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Tuesday, January 28, 2014

Decisions and Regret

 

 

Upon the red table, with the spread-eagled captain’s body empty, new hands began a fight of motion. Into the wet interior were placed organs of copper, brass, silver, aluminum, rubber and silk; spiders spun gold web which was stung into the skin; a heart was attached, and into the skull case was fitted a platinum brain which hummed and fluttered small sparkles of blue fire, and the wires led down through the the body to the arms and legs. In a moment the body was sewn tight, the incisions waxed, healed at neck and throat and about the skull – perfect, fresh, new. The captain sat up and flexed his arms…
                        - The City (Ray Bradbury, The Illustrated Man 1951)

 

There’s a John Varley novella that I reread every couple of years.

It’s a terrible terrible tale, this story.

Not terrible in that it’s badly told or poorly written (Varley is incapable of either sin), no, rather Tango Charlie and Foxtrot Romeo is terrible in its vision.

On the surface, in simple black and white terms, Tango Charlie is a rescue story describing efforts to save a little girl living in a doomed space station.

Underneath, it’s a detailed exploration at the foreseeable edge of social ethics and the terrible morality of gambling the life of one dying child against the lives of others, both children and adults. The story is less about right and wrong, black and white, and more about the shadowy gray area in between those two poles. It’s about personal choice.

That’s the real business of speculative fiction, you know, to explore the human experience and its place in the universe, to look ahead and to the sides and into the past, to seek answers before most of humanity even knows there’s a problem.

The job of people like Varley is to ask one simple question: What if?

What if? And then to chase after the answers for as deep as the rabbit hole goes.

What if it was possible to keep a body running long, long after the person inside has died?

I won’t give away what happens, but a subplot to the main story involves a computerized mechanical sawbones – which today is a lot less far-fetched than the idea was in 1986 when the story was written: 

She was dead, of course, by any definition medical science had accepted for the last century. Someone had wired her to a robot doctor, probably during the final stages of the epidemic. It was capable of doing just about anything to keep a patient alive and was not programmed to understand brain death. That was a decision left to the human doctor, when he or she arrived. The doctor had never arrived. The doctor was dead and the thing that had been Charlie's mother lived on […] All of its arms and legs were gone, victims of gangrene. Not much else could be seen of it, but a forest of tubes and wires entered and emerged. Fluids seeped slowly through the tissue. Machines had taken over the function of every vital organ. There were patches of greenish skin here and there, including one on the side of its head which Charlie had kissed before leaving…

A rotting corpse, dead by any reasonable standard you’d care to employ, given a macabre illusion of life by mindless mechanical fanaticism and through a perversion of technology designed to save life, not to prolong death.

On the pages of a science fiction novel it’s an interesting exercise in What If? But in reality? In the here and now? It’s a travesty.

Every time there is yet another one of these horror shows, like the grotesquery that finally, finally, came to a conclusion last Sunday evening in Texas, I am forcibly reminded of that passage, of that stiff green tinged corpse from Varley’s Tango Charlie and Foxtrot Romeo moldering for thirty years in a ghastly imitation of life under the inflexible attention of a dogmatic agency too stupid to know when to let go.

Nothing, and I mean nothing, exposes the morally bankrupt hypocrisy of the right-to-life zealots like the case of Marlise Muñoz. 

On November 26, 2013, Muñoz, three months pregnant, awoke in the middle of the night.

She got out of bed and went into the kitchen to warm a bottle for her son, a toddler. 

After a while, her husband, Erick, realized she hadn’t returned to bed.

If you’ve been married for a while, you know how this goes. You wake up and the other side of the bed is empty. You vaguely remember your wife getting up quietly in the dark. You thought, if you thought about it at all, that she was just going to pee. Pregnant women, right? (and middle aged men, for that matter). But she’s been gone too long, you know something’s not right. You wait for a while, figuring she’ll be back in a bit. But it goes on, the absence, and on. Eventually you get up to see what’s wrong. You’re expecting what? She’s sick maybe, morning sickness. So you listen for the sound of retching from the bathroom, check to see if there’s light under the door, trying to remember if there’s any Ginger Ale in the fridge – knowing that it’s your job as the husband to run down to the 24-hour store if there’s not. But no, she’s not throwing up in the bathroom. So,  perhaps it’s the kid. Nightmare, loaded diaper, colic, earache, it’s always something with kids.  You expect to find her in the nursery, rocking the child back to sleep. You’ll smile, she’ll roll her eyes, quietly, and damn but don’t you love that image? But she’s not there either and the kid is sound asleep. You start to really worry now, but you know you’re just being foolish. It’s just insomnia. You know how pregnant women are, sure, she was laying there, watching the red digits of the clock count away the minutes, wide awake, so she got up and went into the living room to read or surf Facebook on her laptop. You’ll ask her what’s wrong, nothing she’ll say, couldn’t sleep, didn’t want to wake you, go back to bed.

But she’s not sitting on the couch either.

Instead, Erick Muñoz found his wife collapsed on the kitchen floor.

She wasn’t breathing. She had no pulse.

She was, in blunt point of fact, dead.

She was dead by every clinical definition you’d care to name.

She was already dead when Erick Muñoz awoke and realized something was wrong and went stumbling through the darkened house looking for his wife.

Muñoz was a trained and experienced paramedic, he’d seen it before, hundreds of times.  Medics, doctors, cops, soldiers, firemen, emergency workers, they’re trained to deal with these things in a detached and professional manner, but you never expect it to be your spouse, the love of your life, the mother of your children, laying there lifeless on the kitchen floor.

Muñoz frantically called 911 and started cardiopulmonary resuscitation.

But he knew, as a medic he had to know, what the blue color inside her lips and under her nails meant. Severe oxygen deprivation. He knew, as he bent down to breathe life back into her body, what the slack cooling lips under his meant.  He could feel that her heart wasn’t beating. Her bowels would have let go, along with her bladder, you can smell death. Her skin would have been slack, her eyes already clouded and lifeless.  He knew what it meant … and what it meant for the baby she was carrying.

He had to know.

There was absolutely no way that he could not know the horror of what it meant: she’d been dead for a long time, at least 30 minutes.  Too long.

Now, human beings have been successfully revived after 30 minutes of clinical death. In fact, the record for a successful resuscitation is a bit over three and a half hours, but that was for a victim who was severely hypothermic (immersed in ice water after falling off a ship). The success rate for anything over a couple of minutes at normal temperatures becomes less and less likely with every passing second outside of very special conditions. The body, the organs and limbs, might remain viable, but the brain suffers massive irreversible damage at normal temperatures when deprived of oxygen. It doesn’t take long at all for the brain-stem to die, cutting the brain itself off from the body. At that point, no matter what you do, the heart and lungs and the rest of the vital organs will never work on their own again. At that point, when the brain dies, you, the person, you’re dead and there isn’t any coming back.

As a paramedic, Erick Muñoz would have known that. He would have been thinking about just exactly that – how long had his wife lain there without breathing? without a heartbeat? He would have certainly thought about that while he worked feverishly to save the two beloved and precious lives under his hands, while he waited for the ambulance to come as each frantic second ticked past.

By the time Marlise Muñoz reached John Peter Smith Hospital in Fort Worth, it was far too late.

