In Texas and Canada, Lessons About Who Can—and Should—Make End-of-Life Decisions for Pregnant Persons

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Commentary Human Rights

In Texas and Canada, Lessons About Who Can—and Should—Make End-of-Life Decisions for Pregnant Persons

Andrea Grimes

The heartbreaking cases of both Robyn Benson and Marlise Munoz illustrate the need to defer to families and medical professionals, rather than bureaucrats and lawmakers, in making end-of-life decisions for pregnant persons.

Robyn Benson, the 32-year-old Canadian woman who was declared brain-dead after she collapsed while 22 weeks pregnant in December, was taken off of a ventilator on Sunday, the day after doctors performed surgery to deliver her son.

Delivered at 28 weeks, baby Iver Cohen Benson is “healthy,” according to his father, Dylan Benson. He told CBC, “Iver is healthy and is the cutest and most precious person I have ever met.” At the same time, he said, he misses his wife “more than words can explain.”

The Benson case has drawn inevitable comparisons to that of Marlise Munoz, the pregnant Texas woman who was kept on a ventilator against her, and her family’s, will for eight weeks by a hospital that said it had no choice but to obey a Texas law that bars the removal of life support from pregnant people. Munoz, however, was dead. Munoz’s husband, Erick, had to fight in court to compel the hospital to take his wife’s deceased body off a ventilator at the end of January.

The differences in the two families’ cases are, however, notable: Munoz collapsed at 14 weeks pregnant, well before the point of fetal viability. Benson collapsed at 22 weeks pregnant, on the cusp of fetal viability. Munoz’s family was prevented from carrying out her stated end-of-life wishes to not be put on a ventilator, while Benson’s family did not find themselves at odds either with Canadian law or with the hospital.

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But what both cases illustrate is the need to defer to families and medical professionals, rather than bureaucrats and lawmakers, in these heartbreaking situations.

Wednesday morning, CNN ran this medically inaccurate, not to mention redundant, headline: “Brain-dead Canadian woman dies after son’s birth.” If the Munoz case taught the wider public anything, it is that brain death is death; this was ultimately the reason a Texas judge compelled John Peter Smith Hospital to take Munoz’s body off the ventilator. A brain-dead Munoz couldn’t receive “life-sustaining treatment” because Munoz was already, medically, deceased.

Anti-choice politicians and pundits used the Munoz case to attempt to score political points with extreme right-wing voters, ignoring the reality of Marlise Munoz’s desire not to be kept on a ventilator and dehumanizing her in the process. Facebook commenters even accused Erick Munoz of being a murderer, and the anti-choice public continues to pit Erick Munoz against Dylan Benson, casting the former as a heartless killer while lionizing Benson. In reality, both men were faced with making unthinkable decisions, and both men did what they thought was right by their partners and their families. I believe we can trust both of these men, just as we, as average citizens, can trust ourselves to make these tough decisions without the heavy-handed direction of black-and-white laws written for very, very gray situations.

While CNN’s reporting was imprecise at best, and factually wrong at worst, we must recognize that there is room for nuance in the way we talk and write about these cases. Dylan Benson did not consider his wife dead, and because he was acting in what he and Robyn’s doctors believed was a responsible, ethical way, I believe we owe it to Dylan Benson to allow him to set the terms of the end of his wife’s life. If Dylan Benson says his wife died on Sunday, after doctors removed her from ventilators, Benson is right; equally right, however, are the medical professionals who considered her deceased when she was diagnosed with brain death.

I believe in the average person’s ability to make compassionate, informed, good-faith decisions for their loved ones in these terrible and tragic situations. I do not believe that any given legislator, bureaucrat, or government entity would have known better than Dylan Benson, or Erick Munoz, how to handle a complicated, heartbreaking, and very personal situation involving brain death and pregnancy.

And evidence suggests I’m not alone. While people moved by Benson’s story have donated around $144,000 to help Benson get started in his life as a single father, Erick Munoz also saw a similar outpouring of aid—in the form of money, but also items like diapers and other child-rearing necessities for his son Mateo. What this tells me is that folks do indeed see the gray areas, trusting families to make hard decisions according to what they believe and know about their loved ones—whether that decision is an attempt to sustain a pregnancy, or a decision to end one.

Which illustrates precisely why prescriptive, nuance-free laws, like the one in Texas that John Peter Smith Hospital used to keep a dead Marlise Munoz on a ventilator against her will, are not only cruel, but also not reflective of the way voters and taxpayers believe these situations should be handled.