In late 2013, Dallas-Fort Worth area paramedic Eric Munoz found his pregnant wife unresponsive on the floor of their home. After transporting her to the hospital, Munoz discovered that his wife, Marlise, had likely suffered a pulmonary embolism that had left her incapacitated. The embolism had deprived her brain of oxygen, and left her effectively brain-dead. The doctor said they didn’t know if any damage had been done to fetus she was carrying.
Mr. and Mrs. Munoz were both experienced paramedics. They had previously discussed the question of whether they would want to receive life-sustaining treatment if they were in an unrecoverable medical condition. Eric Munoz said that his wife, even though she had not completed an advanced medical directive, would not have wanted to be kept alive artificially. He told her doctors this, but they were unable to comply with his directions because Texas state law prevents it.
Medical Directives and Pregnancy
Several states, including Texas and Washington, allow people to create advance medical directives, but do not allow the choices they make in those directives to apply during pregnancy. In the Munoz case, since Marlise is pregnant, her doctors cannot withdraw any life-sustaining treatment. Though Texas law allows people to create advance medical directives, the law specifically states that pregnant women cannot refuse to receive such treatments.
Washington Directives and Pregnancy
Like Texas, the state of Washington also imposes restrictions on advance directives made by pregnant women. The law effectively states that a woman who has created a living will or other advance medical directive cannot use that directive when she is pregnant. So, should a pregnant woman become incapacitated and have a directive that states she does not wish to receive life-sustaining treatment, her doctors are prevented from following those wishes.
In the Munoz case, since Marlise did not have a directive, her husband became the person who would be able to make medical decisions on her behalf when she is incapacitated. If a similar case were to arise in the state of Washington, the same thing would likely occur. In other words, a husband of an incapacitated pregnant woman in the state of Washington could not direct her doctors to remove life-sustaining treatment even if he was sure that she would not have wanted to receive it.
The Munoz case shines a new spotlight on the important issue of medical directives. Because state laws are so different, everyone who wants to create an advance directive should always talk to an attorney in their area.
Byrd : Garrett, PLLC is a member of the American Academy of Estate Planning Attorneys.