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Munoz had collapsed from a possible pulmonary embolism on Nov. 26 and was taken to JPS. She was 14 weeks’ pregnant. Two days later, the hospital determined that Munoz “met the clinical criteria for brain death.” That’s when Munoz’s tragic story should have ended. After all, Marlise had told family she did not want to be artificially kept alive. Accordingly, her husband, Erick, requested that she be taken off life support.

But the hospital refused the request, citing the Texas Advance Directives Act, because Munoz was pregnant.

The Texas Advance Directives Act is a 59-page law that offers guidance on matters related to what should happen if you become so ill you can no longer make decisions about your care. Modeled after a 1977 California law and combining three Texas laws - the Natural Death Act, the Out-of-Hospital Do-Not-Resuscitate law and the Durable Power of Attorney for Health Care law - the 1999 statute contains remedies for all types of scenarios. There are pages of definitions and options for transferring to another provider if a doctor or health care facility feels unable or unwilling to comply with a directive.

In those 59 pages, there is just one sentence - Section 166.049 - that addresses pregnancy: “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.”

Although their “patient” was no longer alive, JPS administration decided there was enough ambiguity in that sentence to refuse the family’s request. They said clarification from the courts was needed. Friday, District Judge R.H. Wallace gave it, ordering the hospital to declare Munoz dead and to remove her from life support. To its credit, the hospital accepted Wallace’s ruling and chose not to appeal.

An appeal would have pushed the fetus perilously close to the threshold for viability, which could have complicated matters even further and sent the case into a legal rabbit hole from which the distraught Munoz family might not have emerged for months.

By accepting Wallace’s ruling, the hospital not only provided much-needed closure to the family, but just as important, allowed the ruling to become case law that will set precedent for other such cases, however rare they may be.

This newspaper applauds the hospital’s decision. We also urge the Legislature to revisit and clean up the wording of Section 166.049 in 2015 so that there’s never again a question of whether a corpse is a mother-to-be.


San Antonio Express-News. Jan. 25, 2014.

A needed fix to the Voting Rights Act

The anti-democratic tactics that motivated the Voting Rights Act in 1965 have morphed into methods cleverly camouflaged but with the same discriminatory effects. The act is still all too necessary.

The U.S. Supreme Court in June gutted a key provision of the act.

Texas is the poster boy for why that was to civil rights what a jack hammer is to a block of concrete. Freed of the need to get changes in voting law precleared - because of its history of thwarting minorities at the polls - Texas quickly put its voter ID law into effect. This, despite a federal court ruling that the law intentionally discriminated. It then rushed the Legislature to approve allegedly new-and-improved redistricting maps, which were substantively based on plans another court said also discriminated.

The haste was opportunistic, dismissive of court judgment and motivated by a desire to entrench partisan political power. But, when a 5-4 Supreme Court ruling struck down the section of the act that spelled out the formula for which states were subject to preclearance, it allowed as how Congress could remedy this.

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