Hypothetical: Brain Dead Pregnant Woman

[Broomstick]

Assume another case
Lets say she dies and she has a harvestable heart
She did not give permission to use her organs
In the next room, there is a four year old child who will die without a heart and they are out of time.
This heart matches and it the only one available.
Do you think the state should have the right to mandate the using of the heart
If not, why is the fetus special compared to the four year old girl?

The fetus is already connected to the woman's body and the four year old is not.

Whether or not that distinction should make a difference is a debatable point, but as near as I can tell that's the primary difference.

[Terralthra]

I think it's a moral duty to allow one's organs to be harvested after death, if they can be. Whether that means I think the state ought to mandate such is a trickier issue.

[Kitsune]

Assume another case
Lets say she dies and she has a harvestable heart
She did not give permission to use her organs
In the next room, there is a four year old child who will die without a heart and they are out of time.
This heart matches and it the only one available.
Do you think the state should have the right to mandate the using of the heart
If not, why is the fetus special compared to the four year old girl?

The fetus is already connected to the woman's body and the four year old is not.

Whether or not that distinction should make a difference is a debatable point, but as near as I can tell that's the primary difference.

What we are saying is that fetus is more special than a four year old child just because it is in the mother's body.

[Dargos]

edited because Texas news story already posted

[Terralthra]

The fetus is already connected to the woman's body and the four year old is not.

Whether or not that distinction should make a difference is a debatable point, but as near as I can tell that's the primary difference.

What we are saying is that fetus is more special than a four year old child just because it is in the mother's body.

That difference is not without its practical side-effects. Another donor heart could turn up and be transplanted in the 4 year-old (even if unlikely), where the fetus can not be transplanted to another mother at all, with present technology. There's no way a 20-week gravid fetus can be moved to another uterus. It's the mother it's currently in, or nothing.

[Kitsune]

The fetus is already connected to the woman's body and the four year old is not.

Whether or not that distinction should make a difference is a debatable point, but as near as I can tell that's the primary difference.

What we are saying is that fetus is more special than a four year old child just because it is in the mother's body.

That difference is not without its practical side-effects. Another donor heart could turn up and be transplanted in the 4 year-old (even if unlikely), where the fetus can not be transplanted to another mother at all, with present technology. There's no way a 20-week gravid fetus can be moved to another uterus. It's the mother it's currently in, or nothing.

People, including children, often die while on waiting lists for organ. Your "unlikely" is "extremely unlikely."
My argument is that the people argue for 'fetus rights" seem to forget all about people's rights as soon as they are born.

[Terralthra]

That difference is not without its practical side-effects. Another donor heart could turn up and be transplanted in the 4 year-old (even if unlikely), where the fetus can not be transplanted to another mother at all, with present technology. There's no way a 20-week gravid fetus can be moved to another uterus. It's the mother it's currently in, or nothing.

People, including children, often die while on waiting lists for organ. Your "unlikely" is "extremely unlikely."
My argument is that the people argue for 'fetus rights" seem to forget all about people's rights as soon as they are born.

"Extremely unlikely" is still a difference in kind from "literally and technically impossible."

[Kitsune]

I don't see any practical difference. . . We have decided from a legal standpoint that a person can decide what can be done with their body after death even if we don't like it.

The people arguing for this case are making an exception for trying to keep a fetus alive but not save the life of a four year old girl.
If we had a blanket law of a person's organs will be used after death (if they can be), just how many live would be saved every year?

[Broomstick]

I think you need to remember that the people who passed the relevant law in Texas are convinced that a fetus is just as much a human being as an adult man or woman and should have the same rights as any other human being. You may not agree with that stance, but IF you start with that position then taking a pregnant woman off life support also means taking her child off life support. To them it means deliberately killing a human being.

A lot of the what I see in this thread assumes that he fetus is NOT a human being. Needless to say, that results in conflict with the view of fetus-is-a-human-being.

