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Brain Injury Sparks National Debate

On November 26, 2013, Erick Munoz found his pregnant wife Marlise unconscious. After she was admitted to John Peter Smith Hospital in Texas, Erick was told that his wife had suffered a traumatic brain injury and was brain dead. However, the fetus had survived, and the hospital hooked Marlise up to a respirator and ventilator. While mourning the loss of his wife, Erick had a difficult decision to make.

Erick and other family members decided to unhook Marlise from the machines as she had previously expressed a desire to never be kept alive by machines while brain dead. However, John Peter Smith Hospital refused, citing the Texas Advance Directives Act, a Texas statute designed to protect patient life, including fetal life in the instance of pregnancy. What resulted sparked a national debate about fetal rights in cases concerning mothers with severe brain injuries.

Advance Directives Act
The state’s Advance Directives Act is a statute designed to achieve three main goals:

· Improving patient choices prior to death · Decreasing pain and suffering · Providing compassionate and private treatment to terminal patients, free of outside and/or legal intrusion
The Act serves as a guide for doctors and hospitals on right-to-die situations and how to treat terminal patients. The Act is designed to balance patient interests, family interests, and medical interests.

According to Section 166.049 of the Act, “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.”

In Marlise Munoz’s case, the meaning of this section is unclear and stymied Marlise’s family, lawyers, judges, and legislators.

Court Intervention
Marlise has now been kept alive by ventilators for over seven weeks. John Peter Smith Hospital hopes to keep Marlise on life support until the baby has matured enough to be delivered successfully. Despite Erick’s pleas, the hospital has refused to take Marlise off of life support until the delivery.

On Tuesday, January 13, 2014, Erick filed a civil court petition, requesting that a Texas court override the hospital’s decision and remove Marlise from life support equipment. According to the hospital, Marlise is a patient. She was admitted as a patient back in November and remains under supervision and care at the hospital. However, Erick and some medical and legal experts argue that Marlise’s situation is not covered by the Texas Advance Directives Act because, due to the traumatic brain injury that left her brain dead, she is legally dead and cannot therefore be a patient.

The lawsuit charges the hospital with 14th Amendment violations and cites Section 671.001 of the Texas Health and Safety Code. According to this Code, a person is considered dead when relevant functions that power spontaneous brain function cease. Erick argues that because Marlise is only alive because of the ventilator and respirator, both of which are artificial means of life support, she is considered legally dead under Texas law. According to medical records obtained by Erick’s lawyer, Erick now has definitive proof that Marlise is dead due to her brain injury.

Advanced Directives
This case has stirred up worldwide controversy concerning mother’s rights versus fetal rights. However, one important central issue that isn’t getting much attention concerns how to resolve disputes over the care of brain dead patients that have suffered traumatic brain injuries. One such way to avoid this issue altogether is to use advanced directives.

An Advanced Directive, or living will, is a legal document that states what an individual wishes to do with his or her body if he or she is unable to make an important medical decision. One such example is a “do not resuscitate” or DNR order that instructs hospital staff not to resuscitate a patient in the event breathing ceases or the heart stops. Advanced Directives provide guidance to hospital staff about what to do in these difficult decisions and save the family from the stress and trauma of having to make the decision on their own. In five states, Advanced Directives are allowed for pregnant women and permit them to create a legal document that is binding over what can happen to her body. However, in more than 30 other states, an Advanced Directive that contains a DNR will be ignored if the fetus is viable.

If a loved one has suffered a traumatic brain injury and is on hospital-mandated life support despite a living will, please consider contacting Levin & Perconti today to discuss your options.

See Other Blog Posts:

Hospital Lawsuit Following Brain Injury During Childbirth

Jury Awards $12 Million for Medical Malpractice Resulting in Traumatic Brain Injury