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VAQHMA

Member Since 29 May 2009
Offline Last Active Yesterday, 08:27 PM

Topics I've Started

Pregnancy And Life Support

21 December 2013 - 01:43 AM

Here's a truly touchy one.... http://shine.yahoo.c...-200600388.html
 
In short, the father found his wife lying on the kitchen floor not breathing and without a pulse. He performed CPR and the paramedics transported her to the ED, but she never regained brain activity. There is no knowledge of how long she went without oxygen, but it was long enough to cause substantial brain swelling. She was 14 weeks pregnant. She and her husband had talked many times about not wanting to be kept alive on life support, there are conflicting reports about whether or not she has a DNR, however Texas law invalidates DNRs if a woman is pregnant and maintains that the mother must be kept alive through extraoridinary measures if necessary. She has now been brain dead and sustained by life support for 1 month and is 18 weeks pregnant. 
 
What say you? I'm truly torn in this situation, but I feel it should be up to the family and I believe that the father has a very valid concern about the amount of damage the fetus likely suffered due to the lack of oxygen. Per this article, there has not been extensive testing done to evaluate the damage to the fetus beyond checking for the fetal heartbeat. 
 

On Nov. 26, Erick Munoz woke to the sound of his year-old son crying and found his 14-weeks-pregnant wife, Marlise, lying on the kitchen floor, blue in the face and without a pulse. A firefighter and paramedic, Munoz called 911 and performed CPR, to no avail. When they arrived at the John Peter Smith Hospital (JPS) in Fort Worth, Texas, he thought he would have to make an agonizing decision: refuse life support even though that meant losing both his wife and his future child. Munoz said in a WFAA News report that four years ago, when Marlise's brother was killed in an accident, she told him that she would never want to be on life support something they had discussed many times since.
More on Yahoo: Family Fights to Save Teen Daughter on Life Support

A month later, against his requests, she is still on a ventilator. Not only does Munoz want to honor his wife's wishes, but also he believes that the fetus she is carrying has been seriously harmed. "I don't know how long she was there prior to me finding her," he said. Munoz, who could not be reached for comment, wrote on WFAA's Facebook page, "All I know is that she was without oxygen long enough for her to have massive brain swelling. I unfortunately know what that type of damage could do to a child during crucial developmental time." Doctors say it's likely that Munoz's wife suffered a pulmonary embolism, and no longer has brain activity.

More on Yahoo: Doctors Vary on Willingness to Talk Hospice

When Munoz first arrived at the hospital, he discovered that, according to Texas law, life-sustaining procedures may not be withheld or withdrawn from a pregnant woman, even if she has an advance health care directive (also called a living will) stipulating that she does not want to be kept alive on a machine. There are conflicting reports about whether Marlise Munoz had an official DNR (Do Not Resuscitate order), and the family could not be reached for comment. But according to theCenter for Women Policy Studies, as of 2012, Texas and 11 other states have automatically invalidated pregnant women's advance directives to refrain from using extraordinary measures to keep them alive, and others have slightly less restrictive but similar laws. A spokesperson from the hospital told Yahoo Shine, "Our responsibility is to be a good corporate citizen while also providing quality care for our patients. At all times, JPS will follow the law as it applies to healthcare in the state of Texas."

Marlise Munoz's mother and father say they support their son-in-law's request to take their daughter off life support. "She absolutely DID NOT EVER want to be connected to Life Support," her mother, Lynne Machado, wrote on WFAA's Facebook page. "This issue is not about Pro Choice/Pro Life. Our intent is purely one of education about how this [statute] null and voids any woman's DNR [if she is] pregnant. We know our daughter well enough, after numerous discussions about DNR, that she would NEVER EVER consent to being hooked up to Life Support." While the family's tragic situation hits a nerve in a state where abortion debates rage, Munoz also said he doesn't want to participate in arguments over right-to-life verses pro-choice issues, but instead wishes to honor his wife and inform the public about a little-known law.

Marlise Munoz, at approximately 18 weeks pregnant, remains unresponsive and her husband describes her as "simply a shell." Doctors check the fetal heartbeat daily, but Munoz doesn't think the testing is sufficient to measure the fetus's viability. "Its hard to reach the point where you would wish your wife's body would stop," he said.