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Fundamental Questions on the Marlise Munoz Case

Marlise Munoz is apparently “brain dead”; her body on life support continues to gestate her baby.  Here are a couple of my thoughts.

1. Questions exist around the designation of brain death, namely, whether the neurological criteria are adequate for determining human death; I have my doubts that they are.

2. In light of these doubts, and presuming Ms. Munoz is rightly diagnosed as “brain dead”, we face two possibilities: either
a) Ms. Munoz is still alive (albeit greatly disabled); and she is gestating her baby with the assistance of life support;
b) she died and her body is being used as a kind of incubator to nurture the baby till the baby can live outside it;

3. In the first case we have two patients (mom and baby), both of whom deserve ethically appropriate medical attention; therefore the question of removing life support needs to be assessed in relation to both, independently; life support is rightly removed when it is either futile or excessively burdensome to the patient.  So we ask: is it either or both for the mother?  If she were an isolated patient, and it was either futile or excessively burdensome, we’d be justified in removing from her the life support; but she’s not an isolated patient; we therefore must also consider whether the life support is futile or excessively burdensome for the baby – the other patient; if it is neither futile nor burdensome for the baby, but it is for the mother, we ask: would we be justified in removing the baby from life support–which is what we’d be doing if we remove mommy– on the grounds that mommy never wanted to be kept alive in this way?

I’d say pretty strongly, NO.  Mommy has a duty to care for her baby, which, is seems to me, almost always would entail remaining on life support even when futile for herself if doing so would save her baby’s life.

4. In the latter case, i.e., there is no more Ms. Munoz, only her mortal remains, we have one party who deserves proper attention, the baby.  The mother is gone and so her “right to choose”, however that’s construed, no longer exists; she had a right, of course, to designate how she wanted her mortal remains dealt with; but that preference wouldn’t trump another person’s life.  If the baby’s life can be saved, and the saving can be done without really grave consequences to the family or community, then Ms. Munoz’s  family, doctors, and the community as a whole have the duty to provide what’s needed to save the baby’s life.

 

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