Muñoz case could bring changes to health code

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by LAUREN ZAKALIK/ WFAA

khou.com

Posted on January 28, 2014 at 7:00 AM

For eight weeks, Marlise Muñoz lay lifeless in a Fort Worth hospital.

The Haltom City woman became the center of a legal battle. Her family wanted to take her off of life-support. But doctors said state law kept them from doing so because Muñoz was pregnant.

Now some Texas lawmakers want to make sure what happened to the Muñoz family doesn't happen again.

Doctors cited this sentence in Section 166.049 of the Texas Health Code as the reason for keeping Muñoz on life-support:

A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.

On Sunday, doctors turned off the machines in compliance with a judge's order issued Friday.

The debate thrust this family's private matter into a national conversation about end-of-life wishes. Two Texas lawmakers plan to review the law in the next session of the Legislature.

It's a tiny section in a lengthy law that most of us wouldn't even know about... had it not been for Marlise Muñoz.

Lawmakers from both sides of the aisle agree Section 166 needs to be clarified. What they might not agree on moving forward is how to do that.

"The pain that Mr. Muñoz went through I think is... I don’t see how he's done it," said State Rep. Garnet Coleman (D-Houston).

Marlise Muñoz collapsed last november while 14 weeks' pregnant.

Against family wishes, John Peter Smith Hospital in Fort Worth kept her on life-support until Sunday because of its interpretation of the Texas Health Code.

The code doesn't specify what doctors and hospitals should do if that patient is already brain-dead.

"The language is plain, but not clear," Coleman said.

"I think that’s one of the things this situation has brought out — the ambiguity in the law," agreed State Rep. Matt Krause (R-Fort Worth).

Lawmakers from both sides of the aisle want to see the code clarified in the next legislative session. But that's where the agreements might end.

"It's a very simple fix," Coleman said. He will propose adding a line into the provision that nullifies it if the woman is already dead.

"You can't remove life-saving treatment from a pregnant woman unless they are declared dead," he said.

But Krause has a different viewpoint. He wants to see the law changed to add more protections for an unborn fetus.

"There was a little child inside Ms. Muñoz," he said.

Krause would prefer that the fetus be appointed a guardian to protect its interests if the mother is declared dead.

"I think you always err on the side of life," he said.

Coleman knows that despite lawmakers' best intentions to clear up this law, it's an emotional and political topic... one that doesn't always go well when addressed in Austin.

"It’s a sticky wicket, putting a bill like that on the floor," the Democrat said.

But some believe it's worth the political fight so families like the Muñozes aren't left fighting the hospital when they want to be mourning their loss.

According to a 2011 study, there are 11 other states besides Texas that automatically invalidate a woman's advanced directive if she's pregnant, and there are five states that honor it.

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