She had been dead too long.

Pulmonary embolism, the doctors say, a blood clot that blocked a critical artery and stopped her heart.

No warning. No time to unsay all the things he wished he hadn’t said, you know, like people do.  No time to say all of those things a husband wishes he would have said to his wife, that he always meant to say but never did. No time left to do all of those things they planned together. No chance for a child to see his mommy one last time. No chance to say goodbye.

Erick Muñoz went to bed a husband and woke up a widower trapped in a nightmare.

Just bang, blood clot, and gone.

A tragedy.

A horrible, horrifying tragedy.

Marlise Muñoz was not in a coma. She wasn’t in a vegetative state. She was dead. Her brain had died. You can argue about the nature of consciousness all you like, you can ponder the existence of the soul and what might wait behind this mortal coil, but whatever we are at the fundamental level we are electrical impulses firing in a block of meat. And we can measure that to a fine degree. When those sparks no longer pulse between neurons, we, whatever we are, are no longer here.  There was absolutely no doubt about it. Marlise Muñoz was dead.

This isn’t my opinion, this is the clinical diagnosis of her doctors, this is the consensus of more than a millennium of science, this is even the conclusion of religion.

And yet, through the application of modern technology, her body still lived … after a fashion.

And there it is. Right there.

That single terrible moment. That single terrifying, horrible, hideous, despairing lonely moment when there is no longer a chance, when hope and prayer are exhausted, when you are left alone and bereft and there’s nowhere left to turn, and  you realize that it’s now up to you, that they are looking at you, and you, you, have to decide.

And so Erick Muñoz did, he decided.

As a paramedic, as a husband, as a father, he knew. He knew what he was doing. He knew what it meant. He knew what was right for his wife and what was right for their unborn child. He knew. And he decided to pull the plug because for him, for them, it was the right thing to do.

And that was his right.

More, it was his duty to make that decision. Not yours, not mine, his.

There comes a moment when it’s just you. When it’s your decision. When the entire universe rests on your shoulders. And so it was for Erick Muñoz that day. It was his decision. His duty. Not yours, not mine, not the mob’s. Not the hospital. Not the church. Not the government. His. Period.

I’ve been there. Right there.

You see, last summer I watched my father die.

My brother, my mom, and I, we made the only call we could – others might have decided something else, but it wasn’t their decision to make. It was ours. It was our right, our duty, it fell to us to decide. Not you, not the government, not even the doctor, us.

And so we did, we decided, each of us, separately and together: pull the plug.

And then we stood there at his bedside in the ICU as they turned off the machines, as he pulled in his final ragged breath and then was still at last, and it was horrible.

I served in the military for more than twenty years. I served in two wars and numerous actions short of war. I’ve risked my own life and ordered men to risk theirs. I’ve seen men die in terrible ways. But not like that. It was the hardest, most horrible thing I’ve ever done and I don’t wish it upon my very worst enemy. I never dream of war, but I wake at night sometimes and think of that final moment at the side of my father’s deathbed. And the pain never goes away.  But we had to do it.  We had to. Because, for my dad, it was the right thing to do. You couldn’t decide that. You couldn’t know that. You couldn’t tell right from wrong in that particular case, you didn’t know him, you didn’t love him. Only we could decide, it was on us, his family, and us alone.

Could we have decided differently? Was there really a choice?

They could have kept him alive, his body anyway, maybe even some of his mind. Maybe. The machines could have kept his blood oxygenated and flowing, once a day they could have taken him down for dialysis, they could have kept the dozens of IV’s going. They could have fed him through a tube and carried away his waste.  Certainly they could have kept him going, drugged and without pain. His body might even have lived on to this very day, many months later. 

But what about him? His mind? I don’t know, maybe, in a drugged haze of dim awareness perhaps, unable to speak, unable to move, unable to live. Spread out and pinned down like a science experiment, half machine, half rotting meat. Despite multiple organ failures, despite the fact that he couldn’t breathe, despite the fact that his kidneys would never work on their own again, despite the heart damage, despite the fact that he would likely never really wake up again, not really, sure they could have kept him going. Despite the fact that when he was alive he told us many times that he didn’t want to end up a vegetable animated by clockwork and wires. Despite all of that, they could have kept him alive … after a fashion. Warehoused in some care facility, I guess, and I wouldn’t have to wake up in the night with tears in my eyes. 

He didn’t leave a living will, so we could have decided differently.

But he didn’t need to, he had us. And we knew what was right, what was moral. We loved him dearly and so we decided. We did what was right, for us, for him.

We decided to let him go.

We decided to turn off the machines because to do anything else would have dishonored the wonderful marvelous man he was and all of the memories of our lives together.

Because keeping his body plugged in wouldn’t have been for him, but for us.

Because to do anything else would have been pure selfishness.

And so, we decided to let him go.

Just as Erick Muñoz decided for his wife.

Just as Erick Muñoz decided for his unborn child.

 

There is no decision more excruciatingly painful, more terrible, more horrifying, more hideous, more personal. None. Period.

 

Not a day goes by that I don’t wonder.

If we’d waited another day, maybe, maybe some miracle – and that’s what it would have taken, a genuine no kidding divine miracle from upon high, a miracle that I don’t believe in. But, maybe just this once, just maybe, if we’d only waited, my dad might have recovered. You always wonder. You wake up in the middle of the night and stare at the ceiling and you think about your own mortality and hope that your son never has to make that hideous decision and you wonder.

What if?

What if there was a chance?

In the cold light of day, I don’t think so.

I don’t think we did the right thing, I know it.

But still, maybe, just maybe…

It’s natural to feel regret, to wish without hope that the past can be altered by sheer desire, that we can bring our loved ones back from the abyss.

It’s normal to regret the hard, hard decisions you’ve had to make.

And I do.

I do regret what I had to do, but it’s my regret, mine and mine alone. Not yours, not the government’s, not the doctor’s, and most certainly not some howling mob of selfish sons of bitches who think they have a right to intrude into my life, into my pain, and to take my regrets from me. Those regrets are mine and I cherish them even though the pain is terrible.

Those who condemned Erick Muñoz for his decision are like the robot described above, dogmatic, unthinking, inflexible in belief, and utterly inhuman, just following the program. The difference is that a machine can only do what it’s programmed to do, it has an excuse, it does what it does not out of selfishness because it can’t do anything else.

A machine also can’t be a hypocrite.

But those who shed crocodile tears for Marlise and Erick Muñoz’s unborn child certainly can be.

Almost without fail, those who condemned a grieving husband as a murderer and a monster are the very same, the very same, people, the very same governments, and the very same institutions who vehemently oppose research into the very technologies and treatments that might one day actually save and repair such terrible damage. They see nothing wrong with turning a rotting corpse into an incubator for a monstrously malformed fetus, but gasp in horror and scream “Frankenstein!” when it comes to organ cloning, genetic manipulation, fetal tissue and stem cell research.  They demand that this poor child be born, no matter the terrible toll on those who loved it, no matter the damage, no matter the wishes of the parents, and yet these are almost without fail, the same, the very same, people who vehemently oppose social programs such as government funded prenatal/postnatal healthcare and nutrition programs, who derisively label SNAP and WIC as “socialism” and “communism” and who can’t discuss sex education without including the word “Nazi.” These are the very same people who sit smug and pious in their pews each and every Sunday and listen to the words of their prophet who commanded them to feed the hungry, heal the sick, clothe the poor, and to do unto others as they would be done unto themselves, yes those people, these are the very same selfish sons of bitches who daily turn a blind eye and a sneering averted cheek to the sick and the hungry and the destitute – calling them lazy and entitled instead. In a state that repeatedly threatens to secede from the Union over the matter of individual rights and supposed government overreach, these are the very same people, the very same people, who would take away Erick Muñoz’s right to decide and award that duty to the government, to the court, to the mob, to people who never knew Marlise Muñoz as anything other than just another front in their bankrupt and selfish war.

