The unborn child cannot survive without receiving oxygenated blood. Munoz, who was 14 weeks pregnant when she collapsed at home in November and was deprived of oxygen for up to an hour, is being …More
The unborn child cannot survive without receiving oxygenated blood.

Munoz, who was 14 weeks pregnant when she collapsed at home in November and was deprived of oxygen for up to an hour, is being kept on life support at John Peter Smith Hospital in Fort Worth against the wishes of her husband and parents. Hospital officials say they cannot remove her respirator because of a Texas law that prohibits doctors from withdrawing "life-sustaining treatment" from pregnant women.

On Jan. 14, Munoz's husband, Erick, sued the hospital. The motion filed in Tarrant County District Court states Erick "vehemently" opposes keeping his wife on life support, and would like to bury her.

But the National Catholic Bioethics Center in Philadelphia said in a Jan. 7 statement about the McMath case that nothing in Catholic teaching would contradict the determination of death by the teen's physicians, using "the rigorous application of neurological criteria."

Those criteria can include "a complete lack of blood flow to the brain, the absence of any electrical activity of the brain, the absence of cranial nerve response and the ability of the patient to breathe on her own," the statement said.

If the facts in the McMath case are being accurately reported in the media, the center's statement said, the determination of death has been made "by physicians repeatedly and rigorously applying the neurological criteria" and confirmed by an independent, court-appointed pediatric neurologist from Stanford University.

"If this is accurate, at this point there would be no moral obligation for a hospital or physician to perform any procedure on a corpse such as placing a feeding tube or trying to stabilize the bodily functions that are kept working using mechanical means," it added.

The center quoted from talks by Popes John Paul II and Pius XII, as well as the U.S, bishops' "Ethical and Religious Directives for Catholic Health Care Services," to back its conclusion. The directives, which guide ethical decision-making in Catholic health facilities, read: "The determination of death should be made by the physician or competent medical authority in accordance with responsible and commonly accepted scientific criteria."

The Munoz case in Fort Worth is complicated by several factors -- her pregnancy and the inability of her unborn child to survive outside the womb; the law passed in Texas in 1989 and amended 10 years later that requires the continuation of life support for pregnant women; and federal health privacy laws that restrict any sharing of information with the media without the permission of Munoz's family, which the hospital says has not been granted.

Even if Munoz's physicians have determined her to be brain dead, there is another patient to consider, said Marie T. Hilliard, director of bioethics and public policy and a staff ethicist at the National Catholic Bioethics Center. The unborn child cannot survive without receiving oxygenated blood from his or her mother until he or she reaches at least 23 or 24 weeks of gestation, Hilliard said.

The unborn child's surrogate decision-makers -- which in the Munoz case would apparently be his or her father, Erick Munoz, 26 -- must act in the child's best interests in determining whether continuing medical treatment would be disproportionately burdensome on the patient, the family and the community in relation to the anticipated outcome, Hilliard said.

Catholic teaching is clear, she added, that any "direct, intended termination of a pregnancy" before viability is an abortion and not permitted. "But we don't have the facts to ascribe any intent" to Munoz's husband and parents, who are seeking to force the hospital to remove the woman's respirator, Hilliard said.

It also is unclear whether the Texas law barring the removal of "life-sustaining treatment" for pregnant women was intended to apply to women who have been declared brain dead.

A Texas judge ordered a Fort Worth hospital to remove a pregnant and brain-dead woman from respirators and ventilators on Friday, perhaps ending a wrenching legal debate about who is alive, who is dead and how the presence of a fetus changes the equation.
Erick Munoz, husband of Marlise Munoz, broke down in tears after Judge R.H. Wallace told John Peter Smith Hospital to act on his order by 5 p.m. Monday.
Munoz and other family members had been fighting to have the body released for burial. Hospital officials resisted, saying they were trying to obey a Texas law that says "you cannot withhold or withdraw life-sustaining treatment for a pregnant patient," in the words of the hospital spokesman.
Munoz left the courthouse without talking to reporters, but the family's lawyers spoke out. Jessica Janicek argued that the hospital was "utilizing (Marlise Munoz's) body as a science experiment."