Competing Bills Filed Over End-of-Life Care for Pregnant Women

The mother of Marlise Muñoz, the pregnant Fort Worth woman who in 2013 was kept on life support against her family’s wishes, says her daughter’s death had been “used as a political debate” and wants to prevent other women from going through similar ordeals.

Lynne Machado visited the Texas Capitol on Thursday to push a legislative proposal that would allow women like her daughter — who was 14 weeks pregnant when she collapsed because of a pulmonary embolism and was pronounced brain-dead — to be taken off life support. That measure is one of two competing bills about who should have the authority to decide whether to terminate a brain-dead pregnant woman's life — a preview of what promises to be a fiery legislative battle over end-of-life medical care in Texas.

“A pregnant woman and her family should be allowed to decide what course of treatment is right for them,” state Rep. Elliott Naishtat, D-Austin, said at a press conference on Thursday that Machado attended. “Doctors and hospitals should not be compelled by law to impose medical interventions over the objections of a dying patient and her family.”

Naishtat's proposal, House Bill 3183, would remove the requirement in state law that doctors maintain life-sustaining care for pregnant patients.

State Rep. Matt Krause, a Republican of Fort Worth, has also introduced a measure that is essentially the opposite of Naishtat’s bill. That proposal, House Bill 1901, would strengthen the requirement that pregnant patients be kept on life-sustaining support, including in cases in which the patient is brain-dead.

In 2013, a Tarrant County district judge ruled that Muñoz could be taken off life support because state law around life-sustaining care for pregnant patients does not apply if the patient is brain-dead.

Krause’s legislation would also require health care providers to alert the Texas attorney general if life-sustaining support of a pregnant patient is at issue. If a patient’s family seeks legal action to take a pregnant woman off of life support, the attorney general would be required to appoint an attorney to legally represent the patient’s fetus in court proceedings.

That attorney would be selected from a registry Krause’s bill would require the attorney general to create.

Krause said that Muñoz’s case brought to light new questions around the end-of-life debate and that his legislation was intended to put “better processes in place.”

“Texas certainly has taken great strides in the last couple of years to be ensure it’s a state that promotes and protects the sanctity of life,” Krause said. “Our intent is not to look backwards. It’s to look forwards.”

Muñoz was kept alive at a Fort Worth hospital for 62 days before she was taken off life support. The case received national attention and stirred a political debate in Texas.

At the press conference on Thursday, Muñoz’s parents and husband said they wanted the public to remember her as an individual, not a political prop.

“She was human,” said Ernie Machado, Muñoz’s father. “She wasn’t an experiment.”

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.