Here we go.
Pregnant woman, gestation about 20 weeks collapses from blood clot to lung that causes cardiac arrest, producing brain damage determined to be brain death.
Texas law and law of 31 other states prohibits terminating mother’s life because fetus has right to live.
Imagine that? Parents of the mother argue that she would want to die. No word in the news reports on the opinion of the husband.
John Peter Smith Hospital is a fine institution that provides care for citizens of Fort Worth/Tarrant County, Texas.
whttp://www.nytimes.com/2014/01/08/us/pregnant-and-forced-to-stay-on-life-support.html
At least 31 states have adopted laws restricting the ability of doctors to end life support for terminally ill pregnant women, regardless of the wishes of the patient or the family, according to a 2012 report from the Center for Women Policy Studies in Washington. Texas is among 12 of those states with the most restrictive such laws, which require that life-support measures continue no matter how far along the pregnancy is.
Legal and ethical experts, meanwhile, said they were puzzled by the conflicting accounts of her condition. Brain death, an absence of neurological activity, can be readily determined, they said. It is legally death, even if other bodily functions can be maintained.
http://www.nytimes.com/2014/01/08/us/pregnant-and-forced-to-stay-on-life-support.html
John, I had intended to e-mail you but failed to take down your e-mail address (which I recall you posted somewhere – perhaps here). I’ll look for a “contact” feature elsewhere on the web site.
All my best.
Well, I’ll buy into this one. My personal experience is that “consciousness of one’s individuality” begins at conception. However, if the woman does not want the baby, it is probably better off in “another existence” – yes, that needs some imagination. If the woman has a chance to choose, then she has the right to justify her choice, whatever the reason, whatever the choice. – no question. I rest my case.
Hank, thanks you for your work as a perinatologist and your comments.
Perinatology is something I can’t avoid. I work at the busiest OB hospital in the DOD. Our Obs deliver a lot of babies and we interact with them every day.
I would add on this discussion that because a lot of people commented that the decisions are private and family should be respected, that I felt obligated to go one more and wrote another essay on this web site about the subject.
http://junkscience.com/2014/01/09/who-is-the-baby-whos-mom-is-brain-dead/
I am a medical researcher in the field of perinatology. Let me try to make it plain and simple from my viewpoint. There are two patients – the mother and the child. When the mother is removed from the equation, there remains one patient – the child. The child patient deserves the right to all that medicine has to offer to preserve the life of the patient.
The fact that the mother carried the child to 20 weeks gestation suggests that there was an intent on her part to carry the baby to term. The fact that she was married lends further cause to believe that the hopes and dreams of the parents were to have a child.
When our society gets to the point where others make choices of life and death based on ideology rather than long standing standards of patient care then we have lost all sense of humanity.
I whole heartedly concur. No business of anybody’s but theirs. As I said at the top, the debate has nothing to do with science, but a sideline foray into medical ethics is good exercise for those of us wholve been out of debate club for a few decades or more.
Howdy GH05T
You’ve actually described why I don’t see this case as implicating abortion rights.
A living woman who is pregnant has to use her body to sustain the pregnancy. Depending on the culture and the individuals involved, most women wish to do this or at least are willing to do this. In some segments of society, fewer than half of women who become pregnant are willing to carry the baby to term.
In this case, though, the woman can’t make a decision known. We believe that all she was, except for her body, has been lost. Since she can’t affirmatively decide to end the pregnancy, and since the pregnancy is doing her no harm, it certainly seems that keeping the pregnancy going as long as possible is ethically correct. A child at 20 weeks will usually be born alive but in desperate condition; a child at 30 weeks will be born compromised but with excellent likelihood of living well.
Dollars and cents, it’s much less expensive to maintain the mother than to try to care for a seriously pre-term infant.
Since the woman is dead by current law, any decision should fall to the father of the child in question — he whom we think may be keeping himself out of the controversy on the grounds that it isn’t anyone else’s business.
A more dreadful dilemma might be this: a woman is severely injured while around 15 weeks pregnant. Ending the pregnancy will be an abortion, not a pre-term delivery. Ending the pregnancy may help the woman recover — or it may not. She may recover even if the pregnancy continues — or she may not. If the pregnancy continues, the baby may be lost anyway or may be seriously compromised. How do you present that to the couple, if the woman is able to make a decision? How do you present that to the father if she cannot? And how does anyone blame the couple, regardless of their decision?
