End-of-life debate returns to Texas Lege

Few North Texans will forget the emotional legal battle between John Peter Smith Hospital and the family of Haltom City woman Marlise Muñoz that commanded national headlines during late 2013 and early 2014.

Muñoz, who at 14 weeks pregnant collapsed in her home, was kept on life support for two months pursuant to Texas law, until a court ordered the hospital to remove all life-sustaining measures at her family’s request.

The case was tragic, not only because of the lives lost, but due to the turmoil the family experienced as their very personal story became widely publicized and politically charged.

Politics are hard to avoid when issues that evoke intense emotions enter the public sphere.

And definitive policies to guide society through such murky waters are even harder to formulate. Which is perhaps why the debate continues in the Texas Legislature this session.

Competing bills inspired by the Marlise Muñoz tragedy have been introduced in the Texas House.

One would strike the legal language that kept her on life support in defiance of her family’s wishes. The other would provide a developing fetus legal representation in the event the family was not interested in keeping a loved one artificially alive until the developing baby is viable.

H.B. 3183, also called “Marlise’s Law,” was filed Wednesday by Rep. Elliott Naishtat, D-Austin. The bill would repeal the pregnancy exclusion currently enshrined in the Texas Health and Safety Code that bars doctors from withdrawing life-sustaining treatment from a terminally ill or brain-dead patient who has an advance directive and is pregnant.

“The law should reflect the consideration a woman puts into planning the treatment she wishes to receive, or not receive, when she is no longer able to express herself,” said Naishtat.

In contrast, Rep. Matt Krause, R-Fort Worth, recently proposed H.B. 1901, which would prevent the removal of life support from a pregnant patient “if the life-sustaining treatment is enabling the unborn child to mature.” It would require the state to appoint a guardian ad litem to “represent the unborn child’s interests … in any litigation or other matter regarding the health care decisions made for the pregnant patient.”

Despite the rancor and consternation over these legislative proposals, both bills are well-intended. Each stems from a distinctive and strongly held belief that cannot easily be divorced from a person’s feelings about abortion rights.

Naishtat’s legislation seeks to empower women and families by ensuring that even in the rare circumstance of a pregnant woman’s total incapacitation, her wishes, if known, and those of her family would dictate her care.

Krause’s bill would ensure the interests of the unborn would be specifically represented in any legal dispute where the life of a developing child hung in the balance.

Balancing the rights of an individual or family to make end-of-life decisions with the interests of the state in protecting the most vulnerable remains difficult. We may not achieve a satisfying resolution during this legislative session, or even in those to come.