Pregnant Woman on Life Support

[Guest]

I saw this news tidbit and wondered what y'all would do in this situation.

Why Texas Fetus Might Have Had 'Abnormalities' Before Mother Was Brain Dead - ABC News

Basically, a woman is declared "Brain Dead" and is on life support in a hospital in Texas. The family wants to take her out of life support but the hospital refused to do it because of a Texas law that states you can't take out life support until the baby is born or miscarried. The family is suing the hospital.

So, what do you think?

I, myself, side with the Texas law. But I understand the side of the family. This is such a difficult decision.

[Jenamarie]

I side with the family. The ONLY reason this woman's body has *any* function at all is because of the machines. She's dead. She did not want to be kept on life support and the hospital is not allowing her legal next-of-kin to make this medical decision for her.

And think about it, what does it mean when a woman comes into the hospital, is hooked up to a ventilator, etc., but is determined to be beyond saving? Is the law going to require that a pregnancy test be given to any woman before they're allowed to be disconnected from the machines? Would the law trump a legal "living will" of a woman who is found to be pregnant when her life ends in a hospital setting?

And is it ethical, or even wise, to use a deceased person's body as incubator? Is that any fair to the baby? Reading what the woman's family is saying about the condition of her body and of the developing fetus, I would be absolutely horrified to have to watch a loved one go through that.

[MarginOfError]

There are a lot of things wrong with what this hospital is doing.

To start, if the mother went without oxygen long enough that she ended up brain dead, what exactly makes anyone think the child is can be saved.

Beyond that, I can't recall any medical professional stating a belief that the child could actually survive to term in a brain dead mother. The Ob/gyns I work with don't think it can be done at all, or at least with current technology, and certainly not in this case.

The Texas law prohibits removing life support from a patient. Legally speaking, the child is not a patient of the hospital. And treatment the child receives in the womb requires the consent of the mother. Now that the mother is unable to give consent, treatment ought to be given only under the consent of the next of kin.

With the latest news, physicians have identified serious deformities that would classify the termination of this pregnancy as a medical abortion (in this area of health care, we consider medical terminations and elective terminations to be different). Again, the decision should rest with the family, not with the state.

It's also possible that this law could be found unconstitutional as it discriminates on the basis of medical condition. It's quite plausible that this statute would be overturned for non-viable fetuses. In the same way states are allowed to regulate late term abortions (when the child is viable), the state may be permitted to impose regulations in this situation when the child is viable. But this child was not viable, is still not viable, and probably never will be viable.

The costs associated with this circus will be astronomical. The family is suing the hospital, but I think they should be suing the state to cover the medical expenses.

[Backroads]

From what I understand, most states have such a type of law. If it is reasonable to expect the fetus to survive, the mom goes on life support. This law tends to trump any living wills.

In most cases, I agree with the law. My reasoning is concerning the rights of the unborn baby. And I'd say in many if not most cases, a mother would want the baby to make it.

THIS particular case, though, is a bit iffy. The survivability of the fetus seems questionable. I suppose if I had to pick a side here, I pick the side of the law. But I also don't fault the family for suing. It seems appropriate to challenge the law here.

[Backroads]

Beyond that, I can't recall any medical professional stating a belief that the child could actually survive to term in a brain dead mother. The Ob/gyns I work with don't think it can be done at all, or at least with current technology, and certainly not in this case.

Maybe not this case, but your first statement isn't true, unless we're talking "term" technically.

I personally know of a kid who was in this case. His mom was declared brain-dead, and he was delivered a month or so later. Kid is fine.

Edited January 24, 2014 by Backroads

[MarginOfError]

Maybe not this case, but your first statement isn't true, unless we're talking "term" technically.

I personally know of a kid who was in this case. His mom was declared brain-dead, and he was delivered a month or so later. Kid is fine. There's other cases out there.

It appears you're right. In the limited evidence I've found, there was a boy born three months after the mother was declared brain dead (at 15 weeks gestation). He was born in November and is alive to date (so far as I can tell).

