes provisions for families who have religious reasons to take charge of their deceased relatives. The McGrath's religious reason was to give God more time to miraculously heal their daughter. As any Christian believer knows, there is New Testament precedent for this kind of miraculous healing. Given the released information in this case, it's a given that miracle was not happening at Children's Hospital Oakland. This is a truly tragic case, but the legal issues are pretty clear cut and as brutal as the legal solution was for the family, at least their wishes were met. The Texas case is a different story.
In this situation Marlise Munoz collapsed at Thanksgiving from a brain hemorrhage while 14 weeks pregnant and was pronounced brain dead. The death certificate has been issued. Her husband and family want her taken off life support but a Texas law regarding pregnant women is being interpreted by the hospital, Peter Smith Hospital in Fort Worth, as mandating they keep Marlise on life support until her fetus reaches viability. Texas's Advanced Directive Law states this: "A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." The family maintains that Marlise is no longer a patient because she is legally dead. The hospital maintains they must maintain life support unless the courts decide otherwise. PSH plans to maintain life support until the fetus is viable and can be taken by Caesarean section. This will happen sometime in February unless the legal process sustains the family's position.
There are 30 states that now have laws mandating life support for pregnant women in vegetative states or coma. The Munoz case is different because this is not about a vegetative state as she has been declared legally dead. This is a case of State law being interpreted to mandate a corpse be kept on life support for the sake of a fetus. The potential life of the fetus over rides both the mother's and the immediate family's right to determine a medical course of action. Like 29 other states, Texas has determined that it's best interests lie in supporting the right to life of the fetus. Unfortunately, only the State of Pennsylvania has agreed that they will take on the financial burden of supporting the fetus in these cases. The other 29 are not so supportive. Imagine that.
When I first read the story of Marlise Munoz I had this instant recall of the Axlotl tanks from Frank Herbert's Dune series. I was appalled to be honest, that under the guise of fetal rights, Texas Law had created Herbert's scenario, but according to the LA Times, this is not the first time deceased women have been kept on mechanical life support to continue a pregnancy. The outcomes of these efforts are not particularly good given the percentage of miscarriages. The article offers no information on the mental and physical status of the children who were successfully born and lived past one year, nor is their any information concerning how the decision was made to keep these pregnancies going.
While both of these cases have their disturbing elements, it is the Munoz situation which really angers me. I don't care how one chooses to defend the Texas State Law, what this case illustrates for me is that women are legal slaves to their uterine processes even beyond their death. That is just wrong.