But it’s not their right.

It’s not their decision and it never was.

Texas Lt. Governor David Dewhurst declared on Sunday, “I’m a strong believer of the sanctity of life. This baby could have been born. If I had been in that judge’s shoes, I would have ruled differently.”

The sanctity of life? The sanctity no less. Life. The Lt. Governor of Texas, a state that has executed more than three hundred people in the last decade and is considering a return to the electric chair in order to save money on execution drugs, proclaims the sanctity of life? That’s rich.

Dewhurst is running for reelection, one of his main opponents is State Land Commissioner Jerry Patterson, who weighed in with, “It’s a tragic intersection, the right-to-life concerns and when life ends. We should always err on the side of life. I think we have to change the law.”

Change the law in support of life … by mandating that a corpse be kept on maintenance until the state, or the church, decides otherwise. Right to life, he says, and when life ends. Not only do these people want to control how life begins, they want to decide on when it ends – but, sure, you can trust people like this to leave what comes in between the beginning and the end alone, right? Leave life up to you to decide how to live it. Sure. You go right ahead and believe that if you like.

State Senator Dan Patrick, also a contender for Lt Governor, said, “Life is so precious. There is nothing more precious than the life of a baby in the womb. We are born in the image of God. Whenever we have the opportunity to preserve life, we should.”

Ah yes, God.

The image of God, he says. Preserve life, just like God, you bet.

That would, of course, be the same God who, what? Killed every first born child in Egypt to make a political point? The God who by His own word, drowned every single human being on the planet, less eight, in a fit of pique and for nothing? That God? The one that sent Marlise Muñoz a blood clot as a baby shower gift? Is that the God we’re talking about here? Because if that’s the case, and if you really believe in this stuff, then it would appear on the face of things that Patrick’s God has made His decision brutally apparent: pull the plug. That’s what He did right? Pulled the plug and left Muñoz dead on the floor of her kitchen. Left her surviving son motherless and her husband horribly alone. If you believe in signs and portents, I honestly don’t see how it could get any clearer.

And that wasn’t enough, was it? Then He sent in a bunch of fanatics to torture this poor man for two and half months.  Because, why again?

You want to look up these right-to-lifers’ stance on guns? On military force? On the Texas death penalty? On WIC and SNAP and social programs to feed the hungry, heal the sick, and clothe the poor?

Tens of thousands of children die every month. They cough out their lives on parched ground, starving, diseased, destitute, abused, poisoned, the victims of war and conflict and neglect. They die in the millions every year, unknown and unlamented, here and abroad. Meanwhile, these right-to-life fanatics protest outside a hospital in Fort Worth, Texas, they intrude into the grief and personal tragedy of a stricken family, smug in their morality over one tiny death out of millions, believing that they’ve actually done something worthwhile.

Sanctity of life my ass.

They’ve done nothing, not one goddamned thing other than feed their own diseased egos.

This isn’t about life, it’s about them, it’s about their guilt at their repeated and deliberate failure to live up to the tenets of their own belief, their abject refusal to feed the hungry, to clothe the poor, and to heal the sick. These people aren’t in it for Marlise Muñoz’s unborn baby, they’re in it to make themselves feel better and make no mistake about it – because if they weren’t, if they really truly actually believed in the sanctity of life, well then they’d actually do something about the lives they could save.  All of them.

 

This wasn’t our decision.

This most certainly wasn’t a decision for a politician.

This wasn’t the government’s decision.

This isn’t the press’ decision, or some ad hoc group on Facebook, or the mob’s

This isn’t the church’s decision, and it most certainly isn’t God’s decision – should he in fact actually exist and give a good goddamn about his creation.

For Erick Muñoz, there is no right or wrong, for him there is only grief and loss and tragedy.

Whatever his decision, it was the right one, because only he could make it.

This was his right, his duty, his burden and his regret.

His and his alone, as a husband, as a father.

Nobody else should get a vote.



Note about commenting: Due to the nature of this essay, and the inevitable lunacy it will no doubt attract (has already attracted) comment moderation is on and will remain so.  I will review each comment before allowing it to post. Stonekettle Station isn’t 4-chan, or The Blaze, or Yahoo News, or any other capering monkey shit-fight, so don’t act like it is. You’re entitled to your opinion but you’re a guest here and you’ll damned well behave like a rational adult or you’ll get a boot in the teeth. This is non-negotiable and I don’t care if you don’t like it.  If you want your comment to post, adhere to the following guidelines:

Edit: Since it’s glaringly apparent that evangelicals, anti-abortion nuts, and other such shrill fanatics have trouble with reading comprehension, as the roughly 200+ and counting discarded comments from such can attest, I’ve taken the liberty of bolding the relevant commenting criteria below. Take heed:

1) Don’t be an asshole. Be polite. Be well spoken. Use proper punctuation. The ability to spell and assemble a sentence to the 8th grade level is also appreciated.
2) Keep your religion to yourself. I won’t be proselytized nor will I allow you to preach at my readers, not in any way whatsoever, period. If your God is offended by something I said, he/she/it is welcome to contact me directly, I don’t need you to act as an intermediary.
3) Any comment that includes the word “abortion” will not post. Repeat: It. Will. Not. Post. REPEAT: IT. WILL. NOT. POST.
4) Personal attacks will not post. I don’t care if you think I’m a (insert your favorite insult: Nazi, Commie, Satan Worshipping Baby Murderer, Pinko Liberal Fag), I don’t care.  I. Don’t. Care. So don’t bother. You may assume that I’ve heard it all before by better people than you. 

Hope that clears things up.

Also, if you mention abortion, your comment will NOT post.

//Jim

259 comments:

  1. Every once in a while, Jim, I don't cheer or chuckle at your essays. Now and then you fail to entertain or enlighten me and choose instead to hit me right in the gut.

    Many or most of us - I'd venture to say virtually every family at some point - has faced or will face a choice like Mr. Munoz faced. And it's a very brutal, stark and *personal* decision every goddamned time.

    I follow this blog because of your writing and sensibility Jim, but I thank you simply and particularly for your passion and eloquence today on this subject.

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    1. I was sitting here after reading this post and trying to think how to say what I wanted -- so I clicked over to the comments. Tom said it all for me.

      Thank you, Jim for putting into words the thoughts of many of us who have -- because of our age and experience -- to think about having to make this very difficult decision at some point for ourselves, a spouse, or a parent or child.

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    2. I agree. Thank you Jim for the blog and Tom for for the comment.

