Life and Death and the Case of Marlise Muñoz
Mon January 27, 2014 12:29 am

(Erick Muñoz, husband of Marlise Munoz, is escorted out of court by his attorney Heather L. King, right, Friday, January 24, 2014 in Fort Worth, Texas. Photo via AP.)  

At 11:30 a.m. yesterday morning, doctors at John Peter Smith Hospital ended life support for Marlise Muñoz, a pregnant wife and mother who had collapsed at her home in Haltom City on the night of November 26 while making a bottle for her fifteen-month-old son, Mateo. The details of this case are heartbreaking. Marlise, who was fourteen weeks pregnant at the time, appeared to be in good health but was apparently stricken by a pulmonary embolism. Her husband, Erick, discovered her on the floor of their kitchen perhaps an hour or so later. Though she was still alive, she had stopped breathing for an unknown period of time, which meant that her unborn baby wasn’t receiving oxygen either. And that’s when a terrible private tragedy for the Muñoz family began to play out in a very public way.

John Peter Smith Hospital, in Fort Worth, insisted that Texas law prohibited them from removing Marlise from life support until they were able to deliver the baby. Erick and her parents objected, providing doctors with the living will that she had signed before she had become pregnant. But officials at JPS claimed that the document wasn’t relevant. They pointed out that advance directives, like Marlise’s, contain the line: “I understand that under Texas law this directive has no effect if I have been diagnosed as pregnant.” And they claimed that the Legislature had shown a clear interest in the protection of the unborn, as evidenced as recently as this summer, when the Eighty-third Legislature passed HB 2. Given that, it was perhaps understandable that the hospital was reluctant to deny care, in part for fear of liability and in part for fear of public backlash.

 Thus began the legal battle between the Muñoz family and the hospital, which, over a period of more than seven weeks, meant that Erick was unable to properly grieve for his wife and his lost child. But as the Fort Worth Star-Telegram pointed out in a series of fine reports about the case, even some the drafters of the legislation pertaining to advance directives were concerned about its application in this case. Marlise was declared brain dead two days after being rushed to the hospital, so she was, in fact, legally dead. Thomas Mayo, a professor at SMU who worked on the law during its latest revision, in 1999, told the Star-Telegram: “It never would have occurred to us that anything in the statute applied to anyone who was dead. The statute was meant for making treatment decisions for patients with terminal or irreversible conditions.” 

And though there have been isolated cases of a baby being delivered under such extreme circumstances, medical tests eventually showed that Muñoz’s fetus suffered from hydrocephalus—fluid on the brain—as well as other abnormalities that indicated it might not survive. Neither side disputed the results of those tests.

The case fell to state district judge R. H. Wallace Jr., who saw, as part of the filings, a statement from Erick that was as emotionally devastating as it was gruesome: “When I bend down to kiss her forehead, her usual scent is gone, replaced instead with what I can only describe as the smell of death. As a paramedic, I am very familiar with this smell, and I now recognize it when I kiss my wife. In addition, Marlise’s hands no longer naturally grip mine for an embrace. Her limbs have become so stiff and rigid due to her deteriorating condition that now, when I move her hands, her bones crack, and her legs are nothing more than dead weight.”

On Friday Wallace ruled that the hospital could not keep Marlise on life support against her family’s wishes. The reason? The law in question did not apply to her because she was already legally dead, which appears consistent with the legislative intent described by Mayo. Wallace gave JPS until 5 o’clock today to comply with the ruling or appeal it. Observers were closely watching how the order played out with the politics of the moment. In a conservative state that has consistently tightened its laws restricting abortion while at the same time embracing the ideals of self determination and individual privacy, most officials seemed hesitant to politicize the case or to suggest that it was about abortion in the first place. Governor Rick Perry had called it “tragic,” and his spokesperson added, “This was a matter for the court,” indicating that he was not going to insert himself into the process.

Attorney general Greg Abbott, the presumptive Republican nominee for governor, seemed to agree: “This is a heartbreaking tragedy for the entire Muñoz family, and our thoughts and prayers will remain with them during this difficult time. Texas strives to protect both families and human life, and we will continue to work toward that end.” (Interestingly, the Texas Alliance for Life responded to Wallace’s ruling by stating on social media, “We’re saddened by the judge’s order to remove the life support from Marlise Muñoz. Decision fails to recognize interests of the unborn child.” But as the keynote speaker at the group’s Texas Rally for Life on Saturday at the Capitol, Abbott did not mention the case in his remarks.)

That didn’t stop Operation Rescue, a Kansas-based pro-life Christian activist group, from announcing on its website its plans to stage a protest at the hospital yesterday with the headline “Prayer vigil and sit-in planned in response to ordered execution of Baby Munoz.” Its members agreed to adopt the baby “whether or not he or she is born with health problems,” an offer that exploited the emotions of the case without considering its facts. 

On Sunday, however, John Peter Smith hospital decided not to pursue an appeal well before the deadline set by Wallace, so doctors removed Marlise from life support. Protesters stayed, the vigils continued, but finally, for the first time since the ordeal began, Erick could finally begin to take time to mourn for himself and for Mateo and for all that he has truly lost.

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