The article on Marlise Munoz by Parker

Question: What evidence has the author used to support his/her view? Is there significant evidence missing or a significant point of view that is not addressed? Answer: The article by Parker (2014) is about a 33-year old Marlise Munoz, a patient who was hospitalized after collapsing due to pulmonary embolism. She was later declared brain dead by the medical team besides discovering that she was expectant with a pregnancy of 14 weeks. She was put on life support with reference to the Texas state laws that advocate for support of a critically ill pregnant patient in order to ensure the unborn baby is born or viable unless these actions are against the advance care directive of the patient specifying the desired actions under these circumstances. However, Marlises spouse and parents were against the medical support, arguing that it was against her advance care directive and under the current situation she was being utilized as an incubator. After a lawsuit by the husband, the court provided a directive to withdraw the life support 10 weeks after hospitalization The ethical dilemma with this case is that the client was declared brain dead and in extension she is dead, and life sustenance support cannot be provided to such a person. Thus the question posed was whether it is ethical to keep a dead expectant woman alive with medical technology support to maintain their pregnancy. Other issues in question include abortion, advance care directive, decision-making capacity of the family for the patient and the rights of the fetus. There are various versions that provide guidance on the matter of pregnancy sustenance in different states, Texas being the most restrictive. The variances are due to the consideration of factors such as whether the child can develop till birth and if there is any advance care directive that provides guidance on decision-making under the circumstances. The question brought forth in the article is the ethics surrounding the issue of life support by medical intervention while the critically and terminally ill patient is pregnant with a confirmed brain death. The life-prolonging as provided by most state laws throughout the United States of America stipulate that they are applicable if only one is alive and without suffering from brain death as the case with Marlise (Stauch, Wheat Tingle, 2012). The medical professionals should, therefore, seek an interpretation of the law agencies to understand the laws as well as have an insight on the ethics governing it not to provide interventions against the wish of patients. Notably, the purpose of the article is to provide information on the ethical dilemmas that exist in the medical profession especially is one is pregnant and critically, how they are handled and what implications they have for both the family of the patient involved and the general public. Therefore, the authors point of view is that it is imperative for the advance care directive of the patient to be followed when they are not competent to make their own decisions besides considering the law that governs withdrawal of treatment. Medical ethics can be maintained by having an in-depth understanding of the laws around the four issues highlighted; advance care directive, withdrawal of treatment, euthanasia and abortion (Stauch, Wheat Tingle, 2012). However, the significant point of view that is not addressed in this case is if patient autonomy ceases with the legally recognized brain death, can the family decide to make a contradicting decision concerning the body of the patient? If I could talk to the author, then I would ask, if the response to this question is yes or no, what laws can be utilized to guide such decisions made by the family and what ethical considerations should be made? References Parker, M, (2014, January 21), Brain death, pregnancy and ethics: The case of Marlise Munoz, Retrieved September 25, 2016, from the conversation.com, https://theconversation.com/brain-death-pregnancy-and-ethics-the-case-of-marlise-munoz-22076 Stauch, M, Wheat, K, Tingle, J (2012), Text, cases and materials on medical law and ethics, New York: Routledge.