[Kitsune]

My stance is different. . . .Even if we assume that fetuses are full people, a four year old girl is too.
You can, by violating a person's wishes save her life even more surely by giving her the heart than you can by forcing the dead mother to carry the child.
Think of it as forceful donation of uterus to carry a child vs forceful donation of heart to save a child.

[PainRack]

Assume another case
Lets say she dies and she has a harvestable heart
She did not give permission to use her organs
In the next room, there is a four year old child who will die without a heart and they are out of time.
This heart matches and it the only one available.
Do you think the state should have the right to mandate the using of the heart
If not, why is the fetus special compared to the four year old girl?

Honestly? It doesn't matter. Organ transplant is a gift, the needs of any potential recipient has no impact on the medical needs and ethics of one case.

Its only when a prior contract has been made, such as a patient having given consent for organ harvesting that this will arise and even here, the first ethical considerations will still be the same as that quoted earlier in the thread.

[Simon_Jester]

My stance is different. . . .Even if we assume that fetuses are full people, a four year old girl is too.
You can, by violating a person's wishes save her life even more surely by giving her the heart than you can by forcing the dead mother to carry the child.
Think of it as forceful donation of uterus to carry a child vs forceful donation of heart to save a child.

From the sound of it, keeping a pregnant woman on life support to sustain her child is if anything more likely to result in a child living a long, healthy life than a heart transplant from an adult to a four year old. Transplant surgery is pretty risky too- I did a quick check and overall rate of 10-year survival for children receiving heart transplants is about 60%. Organs are not plug-and-play.
_______________

The other point I'd like to make is that medical ethics usually tries to avoid deliberately making one situation worse in hopes of making another one better elsewhere, especially without explicit consent. Letting Person A die* to ensure the life of Person B runs up against one of the rules doctors traditionally try to stick to: "first, to do no harm."

Sure, you might be able to make some kind of argument by hypertrophied calculation that letting Person A live results in 100 utilons and letting Person B live results in 110 utilons. But such arguments are inherently tricky, and frequently based on miscalculations or sweeping generalizations (like assuming that a child who gets a heart transplant will live to grow up).

So there's a good general rule we should bear in mind, which is that in zero-sum games it is usually best not to upset the status quo, and not to rob Peter to pay Paul. Unless we have a very very compelling reason for robbing Peter. Otherwise, we risk opening the door to large classes of meddling, that are very questionable in terms of ethics in general, and even in terms of utilitarian outcomes in particular.**
_____________________________________________

*This is assuming that fetal personhood is at least a potentially open question; we can argue it separately but we can hardly claim that the entire community of medical ethics in the world has come to agreement on the matter. So it might be best to, y'know, NOT automatically assume that a fetus is not a person for purposes of setting policy.

**Say, patients going down on the operating table and waking up with one less kidney without their consent. Because, surprise, they're compatible with someone on the donor list, and the surgeons made a utilitarian calculation that they needed their second kidney less than that recipient needed their first kidney...

[Kitsune]

My argument is simply that we have body autonomy in the United States. We are not forced to give blood, are not forced to give marrow, not forced to give organs at death, and as such are not forced to carry a baby in our body if we don't want to. While I respect Pain Rack, we are working from potentially different legal perspectives from different countries.

Looking as far as sources, there appears have only ever been three births from brain dead mothers from before the point of viability and one of those three did not survive past birth. No information that I can find about how often it is tried. Have a feeling it has been tried and usually fails. As such, does not look like it is a very likely thing. With premature births, survival rate appears to be 80% to 1 year (this is with at least a living mother not on life support constantly) with 25% of them being severely disabled.
Based on how I fudge factor all the variable into the actual success rate, I suspect the chance of success is pretty low.

Compared to that, sixty percent 10 year survival seems pretty reasonable especially when those operations include older people who get transplants which will likely skew results unless you only factor for otherwise healthy patient.*

One trouble is that you seem to be going on is a tangent. She is dead, you are not talking organs from a living person.