      I will add only my own PERSONAL opinion, which is not Jim's or Tom's, as follows:

      Texas again. It figures. Got to be something in the water.

      Delete
  2. Yup...

    re, your father... very sorry... I was in the same position myself with my father just last September... it never goes away...

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  3. Well said, Jim. I've stood where you did, and turning off the machines keeping *my* father alive was as horrible, and impossible, and necessary, as you say. I remember it as if it were yesterday, and the pain of it is still sharp, though in reality it was over three decades ago now. The *only* people who have a right to make such a decision are family.

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  4. Jim once again your words are more skilled and eloquent than mine can be in a thousand years. Your point is so painfully eloquent.

    My Sincerest condolences on the loss of your Father, and on having to go through that experience.

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  5. Nick formerly from the O.C.January 28, 2014 at 6:22 PM

    Damn but this is one of your best ever. We had to "pull the plug" on my father -- thank the Lord he had given us power of attorney and had left strict DNR orders. Made our decision much easier to make.

    I agree with every point you wrote, including the compliments to John Varley, one of the greatest SF masters.

    Re-reading this, I see I sound like one of your minions. So be it.

    Damn good post, damn good points.

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  6. Thank you for putting words to my pain.

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  7. This one touched a bit close to home for me.

    My mom is not quite at the point where I have to make the big decision, but I have been mentally preparing for that day since the accident that put her in a semi-coma three years ago.

    She can somewhat make an occasional sentence. She sometimes opens her eyes. She squeezes my hand. To me, there is still life therein.

    To her best friend, I should pull the plug to "end her suffering." Except there is no plug to pull. She's not brain-dead.

    Thank you for this sir. Give me 20 minutes to man up after reading this one. ;)

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  8. Stunningly powerful essay. That's about all I can say.

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  9. My husband died in 02. From ALS. He chose not to get a feeding tube or a ventilator because he didn't want me to have to provide 24/7 care nor did he consider having those interventions to be living. This, despite not being brain dead until his lungs failed after 3 years of progressive peralysis. I still feel guilt over many things, including maybe encouraging at least the feeding tube. But it was HIS decision. In TX, all DNRs by pregnant women are null and void by state law.

    In the pursuit of holier-than-thou, no one is safe from the religious, control freaks in power, especially women.

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  10. Passionate, caring and thoroghly convincing. Thank you.

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  11. Damn skippy. Truer words...

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  12. I knew there were reasons to like you a lot. As a retired nurse,well,people have no idea what horror stories are linked to forcing people to live. I used to force people to live [restraints,tubes] at their pious family's demand. I will feel like a monster the rest of my life. Thank you for stating this so well.

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    1. I have great respect for anyone who has to face this and do this. Blessings.

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    2. Jim, this is the truth as I see it; too many people let their sentimentalism over an 'innocent life' take over their reasoning. From the time that the baby's mother died, there was no chance for the child. This whole charade merely prolonged the agony, and it is wrong and shameful to do so. In other words, thank you. I agree with you.

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    3. @Sharon Ellis: a member of the hospital's board successfully forbid abortions in 1988. I suspect the point of this whole torture session was to keep the fetus alive up until viability so they could deliver it and declare victory; they almost made it. I found it interesting (by which I mean appalling) that only after the fetus was determined to be profoundly damaged that the hospital gave in.

      Delete
  13. been there done that, it sucks. I agree with you 100%

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  14. I also meant to add my heartfelt, "Thank you, Jim!" for this wonderful essay and for your blog: a light of sanity that inspires and encourages me in these times of creeping US, political inanity. (Which, not coincidentally, rhymes perfectly with Hannity.)

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  15. Wow, just wow. We all have to make tough decisions in our lives, no one makes us make them, we just do it. Then we live with it as best we can. Thanks Jim for your insight.

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  16. You Sir, I am grateful for your voice and your truth. We are all richer for your strength in writing and for sharing clarity.

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  17. Yes. And WHAT THE HELL IS WRONG WITH THESE PEOPLE?

    Dr. Phil

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  18. Went through this with my father, my mother and my father-in-law. Thank God they all had living wills which took the decision out of my hands, Thanks for bringing this subject to the forefront.

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  19. Absolutely correct, particularly in your description of those Texas pols.

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  20. Once again, nail head hitting achieved. Excellent, if extremely painful, piece.

    Please don't lump all of us Texans together, though. Many of us actually have brains, and revere personal rights and are working to get people like Dewhurst, Cruz, and Abbott out of office.

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  21. Well-written and this needed to be said. Eloquent and passionate. Thank you.

    Leslie

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  22. I live in Texas and read this in Fort Worth (on a business trip). You have nailed so many of the things that sadden (and horrify) me about my home state. Thank you for saying it all so very well.

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    1. Have to help us change it. I've been working with BGTX, my mom raised me in Weatherford.

      I'd *really* like to know how the press got wind of their story. Likely someone combing the court reports or Mr. Munoz reached out seeking support but I'm still curious.

      This "case" has had me fit to be tied since I first learned of the situation.

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  23. We didn't have to "pull a plug" as much as my family had to decide not to plug anything in to begin with after my mother's (massive, yet not quite fatal) stroke. She had enough awareness to respond to yes/no questions and made it clear that she did not want mechanical support. We were lucky to be able to bring her home, celebrate her life over a final weekend, and she slipped away early on a Monday morning.

    I followed the Muñoz case with great sadness and no small amount of anger. You hit the nail right on the head with the hypocrisy of citing the sanctity of life while so very many policies of the state of TX, and the individuals who preach it, violate it in so many ways,

    And the one unaddressed question in all of this, crude as it is, is that of money. The costs of keeping this woman on artificial life support for those 7 weeks has to have been astronomical. As it was done against the family's will, will the hospital bill them for it? Is the state footing the bill? Is the hospital just going to absorb the costs? Billing the family *should* be unconscionable, but I can see it happening. And the killing irony of spending hundreds of thousands of dollars to keep a dead woman alive enough to serve as an incubator while gutting children's health support, education, and dozens of other programs is enough to make one physically ill.

    I'm glad I escaped the state. There are times I wish I could escape our greater culture.

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    1. This had been my thought too. Once the family's rights had been shoved under a bus and the woman's body enslaved by the state, you'd think... at least those of us with logic, compassion and sanity would think... that the state would therefore assume ownership of the bills too. I doubt this will happen. I can see the Munoz family being driven into bankruptcy over this. It is beyond shameful.

      Another result of this could very well be people in similar situations NOT contacting 911 or otherwise seeking treatment for their ill relatives, for fear of similar treatment and financial ruin.

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    2. Well put! The amount of money wasted on dead-end treatments is mind- boggling and senseless.

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  24. Thank you so much for your voice of sanity and reason. I see I am not alone in my reaction to this essay.

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  25. Totally with you. I am a Texan, and I am constantly astonished at how my supposedly freedom-loving neighbors believe that cases like this are where the government gets to step in, with someone else's religious beliefs yet, and tell an individual or a family what is right for them. It revolts me and it always has.

    A lot of things horrify me about this case, but the thing that really sticks in my nightmares is the idea that if the so-called conservative politicians change the law on this here, it would seem they want to change it so that if a woman in Texas is found dead, she immediately must be pregnancy tested and hooked up to machines that will attempt to turn a beating heart cadaver into an incubator. There is nothing good, right, or godly about something like that. It makes me sick to think of it.

