Texas Politics

‘Marlise’s Law’ escalates end-of-life debate

Erick Munoz makes his way through cameras as he leaves a Fort Worth, Texas courtroom after a judge ruled that his wife and unborn child could be removed from life support on Friday, Jan. 24, 2014. On the left is the mother of Marlise Munoz. Judge R. H. Wallace Jr. issued the ruling Friday in the case of Marlise Munoz. John Peter Smith Hospital in Fort Worth had been keeping Munoz on life support against her family's wishes. (AP Photo/Star-Telegram, Ron T. Ennis)
Erick Munoz makes his way through cameras as he leaves a Fort Worth, Texas courtroom after a judge ruled that his wife and unborn child could be removed from life support on Friday, Jan. 24, 2014. On the left is the mother of Marlise Munoz. Judge R. H. Wallace Jr. issued the ruling Friday in the case of Marlise Munoz. John Peter Smith Hospital in Fort Worth had been keeping Munoz on life support against her family's wishes. (AP Photo/Star-Telegram, Ron T. Ennis) AP

An emotional debate over end-of-life medical decisions intensified in the Legislature on Thursday with the introduction of a proposed new law backed by the family of Marlise Muñoz, who was left brain-dead by a pulmonary embolism but was kept on life support for two months in a Fort Worth hospital because she was pregnant.

“Marlise’s Law” would rewrite the Texas Health and Safety Code to remove language that bars doctors from withdrawing life-sustaining treatment from a terminally ill patient who is pregnant. That provision was at the center of a nationally publicized ordeal that played out in late 2013 and early 2014 as doctors at John Peter Smith Hospital, citing Texas law, refused the Muñoz family’s request to remove life support from Marlise Muñoz.

Muñoz, who like her husband was a young paramedic, was removed from life support in January 2014 after a court granted the family’s request and the hospital said it would not appeal.

“Our daughter’s death was one of the most difficult moments of our lives,” said Muñoz’s mother, Lynne Machado, as family members joined a group of lawmakers at a Capitol news conference to introduce House Bill 3183, authored by Rep. Elliott Naishtat, D-Austin. “It became more difficult because politics was involved.”

Muñoz’s father, Ernie Machado, and her widower, Erick Muñoz, a 27-year-old firefighter-paramedic in Crowley, also stepped to the podium to recall their unwanted plunge into the national spotlight and to share memories of Marlise Muñoz.

The adults took turns minding the Muñoz couple’s 2-year-old son, Mateo, as the others spoke. The unborn child, whom Erick Muñoz named Nicole, Marlise Muñoz’s middle name, would have been their second.

“She was an individual, she was a mother, she was a spouse, and she was a daughter,” Ernie Machado, an Air Force veteran, told reporters, saying he wanted to “give you a taste of the fact that she was human. She wasn’t an experiment. We wanted her to live with and die with dignity. We didn’t get to see that.”

The introduction of HB3183 escalates a debate that was already taking shape over end-of-life decision-making after Marlise Muñoz’s prolonged hospitalization and death.

Rep. Matt Krause, R-Fort Worth, representing an opposing viewpoint, has introduced “The Unborn Child Due Process Act,” which would provide representation for fetuses in court hearings in cases similar to Marlise Muñoz’s.

“Ours definitely is a different direction,” Krause told reporters Thursday, saying he believes the so-called pregnancy exclusion targeted by Naishtat’s bill should be preserved. “Texas has done a good job of promoting a culture that honors the sanctity of life, and I think that’s a policy that furthers that interest. … I think it’s a good sound policy for Texas, and I would hate to see it go away.”

‘The bad guy’

Krause said he empathizes with Muñoz’s family and conceded that he is “definitely being portrayed as the bad guy” in the debate.

“You ought to see my Twitter feed,” he said.

But he predicted that the heavily Republican membership in both chambers will support his bill and reject HB3183.

“I don’t see that bill passing,” he said. “In my opinion, you’re not going to get this body to overturn the policy that pregnant women should be kept on life-sustaining treatment.”

But Naishtat said his bill would empower pregnant women and their families with the same rights as others who face a decision over whether to continue life support.

“A pregnant woman and her family should be allowed to decide what course of treatment is right for them,” he told reporters.

He said doctors and hospitals should not be compelled by law to impose medical intervention “over the objection of dying patients and their families.”

Terri Burke, executive director of the American Civil Liberties Union of Texas, opened the news conference by declaring, “We’re here today so that no other woman or family will suffer the indignity of being treated as a second-class citizen.”

Marlise Muñoz was 33 when a blood clot caused her to collapse at her Haltom City home in November 2013. After two scans at John Peter Smith Hospital revealed that she was brain-dead, her family asked the hospital to remove her from life support. But doctors said state law compelled them to keep her alive.

Section 166.049 of the Texas Health and Safety Code states: “A person may not withdraw or withhold life-sustaining treatment … from a pregnant patient.”

‘What she wanted’

Erick Muñoz and his father-in-law both recalled how Marlise Muñoz, drawing on her experiences witnessing trauma as a paramedic, had told them that she would not want to be kept alive in a hopeless situation.

“She was a professional paramedic. She had seen accidents. She had seen the effects of trauma on the body,” Ernie Machado said. “She frankly and openly talked to us about what she wanted.”

All three relatives said the family was united throughout the ordeal and has remained so after Marlise Muñoz’s death.

“We did what was best for Marlise and our family, and we are proud of that,” Machado said. “We did what was best for Marlise [and] we continue to do what we think was best for Marlise now that she has passed away.”

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