*On the subject of organ donations, often it is done on a first serve basis. I honestly think it should be more utilitarian. If you are younger, healthier, and have good odds of a long life, you should be moved up on the organ list. I think in general a 25 year old should be high on the list than a 65 year.

[Broomstick]

My argument is simply that we have body autonomy in the United States. We are not forced to give blood, are not forced to give marrow, not forced to give organs at death, and as such are not forced to carry a baby in our body if we don't want to.

Incorrect. In the first trimester women are not forced to carry a fetus to term but past that things get much murkier and there is a point where, sorry, no, you can't quit now you MUST finish the pregnancy. We have already limited the autonomy of pregnant women in the US.

*On the subject of organ donations, often it is done on a first serve basis. I honestly think it should be more utilitarian. If you are younger, healthier, and have good odds of a long life, you should be moved up on the organ list. I think in general a 25 year old should be high on the list than a 65 year.

There are probably a hell of a lot more 65 year olds looking for new organs than 25 year olds. Also, because there is the problem of rejection the first selection is based on how likely the recipient is to reject the new organ. There are donated organs that go unused simply because they are not immunologically compatible with any waiting donor.

[Kitsune]

Incorrect. In the first trimester women are not forced to carry a fetus to term but past that things get much murkier and there is a point where, sorry, no, you can't quit now you MUST finish the pregnancy. We have already limited the autonomy of pregnant women in the US.

And there are plenty of respected lawyers who consider them to be be bad called based on previous stances.

There are probably a hell of a lot more 65 year olds looking for new organs than 25 year olds. Also, because there is the problem of rejection the first selection is based on how likely the recipient is to reject the new organ. There are donated organs that go unused simply because they are not immunologically compatible with any waiting donor.

Ethicists seem to consider it an argument worth having
"I've been arguing for a long time that the system should pay more attention to age because you'll get a better return on the gift" because younger people are more likely to live longer with a donor organ, Caplan said.
http://www.cbsnews.com/news/dick-cheney ... ge-debate/

[PainRack]

My argument is simply that we have body autonomy in the United States. We are not forced to give blood, are not forced to give marrow, not forced to give organs at death, and as such are not forced to carry a baby in our body if we don't want to. While I respect Pain Rack, we are working from potentially different legal perspectives from different countries.

Legal yes, ethically, no.

I repeat this. The needs of a donee is NOT supposed to impact the care of a patient, period. By all rights, the transplant team has no right to step into the care of a patient, the only consideration a physician is supposed to have is the patient under their care. In this case, the mother and the foetus.

Furthermore, under this scenario, the pregnant woman is not under any compulsion to donate her organs as she has not opted in. This would be a different scenario in Singapore due to the Human Organ Transplant Act, where organ donation is opt out. In my country, the physician would have a duty to consider the needs of the viability of organs and may face a need to approach the transplant ethics committee to step in and interview the family.

There might be different pressures here because HOTA places more pressure and emotional issues to bear . However, the ethical principle that the needs of the donee does not impact patient care is lifted from US guidelines. As a nurse, I haven't been directly exposed to such a scenario, indeed, the closest scenario I been to, the ICU team let the patient simply die in place so I don't have any practical experience to quote here but these are the guidelines established here.

Looking as far as sources, there appears have only ever been three births from brain dead mothers from before the point of viability and one of those three did not survive past birth. No information that I can find about how often it is tried. Have a feeling it has been tried and usually fails. As such, does not look like it is a very likely thing. With premature births, survival rate appears to be 80% to 1 year (this is with at least a living mother not on life support constantly) with 25% of them being severely disabled.
Based on how I fudge factor all the variable into the actual success rate, I suspect the chance of success is pretty low.

Compared to that, sixty percent 10 year survival seems pretty reasonable especially when those operations include older people who get transplants which will likely skew results unless you only factor for otherwise healthy patient.*

All correct. Like I said, the decision to maintain the foetus on life support should consider the possibility of carrying it to term, which is very low, although god knows how anyone would be able to come up with figures in cases like this.

