Nearly two months after his wife arrived at John Peter Smith Hospital in Fort Worth, a Texas husband has sued the facility to force her removal from life support.
Marlise Munoz arrived at the hospital Nov. 26 after her husband, Erick Munoz, found her on the floor of their home. Doctors discovered a blood clot in Marlise Munoz' lungs, and at the time of her visit, she was 14-weeks pregnant. That same day, according to court documents obtained by various outlets, Erick Munoz was told by doctors that his wife had lost brain stem activity. He says he also saw medical charts which indicated in writing that she was "brain dead."
With the agreement of his wife's parents, Erick Munoz asked doctors to take her off life support. He and his wife, both paramedics, frequently talked about end-of-life decisions, and he knew she would not want to be resuscitated if she was ever "brain dead," the documents note.
But the hospital has refused his wishes, citing Texas code that states "a person may not withdraw or withhold life-sustaining treatment" from a pregnant patient.
If the hospital turns off the ventilator and respirator, Marlise Munoz will not survive, and her fetus will die as well. In the U.S., an unborn child is considered viable at 24 weeks. Erick Munoz has said doctors have talked about taking the fetus to full term.
Erick Munoz argues in his complaint that a different Texas law clarifies the definition of clinical death for those on life support when it says "... the person is dead when, in the announced opinion of a physician, according to ordinary standards of medical practice, there is irreversible cessation of all spontaneous brain function. Death occurs when the relevant functions cease."
Under Texas law, brain death and death are equivalent, he asserts.
The complaint also says the hospital's interpretation of Texas law "makes no sense [and] amounts to nothing more than the cruel and obscene mutilation of a deceased body against the expressed will of the deceased and her family."
The hospital has not publicly confirmed whether Marlise Munoz is brain dead, CNN reports.
Art Caplan, head of the medical ethics division at NYU Langone Medical Center, told CNN's Anderson Cooper Tuesday that Texas laws that mandate continuing life support for pregnant individuals are wrong and that the hospital's actions also are wrong.
"The state of Texas is basically saying, 'You know we're going to treat her as an incubator.' If she was awake, she certainly wouldn't have this happening to her. If she was awake, she could actually go out and have an abortion at the age of this fetus. Asleep she's being ignored. It's unethical."
From a legislative view, Texas is a markedly conservative state, with anti-abortion rights Gov. Rick Perry, a Republican, at its helm, along with a legislature that last year passed stringent abortion restrictions.
Eric Kodish, chairman of the bioethics department at the Cleveland Clinic Foundation, says the unborn child may not be healthy once it reaches viability, "because the heartbeat of a pregnant woman is essentially the key determinant of blood supply to the infant."
The child's removal also raises other questions regarding consent.
"If the hospital's plan currently is to maintain this body on life-support machinery until the fetus becomes viable and then do a C-section, I'd ask the hospital lawyers to think about who's going to provide consent for that C-section. Because it would be unethical to do a procedure like that without informed consent of some kind," he says.
The Tarrant County District Attorney's Office is representing the hospital. No individual defendants were named in the complaint.