In another case, in 2005, a girl was born three months after the mother was declared brain dead (also at 15 weeks gestation). The girl weighed in at just over a pound and passed away before six weeks of an infection.

The only other news story I've found involved a mother who was declared brain dead at a little over 20 weeks gestation. They delivered the child at 24 weeks.

But a key difference in all of these stories is that the mother walked into the hospital for treatment and went brain dead at the hospital. They weren't found unconscious and not breathing for an unknown length of time and then taken to the hospital.

What's more, there's still a lot we're not sure about in these cases. In the Hungarian case, the child gestated for three months and came out at over three pounds. In the 2005 case (in Virginia) the conditions were very similar and the child was delivered at just over a pound. There are a lot of variables in play, and I would be hesitant to say that just because we've done it a handful of times that we could have the confidence to do it routinely.

[Backroads]

Okay, reading more on this and the more articles I read that seem to be factual, the more I'm on the family's side.

I still agree with the intent of the law here, but I believe in this case it is being horribly twisted.

[Backroads]

It appears you're right. In the limited evidence I've found, there was a boy born three months after the mother was declared brain dead (at 15 weeks gestation). He was born in November and is alive to date (so far as I can tell).

In another case, in 2005, a girl was born three months after the mother was declared brain dead (also at 15 weeks gestation). The girl weighed in at just over a pound and passed away before six weeks of an infection.

The only other news story I've found involved a mother who was declared brain dead at a little over 20 weeks gestation. They delivered the child at 24 weeks.

But a key difference in all of these stories is that the mother walked into the hospital for treatment and went brain dead at the hospital. They weren't found unconscious and not breathing for an unknown length of time and then taken to the hospital.

What's more, there's still a lot we're not sure about in these cases. In the Hungarian case, the child gestated for three months and came out at over three pounds. In the 2005 case (in Virginia) the conditions were very similar and the child was delivered at just over a pound. There are a lot of variables in play, and I would be hesitant to say that just because we've done it a handful of times that we could have the confidence to do it routinely.

I wound up deleting my post on the rethink I was getting off topic and argumentative, and now I find myself absorbed in your reply (darn you!)

Yes, there is a big difference in the cases and that's where I find myself having difficulty.

I still think these laws should apply where its reasonable for them to apply, but it does enter into murky territory.

[Guest]

For me, the viability of the child is questionable. If it's not viable, it will die. If it is, it will live. So that goes with the "delivered or miscarried" provision in the law on when the patient can be removed from life support. I just don't think we have the authority to decide viability. This is where Roe vs. Wade gets mangled. The Supreme Court decided that a baby before 24 weeks old is not viable and can be aborted. The Supreme Court can now decide viability. Which is scary when you think that my fully self-supporting 52 year old next-door neighbor who is in a wheelchair but otherwise fully capable was born at under 20 weeks.

By the way, the law is not that you can't take out life support from any patient. The law is that you can't take out life support from a pregnant patient until such time that the baby is delivered or miscarried.

The deformities or genetic issues of the fetus is the same issue as a normal mother carrying a baby with genetic abnormalities... I understand that in cases of deformities the Church is open to the option of abortion being decided by the mother with prayerful appeal to the Holy Spirit through the authority of the bishop. But with the mother incapable of expressing her decision, I side with giving the baby the opportunity to live. He went into the hospital at 14 weeks. 6 more weeks and he has a fighting chance.

Edited January 24, 2014 by anatess

[pam]

I wound up deleting my post on the rethink I was getting off topic and argumentative, and now I find myself absorbed in your reply (darn you!)

It's back. :)

[MarginOfError]

This is where Roe vs. Wade gets mangled. The Supreme Court decided that a baby before 24 weeks old is not viable and can be aborted. The Supreme Court can now decide viability.

That isn't what the Supreme Court decided. The Supreme Court decided that the government doesn't have the authority to impose restrictions on the mother's right to choose before 24 weeks. 24 weeks was chosen because it was a kind of tipping point where medical intervention could reasonably be expected to keep the child alive independent of the womb. In other words, the Supreme Court didn't decide anything about viability. It defined a point at which the government could be allowed to impose itself on the rights of a citizen.