One trouble is that you seem to be going on is a tangent. She is dead, you are not talking organs from a living person.

She's braind dead. However, as long as the decision has not been made to withdraw life support, she is still a patient under our care.

*On the subject of organ donations, often it is done on a first serve basis. I honestly think it should be more utilitarian. If you are younger, healthier, and have good odds of a long life, you should be moved up on the organ list. I think in general a 25 year old should be high on the list than a 65 year.

From a lecture our liver transplant surgeon gave, I was under the impression that this is the case in the States. Or rather, the utilitarian factor is considered, am I wrong?

[Kitsune]

Going to argue only one item. . . .The woman was firm with the "Do not keep alive on life support"
If anybody, she would have discussed it with her husband the issue about what happens if this occurs when pregnant.
Maybe he might feel a bit differently if she had been closer to the time of birth and there were no concerns of serious complications.
As such, I think that the right to decide should be the woman's and her husband can clarify "Yes, she really meant even if pregnant."
If the position of the woman and her husband seemed to be "Keep alive until birth", I think I would have a different position.

Well, I guess I will state what I read on organ donation. Seems to be up to the transplant hospital not the actual federal system.
Organ transplants are also very expensive meaning the wealthy and those on medicare are actually more likely to be able to afford the transplant than a normal younger working stiff.

[Simon_Jester]

My argument is simply that we have body autonomy in the United States. We are not forced to give blood, are not forced to give marrow, not forced to give organs at death, and as such are not forced to carry a baby in our body if we don't want to.

Yes, but Ann's* bodily autonomy does not give Dr. Bert* a right to decide what to do with her body- obviously.

In this case, you're saying Dr. Bert has a right to dispose of Ann's brain-dead body for the benefit of Claire, at the expense of attached fetus (call them... proto-Dave).

Whatever justification you have for this, bodily autonomy isn't it. A woman can't be forced to give birth, but she also can't be forced to agree to organ donation... and if we're going to respect her wishes, we have to seriously consider whether she'd rather posthumously give birth or posthumously become a source of spare parts.

*name chosen randomly

Looking as far as sources, there appears have only ever been three births from brain dead mothers from before the point of viability and one of those three did not survive past birth. No information that I can find about how often it is tried. Have a feeling it has been tried and usually fails. As such, does not look like it is a very likely thing.

Please don't advance an argument based on "I don't know the rate of X, but it must be lower than the rate of Y." It's tiring.

Compared to that, sixty percent 10 year survival seems pretty reasonable especially when those operations include older people who get transplants which will likely skew results unless you only factor for otherwise healthy patient.*

One trouble is that you seem to be going on is a tangent. She is dead, you are not talking organs from a living person.

Since she might reasonably have wished that her body be used to try and bring her unborn child to term, you can't simply say "she's a dead body, let us do as we please."

*On the subject of organ donations, often it is done on a first serve basis. I honestly think it should be more utilitarian. If you are younger, healthier, and have good odds of a long life, you should be moved up on the organ list. I think in general a 25 year old should be high on the list than a 65 year.

To some extent this already happens. To a larger extent... you seem to have totally missed my argument against the idea of 'medical arrogance.'

In medical ethics, we would be wise to exercise SOME degree of restraint when deciding "this person should live, this person should die." Maybe we can come up with a perfect system that optimizes utility-function for all humans. But if we try and fail, then we are directly responsible for terrible injustices, and deaths in the name of healing.

To avoid becoming monstrous, it is wise for us to recognize our own limitations, and create a system of rules that is a bit more foolproof. A system under which we are NOT routinely responsible for committing actions that are morally justified ONLY if we are in very solid command of the facts. Deciding to terminate a fetus for the sake of someone else's organ transplants is an example of such an action. Deciding to bump one person up the donor list for organs and another person down is another example.

