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Hospital told to take pregnant woman off support

FORT WORTH, Texas (AP) - For two months, Erick Munoz has sat inside a North Texas hospital room next to his pregnant, brain-dead wife, with what would be their second child together growing inside her.

Now a judge has ruled that the hospital must follow Munoz's wishes and disconnect Marlise Munoz from life support that it's refused to remove in hopes of saving the fetus inside her.

The judge's ruling Friday could give Erick Munoz a long-awaited chance to bury his wife and move forward to care for their son and his relatives. It would also mean the fetus would never be born.

Judge R. H. Wallace Jr. gave John Peter Smith Hospital in Fort Worth until 5 p.m. CST Monday to remove life support. The hospital did not immediately say Friday whether it would appeal.

Both the hospital and the family agree that Marlise Munoz meets the criteria to be considered brain-dead - which means she is dead both medically and under Texas law - and that the fetus could not be born alive this early in pregnancy. But while the hospital says it has a legal duty to protect the fetus, Munoz contends his wife would not have wanted to be kept in this condition. And his attorneys have said medical records show the fetus is "distinctly abnormal."

The case has raised questions about end-of-life care and whether a pregnant woman who is considered legally and medically dead should be kept on life support for the sake of a fetus. It also has gripped attention on both sides of the abortion debate, with anti-abortion groups arguing Munoz's fetus deserves a chance to be born. Several anti-abortion advocates attended Friday's hearing.

Hospital officials have said they were bound by the Texas Advance Directives Act, which prohibits withdrawal of life-sustaining treatment from a pregnant patient. But in his brief ruling, Wallace said that "Mrs. Munoz is dead," meaning that the hospital was misapplying the law. The ruling did not mention the fetus.

Marlise Munoz was 14 weeks pregnant when Erick found her unconscious Nov. 26, possibly due to a blood clot. The hospital has not pronounced her dead and has continued to treat her over the objections of both Erick Munoz and her parents, who sat together in court Friday.

Larry Thompson, a state's attorney representing the public hospital, told the judge Friday that the hospital recognized the Munoz family's pain and rights, but said it had a greater legal responsibility to protect the fetus.

"There is a life involved, and the life is the unborn child," Thompson said.

As Wallace gave his ruling, Erick Munoz embraced his wife's parents and one of his attorneys. Munoz declined to comment as he left court Friday. But he told The Associated Press earlier this month, in a phone interview sitting in the hospital room, that he and his wife were both paramedics who knew they didn't want to stay on life support this way.

Munoz described in a signed affidavit filed Thursday what it was like to see her now: her glassy, "soulless" eyes; and the smell of her perfume replaced by what he knows to be the smell of death. He said he's tried to hold her hand but can't.

"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," Munoz said.

Jessica Hall Janicek and Heather King, Erick Munoz's attorneys, accused the hospital of conducting a "science experiment" and warned of the dangerous precedent her case could set, raising the specter of special ICUs for brain-dead women carrying babies.

"There is an infant, and a dead person serving as a dysfunctional incubator," King told the judge.

King and Janicek did not say what they would do next, pending a potential appeal by the hospital.

The hospital said in a statement that it "appreciates the potential impact of the consequences of the order on all parties involved" and was deciding whether to appeal.

The hospital argued in a court filing Thursday that there was little evidence of what state lawmakers and courts thought of this issue, but recent laws passed by the Republican-controlled Legislature to restrict abortion made it clear that they wanted to preserve a fetus' rights.

The Advance Directives Act "must convey legislative intent to protect the unborn child," the hospital said in its filing. "Otherwise the Legislature would have simply allowed a pregnant patient to decide to let her life, and the life of her unborn child, end."

Not much is known about fetal survival when mothers suffer brain death during pregnancy. German doctors who searched for such cases found 30 of them in nearly 30 years, according to an article published in the journal BMC Medicine in 2010.

Those mothers were further along in pregnancy - 22 weeks on average - when brain death occurred than in the Texas case. Birth results were available for 19 cases. In 12, a viable child was born. Follow-up results were available for six, all of whom developed normally.

Judge Orders Brain-Dead Pregnant Woman Off Life Support

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Lazaraescudaro January 31 2014 at 8:14 PM

Until the sick dogs have rights ! http://www.huffingtonpost.com/2014/01/31/pit-pull-puppy-miss-harper-leg-ear-cut-off-recovering_n_4703430.html?ref=topbar

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veronisheeh January 28 2014 at 2:46 PM

I hope you're all happy that the beautiful baby Nicole is dead. Yes, that's right she was a female and her name was Nicole....Where was her right to choose to live?

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bbhuey4213 January 26 2014 at 5:06 PM

Almost as sad as what this family has been going through is the number of people purporting to be christians posting such hate and slanderous vitriol against this man because he had the audacity to try to abide by his wife's wishes to the best of his ability. They truly think that their religious beliefs should be imposed upon this woman's family no matter what, conveniently ignoring the fact that we can readily see what theocracy looks like by looking at the examples of Afghanistan and Iran. Maybe the next time they're talking to their jesus they can ask him how to say "taliban" in Aramaic.

And yeah, I said "their jesus", because the Jesus *I* know would expect His followers to at least *attempt* some measure of compassion to this woman's family...her parents have lost their daughter and grandchild, and the husband has lost his wife and child, and the best *this* lot can do is pretend that *they* know what Mrs. Munoz would want better than her family does and call Mr. Munoz an adulterer and murderer. Yeah, great demonstration of Christ-like behavior there, folks...heartening to know that so many of you have achieved such a state of perfection that you can advocate overturning the god-given free will of others in order to force them to comply with your arbitrary decisions on what God *really* wants...keep up the good work...are the burkas on backorder?

