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Texas court orders brain-dead pregnant woman off life support

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A Texas judge has ordered that a brain-dead pregnant woman be removed from life support after her husband filed suit against a Fort Worth hospital for "cruel and obscene mutilation" of a dead body.

In a case that has captured national headlines and become a battleground for both sides of the abortion debate, state District Judge R.H. Wallace ordered John Peter Smith Hospital to remove the woman's body from a ventilator by 5 p.m. Monday.

Marlise Munoz, 33, was 14 weeks pregnant when her husband, Erick Munoz, found her unconscious on the floor of their kitchen on Nov. 26, possibly due to a blood clot in one of her lungs.

Although doctors at the county-owned hospital later told the husband that his wife was brain dead and would never recover, the hospital chose to keep her body on life support against the family's wishes, citing a Texas law that prohibits hospitals from suspending "life-sustaining treatment" on patients who are pregnant.

On Friday, lawyers for the husband argued in court that hospital officials had misread the law and said it did not apply to a corpse. They also told the judge that the now 22-week-old fetus was "distinctly abnormal."

[Updated Jan 24, 5:04 p.m. PST: Following the judge's decision, the hospital released a statement saying the JPS Health Network "appreciates the potential impact of the consequences of the order” and would consult with the Tarrant County district's attorney's office, which represents the hospital."

The Associated Press reported that hospital lawyers agreed in court documents that Munoz's wife did meet the criteria for brain death and that the fetus was no longer viable.]

In an affidavit filed in court Thursday, the husband said it was clear to him that his wife was no longer alive. 

"When I bend down to kiss her forehead, her usual scent is gone, replaced instead with what I can only describes as the smell of death," Munoz wrote in court papers.

Before Friday's hearing, demonstrators outside the hospital either demanded that the woman's body remain on life support so that the fetus could be kept alive or that the hospital "let Marlise rest in peace."

Just prior to Friday's court hearing, lawyers representing the husband released a statement to the media insisting the 22-week-old fetus was "distinctly abnormal."

"Even at this early stage, the lower extremities are deformed to the extent that the gender cannot be determined," lawyers Heather King and Jessica Hall Janicek wrote.

"The fetus suffers from hydrocephalus [water on the brain]. It also appears that there are further abnormalities, including a possible heart problem, that cannot be specifically determined due to the immobile nature of Mrs. Munoz's deceased body," the lawyers wrote.

"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 lawyers wrote.

Hospital officials had remained close-lipped about the matter, saying the issue was best decided by a court. 

Hospital spokeswoman J.R. Labbe told reporters initially that the hospital was following the law and standing by its decision.

The state law at issue, Texas Health and Safety Code 166.049, states that "a person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient."

Numerous legal and health experts, however, said that if in fact Marlise Munoz was determined to be brain dead, the law would not apply.

The term "brain death" refers to the irreversible cessation of all functions of the entire brain, including the brain stem, which controls autonomic functions such as breathing and heart rate.

By comparision, patients in a coma or vegetative state have full or partial autonomic brain function and may recover, although the chance of that decreases the longer the condition persists, according to physicians.

Erick Munoz has inisted in court documents that the  hospital's conduct has been outrageous.

"One of the most painful parts of watching my wife's deceased body lie trapped in a hospital bed each day is the soulless look in her eyes," he wrote in the court affidavit. "Her eyes, once full of the 'glimmer of life,' are empty and dead. My wife is nothing more than an empty shell. She died in November 2013, and what sits in front of me is a deterioriating body."

RELATED: Q&A: Can brain death be reversed?

Cases of pregnant women who are kept on life support after being declared brain-dead are rare. Researchers from Heidelberg University in Germany searched the medical literature for examples and found only 19 cases from 1982 to 2010.

Twelve of those fetuses were deliverd by caesarean section and survived for some period of time after birth. One of the babies, born prematurely after just 25 weeks of gestation, died of an infection at the age of 30 days. Six of the others were developing normally at the time the case reports were written.

The authors said that because the data were incomplete, there was no way to determine the liklihood that a fetus would survive after its mother suffered brain death.

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