Your arguments are showing a lot of this kind of arrogance, this willingness to assume that you have the right to make decisions that are moral if you are in possession of all the facts. But these decisions immediately become very immoral if you start making mistakes, and you start doing things that everyone involved will regret.

I don't think it's good practice for a profession that handles matters of life and death to adopt policies which fail ungracefully.

[Kitsune]

Yes, but Ann's* bodily autonomy does not give Dr. Bert* a right to decide what to do with her body- obviously.

In this case, you're saying Dr. Bert has a right to dispose of Ann's brain-dead body for the benefit of Claire, at the expense of attached fetus (call them... proto-Dave).

Whatever justification you have for this, bodily autonomy isn't it. A woman can't be forced to give birth, but she also can't be forced to agree to organ donation... and if we're going to respect her wishes, we have to seriously consider whether she'd rather posthumously give birth or posthumously become a source of spare parts.

Can you fail to read what I wrote any worse than you did, seriously?
Taking her off life support is, to the best of knowledge by the doctor, the will of the woman even if pregnant.
Both her instructions and her husband confirmed this.
It is not the doctor deciding for her as you seem to be arguing.
Now, I will grant that he is in a bad place because of Texas law.

Please don't advance an argument based on "I don't know the rate of X, but it must be lower than the rate of Y." It's tiring.

Lets be honest here, the nurse on the board though my argument was reasonably valid as far as the numbers.

Since she might reasonably have wished that her body be used to try and bring her unborn child to term, you can't simply say "she's a dead body, let us do as we please."

Which is exactly not what I said. . .I said that we seem to know her wishes and we should follow them.
The best we have is what she might have said / written and what her husband has stated.
We don't go by what you imagine. Maybe she might have changed her mind but we have no evidence of that and the best evidence is that she did not.

To some extent this already happens. To a larger extent... you seem to have totally missed my argument against the idea of 'medical arrogance.'

In medical ethics, we would be wise to exercise SOME degree of restraint when deciding "this person should live, this person should die." Maybe we can come up with a perfect system that optimizes utility-function for all humans. But if we try and fail, then we are directly responsible for terrible injustices, and deaths in the name of healing.

To avoid becoming monstrous, it is wise for us to recognize our own limitations, and create a system of rules that is a bit more foolproof. A system under which we are NOT routinely responsible for committing actions that are morally justified ONLY if we are in very solid command of the facts. Deciding to terminate a fetus for the sake of someone else's organ transplants is an example of such an action. Deciding to bump one person up the donor list for organs and another person down is another example.

Your arguments are showing a lot of this kind of arrogance, this willingness to assume that you have the right to make decisions that are moral if you are in possession of all the facts. But these decisions immediately become very immoral if you start making mistakes, and you start doing things that everyone involved will regret.

I don't think it's good practice for a profession that handles matters of life and death to adopt policies which fail ungracefully.

The U.K. has a rationing system where people might only live a few more years are not likely to get super expensive care when it will likely only extend their life a few years. They have approximately as good care as the US while spending half as much per person.

You know what, you are going to make mistakes. Just accept it and do the best you can. There is no reason why the ethics of transplants having some criteria based on how long the person can be expected to live cannot be discussed. Never will get a perfect system.

[PainRack]

Lets be honest here, the nurse on the board though my argument was reasonably valid as far as the numbers.

The nurse also knows shit regarding the viability of a foetus other than its extremely low in cases like this.

The U.K. has a rationing system where people might only live a few more years are not likely to get super expensive care when it will likely only extend their life a few years. They have approximately as good care as the US while spending half as much per person.

You know what, you are going to make mistakes. Just accept it and do the best you can. There is no reason why the ethics of transplants having some criteria based on how long the person can be expected to live cannot be discussed. Never will get a perfect system.

Just....... how is N.I.C.E or QUALY or etc applicable in this scenario however?

