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#1
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Texas law won't allow pregnant woman to be taken off life support
From the Dallas News: Marlise Munoz, 33, has been completely brain-dead since she suffered a pulmonary embolism after Thanksgiving. She made clear before it happened that she didn't want to be kept alive by artificial means, and her family wants to take her off life support. But she's pregnant, and in Texas.
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Last edited by BrainGlutton; 01-03-2014 at 06:25 PM. |
#2
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After reading the act, I think the hospital's misreading law rather than the law itself being particularly heartless in this regard. The text they're pointing to reads: Quote:
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#3
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Did she explicitly say she wanted to be taken off life support even if she was pregnant? It's probably not a situation most women would have specifically thought about.
Overall, I would tend to agree with the law on this one. The main argument against forcing a woman to carry a foetus to term is the negative impact it would have on her life. And to be blunt, that's not an issue here - for all practical purposes, Marlise Munoz no longer has a life that can negatively effected. So keep her body alive long enough for the baby to be born and then shut off the life support. I'll grant that the viability of the foetus is an issue. But I'm no going to accept the father's opinion that "For all we know, it's in the same condition that Marlise is in" as a medical finding. |
#4
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RO, with nowhere near the info needed in the article to judge either way.
And what's up with pitting yourself for contributing to the problem you are so concerned about. Have you considered a 12 step program? I'm sure you could find one in Texas that would be just right. Last edited by John Mace; 01-03-2014 at 09:54 PM. |
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#5
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Is it too late for an abortion under Texas law? And, even if not, can the husband, his wife's 'surrogate decision maker' (or 'Power of Attorney for personal care' or whatever) request and be granted an abortion for his wife? I assume not or they would have tried to go that route.
Little Nemo - you really think that a woman who explicitly declared that she didn't want to be kept alive by artificial means would want her brainless body to be used as hatchery (while she is kept alive by artificial means)? Can people not be allowed to make their own decisions about their bodies and lives without the Government and the self-righteous trying to exert control. And, no doubt, Texas prides itself in the freedom found there. Yeah, freedom to do what the zealots permit. |
#6
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Did you not read before you went off on your crazy rant?
It's a single line in a bill intended to specifically allow health care professionals to pull the plug in cases of terminal illness. They put the single line in for the situation where the mother may be brain-dead or whatever, but the fetus is fine, which we'd all agree is reasonable to prevent the removal of life-sustaining treatment in that case. This case wasn't foreseen by that law, so it'll have to be hashed out in the courts; no judge has had a hearing on it yet that I'm aware of. It's not the state so far, it's John Peter Smith Hospital saying no, and there are quite a few other articles where lawyers and other legal experts say that the hospital is misinterpreting the statute. That clearly doesn't matter though because you're just so eager to get in and bash Texas and conservative people, even if your facts are wrong or misunderstood. |
#7
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And we don't know that the fetus is "just fine". That's not a fact either. We won't know for months - at which point the next of kin will get stuck raising the child all alone and also stuck for six months of major medical bills. There's nothing fine about any of that either. Not wanting to be responsible for the bill of six months of life support is, all by itself, a perfectly good reason to allow the fetus to die. It's not like there's some kind of fetus shortage in the world that we have to force people to care for this one. So as usual, the Texans and Conservative People deserve any bashing they get. |
#8
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It's the hospital misinterpreting a single line in a law that specifies the EXACT FUCKING OPPOSITE thing than keeping people alive. The law hasn't even been "applied" in this case yet- no judge has heard the case, no ruling has been made, etc... Right now, it's the hospital lawyers pushing their interpretation of the law against the family; no actual legal decisions or anything have been made yet. The law is NOT some kind of wacko right-wing law specifically to keep fetuses alive at the expense of their mothers. The law in question is one that's expressly designed to let healthcare providers discontinue "futile care" and have immunity against prosecution or suit. The law would apply to that girl in California if she were in Texas. There's ONE single line in that particular act that says "A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.", and I'm guessing that the spirit of the law is that if there's IS a viable fetus in a brain-dead woman, the hospital's not allowed to pull the plug on the mother in that situation. Seems reasonable as a general principle to me assuming the fetus is viable. Since the law's more intended for pulling the plug, not keeping mothers alive, they probably didn't think too much into that one line. Now in the Munoz case, the hospital administrators are taking the most literalistic approach at interpreting that one line that they can. This'll have to be hashed out in the courts, like all vague or poorly phrased pieces of legislation are. But for now, the courts aren't involved and haven't made any rulings, etc.. so quit jumping on people without doing the research. |
#9
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The law in question appears to be clear and unambiguous on the point. You can't pull the plug on a pregnant woman in Texas. I disagree with the law, and wonder if it can survive legal challenge...but that challenge may take long enough to render it moot in this situation.