Not coincidentally, this is why I stated that the law being applied here could be rule unconstitutional at least until a later part of the pregnancy.

Applying that logic to the current scenario, the state shouldn't have any authority to prevent the family from choosing what happens with this child unless the pregnancy is at least 24 weeks along.

[Wingnut]

An update on the story: Hospital, family concur brain-dead Texas woman's fetus 'not viable' - CNN.com

[Guest]

Sad story all around.

[applepansy]

Very sad story.

I skimmed through the thread. I didn't see anyone mention that the baby had problems which is one of the reason the family wanted to terminate life support.

The saddest part of this is that the husband and family have lost two loved ones and now they have to fight with the legal system to let them go.

[Suzie]

I read that the baby is very sick and deformed because of the lack of oxygen. It breaks my heart.

[Vort]

I read that the baby is very sick and deformed because of the lack of oxygen. It breaks my heart.

The doctor pretty much laid that myth to rest. Such developmental deformities occur during the embryonic and very early fetal stage. Late-stage oxygen deprivation could not account for them.

[Just_A_Guy]

(Tangent:

Guys, make out your advance medical care directives. Seriously--it saves a lot of heartache, and it's ridiculously easy. If you live in Utah, here's a solid form to use.)

[Guest greengal]

Very sad case. Makes one wonder if these kinds of laws should exist at all. Where do you draw the line? Try to help tge fetus after x weeks but not before? All-out consider using a body that cant say yes or no to develop a fetus unethical? Not many think to put this scenario in advance medical directives. Do the fetus rights of survival apply here?

[MarginOfError]

A judge has ordered the hospital to remove the patient from life-support.

In the ruling, it appears that the judge chose not to address any issues of constitutionality. Instead, he said the laws the hospital cited for maintaining life support did not apply in this case because the mother was already dead.

Texas judge orders brain-dead pregnant woman off life support - U.S. News

[Bini]

Jenamarie and MOE stated what I feel very clearly. I side with the family.

[applepansy]

(Tangent:

Guys, make out your advance medical care directives. Seriously--it saves a lot of heartache, and it's ridiculously easy. If you live in Utah, here's a solid form to use.)

Sometimes it does. Working in Home Care I saw a case or two when family members disregarded the advanced directives and the doctors went along. Family members can sue, a comatose patient can't.

Still... advanced directives are very important. Mine have been done for awhile. I guess I should find them and make sure my family knows where the paperwork is.

[Backroads]

Very sad case. Makes one wonder if these kinds of laws should exist at all. Where do you draw the line? Try to help tge fetus after x weeks but not before? All-out consider using a body that cant say yes or no to develop a fetus unethical? Not many think to put this scenario in advance medical directives. Do the fetus rights of survival apply here?

Well, I'm a pro-lifer and like I said earlier, I support the idea of these laws. I do see fetuses, in general, as living beings. If it reasonable to expect the fetus to survive until it would be viable outside the womb, that route should be taken as appropriate. (I don't think it was reasonable in this case.)

At the risk of sounding very, very harsh, yes, I think someone who had not yet made the conscious choice to terminate a pregnancy could be considered as agreeing to be the "incubator".

Just my opinion on the broader situation.

Guys, make out your advance medical care directives. Seriously--it saves a lot of heartache, and it's ridiculously easy. If you live in Utah, here's a solid form to use.)

This morning I was reminded of a novel I read sometime ago. The premise was this type of situation. Completely fictional with too much optimistic medical care, but I enjoyed its sappy sweetness. Anywho, in this novel, a pregnant woman became brain-dead after a fall and her advance directives were... a mess. If I remember the story correctly, she had made one living will, had forgotten about it, later made another contradicting one, and had told her godmother something completely different.

I'm sure other legal messes have occurred in reality when forms and wishes aren't clear.

[Crash]

The Court ordered that she be taken off life-support by Monday. The hospital is seeking advice from the district attorney.

From the reports I have heard, the child is deformed and has a small chance of survival. It is a slippery slope because she is pregnant. Hopefully, whatever choice is made, it is the right one.