HALTOM CITY, TX, January 6, 2014 (LifeSiteNews.com) – A North Texas woman and her unborn child are being kept on life support against her husband’s wishes thanks to a 1999 law signed by then-Governor George W. Bush that forbids hospitals from withdrawing extraordinary care from pregnant women before their babies are viable for delivery.
http://www.lifesitenews.com/mobile/news/pregnant-mom-being-kept-on-life-support-over-husbands-objections-due-to-tex
I failed to paste the first paragraph of my diatribe…
True, but the wrinkle here is that if the woman is in fact dead, she has no more decisions to make. All of the usual arguments for right to abortion are null. Even legal last wills are not actually a decision of the deceased but the decision of the living to carry out the deceased’s decision. If a pregnant woman is the only person with the right to choose, and the pregnant woman cannot choose, than no one has the right to choose.
If the woman is dead than nothing is being done to her or for her. The only consideration is the fate of the fetus. That means this is a simple matter of triage. The doctors must care for the life currently at risk in the best way they can. Less urgent matters, like carrying out the woman’s last request, are necessarily a lower priority to be taken care of after the first task is complete.
The only reason this is even being debated is because right to abortion advocates are unnerved by the legal ramifications of a fetus being considered a life worth saving. They fear, probably rightly, that this will be used as ammunition by the pro-life crowd. Just another attempt to politicize the personal tragedy of an individual.
When I was a young doc, I delivered a woman who had a fatal stroke when she was in labor.
She had a spontaneous delivery, and afterwards she died, but the baby was fine.
If this woman in Fort Worth is 20 weeks the baby needs 10 weeks to get a reasonable reduction in risk of prematurity.
Tests can be done for lung maturity and therapy to encourage lung maturity. Then delivery by C Section. It’s a life, the apparent contradictions in the law come from a balancing of rights. In this case a probate court can act in the interests of the unborn child since pulling the plug has consequences to another life. It’s kinda like forcing a pregnant person to undergo treatment for the benefit of the unborn child, so in an abortion friendly culture, things get turned sideways a little.
Interesting legal issue to say the least. A woman can choose to kill her baby but if the woman is dead, no one can kill her baby because the baby has the right to life. That is an oxymoron.
If that is his stance, I support his right to keep that privacy, court case or not. Best wishes, and condolences to this poor man.
Perhaps the Times is trying to a create a woman’s right to die within the right to choose version of women’s reproduction rights in the war on women’s rights. Right?
Perhaps the husband is maintaining a dignified privacy about this tragedy. My thought would be that he hopes to have a live child at the end of this.
If a person is genuinely brain-dead, maintaining her body as the child’s life support does her no harm. I imagine it would be hard on the family but I imagine that the promise of a child would be worth the sorrow. I also imagine this is the family’s business and the rest of us should only pray for the best outcome possible. We should not define that outcome.
There is no doubt that a brain dead or comatose pregnant woman can go on to deliver a normal child, and it has happened before.
The paucity of information about the husband, who is the priority decision maker in the law, leaves questions unanswered.
That was my thought as well. Without knowing the specifics of this case, there is a possibility of the child surviving. Even if born premature at 30 weeks a child can survive.
http://preemies.about.com/od/readersstories/a/World-S-Smallest-Preemies.htm
Even if the mother is brain dead her body could still act as a life support system for the child.
The fact that there has not been a court challenge yet seems to be very telling. Either the law is ironclad and already ruled on by the State Supreme Court, or there is dissension in the family over the fate of the child. The husband should be able to file suit to get life support removed in the face of this overburden-some law and he has not done so. He should be able to release all medical information to the press to gain public sympathy for his position, but he hasn’t done so. I suspect that he is holding out hope that the child will be normal and healthy despite the mother’s condition.
This argument will always be more emotional than scientific. The crux of the debate is the definition of life which, as we’ve recently gone over, is much cloudier than many know. It’s easy for me to get behind DNR wishes of competent adults. That lies clearly in the realm of personal choices that are none of my business. Whether a fetus counts as a human life, however, lies more in the realm of opinion, philosophy, and religion. It may well be that the woman in question wouldn’t have wanted her body to linger on at great emotional and financial cost to her loved ones, but does that mean she would feel the same way about her own child? If you believe the brain is destroyed, there’s nobody home and they’re never coming back, than the question is really about how to dispose of the body and that decision is often based more on the desires of your surviving loved ones, not so much on what you would want if the roles were reversed. Unfortunately, updating the will and deciding what to do if your future child is on life support is something few people get around to during pregnancy. The word of loved ones is all we have to go by.
My big question here would be whether there is a possibility of live birth if life support remains. If the fetus is relatively healthy, then we could consider the mother’s body as a life support system in its own right. The question then is should we pull the plug on the child? The child hasn’t had a chance to choose whether its life is worth “heroic measures”. In cases where no clear decision is made prior to injury, I err on the side of life if possible. Of course if you believe the fetus is just medical waste, then the whole debate would seem ridiculous.