Dead people are causing a lot of anguish in the ethics world lately. First, a family wants to force a hospital to keep their brain-dead, which is to say, dead, daughter on life support just in case a miracle occurs, while the rest of society pays for it. Now, in Texas, we have a true brain death dilemma that once again highlights the problem with U.S. abortion law and ethics.
Texan mother Marlise Munoz was 14 weeks pregnant with her second child when she collapsed and later died from a blood clot in her lungs. Her parents and husband told the intensive care unit at Fort Worth’s John Peter Smith Hospital to honor her stated wish not to be left on life support, but the hospital has so far refused to comply with their instructions. Texas is one of 31 states that prohibit medical officials from cutting off life support to a pregnant patient. Now, more than a month after her brain stopped functioning, the late Marlise Munoz is still connected to life-support machines, and her unborn child is now in its 20th week of development.
I think the stand of the hospital is the ethically correct one, as well as in the spirit of the intent of the law, but I have doubts about whether the law, as I understand it, will sustain the hospital’s current interpretation of it. The law was passed by the Texas Legislature in 1989 and amended in 1999, and states that a person may not withdraw or withhold “life-sustaining treatment” from a pregnant patient. The issue is whether any treatment can be “life-sustaining” if the patient is dead. The hospital’s lawyers obviously believe that “life-sustaining” applies. because the treatment is sustaining the fetus’s life, which they alos regard as their patient. The New York Times, however, surveyed ethics experts in the field that seemed to agree that the parents have the better case:
“If she is dead, I don’t see how she can be a patient, and I don’t see how we can be talking about treatment options for her,” said Thomas W. Mayo, an expert on health care law and bioethics at the Southern Methodist University law school in Dallas. Arthur L. Caplan, director of medical ethics at NYU Langone Medical Center in Manhattan, agreed. “The Texas Legislature can’t require doctors to do the impossible and try to treat someone who’s dead,” Mr. Caplan said. “I don’t think they intended this statute the way the hospital is interpreting it.” Critics of the hospital’s actions also note that the fetus has not reached the point of viability outside the womb and that Ms. Munoz would have a constitutional right to an abortion.
If this really is the consensus agreement among bioethicists, I think we need to junk bioethics and start all over. The convenient fiction behind the extreme pro-abortion position has obviously infected the field. Why wouldn’t reasonable respect for life have all parties supporting the hospital’s decision?
1. The family’s main argument is that Marlise Munoz had said that she didn’t want to linger on life support. Did she really specify that this would be true even if removing it meant ending her unborn child’s life? I can’t find any accounts that suggest this, and I find it very unlikely.
2. The ethics of abortion decisions should turn on the balance between the child’s right to live and the mother’s right to have control over her body and her future. I think the typical “choice” position does not treat the life of the child with proper consideration; I think the absolutist “pro-life” position is wrong to treat the woman’s right of self-determination as completely subordinate. But how is this situation even a tough call? On one side is a human life just wanting the chance to be born. On the other, there is a dead woman who has no future, except to give birth.Isn’t the choice in this case clear, convincing, humane and obvious?
3. Why would she not want to give birth? If she can’t raise her child, then nobody can? Would she want to take the child with her so they could be together in heaven? Is there something about her family we should know about? How would “if I die, I want to make sure my baby dies with me” every be a reasonable, even respectable request?
4. The mother is not endangered or inconvenienced by this childbirth in any way. The worst that could happen is the same result the family appears to want. What possible justification can the family, the state or the society have for not allowing the fetus to reach viability?
5. Sure, the wishes of the deceased should be given respect and be followed when it make sense to follow them, but there have to be limits. Protecting a deceased family member’s dignity—although the dead really don’t suffer from indignities. you know, since being dead is a lot worse than being embarrassed, and they really don’t care—is a respectable objective, but not at the cost of a life, or a potential life, or whatever you want to call it. That seems cruel, and indeed insane.
A child will be born if the hospital does what it is doing; a human being will have a chance at life. If the family, including the father, don’t want the baby, swell–I’m sure some loving family will be thrilled to take it. Then they can have their dead daughter taken off life support, and apologize to her for the horrible, cruel inconvenience visited on her by that unfeeling hospital that chose life over a dead woman’s preference that may not have applied in this situation anyway. That is obviously the most ethical result.
Next, I want to know why the current group of U.S. bioethicists are in their field at all if they regard human life so callously.
Pointer: ABA Journal
Source and Graphic: New York Times