Texas judge: Remove brain-dead woman from ventilator, other machines

Posted at 3:57 PM, Jan 24, 2014
and last updated 2014-01-24 17:57:33-05
By Greg Botelho


(CNN) — A Texas judge ordered a hospital on Friday to remove a pregnant and brain-dead woman from respirators and ventilators by 5 p.m. Monday.

The hospital can appeal the decision.

On Friday, John Peter Smith Hospital acknowledged for the first time that Marlise Munoz, who is being kept on a respirator under Texas law, has been brain dead since November 28 and that the “fetus gestating inside Mrs. Munoz is not viable,” according to court documents released before a Friday hearing.

The woman’s husband has repeatedly made these claims in his efforts to have her removed from the machines so the family can bury her.

Erick Munoz contends doctors told him his wife “had lost all activity in her brain stem” and an accompanying chart stated that she was “brain dead.” He has further called her “nothing more than an empty shell” who should be left to rest in peace.

The overarching, complicated issue of whether the pregnant woman should be kept on a ventilator, as prescribed by Texas law, has been the subject of debate.

The wrenching story started with a pregnant woman found unconscious on her kitchen floor. In the more than eight weeks since then, lying supine in a hospital bed, the 33-year-old became the focus of an intense, emotional debate about who is alive, who is dead, and how the presence of a fetus possibly changes the equation.

Hospital spokesman J.R. Labbe said last month that doctors are simply trying to obey a Texas law that says “you cannot withhold or withdraw life-sustaining treatment for a pregnant patient.”

But to Munoz’s husband, Erick, she is not a patient because she is not alive. He and other family members say the hospital should abide by her wishes — which weren’t written down but, they say, relayed verbally to them — and not have machines keep her organs and blood running.

In an affidavit filed Thursday in court, Erick Munoz said little to him now is recognizable about Marlise. Her bones crack when her stiff limbs move. Her usual scent has been replaced by the “smell of death.” And her once lively eyes have become “soulless.”

“Over these past two months, nothing about my wife indicates she is alive,” Erick Munoz said. “… What sits in front of me is a deteriorating body.”

Husband: ‘Obscene mutilation of a deceased body’

It should have been a happy time for Marlise and Erick Munoz, two trained paramedics awaiting the arrival of their second child.

Then everything came crashing down around 2 a.m. on November 26, when she was rushed to the north-central Texas hospital.

Once there, Erick Munoz said, he was told his wife “was for all purposes brain dead.” The family also says the fetus may have been deprived of oxygen.

In his lawsuit, Munoz claims subsequent measures taken at the hospital — and, in turn, the state law used to justify them — amount “to nothing more than the cruel and obscene mutilation of a deceased body against the expressed will of the deceased and her family.”

The family’s attorneys more recently said that Marlise’s fetus “is distinctly abnormal,” suffering from hydrocephalus and “deformed to the extent that the gender cannot be determined.”

“Quite sadly, this information is not surprising due to the fact that the fetus, after being deprived of oxygen for an indeterminate length of time, is gestating within a dead and deteriorating body, as a horrified family looks on in absolute anguish, distress and sadness,” attorneys Jessica Janicek and Heather King said in a statement.

The hospital and the Tarrant County District Attorney’s Office, which said it will defend the medical facility, have not offered the same level of detail as members of the Munoz family.

But earlier this month, Labbe did tell CNN that his hospital believed “the courts are the appropriate venue to provide clarity, direction and resolution in this matter.”

Strong opinions on both sides of debate

The strong feelings about the next chapter for Marlise Munoz and her unborn child were on display Thursday outside the Fort Worth hospital.

Some held signs reading “God stands for life” and “Praying for Baby Munoz and family,” believing that doing whatever is necessary for the unborn child’s sake was imperative.

The opposite view was represented by those toting placards with messages like “Let Marlise rest in peace” and “Respect Marlise’s wishes.”

“Her family doesn’t want life support for her, and we don’t feel its right for the state or the hospital to force this on her,” a woman on that side of the debate, Autumn Brackeen, told CNN affiliate WFAA.

Another person who doesn’t believe the “life-sustaining measures” are warranted is Tom Mayo, a Southern Methodist University law professor who helped write the law being cited by the hospital.

“She’s not a patient anymore,” Mayo said, adding that the hospital was misinterpreting the statute. “So I don’t see how we can use a provision of the law that talks about treating or not treating a patient in a case where we really don’t have a patient.”

For all the passions on both sides of the debate, others saw plenty of gray area — the kind of thing that might not be resolved until the baby is born and, perhaps, develops outside the womb.

“A lot depends, first of all, on how long the patient here was deprived of oxygen, or otherwise compromised,” said Dr. Jeffrey Ecker of Massachusetts General Hospital, who works on complicated pregnancies and prenatal diagnosis

“We can certainly use tools like ultrasound and MRI to sometimes see where there has been injury as a result of low blood pressure or low oxygen. But just seeing that things look well isn’t the same as saying that things will be well,” Ecker said.

CNN’s Ed Lavandera, Dana Ford and Jason Morris contributed to this report.

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