Unless you're restricting your comments solely to transplants, which a google search shows that the US does consider lifespan after transplantation to be a factor as it is.
http://www.ncbi.nlm.nih.gov/pubmed/9404965

There's....... ethical discussions about allowing age to be a major factor on a transplant list, that such factors are ageist and discriminatory. I think its an interesting tangent to discuss though.

I think the AMA guidelines here should be posted.
Regarding organ transplants
http://www.ama-assn.org//ama/pub/physic ... on216.page

(3) Full discussion of the proposed procedure with the donor and the recipient or their responsible relatives or representatives is mandatory. The physician should ensure that consent to the procedure is fully informed and voluntary, in accordance with the Council’s guidelines on informed consent. The physician’s interest in advancing scientific knowledge must always be secondary to his or her concern for the patient.

Note in particular section 1 which states

A prospective organ transplant offers no justification for a relaxation of the usual standard of medical care for the potential donor.

Another relevant section is this one.
http://www.ama-assn.org/ama/pub/physici ... on220.page?

although it obviously won't cover our scenario here.

[Simon_Jester]

Can you fail to read what I wrote any worse than you did, seriously?
Taking her off life support is, to the best of knowledge by the doctor, the will of the woman even if pregnant.

Not being harvested for organ donation is also the will of the woman. She may not have fully considered the situation, but in any case we should default to certain rules. Our options are:

1) Follow the will of the patient- mother is off life support, fetus dies, child needing transplant dies.
2) Preserve life by preserving the status quo- mother is on life support, fetus is hopefully carried to turn, child needing transplant dies.
3) Preserve life by intervening in the status quo- mother is chunked up for spare parts, fetus dies, child need transplant hopefully lives.

My argument is that in cases like this (2) is preferable to (3) as a rule. Trying to preserve life (in the biological sense) rather than ending lives in order to save others, is a better practice in general. In theory, the arithmetic of killing two patients to save three adds up and works out.

But in practice, it is not so good to have doctors who have made up their minds to routinely kill two patients if that's what it takes to save three, except in the most desperate of triage situations. That sort of mindset can result in doctors doing things posterity will consider horrifying, with good reason.

Now, maybe we should stick to (1) instead of (2). There are rule-utilitarian arguments for doing so. I am restricting my argument to the claim that (2) is preferable to (3). That yes, there is a difference between ending Life A to save Life B, and simply doing something to ensure Life A continues, regardless of what happens to Life B.

The U.K. has a rationing system where people might only live a few more years are not likely to get super expensive care when it will likely only extend their life a few years. They have approximately as good care as the US while spending half as much per person.

You know what, you are going to make mistakes. Just accept it and do the best you can. There is no reason why the ethics of transplants having some criteria based on how long the person can be expected to live cannot be discussed. Never will get a perfect system.

A sane person accepts that they'll make some mistakes, and deliberately limits their ability to make other mistakes. Precisely because they know their judgment and their system are not perfect, they do not try to make certain decisions, do not decide they know best when they obviously do not.

Because when you make a decision that X will live and Y will die, you're accepting responsibility for the death of Y, in a way that you are not doing if you just make no decision. Sometimes, you can know this decision was justified. In other cases you cannot, and in those cases, I think we should default to not trying to choose.

Discriminating between a 25-year-old and a 65-year-old on the transplant list can make sense. The difference between fifty and ten years of life matters a lot, so we can bump the 25-year-old to the top of the list. And to some extent people do that, which is why I said "to some extent this is already done."

But what if the older recipient is 45 and the mother of two, while the younger one is 25 and single? What if the older recipient is 40? 35? 30? What if the 45-year-old needs a transplant because of a viral disease that fried their liver, while the 25-year-old needs a liver transplant because of teenage drug abuse?

At some point, you have to have some kind of granularity in the system, to say "we cannot meaningfully judge whether A or B is more deserving, so any decision about whether A or B gets the organ is made on a first-come, first-served basis."