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  26. Holy fuck.

    Not my father, my brother, and I didn't make the decision, just drove like demons from hell were chasing me to be there when he died. Dunno if he knew me. I miss him.

    My parents are on the slippery slope, with lots and lots of medical talent around to decide dead-or-alive, and I dunno if they've got living wills or anything. After my brother, I've got one, and a strong-minded friend with my healthcare POA.

    And I'm reading this and crying my fucking eyes out.

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  27. Jim, my God is not offended. Neither am I. I think this was exceptionally well-written, and I thank you for it.

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  28. We didn't have to "pull a plug" as much as my family had to decide not to plug anything in to begin with after my mother's (massive, yet not quite fatal) stroke. She had enough awareness to respond to yes/no questions and made it clear that she did not want mechanical support. We were lucky to be able to bring her home, celebrate her life over a final weekend, and she slipped away early on a Monday morning.

    I followed the Muñoz case with great sadness and no small amount of anger. You hit the nail right on the head with the hypocrisy of citing the sanctity of life while so very many policies of the state of TX, and the individuals who preach it, violate it in so many ways,

    And the one unaddressed question in all of this, crude as it is, is that of money. The costs of keeping this woman on artificial life support for those 7 weeks has to have been astronomical. As it was done against the family's will, will the hospital bill them for it? Is the state footing the bill? Is the hospital just going to absorb the costs? Billing the family *should* be unconscionable, but I can see it happening. And the killing irony of spending hundreds of thousands of dollars to keep a dead woman alive enough to serve as an incubator while gutting children's health support, education, and dozens of other programs is enough to make one physically ill.

    I'm glad I escaped the state. There are times I wish I could escape our greater culture.

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  29. My great-grandfather was being kept semi-alive on machines after he (refused) to come out of a gall bladder surgery. (No, really. He refused. When he came to, his blood pressure spiked so high they had to put him back under. Twice. Then he refused to breathe when they took the tube out, so they had to re-entubate him. Three times. He wanted to go)

    My mother, the one with his POA, found out and put on a whole show and kept him on the machines, despite his DNR (granted, the docs were unsure if the unique situation qualified for the DNR). It took, literally, all of his surviving children and a threat to call the news before they agreed to let him go.

    Since then, relationships with my mother have been strained, at best. That level of selfishness is just disturbing to everyone else in the family. The man, quite literally, chose his death, who were we to ignore his wishes?

    This is all a round-about way of saying I empathize. Losing parents and grandparents is especially hard. They, more than anyone else, are the few people you have never had to live life without up until then. It's hard.

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  30. 20 years ago my mother and I did for my father what you and your family did for yours. 20 years on. 20 years on, and you have so perfectly described the kinds of things that rattle around my skull in the dark hours.

    Dad had lung cancer. He was 81. Not a surprise, considering that he'd mined coal for 40 years and already had black lung disease. He had one chemo treatment and said, "No more." He was quite sound of mind. My mother and I stood by his wishes in the faces of the doctors, and Mom took him home. A few months later on December 17, 1993, he was gone.

    14 months later, so was my mom - of non-Hodgkins' lymphoma. I cared for her for her last 6 months despite social workers and their pleas for me to put her away (we had the good insurance courtesy of the UMWA and all its benefits, you see). I refrained from physical violence, although my patience was indeed tried - but if I went to jail for decking a sanctimonious social worker, who would care for Mom?

    She had had the requisite 8 chemo treatments, and they didn't work. The cancer that wasn't supposed to cross the blood/brain barrier, did - as did the chemo that wasn't supposed to make her sick, because it was given directly into the brain, and wouldn't cross the blood/brain barrier. Oh wait, what? She sent me out for ice cream (very insistent, she could be), and when I came back, she was gone.

    Like you, I know she and I and we did the right things. Had some outsider tried to take charge of my dear ones, physical violence would have ensued (no "probably" about it), and I would have gone to jail. But in the dark times, what if, what if, what if there were a miracle cure? I know there wasn't, there isn't - it's 20 years on and there's not. But what if?

    You have captured the torment perfectly, damn it. But it could have been so much worse had I had to endure the additional torture foisted on Erick Munoz by these completely evil people. I say evil, because you are so right in telling the process that leads to these decisions; once having decided, to have your decision taken away, criticized, examined, autopsied by strangers is cruel, barbaric, and horrific.

    You are so right. Damn it all.

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  31. I checked the reaction box I have NEVER checked before. I sometimes wonder how people like those mentioned in your essay could possibly think they truly believe in sanctity of life. Hypocrites all!

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  32. I had to make that same decision when my husband, at age 44, had a heart attack and was determined, after four days, to be brain dead. Our daughter was only 11. They could have kept him "alive" in the ICU, with tubes in and out of every orifice, we could water him like a plant. But Mike lived in his head; he was the brightest man I ever knew. No way he would have chosen that for himself. I miss him every day still and that was 27 years ago, The doctors told us, if he was their relative, they woul let him go. I sat there at a table in the company of my mother-in-law and his two siblings, we did not look at each other, we did not even confer, we all answered in one voice, "Pull the plug." We knew. Mike died wihtin 24 hours.

    Three months later, in another state, some one's grandmother was in the same position, and it took a court order to get the plug pulled. I can't imagine adding that kind of agony to such a horrendous time.

    You're absolutely right, Jim. Thank you.

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  33. Well said.

    To take the Speculative Fiction further, how many Sci-Fi stories have you read where women are made into drugged autonomous baby making factories? I never thought I would see the day where it was considered. And to compound the horror, the justification is religion and the sanctity of life. What is next? Soylent Green as a way to control illegal aliens?

    Danny

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    1. The Blacklist did just did this trope, positing it to be no longer speculative but a real possibility, given the money to be made in private adoptions for "perfect" children.

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    2. The Handmaiden's Tale. They weren't drugged-up but women of child-bearing age were basically treated as brood mares for the rich & powerful-- under the guise of religion. Terrifying on many levels.

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    3. Probably the closet scifi theme to this sad tale is Frank Herbert's Dune series. In the later books you learn that the mysterious "tanks" where the IXans grew all sorts of biological experiments, including human clones, were really genetically modified women, mindless and plugged into machines, basically life-support systems for their monstrously modified uteruses.

      There's a pretty horrifying vision for you.

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  34. I had to make the same decision about my brother last June, my last family member, and boy oh boy I didn't want to make it, but I knew it was what he would have wanted. Doesn't hurt less, and I am Thankful I live in a province and country where the Dr's supported my decision, and the hospice care couldn't have been better. I still wonder every single day, if maybe there would have been a miracle.

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  35. I am lucky to have a keyboard because I cannot speak at this moment. Too close to home and damned well written. Thank you.

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  36. Awesome expresson of what I have been thinking on this. The thugs that are "right to life" don't give a shit once the babies are born, after they're born they can die in the streets.

    Good job on an ugly topic.

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  37. The real shit, is those morons will never understand the difference between everyone having a personal choice, and only the select having control over all personal choice

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  38. My heart goes out to him, and to you. And you're absolutely right; it's nobody's goddamn business. Three of us had to decide to take my best friend out of the hospital and into a hospice where she died less than a week later. Nobody's goddamn business but ours.

