It’s one of the most nightmarish ways for a pregnancy to end: with the death of the mother, leading to loss not just of the fetus, but also of a loved partner and companion.
Such tragedies are fortunately rare, and rarer still are cases in which women are declared legally brain dead, but can be kept functional with life support. Machines are necessary to perform bodily tasks, and patients require constant monitoring and treatment, but theoretically, it can be possible for a brain dead person to be kept “alive” for years, even though she has no brain activity and is clearly non-responsive with no hope of revival.
Typically, the use of life support after brain death is recommended only in cases where people want to wait for family members to arrive to say goodbye, or when someone is an organ donor, and hospital personnel want to keep the organs as viable as possible. In other cases, medical professionals typically recommend letting go, removing life support and allowing the patient to die naturally. But in some cases, that’s not what happens. In the case of Natalie Muņoz, for example, doctors compelled a family to keep a brain-dead woman on life support for weeks because she was pregnant, arguing that they should wait until they could deliver the fetus. Against the wishes of Muņoz and her family, the poor woman was kept on a ventilator in a hospital while a legal battle swirled around her.
Her surviving family members pushed people to have conversations about what to do in the event of brain death so they wouldn’t be surprised by such events, and it appears that some people are responding, but maybe not as intended. In Louisiana, new legislation would mandate that if a fetus is over 20 weeks gestation and a woman’s bodily processes can be “reasonably” maintained, she must be kept on life support until delivery of the fetus. The law would be just vague enough to create a lot of room for interpretation, and, if passed, would join similar legislation in other states used to deprive women of their basic right to determine whether they want to continue with treatment.
Such laws are offensive enough on their own. All patients should have the right to determine the scope and nature of their medical treatment, and to make advance directives in the event they can’t participate in their own treatment. Such directives should be honored by family members and medical personnel. Depriving women of their medical autonomy is an attack on their bodily autonomy — and laws like this women reduce women to the status of incubators, instead of treating them as whole human beings.
Furthermore, the necessity of such a law is highly dubious, even for those who believe that allowing a fetus to expire is murder. Women who are sick or injured enough to be brain dead and on life-support are likely not carrying viable fetuses — it’s possible the fetus is causing the complications in the first place, or that the nature of the injuries that caused the medical crisis also resulted in severe damage to the fetus. The fetus could be dead or dying, or it could face abnormalities incompatible with life, like brain damage so severe that it would be doomed within hours of delivery. Furthermore, long-term life support increases the risk of complications, as it requires a constant balancing act to prevent organ failure, monitor blood chemistry, and provide medications, some of which can cause birth defects of varying degrees of severity. Forcibly keeping a woman on life support wouldn’t, in other words, result in a live delivery in very many cases.
If a woman chooses life support and surgical delivery once the fetus is viable, and expresses that wish in advance, that’s her right as a patient. But it’s not something that should be forced on women, just as carrying a pregnancy should never be forced on a woman in any other circumstance. In this case, the law itself may be unconstitutional — but it would need to be taken to court for a challenge to determine that. In the meantime, women will suffer.
Image credit: Victor