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#10
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I cannot fathom any other way in which to read that line, bump, and I don't think you've done a good job of explaining this alternate interpretation you seem to be getting from it.
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Because I read it like the hospital reads it: there is legal protection for the person withdrawing "life sustaining treatment" from a person, unless that person happens to be pregnant. Because womb occupancy makes a person no longer a person, but a pregnant patient, and pregnant patients are treated differently than other patients. No way in HELL I'd want to saddle my husband with the burden of caring for an oxygen deprived disabled child for it's whole life, especially without me to help. *Can we please stop calling it "life-sustaining treatment" when it's done to dead people? |
#11
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Does this law require the family to just suck it up and pay the medical costs? If the costs could be transferred to the state, the law would probably change pretty quick.
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#12
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I know that when I was pregnant, I would have wanted my body to be used as a "hatchery" if need be. I certainly wouldn't have had any objection. Were the baby viable, I wouldn't want someone else deciding I couldn't be a "hatchery" because it cost to much, or was macabre. |
#13
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I'm entirely ignorant of Texas law, and don't feel competent to have any opinion on this case in particular without significantly more facts, but if she was 14 weeks pregnant at the time she entered the coma - would she have been able to request an abortion? Or is the line 12 weeks, which seems to be the more common limit.
Because if she would be required to carry to term while alive and competent, I'm not seeing the difference (in principle, not necessarily in practice) between that and requiring her to do it while brain-dead. |
#14
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Possibly a dumb question, but can they just transfer her to a hospital in another state?
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#15
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#16
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Right, and if I am understanding bump correctly, the law is doing half of that: it's stopping the hospital from making the decision for the patient. It is not, however, going all the way to letting the family make the decision instead.
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#17
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If they meant, "final trimester, about to be born, probably perfectly healthy and just needs a few more days to finish cooking," then they should have written it that way. But since they wrote nothing about the fetus at all, they're the ones who made this about pregnant women, not about very-soon-to-be-babies. Has Texas had a particular problem with hospitals yanking nearly term dead women off life support against the will of their families? |
#18
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http://www.dallasnews.com/news/local...fe-support.ece
DMN article about how legal experts think the hospital is misreading the law. The misinterpretation comes in that under Texas law, she's legally considered dead apparently. And FWIW, this is exceedingly uncommon; something like 30 cases in 30 years out of all the millions of pregnancies and brain-deaths out there. It's not surprising that a law wouldn't be finely tuned to account for something so ridiculously uncommon, regardless of whether Republicans, Democrats, Know-Nothings, Whigs, Labour, Conservatives, Social Democrats or whoever wrote it. Last edited by bump; 01-04-2014 at 10:53 AM. |
#19
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#20
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I'd want the choice - and if I'm not in a position to make it, I'd want my husband to be making the choice whether to keep my body alive for the sake of the baby or to let me and the baby go. Not the hospital telling my husband that they HAVE to pull support because I'm brain dead or that they WON'T pull support because there is some chance of a viable (or even not viable) baby. Its that funky word "may" in there - along with the "under this subchapter" clause. May is an ambiguous word. Does it mean that "A person MUST not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." Or does it mean that the hospital and doctors don't get to make that choice, but if the family does, the hospital is clear to remove life support just not using this subchapter as support. |
#21
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If somebody can show clear evidence that Munoz was planning on having an abortion then I'd agree she had made a decision about her pregnancy. But absent such evidence, then deciding to end Munoz's pregnancy is just as much somebody else making a decision about her body as continuing her pregnancy is. |
#22
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Last edited by doreen; 01-04-2014 at 01:40 PM. |
#23
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Last edited by Manda JO; 01-04-2014 at 02:16 PM. |
#24
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#25
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I simply cannot conceive how anyone would want the default in such situations to be that the state decides (absent a reasonable suspicion of malice on the part of the substitute decision maker or whatever the term is in Texas and the US). Does Texas not subscribe to the concept that when a person is incapacitated, others* (not necessarily declared in advance) may decide for him/her? (*in Ontario, this is called Power of Attorney for Personal Care. POAs can be designated in advance or, more commonly, spouses, children, etc (there is a hierarchy) can make decisions for personal care, including health and medical, for their spouse, parent, etc. even in the absence of an official prior designation. To my mind this is infinitely better than having the government step in and decide for you.) |
#26
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Some of the more conservative Texans are of the belief that even the slightest move to legitimize abortion of any sort (even in this case) is anathema. I can't say for certain in absolute fact, but I'm personally sure that many conservative Texans agree with keeping the woman on life support even if (and for some, especially if) the fetus will be developmentally compromised. On the other hand, they also don't believe in much of the way of state support after such a child is born. So, screw them and their beliefs. |
#27
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Typical. Fucking conservatives always worried about their "precious snowflake" fetuses, each and every one the most important god damned thing in the universe. Back in the good ol' days when the world was more sane and librul-like, we left our fetuses to fend for themselves, and they learned how to be men, instead of developing into mamby-pamby "wah, nanny government save me from my brain-dead mother" crybabies.
