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Recent stories highlight issue of end-of-life care, medical preferences

There has been a lot in the news of late regarding tragic stories involving difficult end-of-life situations. Los Angeles readers have by now probably heard of the sad story involving Jahi MaMath, a 13-year-old California girl who ended up brain-dead as a result of complications from a tonsillectomy at Oakland Children's Hospital. McMath's situation involved a legal battle between the hospital and the family over whether to keep her on life support. Because she was declared brain-dead, the hospital was not required to do so. The girl ended up being kept on life support and was eventually released to her family.

Then there is the story of Marlise Munoz, a 33-year-old Texas woman who ended up brain-dead after collapsing on her kitchen floor last November. At the time, she was 14 weeks pregnant. In her situation, although her family wanted to honor her last wishes and remove her from life support, hospital officials argued that state law prohibited them from doing so because she was pregnant. The fetus, though, was agreed to be non-viable. Eventually, her wishes were honored. 

Another story involves a situation similar to that of Munoz, except that the brain-dead Canadian mother carries a child who is viable and whose husband wants to keep her on life support until her baby can be delivered.

Each of these stories is a reminder of the complications that can arise in end-of-life care and the legal implications of a patient's wishes regarding medical preferences. The Munoz case highlights in particular the clash between public policy and a patient's wishes.

In our next post, we'll continue exploring this topic, and offer some thoughts on livings wills and advance health care directives as documents to include in the estate planning process. 

Source: Huffington Post, "Here's Where Your Living Will Can Be Ignored When You're A Pregnant Woman," Alissa Scheller & Katy Hall, January 8, 2014. 

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