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  39. We didn't have to "pull the plug" on my Dad, he was failing so fast from Altzheimers that we could scarcely keep up. He went from symptomatic but functional to lost to us in 90 days. Then he HAD to go to managed care. That would have been his nightmare, warehoused in a home and drugged into submission - but that's' exactly where he wound up.
    There was no getting him back, there was no hint until too late that the care home folks did not know that if he ate gravy and went to bed, that he would aspirate.
    The altzheimers did not kill him, aspirated pneumonia did. Not right away of course.
    They asked us if we wanted a feeding tube. They asked us if we wanted a ventilator.
    But like you said so well, Dad was gone, and he was not coming back. He was in a place that he, in rational times, would have regarded with absolute terror.
    We said no to all of it. He slipped away.
    I can never bring myself to criticize or comment on anyone else's situation ever again.

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  40. This post here is perfection. I'm not sure you've ever written anything better.

    And I don't know about you, but I'm pretty anxious to hear the follow-up to this tale, namely who is going to foot the bill for the treatment that neither he nor his wife consented to (not to mention the bills for the lawyer they no doubt had to employ to end the unwanted interference). If the family has to declare bankruptcy, or loses their home, or the surviving child is denied higher education that would be adding the greatest insult to injury.

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  41. One of the bravest, kindest things my mother in law did was, when she found that her husband of 40 years had died in his sleep, was to wait for THREE HOURS before calling anyone, including us. She and Joe both had DNR orders, and he was adamant about not being on life support. He wanted to die in his own home. So to be sure his wishes were carried out, she waited. She did not call us, because she didn't want to have us have to make the decision with her (we would have supported her). It is the hardest ones to make. How dare those sanctimonious hypocrites, who whine about the "nanny state" try to take that last act of caring away from Erick Muñoz.

    Nalu Girl

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    1. My parents have repeatedly told me that if I found them at home that way to make sure they were good and cold before I called. I'm not sure all my siblings are on board with that, but I will respect their wishes.

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    2. Even being cold may not be enough. My husband died in his sleep and was cool to the touch when I woke up. The emergency people worked on him and brought him to the hospital because even though I knew he was probably gone no one was quite sure. I followed to the hospital and they had declared him gone already. I don't blame them at all. Even if it happened again, I don't think I would have had the presence of mind to wait another hour or two.

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  42. My experience is, I guess, the inverse of yours. My sister had surgery in 1988 to remove a tumor in her brain. After the surgery, her brain began to swell uncontrollaby, eventually crushing her brain stem. She was a nurse, and though she had never gotten around to signing an organ donor card (hell, she was only 37 for fuck's sake), we knew that she would want to be a donor. The drawback was that she would have to be kept on the machines overnight until the surgical team could arrive in the morning. To get my mother to go home & try to sleep, I promised to stay in the hospital overnight.

    That is the most horrible night I have ever lived through. I came to loathe the sound of the respirator in those hours. My sister's eyes were partially open, and they were empty. I knew that she was gone, but we didn't really let her go for about 16 hours.

    And all through that night was the nagging doubt that just maybe she was suffering in some way, and we were prolonging that. I would not wish this experience on anyone. But mine was only a few hours, I cannot imagine what Mr. Munoz went through.

    Bruce

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    1. Thank you for doing this. My husband had been an organ recipient and the joy of getting a kidney was always tempered by the fact that somebody's family was grieving.

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    2. Just as the grief is (somewhat) tempered by the knowledge that some good has come out of the loss.

      One thing we did not expect was that a few months later, the organization that handles the transplants ( I forget the name) sent us a letter telling us of some of the results of our decision. No names, of course, but we learned that an eye patient in Philadelphia regained at least partial eyesight; a burn victim elsewhere had a skin graft; a heart patient still living; etc.

      Bruce

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  43. Thank you! Nailed it! So tired of those intrusive, self-righteous, hypocrites!

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  44. A compelling piece. I completely agree.

    My best to you and your family for your difficult decision.

    And on a typographical note, you say "Not only does do these people" in the paragraph that begins "Change the law in support of life … "

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    1. Fixed. Thanks for the assist // JIm

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    2. You also say that Mrs. Munoz "awoke up".

      Bruce

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    3. That's because I rewrote the sentence and changed woke to awoke. Thanks, it's fixed. // Jim

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  45. Thank you. We need to talk about this. All of us. This kind of thing happens too often.

    My mother died from a horrible and rare brain disease. My father did everything he could to keep her body alive. I certainly don't fault him for that. He failed often as a father and a husband, but all would be set right when he retired and they would have happy years ahead of them. Those years were filled instead with caring for a loved wife and mother whose brain was literally rotting.

    There really was no place for her to go 35 years ago, so their bedroom became a hospital room. For years. She was in a coma, for lack of a better term as so much of her brain was gone during that time, for two years. It's hard to prevent bedsores, fungus infections and so many things when a body is in that state. Sometimes I laid next to her and held her in my arms, telling her it was ok to die, that we loved her and we'd be ok. The body was kept alive. Months passed.

    When the end came, she was alone with a nurse. I was called before a doctor and helped clean up my mom and position her before dad came home. We have our suspicions about that situation. But it was long past time to accept the end. If the nurse did something... we should have accepted mom's fate long ago rather than preserving a horrible situation.

    When Muñoz spoke about smelling death when with his wife, I knew what he was saying. I smelled it for months.

    I still have many emotions about what occurred, and they have been triggered by the horrible situation faced by Mr. Muñoz. But I must mention that my dad, my siblings and I all wrote living wills and signed DNR papers as soon as those options became available. Readers, please consider those documents for yourselves and the people you love.

    I'm now an old, divorced woman, but I have always spoken honestly with my adult children about what I experienced and my wishes. When the time comes, as it will, cherish the good memories, forgive me the bad ones, and let me go. Frankly, at that point, I'm already gone.

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  46. 4 years ago, Mary (then 86) decided to make an exception to her living will, and accept mechanical ventilation, I suspect because it was Christmas day, and didn't want the day to be associated with her passing. She even improved for a day or two, still needing oxygen, but off the tube, and able to talk.

    It didn't last long, On the third of January, her kidneys quit, and after a 4 hour delay for daughter #2 to arrive (she had to go home, so the grandson could return to school), all the IV's save pain killers were disconnected, along with the monitoring leads. We said our goodbyes, and the ventilator was disconnected. She managed a few breaths and fell still.

    It was the right decision.

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  47. This essay should be required reading, and I understand the difficulty of the decision your family made for your dad.

    I, with my family made the decision for our Mother in December, just before Christmas. The stroke left her unable to move, speak or swallow. We all knew how much she hated the last couple of years as she lost independence and mobility due to illness. We could not, in good conscious keep her going on tubes.

    This is a decision no loving family makes lightly, the church and politics have no place forcing a family to prolong the suffering of the individual or their family. The politicians and churchmen who tortured this family for so long, will someday be in the position where others are making personal decisions for their families regardless of what is right or their own wishes.