Of course, once it's born, and it needs state assistance, well, then fuck that baby and it's use of the socialist medical system. IOW, I'm appalled that this is even an issue; that a brain dead (read: dead) person could fall under any law that requires the state to keep her alive because she carries a pwecious wittle baby. (sorry, I'm feeling pissy tonight) |
#28
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#29
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Suppose Marlise Munoz was not in a permanent coma. Suppose rather that she was in a coma but doctors could tell that it was a temporary condition and she would wake up and make a full recovery in about a year. In those circumstances would you allow Marlise Munoz's family to decide that a year is a long time and they really don't want to deal with it so they'd rather pull the plug on her and let her die now rather than wait a year for her recovery? I think it's obvious nobody would be arguing that her husband or parents have the authority to make that kind of decision for her just because she's in a coma. The only time the family is asked to make the decision about withdrawing life support is when the condition is hopeless. Prior to that, neither the family nor the state can pull the plug. Now here's another hypothetical scenario. Suppose Marlise Muniz was in a temporary coma that was only going to last a few weeks. And her husband Erick wants her to receive full medical care so she wakes up and recovers. But when the doctors discover Marlise is pregnant (something nobody had known) Erick decides he doesn't want to have another kid. So he tells the doctors he wants them to perform an abortion on Marlise while she's in a coma. His justification is she's in a coma and he's making the medical decisions on her behalf so he can authorize the abortion just as she could if she were conscious. Again, I don't think may people are going to argue that a family member's authority extends to making decisions like that. So what the state appears to be saying in this case is that nobody is in a position to make the decision to end Marlise Muniz's pregnancy. Marlise Muniz is the only person who could make the decision to end her pregnancy and she is in a coma. So absent her consent, the state will allow the pregnancy to continue to its completion. Then when the baby is born, the family can decide if Marlize Muniz's life support should be continued. And if it turns out the baby's condition is hopeless and it also cannot live without life support, the family can decide for the baby as well. |
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#30
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She's not in a coma, she's brain dead - that is, dead. They are not the same thing.
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#31
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And, what Steophan said. |
#32
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In terms of cost, who cares? At this point, it's the difference between several million you can never pay and tens of millions you can never pay. |
#33
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In either of your hypotheticals (which bear little to no resemblance to the issues of the OP), I as an ethical nurse with a strong advocacy for patient autonomy would sit the husband down and explain that, first. Then I'd like to hear what the husband has to say. Did he have a conversation with his wife where she admitted she wasn't certain she wanted to continue this pregnancy, and that if their lives got more difficult in some way, she'd seek an abortion? Was she on her way to a doctor to discuss abortion options when her accident happened? Does he have any reason to believe that she would request an abortion now, if she were suddenly able to open her eyes and ask for one? At that point, he'd probably admit that no, he wasn't thinking about what she would want, but he was scared and overwhelmed and then we'd talk more about that and his feelings. I'd probably ask the hospital's medical social worker to stop by and discuss these issues with him more in depth, and find him community and social service support to deal with his grief, with financial issues, with housing arrangements and the other things he needs to help him through this very difficult time. If he said yes, his wife would want an abortion and he had no doubts about that, then I would page the hospital ethicist for a consultation. If the husband had me convinced that he was advocating for his wife and her wishes, then I'd do everything I can to support him and advocate for her getting an abortion, as well. No one, husband or not, should be able to request an abortion for someone else because he wants one. But if he's requesting it because he knows she wants one, that's a different situation. |
#34
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While ordinarily I'd be totally on the side of "let the person affected decide" in regards to continuing life support, once you're brain dead you are dead. We can cut you up for organ donation or use your corpse for research purposes and so forth. When you're dead you lose the rights you enjoyed as someone alive.