[PainRack]

But what if the older recipient is 45 and the mother of two, while the younger one is 25 and single? What if the older recipient is 40? 35? 30? What if the 45-year-old needs a transplant because of a viral disease that fried their liver, while the 25-year-old needs a liver transplant because of teenage drug abuse?

At some point, you have to have some kind of granularity in the system, to say "we cannot meaningfully judge whether A or B is more deserving, so any decision about whether A or B gets the organ is made on a first-come, first-served basis."

Drug abuse tends to get someone kicked off the transplant criteria...... I mean, Mr Friendly Guy posted that article about the Australian lady seeking a transplant in Singapore for a reason.

Its........ one of the quirks in MTERA(Medical, Therapy, Education, Research Act) where we allow someone to donate their body to someone else, be it for science or therapy, although HOTA still forbid the trading in organs.


A first come first served basis does raise other ethical issues though. Patients who have lived longer on the waiting list for kidneys may be worse off than patients whose bodies haven't been wrecked by dialysis yet for example. Ignoring quality adjusted life years entirely is in itself problematic.......

[PainRack]

Can't edit my previous post, so, here's the previous thread where Mr Friendly Guy created about liver transplant.
http://bbs.stardestroyer.net/viewtopic. ... t&start=25

[Jaepheth]

No longer hypothetical:

Attorneys: Brain-Dead Woman's Fetus 'Abnormal'
DALLAS January 23, 2014 (AP)
By NOMAAN MERCHANT Associated Press

The pregnant, brain-dead Texas woman being kept on life support over her family's protests is carrying a fetus that is "distinctly abnormal," attorneys for the woman's husband said Wednesday.

Marlise Munoz remains hooked up to machines in a Fort Worth hospital, while her husband and the hospital are locked in a court battle about whether to retain life support.

The case has raised questions about end-of-life care and whether a pregnant woman who is considered legally and medically dead should be kept on life support for the sake of a fetus. The case has gotten the attention of groups on either side of the abortion debate, as anti-abortion groups argue Munoz's fetus deserves a chance to be born.

Erick Munoz said his wife, a fellow paramedic, was clear with him before he found her unconscious on Nov. 26: If she ever fell into this kind of condition, pull life support. But John Peter Smith Hospital says it's bound by state law that prohibits the withdrawal of treatment from a pregnant patient, although several experts interviewed by The Associated Press have said the hospital is misapplying the law.

Munoz's attorneys, Heather King and Jessica Hall Janicek, issued a statement Wednesday describing the condition of the fetus, now believed to be at about 22 weeks' gestation. King and Janicek based their statement on medical records they received from the hospital.

"According to the medical records we have been provided, the fetus is distinctly abnormal," the attorneys said. "Even at this early stage, the lower extremities are deformed to the extent that the gender cannot be determined."

The attorneys said the fetus also has fluid building up inside the skull and possibly has a heart problem.

"Quite sadly, this information is not surprising due to the fact that the fetus, after being deprived of oxygen for an indeterminate length of time, is gestating within a dead and deteriorating body, as a horrified family looks on in absolute anguish, distress and sadness," the attorneys said.

Spokeswomen for the hospital and the Tarrant County District Attorney's office, which is representing the hospital in the lawsuit, declined to comment Wednesday.

A hearing in the case is scheduled for Friday. Munoz's lawsuit asks a judge to order the hospital to pull life support and return Marlise Munoz's body to her family.

Several experts have said the Texas Advance Directives Act doesn't apply in this case because Marlise Munoz, having suffered brain death, is legally and medically dead — a key argument in Erick Munoz's lawsuit.

Munoz previously told the AP he wasn't confident about the health of the fetus. His wife was 14 weeks pregnant when he found her unconscious in November, possibly from a blood clot.

I think in this case it's pretty clear the plug needs to be pulled; I find it odd the hospital is the sole holdout.

[Kitsune]

Saw a dishonest (as far as I can tell) "Pro-Life" sign - Baby's heartbeat begins at 18 days
Checked and it seems to be 6 to 8 weeks (42 to 56 days)