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  48. Dear Mr. Wright,

    A friend pointed out your essay on Twitter and I came over to read it. The tragedy of the Munoz family punched me in the gut, especially since they had discussed exactly what they wanted in terms of their own personal end of life decisions only to have them thrown out the window because of a short sighted law.

    Like many of your commentors, I've been down the road of having to make sure someone's end of life decisions were respected. In my case, it's been every member of my immediate family. My mother and brother died withing two years of each other, of pancreatic cancer and AIDS respectively. They both had DNR orders which we all agreed was right and proper. It didn't lessen the loss but it did offer a lifeline, a guideline as to what to do when the time came.

    My father married again and when he grew ill (organ failure after a quad bypass), my stepmother came to me with the DNR papers. She told me then she wasn't ready to sign them at the moment and that if I objected, she would because he was my father. What I said to her was, "He's my father but he's your husband. I'll support any decision you make." It was their life together, not mine.

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  49. My father died in 2003. He was diagnosed with pancreatic cancer in January and was a shell of his former self by April. I am British by birth but live in the US and received the call from my brother in mid-April - "Come home, Dad is dying". We had to decide on my Father's quality of life and being in the medical field were able to administer painkillers. The hardest part was administering increasing doses of medication to relieve the pain beyond the point of overdose. I should point out that there was also an attending physician who counseled us. Unless one has walked in those shoes, it is impossible to judge. My heart goes out to you Jim. There isn't a day that goes by where I do not think of that day in April.

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  50. I often wonder if my family and I are going to have to make this decision for my mother one day. With AD and seizures, it's a possibility. It's hard enough to prepare for death, let alone pull the plug...I couldn't even imagine. I especially don't think I could handle people disrupting my personal grief over something that doesn't involve them. Powerful essay.

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  51. this essay deserves a pulitzer. i guess they don't hand those out to bloggers, so to hell with awards. i'm weeping right now.

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  52. I flew 15 hours to be by my Dad's bedside after his stroke. My sister and I talked the Catholic hospital in Milan into DNR, given that the hemorrhage was so deep and large. Then I help his hand while he went.
    I have no idea how I would have reacted if someone had tried to keep him alive. Thank god I didn't have to find out.
    Thanks, Jim.

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  53. Thank you. And thank you commentators, this has been very moving.

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  54. Spelling: When you breathe you produce breath. You don't breath (breath is a noun). You breathe (an action verb).

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    1. It was a typo, I don't need a lecture on the English language. It's fixed, thanks.

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    2. If that's all you took away from Jim's piece, there's something wrong with you. Go away.

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  55. I'm crying over the power of your words. I still remember the awful time when my mother in law lay in the ICU for over a month, kept alive by machines and tubes against her wishes, but her sons couldn't take that step to turn off the machines. They were desperately hoping for the miracle that would wake her up. But it never came. She suffered and finally died in spite of the medical intervention. I am going to share your essay with my daughter who is a doctor in Texas in the hope that she can use it to educate others. She has been an outspoken critic of JPS' treatment of Ms Munoz.

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  56. Thirty years ago my brother, age 40 collapsed at work and was rushed to the hospital. There they diagnosed a massive stroke. Over three days, they worked to save him while system after system shut down. It was clear that if he survived he would remain in a vegetative state. He had a wife and an infant daughter. His devastated wife said that if he lived she would have two infants to care for but one would never progress. Our family agreed. We told the lead doctor that we knew he would have wanted to die and that the family were in agreement. We were shocked when the doctor said she would have to confer with the team of doctors who had worked to save him. It had never occurred to us that they could over-rule. Fortunately, they agreed. Back then we were not allowed to stay in the room with him but were allowed to say good-bye. I will never forget the pain of that decision or the peace that came with knowing it was the right thing to do. More recently I have held my husband's hand as he peacefully passed from this life. The emotional pain we both felt at our impending separation was nearly unbearable. There was a healing peace in his dying. Remembering the exact moment he died, I can say now that there is also sanctity in death. Perhaps those insisting on life at all costs should remember that there is "a time to be born and a time to die".

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  57. All I can say at the moment is a whole hearted AMEN. Maybe will post something more later when I can get my head in a better frame of mind. Although I'm not sure what else could be said. You nailed this one plain and simple. Thank you.

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  58. Many of those comenting have related personal, family decisions, and I also have those, but I will tell another story.

    In the 90s, there was a young woman in Germany, who was pregnant and fell into a coma. Probably due to an accident of some kind, but I forget the details.
    The hospital? doctors? determined to keep her alive until the fetus could be born.
    The general public reaction was condemnation of those "playing god".

    Then, her parents agreed to an interview, broadcast live. They acknowledged their daughter's coma and that she would never wake, but the fetus was, according to ultrasound, still in good health. They were trying to salvage crumbs from an incredible family tragedy. They understood the risks, and the rancor of the public. They also insisted that they were not "playing god", that if their daughter died, then they would let them both go.

    The interview changed public opinion. But not the outcome. Less than a month later, both died.

    The difference between this case and the Muñoz case, and it is the only difference that matters, is that this is what the family wanted. The family made this decision in consultation with the doctors. The government was not invited. The insurance company was not invited. The public was only included later, so they can be considered an after thought at best.

    The family made this horribly difficult decision.
    They understood that they were clutching at straws, but they were their straws to clutch.
    I don't know what I would have done in their place. But, then, I wasn't in their place, and it wasn't my decision.

    I have been there, though. My mother was diagnosed with pancreatic cancer. She lived less than 6 months after the diagnosis. I flew home when she entered home hospice care to assist my father with her care. The morphine may have eased her pain, but it stole my mom before her death.
    My decision, the one I still question, was to keep my daughter away from my mother in those last weeks. It was not made lightly, and my father agreed with me. But I still agonize over it.

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  59. Thank you. Just ... thank you.

    When my time comes - should it come in a medical setting - I hope by all that's holy that those who have to make the final decisions are able to do so in accordance with my wishes, and without interference from the state. We all deserve to go with what dignity remains.

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  60. I cannot imagine what that poor man is going through, since most decisions like that are private. That he had to have a court order to force the hospital to do what was right is a travesty. That they hid behind a twisted interpretation of a law on the books is worse. A hospital full of doctors, who had to have known that the length of time she was without oxygen would not only kill her, but also the baby, that they took this to court...well, I hope I never need a hospital in Texas. They should re-examine the oath they took to do no harm. I shudder to think of what would have happened had the judge ruled the other way. It would have opened the door to human incubation, no test tube needed, just a fresh corpse with viable organs.

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  61. Thank you, Jim, and to all the commenters who added their own experiences. I have not -yet- faced such a decision, but like many have said, anyone who tries to insert themselves between my family members and such a decision will have a fight on their hands. I was horrified to read about Mr. Munoz's ordeal. The doctors who refused to disconnect the machines until forced to do so by the Court should lose their medical licenses.

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  62. This piece was well written, moving and spot on in my view.

    I think opponents need to ask what they'd wish for themselves and what right and basis they could possibly have to impose themselves on anybody else in this situation - and how they'd feel if someone imposed the opposite of what they want upon them and theirs.

    If someone wishes to die an agonising, humiliating death or to keep a corpse "alive" long after its life has really left well, I won't stop you.

    Its not my choice but I respect the wishes of others.

