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Advance Directives: What are they and why they are important

On January 23, 2014, there was a new development in the tragic case of Marlise Munoz, the 33 year old Texas wife and mother of a 15 month old son, who collapsed on her kitchen floor in November from a pulmonary embolism. At the time she collapsed, Munoz was 14 weeks pregnant. Munoz was ultimately declared brain dead, which is considered deceased under Texas law. However, despite her husband and family stating that she had expressed clearly she would never want to be kept alive by artificial means, the Texas hospital cannot remove her from life support. The hospital is bound by a state law–a law that 31 other states have as well–that forbids the removal of “life-sustaining treatment” from a pregnant woman. Munoz’s family is arguing that the law does not apply to this case because Marlise Munoz is dead under the law.

The new development is information on the condition of the unborn baby. Now that Munoz is 22 weeks pregnant, the health status of the baby can better be determined. Unfortunately, the oxygen deprivation suffered due to Munoz’s collapse combined with gestation in a dead and deteriorating body has led to what the Munoz family attorneys describe as severe deformities in the lower extremities (the gender of the child cannot even be determined), hydrocephalus (fluid on the brain), and heart problems. The statement released did not indicate whether the viability of the baby is known. For their part, the Munoz family say they are grieving both Marlise and their unborn child. They want to be able to put them both to rest, as they believe Marlise would want.

Although the Texas state law mentioned above may prevail, your Denver personal injury attorney will explain how having an advance directive(s) would have given the Munoz family a better chance of carrying out the wishes of Marlise as they believe them to be. Mr. Munoz insists that he and his wife, both paramedics, saw many situations while working that made them think about what kind of end of life care they would want. Mr. Munoz is adament that they both never wanted to be on life support. So why is Marlise Munoz on life support now?

Your Denver personal injury attorney points out that even if the application of the Texas law were not in dispute, Marlise Munoz did not have a living will. A living will is one form of an advance directive that contains written instructions to health care providers. Even if Munoz had a living will, it is highly unlikely that it would have anticipated the scenario of her being brain-dead while pregnant. This is why the other form of an advance directive is also a good idea to have: a health care proxy, or “power of attorney” for health care decision making, in which you designate a person who will be sympathetic to your desires in medical decision making. Munoz did not have a health care proxy or a power of attorney; although her husband was attempting to act as one, he lacked the legal authority to do so since she had never officially designated him as a proxy or given him power of attorney authority over medical care decision making.

In order to ensure that our end of life care decisions are carried out, our advance directives must be valid and enforceable.  Advance directives have detailed, state-specific requirements that must be met in order for the directives to be enforceable. Precisely because advance directives are so important and because they must meet certain requirements, it is advisable to consult with your Denver personal injury attorney at Levine Law when creating your medical decision-making plan.

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