Marlise

Happy New Year! It’s 2014. The year of the horse, the legalization of marijuana in Colorado, and the year our second child will be born. Yup, I’m pregnant again. Bret and I are thrilled.

I’m especially looking forward to my morning sickness subsiding. It’s rough. It doesn’t just afflict me in the morning, either. I wake up feeling nauseous and that feeling persists until I pass out around 8:30 every night. I experienced the same thing when I was pregnant with Abigail.

Speaking of which, I want to discuss something about this pregnancy that I didn’t even have to think about in my last pregnancy. We lived in California when I was pregnant with Abby. And now, we live in Texas. So what, right?

Well, so this:

While browsing the CNN website one morning last month, I happened upon an article about a woman in Fort Worth, TX. Her name is Marlise Munoz and she’s been hooked up to a ventilator in a hospital since November 26th. She apparently suffered a pulmonary embolism and collapsed on her kitchen floor. Her husband found her unresponsive and not breathing when he arrived home from work. He performed CPR to no avail and Marlise was rushed to the hospital. Unfortunately, she had been without oxygen for too long. A neurologist declared her brain-dead. She was 14 weeks pregnant with her second child.

I wept profusely for twenty minutes. Luckily, Abby was at the park with her dad and I was alone in the house with our two dogs (who took no notice of my noisy blubbering). As some of you know from experience, being pregnant makes one highly sensitive and rather vulnerable to tearful outbursts. But also, I felt so terrible for this poor woman, her husband, her family, and her beautiful first child who is now to grow up without a mother. I thought of my own beautiful Abigail and of my intense love for her. Then I thought of the growing fetus inside me. I am grateful for this pregnancy but I don’t have the same allegiance to this still-unnamed person developing in my womb. I’ve seen ultrasound pictures and I’ve watched him or her pump those tiny arms and legs and it moved me to tears. But my baby, this fetus, is barely 12 weeks. Not yet a complete human. Not yet someone to whom I am attached the way I am to my 3 ½ year old spitfire first-born.

I pulled myself together (read: blew my nose) and kept reading.

The article stated that Marlise Munoz’s husband and parents are insisting that she would not have wanted to be hooked up to a machine and, in honor of her wishes, they have asked the hospital to take her off life support. The hospital has refused. Not because the doctors believe Marlise will wake up, but because if the hospital takes Marlise off life support, it would effectively be breaking the law. In the state of Texas, life-sustaining treatment cannot be withheld from a pregnant patient, regardless of her wishes or the age of the fetus.

I wept again; this time out of frustration. I could not believe what I was reading. “…regardless of her wishes or the age of the fetus.” So that means if a woman is pregnant, all of her carefully planned and composed health directives go out the window?

Yes, that’s what that means. It so happens that while Marlise had stated to her family several times that she would never want to be hooked up to machines she never actually put it in writing. But it wouldn’t matter if she had. Regardless of what Marlise might have written in her advance directive, the state of Texas has made the executive decision to keep her alive.

I stopped reading. I felt sick. Not just the morning sickness. My mind was reeling. I live in Texas and was just shy of ten weeks pregnant while I read this article. It dawned on me, as I sat in bed listening to my dog lick herself, that if I found myself in this same unfortunate circumstance as this poor family, my husband would be powerless to carry out my wishes regarding my own life.

But what about the baby, right?

Wouldn’t any mother want to give her unborn baby a chance even if she herself were already dead?

My answer to that, in thinking of the actual baby growing in my womb as I write this? It depends. How far along am I? Two months? Eight months? Does my husband want to raise a potentially brain-damaged child, as well as our other child, by himself? But the issue here is this: if a baby isn’t viable outside of the womb, then why does that baby’s rights outweigh its mother’s? I realize many babies are born prematurely, survive in the NICU for weeks to months, and then go on to live a normal life. But why, in the event that the mother is incapacitated, is this decision left up to the state and not the individual? In Marlise’s case, no one knows exactly how long she was without oxygen, so there’s no telling what kind of brain damage the baby suffered. There’s no telling if the baby is even alive. Its heart is beating because of the ventilator attached to its mother. The doctors are apparently waiting until the fetus is 24 weeks at which point they will remove the baby from Marlise’s womb and assess the damage. That’s still five weeks away.

Here’s the thing: I’m not expecting to collapse on the kitchen floor anytime soon. But the discovery that once I become pregnant, I no longer have the same rights as other citizens of my state makes me angry. Is the state of Texas planning to help pay for Marlise’s child’s special needs once it is born? The baby will be born prematurely and will likely have suffered some sort of cognitive impairment, if it is even alive at all. Is there a law protecting this child’s best interest once it is outside the womb? What about a law providing for extra help for the baby’s father? He works full time and will now be saddled with raising two children, potentially one with special needs. Is the state prepared to help him pay for the childcare and medical bills with which he’ll no doubt be faced? The state is essentially forcing this man to go against his wife’s end-of-life wishes and raise a child he may not be prepared to care for.

I want to be clear. I’m not pro-abortion, nor am I anti-life. Who the hell is anti-life? I’m pro-choice. Abortion is no picnic. Neither is making the executive decision to pull the plug on your brain-dead spouse, even if that’s what she wanted.

But no one has the right to override a person’s advance directive. I doubt Marlise Munoz had any notion that she would be declared brain dead at the age of 33 while carrying her second child. What she did know, and stated several times to her family, was that she didn’t want to be hooked up to machines in the event of such a catastrophe. Incidentally, she was a paramedic herself and had seen firsthand what victims of these kinds of tragedies go through. Marlise’s own brother was on life support after an accident and her family made the difficult decision to take him off. She was not an uninformed person. But that’s beside the point. The real issue here is that the state has no right to interfere in such personal matters and essentially rob the rights of a protected class.

After weeping through this article, I immediately researched individual state laws on advance directives. I discovered that several states, including Texas, have a No Effect law, which means that a woman’s advance directives are not in effect during her pregnancy. California has no law regarding this issue. As I scrolled down the list of states that have a No Effect law (Alabama, Connecticut, Idaho, Kansas, Kentucky, Missouri, among others), I became increasingly angry.

According to this law, pregnant women residing in these “No Effect” states do not have the same rights as non-pregnant women and men. In these states, pregnant women are excluded from the protected right to die.

Whatever her choice, any woman with the forethought to write up an advance directive has likely given the decision some thought. Whatever her choice, a pregnant woman deserves the respect and dignity of having her end-of-life wishes carried out just like anyone else. Much like the abortion debate, it is a mistake to remove the mother from the equation.

My expectation is that I will make it through this pregnancy just fine and that my second child will bring as much joy and wonder as my first.

And I have no doubt, regarding her own life, that Marlise Munoz expected the same thing.