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veronisheeh January 28 2014 at 4:14 PM

We're not 'imposing' our religious beliefs...we're trying to stop the 'execution' of an innocent defenseless baby Nicole....They are imposing their will on that child. The hate is with those who do not have enough respect and love for the dignity and value of 'all' human life...Death was not the answer. And yes, I do feel for the family because they will have to live with this decision for the rest of their lives....

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mary January 26 2014 at 4:42 PM

amen she is finally at peace now all you ignorant people can stop judging this family. move on to your next cause to be hypocritical about

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veronisheeh January 27 2014 at 5:14 PM

They will never be at peace now that they failed to allow an innocent child of God to live..
.Hypocritical, judging..no I don't think so...More like trying to prevent the death of a life.
Who are the hypocrites and who is judging? All those who misguidely believe that all life isn't precious. And I won't engage in name calling because that seems to fit better with those who embrace the 'culture of death'.....

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Lazaraescudaro January 26 2014 at 3:37 PM

Gods and Demons....

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Tonja January 26 2014 at 1:01 PM

This child is severely deformed because it too suffered from the lack of oxygen, the same as the mother. Now the mother is decomposing, internally, and this is circulating in the fetus as well.

If not for modern technology... the ability to rescusitate the mothe by getting her heart to start beating again and then put her on artificial ventilation-this fetus and mother would have been buried 2 months ago.

The video, if you would bother to watch it, says that graphic details were given in the court hearing about the deformities that this fetus has endured. This child, if allowed to be born, will probably be severely mentally impaired, and physically empaired. There are times when death IS better, and this is one of those time.

I do not know why this is so hard for people to understand. And if you still want to believe that this fetus should be allowed to be born, then you need to step forward and offer to care for this baby.

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bbhuey4213 January 26 2014 at 9:10 PM

This case has less to do with whether the fetus/child is deformed/handicapped and more to do with the wishes of the patient and/or family being usurped by others. If this most difficult of decisions can be overridden by hospitals and/or politicians who's to say that the next law passed won't require the harvesting of organs from patients even if they have expressly stated that they do not want to be donors? Or maybe a law requiring circumcision of infants even if the parents object...

It seems a safe assumption that the patient's husband and parents would have at least a vague idea of what Mrs. Munoz's feelings were on the subject of artificial life support in the even of brain death, which makes them the ones best qualified to make the decision of whether or not to put and/or keep her on "life support". If they had chosen to try to keep her body functioning long enough to bring the fetus to term then so be it. If they chose to discontinue artificial means of keeping her body functioning so be it.

Trying to determine whether to use "any means neccessary" to keep a loved one alive or decide to let them go is the hardest decision I've ever had to participate in - on the one hand I didn't want my loved one to die, but on the other hand I had to acknowledge that the damage to her brain (massive brain bleed) was so extensive that even if she's survived the neurosurgery that would have been needed to "save her life", what she would have been left with wouldn't have been life but merely existence. And it would have been an existence that she would have *hated*, providing she would have even been aware of it. The last thing we would have needed while making this choice was some batch of politicians with a political agenda or a pack of religious zealots arrogant enough to claim to know the mind of God had stepped in and told us that they had to make the choice for us because they knew best...

As far as your comment about " if you still want to believe that this fetus should be allowed to be born, then you need to step forward and offer to care for this baby", I'm not sure I'd trust any from that crowd to care for my houseplants (even the artificial ones), let alone a child...

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veronisheeh January 27 2014 at 5:17 PM

I hope to God you never have to deal with someone who is 'defective'. God help that person....Subsitute other groups of people who were considered 'defective'...I can think of at least one group in Germany....And aren't we all defective in one way or another

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Lazaraescudaro January 26 2014 at 11:01 AM

Pray for the fetus 22 weeks and ... It is alive! Within 24 weeks he can be here with us.

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mary January 26 2014 at 4:44 PM

the mother is off life support is the fetus still alive? or did what god intended to happen on nov 26 2013 finally happen rest in peace to the woman who died nov 26 but man would not let her go

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veronisheeh January 27 2014 at 5:18 PM

No justice no peace as they say...The child's life was ended..not let go....

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nickynoo January 26 2014 at 7:59 AM

You can't murder someone who already is dead. I'm glad the family is getting their wishes and can respectively bury their family member.

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veronisheeh January 27 2014 at 5:31 PM

How do you know the child was dead? ...The unborn child was breathing and growing and alive in the womb... The child's life was ended....I can't believe this obsession with death....
"I have set before you life and death, the blessing and the curse, Choose life

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Renga January 31 2014 at 2:19 AM

The baby was NOT dead, so, even by your flawed thinking, they did murder a living being; the baby.

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Tonja January 26 2014 at 5:44 AM

This has become so ignorant. For the last 16 hours now this news article says the unborn baby is "Distinctly ABNORMAL" and then da doop da doop da doop someone comes along and says " as long as the baby is normal" or some other clue that states "I never bothered to read this article."

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Tekoa55 January 26 2014 at 3:22 AM

They said she was 14 weeks pregnant when she died on Nov. 26th. So should be about 22 weeks now. How many more weeks before they could take the baby by C-section? Not sure how many weeks is considered full term.

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labarberad January 26 2014 at 5:43 AM

"Full term" varies somewhat between children. It depends on many factors including the sex and weight of the child. Lower weight girls have been known to survive earlier. It seems that weight alone does not predict maturity. The prediction of a "due date" is more of a probability than an exact science.

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