Brain death is a concept used in situations in which life-support equipment obscures the conventional cardiopulmonary criteria of death, and it is legally recognized in most countries worldwide. Brain death during pregnancy is an occasional and tragic occurrence. The mother and fetus are two distinct organisms, and the death of the mother mandates consideration of the well-being of the fetus. Where maternal brain death occurs after the onset of fetal viability, the benefits of prolonging the pregnancy to allow further fetal maturation must be weighed against the risks of continued time in utero, and preparations must be made to facilitate urgent cesarean section and fetal resuscitation at short notice. Where the fetus is nonviable, one must
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The intent of this law is to make patients aware of their rights with regard to end- of-life care. State laws have also proven important in cases involving maternal somatic support. The Texas Advance Directives Act, also referred to as the Texas Futile Care Law , provides hospitals with discretion over continuing the provision of life support, and voids advance directive wishes for patients who are pregnant. This Texas law served as a point of contention in the death of Marlise Munoz—a situation in which end-of-life care became entangled with abortion laws and politics. Marlise Muñoz was 14 weeks pregnant when this incident occurred, and while an abortion is legal at 14 weeks in Texas, the state’s law dictates that a hospital must provide life support for pregnant women. Absent from the legislation are specifics as to how the law should be applied depending on how far along a woman is in her pregnancy, as well as the definition of terminally ill versus brain dead. This Texas law does not specifically detail a hospital’s obligation in the case when a pregnant woman is brain dead, thus leading to the long-drawn legal battle that ensued in the weeks following Marlise Muñoz’s pulmonary embolism.[10] Texas is one of several states that have laws that pertain to pregnant women and advance directives or Do Not Resuscitate (DNR) directives. Specifically, 26 states have laws that ignore advance directives when a woman is terminally ill, but pregnant. This recent situation involving Marlise Muñoz raised a host of questions related to unborn fetuses, patient and family preferences, and hospital discretion in interpreting state laws that involve advance
The intent of this law is to make patients aware of their rights with regard to end- of-life care. State laws have also proven important in cases involving maternal somatic support. The Texas Advance Directives Act, also referred to as the Texas Futile Care Law , provides hospitals with discretion over continuing the provision of life support, and voids advance directive wishes for patients who are pregnant. This Texas law served as a point of contention in the death of Marlise Munoz—a situation in which end-of-life care became entangled with abortion laws and politics. Marlise Muñoz was 14 weeks pregnant when this incident occurred, and while an abortion is legal at 14 weeks in Texas, the state’s law dictates that a hospital must provide life support for pregnant women. Absent from the legislation are specifics as to how the law should be applied depending on how far along a woman is in her pregnancy, as well as the definition of terminally ill versus brain dead. This Texas law does not specifically detail a hospital’s obligation in the case when a pregnant woman is brain dead, thus leading to the long-drawn legal battle that ensued in the weeks following Marlise Muñoz’s pulmonary embolism.[10] Texas is one of several states that have laws that pertain to pregnant women and advance directives or Do Not Resuscitate (DNR) directives. Specifically, 26 states have laws that ignore advance directives when a woman is terminally ill, but pregnant. This recent situation involving Marlise Muñoz raised a host of questions related to unborn fetuses, patient and family preferences, and hospital discretion in interpreting state laws that involve advance