Normally, I'd prefer to abide by the wishes of the deceased in regards to her body, but not when doing so could harm others. If disconnecting her body's life support machinery would kill a viable fetus then sorry, the body remains hooked up until the baby can be delivered. So it comes down to what is the condition of the baby? And it looks like we can't know that, certainly not we sitting here without all the full details. |
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#35
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I think we're also in agreement that the decision to end a pregnancy is the sole prerogative of the pregnant woman. It's not a decision that can be delegated to a family member or the government. |
#36
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In either case, the decision must be made by someone else - or else, no decision is taken and both die - and the state needs to be involved in some way, if only to say who makes that decision. |
#37
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You missed the distinction mentioned earlier. Assuming that we talking about a coma and not brain death, the "decision maker" should really be called the "decision communicator". Because what he or she is supposed to do is communicate the decision the patient would have made to the medical staff when the patient cannot do so. Not the decision he or she would make, which may be different. It's not always possible for a third party to tell the difference, but sometimes it is.
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#38
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I disagree. I believe the pregnant woman is the only person who can decide to end her pregnancy. If she is unable to make that decision, then nobody can make it.
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#39
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Why is this situation different from any other medical situation where someone else has to make the decision? You would prefer a woman and foetus to die rather than an abortion be performed, if that would save her life?
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#40
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IIRC, weren't you adamantly against presumed or opt-out organ donation anyway? Quote:
We don't donate peoples bodies or organs against the wishes of the deceased or their next of kin. And thousands of already born people die everyday because of this. If the state can't mandate organ donation how they can mandate gestation by a dead person's body? At least in organ donation, the next of kin isn't on the hook for medical bills incurred due to the states appropriation of the woman's body. Not to mention the mental anguish imposed on the family by prolonging this women's death/funeral or that the family is now forced to assume responsibility for a potentially profoundly disabled child. I agree with Peter Singer, professor of bioethics at Princeton University, that "The Texas law in this case "imposes the view of the state on the adult pregnant woman, as to whether or not the fetus counts as a human being." |
#41
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At least no one on this thread so far is trying to "speak for the fetus." That's encouraging.
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#42
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We wouldn't be talking about maintain the woman's body indefinitely, only until the fetus/baby no longer needs it. After that, after following the woman's prior desires can't kill someone else, we can go back to what the woman wanted while still alive. Quote:
We don't know either of those two states to be true. In an ambiguous case I'd prefer to err on the side of life. It will be another 12-14 weeks minimum before the baby could be viable outside the womb, and if healthy at that point and we could still maintain the mother's body it would be in the interest of the child to continue the pregnancy as long as possible. The only time I'd say cut the power right now if it could be established that the mother absolutely intended to the abort but apparently that was not the case here. Quote:
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And nobody knows if the child will be disabled or not. Nobody. It's all assumptions. Unless the doctors have some key evidence but if they're ethical they'll never share the information with the media, so we'll never know. Quote:
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#43
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"When Is An Organ Donor Not An Organ Donor" Quote:
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![]() More pointedly, conflating the removal from life support of the pregnant women with abortion is not accurate. The intent to remove Munoz from life support is not the same as the intent to terminate a pregnancy - though the outcome for the fetus (which is NOT a legal person) may be the same. Furthermore, the 'allowing Munoz to be removed from life-support only if she intended to abort' argument isn't logical or compelling, as it can be safely assumed that Munoz's intent in carrying her pregnancy to term was not surrogacy, but a parenthood. There is no such opportunity for that relationship now that she is deceased (outside of the purely biological). Of course the most qualified person to speak on her behalf is her husband - who the state is overriding. Quote:
And yes, her warm corpse is still the body of an adult pregnant woman who happens to be brain dead and her wishes should be as legally binding as any other 'warm corpse' or decedent. Last edited by EverwonderWhy; 01-05-2014 at 04:45 PM. |
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duplicate post
Last edited by EverwonderWhy; 01-05-2014 at 04:55 PM. |
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#45
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Can you show who is harmed by waiting in this case? By common consensus, the woman is irreversibly brain dead and is beyond any further harm. How is delaying the death of her body going to inconvenience her? |
#46
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And you're ignoring the central tenet of the pro-choice position: the decision to terminate a pregnancy is solely the pregnant woman's to make. It doesn't matter if you're arguing that the government wants to terminate the pregnancy or the husband wants to terminate the pregnancy or the grandparents want to terminate the pregnancy - the basic principle is the same: nobody but the woman can make that decision.
