Brain-dead, pregnant Texas woman removed from life support

Life support has been removed for Marlise Muñoz, the pregnant 33-year-old paramedic whose brain-death case fueled complex debates about medicine's role in the beginning and end of life. Life-sustaining measures were removed Sunday at 11:30 a.m CST, according to attorneys. The families will now proceed with laying her body to rest and grieving the loss that has been suffered, attorneys said.

On Friday, a judge in the 96th District Court of Tarrant County, Texas ruled that John Peter Smith Hospital in Fort Worth should remove Muñoz from life support by Monday. She was declared brain dead Nov. 26, but a Texas law prohibiting withdrawal of life-sustaining treatment from a pregnant patient meant the family could not have her removed from life support as they had wished.

“The past eight weeks have been difficult for the Munoz family, the caregivers and the entire Tarrant County community, which found itself involved in a sad situation,” wrote a spokesperson from the JPS Health Network in a statement. “JPS has said its role was not to make nor contest law, but to follow it."

As the hospital and family awaited the court's decision, healthcare economists estimate that the cost of keeping Muñoz on a ventilator in the intensive care unit between Nov 26. and Jan. 25, was likely upwards of $300,000 before reimbursements. A 2002 study found that providing long-term care for a patient receiving mechanical ventilation cost around $3,968 per day, that's $5,233 in 2014 dollars, said Adam Powell, an economist with Payer+Provider, a healthcare consulting agency based in Boston.

About a dozen states, including Alabama, Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, South Carolina, Texas, Utah, Washington and Wisconsin, have similar pregnancy exclusions in their advance directive statutes according to the Center for Women Policy Studies. Healthcare providers in those areas have been following the developments closely.

The Muñoz lawsuit is one of two recently that have highlighted concerns about whether physicians and the public fully understand the term "brain death" and, more importantly for healthcare organizations, whether physicians effectively communicate what it means to patients' families.

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