My heart aches for the family of Marlise Muñoz. For the past two months, John Peter Smith Hospital has kept her on life support, against the wishes of her family, in order to allow her unborn child to reach viability outside the womb. I can’t imagine their pain, the loss they must feel. The agony that we experience while waiting to grieve is intense and unreal, often even more difficult than the actual grieving process itself. The hospital believed it was acting in accord with a Texas state law that prohibits the removal of life sustaining treatments on a pregnant woman, but a state district judge ordered them to remove her from life support, determining that, because she was brain dead, she was no longer a patient and the law did not apply. She was 22 weeks pregnant at the time. I have tremendous compassion for her family, and I cannot imagine how they must be hurting; however, this tragedy seems to be yet another instance of complete disregard for a second patient who was involved in this case: the unborn child.
In many clinical cases, the health and well-being of two individual patients can seem to be at odds with one another: the patient fighting for his life after a tragic car accident and the one dying of heart failure, clinging to the hope that someone might donate the long awaited for heart for transplantation. In a case such as this one, it is necessary to give the car accident victim every chance to survive, not because he is more important or more valuable than the man awaiting a heart transplant, but because we cannot do harm to one person, even if it would save the life of another. The good we can do for one man is limited by any harm we might do to another.
In the case of the Muñoz family, the woman had clearly stated that she did not want to be on life support, which she has every legal right to choose. However, when a second patient is introduced into the picture, clinical limitations and obligations change. The removal of life-sustaining treatments not only affects Mrs. Muñoz, but it also extinguishes any hope the child might have of surviving. While a woman might have the right to decide that she does not want to be on life support once she is brain dead, she does not have the right to choose that for someone else who is fighting for her life. In the case of a pregnant woman, because a child is dependent on her for survival, her obligation to sustain the life of her child changes the dynamic of her care. Due to the circumstances involved in the Muñoz case, the child did suffer from severe physical deformations as well as hydrocephaly, which put the child at a distinct disadvantage for survival. As a human person, however, Baby Nicole was owed every possible opportunity to live.
When trying to understand the moral implications of a complicated case such as this, it can be helpful to understand some of the ethical principles involved. Direct abortions are always wrong – they are an intrinsic evil, as they are the direct and intentional taking of an innocent life. This case, however, was not a direct abortion. The doctor did not directly end the life of the unborn baby; however, the baby’s life was ended by his actions. This case was somewhat more complicated than that, so it requires a deeper look. In some situations, a Principle of Double Effect can be applied wherein a morally good or morally neutral action that has a foreseen, though unintended, negative consequence can be justified in light of the fact that there is a proportionally good result as well. Some might argue that removing Marlise’s Munoz’s life-sustaining treatment would have the good result of allowing her to be buried and her family to grieve, justifying ending the life of her baby. However, this principle can only be applied correctly if four conditions are met. Among these is the condition that the two effects must be proportionate to one another. In this case, the two effects are not proportionate – a life being ended is not proportionate to another being able to be laid to rest. For this reason, even though it was not a direct abortion, it was unethical to take Marlise Muñoz off of life support, taking the life of her unborn baby.
So often in the fight for freedom or a particular set of rights, the fundamental rights of others are trampled. We, as a society, can get tunnel vision in trying to protect ourselves and the freedoms we think are paramount, only to forsake completely the poor, the helpless, and the vulnerable. Many of the countless articles that have been written about the Muñoz family and their struggle have attacked the hospital and the Texas law, criticizing them for forcing women to remain on life support even against their will. They have been branded anti-feminist for going against the wishes of women in order to protect their unborn children. I can’t help but notice that in this battle for women’s equality, we have neglected the idea that all rights are limited by the rights of another person. We have arrived at a point in the abortion argument where biological facts no longer seem relevant. No matter how much information we have about the incredible development of an unborn child, their genetic makeup, the complex structures that exist from the earliest stages of life, the argument is at a stalemate. It comes down to a question of human dignity and the value of each life as determined by God, the author of all life, and given to us by Him and Him alone. The sacredness of each life is at the foundation of every right we enjoy as human beings, and when we push it aside, for whatever reason, we shake the very cornerstone of our society.
Perhaps the most heartbreaking aspect of this story is the lost opportunity of the Muñoz family to allow this precious life to comfort them in this most devastating time of their lives. Even a life that lasts just a short while can offer an incredible ray of hope and solace in an otherwise terrible tragedy. Every life, even one born of difficult circumstances or suffering severe handicaps, has an inestimable value, ordained by its Creator, and held precious in His hand.