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#47
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And while I won't speak for the whole pro-choice tent here, my belief centers around body autonomy. If Munoz wished to not to have her body on life support and the person most qualified and legally authorized to represent her wishes in this tragic and unique circumstance conveys that - then her wishes should be as legally binding as any other person. Any person has the right be removed from life support, except pregnant women . Despite their wishes or advanced directives? How does that not turn pregnant women into second class citizens and deny their body autonomy? |
#48
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To a woman who wants a child a miscarriage is more upsetting than a menstrual period, and miscarriages can cause as much grief to would-have-been parents as the death of a infant just after birth. And, yes, sometimes an abortion is an enormous relief for a woman who does not want a child at that point. You can't issue blanket statements about something so variable. Yes, abortion IS killing. It's not killing a legally defined human person but it most certainly is killing something alive. Pretending it's not causing death to something is ludicrous. The question is whether it's murder - that is, killing a living, legal human being - or of no more consequence than killing a mouse or something. The truth is that the legal dividing lines are fuzzy, and always will be absent a standard of "life begins at conception". Quote:
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That doesn't square with the women who are willing to risk their lives to complete a pregnancy, or forgo cancer treatment long enough to birth a child even though it puts their own lives at greater risk, or women who, facing death and without a spouse, make arrangements for the custody and care of their children after their gone. Thus, I reject your argument that, if we could communicate somehow with this dead woman, she would automatically argue to kill the fetus by taking her body off life support. Quote:
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In other words, when making out medical directives or living wills women of childbearing age need to consider how pregnancy could affect their wishes regarding their remains. Quote:
Beyond that, if your wishes regarding the disposition of your corpse could harm or kill the living then I say tough crap, you don't get your wish honored. This would probably be less muddy if she were, say, 30 weeks along instead of 14 and the fetus much closer to clear and full legal status as a person. Maybe it's just my hesitation to get the state involved in killing people or even potential people. The 20th Century had all manner of horrific abuses done by governments in the name of eliminating life deemed unworthy of life, including slides down slippery slopes, and I do not want that to happen again. I am opposed to capital punishment as well. As I said, I'd rather err on the side of life, it makes it less likely to categorize significant numbers of people as disposable. |
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#50
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MOST married women who are three months and some change along want to have the baby. Many, if not most, pregnant women are willing to run risks to bring their baby to term, and submit to various medical procedures to bring their baby to term. Assumption that a pregnant woman who has not secured an abortion by the second trimester wants the child is reasonable. The default assumption in medicine is that if a woman is pregnant the assumption is she is keeping the baby until she says otherwise, and medical procedures, even on unconscious women, are conducted with that in mind. Absent solid proof otherwise I don't see a problem with that. Now, if the woman had a living will where it was explicitly written that she did not desire life support post-brain death even if she was pregnant I'd say that there is a much more significant basis for turning her off in this case. We don't have that. Yes, her husband is next of kin and apparently has the power of attorney in this case. However, the dead woman is not suffering and I for one have no problem with taking a week or two to carefully examine and question what is the best course here. Medical ethicists and maybe a judge can consider the question with access to details you and I will never see, and I have no problem with doing it that way. If the widower wants to terminate parental rights prior to birth the child would then become a ward of the state. I would feel much more comfortable about an ethical review which ends in turning off the machines in a fortnight than simply yanking the plug right now without a second thought. |
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