    But how dare they, how *dare* they insist that someone who does NOT want to die an agonising, humiliating death or who does not want to keep a "living" corpse around in a state of medical limbo and a source of continual dragging unresolved misery for who knows how many, for who knows how long, has to do just that?

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  63. I've been a Stone Kettle reader for a little over a month now. Most everything I've read is pretty much my saying "what he said".

    I've gone through similar experiences. Sanctimonious ass holes condemning me or my family for decisions that were our right to make.

    My mother took her own life in 1996. She took 16 Unisom and 100 aspirin. She wrote that she hoped she got the mixture right because she didn't want to vomit her cocktale and wake up feeling miserable.

    Everyone has to deal with the death of a parent at some point. But I never expected to literally be scraping up what was left of her off the kitchen floor of her apartment. She took her life on Aug 5 1996. She wasn't found until Aug 13. By the time I arrived the medical examiner had removed her body. But they left those extra thick electrical rubber gloves on a tarp and they didn't bother to remove the towels she used for her final pillow. My mother was also a cat lady. She opened every renaining can of cat food she had.

    So my last experience of my mother was the smell of old catfood mixed with the stench of 3 week old decomposing flesh.

    Why am I telling you all this? Because at the time I was still a delusional christian. And you know what christians say about people who commit suicide. Fuck them!

    My mother was in pain all the time. She suffered from debilitating depression. I miss my mom. She was every bit as much of a nerd as I am. She is the reason I'm a scientist. If the loving Father God exists as we've been taught, I can't believe he'd be so cruel as to damn her immortal soul (if there is such a thing) to eternal pain and suffering.

    I wish she had played out the details of her suicide a little differently. But it was her right to do it. I respect her decision. It was *her* decision and nobody elses. She was only 55 but it was her time to go. She went out on her own terms. If we lived in a society that truly respected the rights of an individual, maybe she could have died more comfortably in the care of a doctor.

    So to your family, Jim...and to the family of the Munoz, tell all those self righteous beaurocrats to FOAD! It's not *their* decision!

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  64. I've been a Stone Kettle reader for a little over a month now. Most everything I've read is pretty much my saying "what he said".

    I've gone through similar experiences. Sanctimonious ass holes condemning me or my family for decisions that were our right to make.

    My mother took her own life in 1996. She took 16 Unisom and 100 aspirin. She wrote that she hoped she got the mixture right because she didn't want to vomit her cocktale and wake up feeling miserable.

    Everyone has to deal with the death of a parent at some point. But I never expected to literally be scraping up what was left of her off the kitchen floor of her apartment. She took her life on Aug 5 1996. She wasn't found until Aug 13. By the time I arrived the medical examiner had removed her body. But they left those extra thick electrical rubber gloves on a tarp and they didn't bother to remove the towels she used for her final pillow. My mother was also a cat lady. She opened every renaining can of cat food she had.

    So my last experience of my mother was the smell of old catfood mixed with the stench of 3 week old decomposing flesh.

    Why am I telling you all this? Because at the time I was still a delusional christian. And you know what christians say about people who commit suicide. Fuck them!

    My mother was in pain all the time. She suffered from debilitating depression. I miss my mom. She was every bit as much of a nerd as I am. She is the reason I'm a scientist. If the loving Father God exists as we've been taught, I can't believe he'd be so cruel as to damn her immortal soul (if there is such a thing) to eternal pain and suffering.

    I wish she had played out the details of her suicide a little differently. But it was her right to do it. I respect her decision. It was *her* decision and nobody elses. She was only 55 but it was her time to go. She went out on her own terms. If we lived in a society that truly respected the rights of an individual, maybe she could have died more comfortably in the care of a doctor.

    So to your family, Jim...and to the family of the Munoz, tell all those self righteous beaurocrats to FOAD! It's not *their* decision!

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  65. You brought me to tears. And ordinarily tears would piss me off. But I could only wish I could articulate these concepts so well. In point of fact, my daughter has been arguing at school over some of these concepts--but I don't think I should send her with a link to this article to take to school. Certain to cause more trouble. (Catholic school. Hubby promised his mother.) But I could wish it was required reading.

    My one Grandpa had a living will on file, but when he had a car accident and ended up in the the ER, by the time my dad got there, they had already been working on him long enough that they were determined not to stop. They'd already "lost" him two or three times, briefly, and likely because of that, he never really recovered. At first, he was lucid enough to be very angry about it--after all, he was walking (if in half-inch steps, and a cane) and driving a car "the day before" and now stuck needing care, looking at a future of never being independent again. I think he was 93. Yeah, I know. We should all be so lucky. He ended up in a nursing home--something he emphatically never wanted--and essentially stubborned himself to death from there. Refused to assist with any physical therapy while he could have, until he couldn't. Lasted another three years that way. If he had carried his paperwork on his person, I wonder if they would have let him go at the time of the accident. More shocking, of course, but I know that for him, it would have been his preference. And truly, if a person lives to the age of 93, you'd think they'd be allowed to decide how they want to go. (Not that there needs to be some magical number, but 93 seems impressive to me.)

    The image of the kitchen floor hits me extra hard. My own father was found on his kitchen floor, chilled and not quite dead yet some years ago. Thankfully his wife found him in time to call for help. And the drug that caused his arrhythmia has since been taken off the market. Thankfully, the situation was not an exact duplicate. When the time comes that I will have to say goodbye, (hopefully a LONG time into the future) I hope I can listen to what's best for him, not for me.

    Gretchen in KS

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  66. Absolutely one of your best. Thank you for articulating, once again, exactly what I have been thinking about the entire Munoz story.

    I was listening to a show on NPR on Monday morning with this as the topic. Most callers were of the same viewpoint as your post, and the commenters thus far. Suddenly there was one woman blathering on about how sorry she was for the family and she felt so bad for them and, yada, yada, yada, but that we should always protect the most vulnerable (meaning the fetus) and that they (the family) should not have been allowed to kill the fetus. Seriously. She said all of that. I had to turn off the radio as I was so angry I could not see straight. The hypocrisy of that woman, and all of her ilk, is astounding. The very same people who go on and on about the need for less government intrusion in their lives think the government should dictate the terms of death.

    Thank you for putting into words what I have been feeling. I am truly sorry for the loss of your father and the decision you had to make.

    I am a veterinarian and a physical therapist. As a veterinarian, I am given the beautiful gift of helping to end an animal's suffering with euthanasia. It is truly a gift. As a physical therapist in a human hospital, I am frequently witness to horrendous ends of life, be they from families unwilling to let go, physicians not being completely forthright and honest with their patients, offering one treatment after another to those terminally ill, or simply the way of death. I leave work many days saddened by what I've seen. Death is sad. But it is inevitable.

    I thank you again for your post.

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    1. Thank you for your reply. I have been a nurse for more than 30 years. I am also the daughter of a veterinarian. What I have seen at times in the hospital makes me wish I could help people end their lives quietly and without pain, when their time has come, as veterinarians do. There are worse things than death.

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    2. Anonymous, my mother spent the last few years of her life in constant, horrible pain, locked into a crippled, age-deformed, nearly helpless body -- with her mind intact, hopelessly hoping for death to come and release her. For the last few days of her life she was finally allowed to have the mercy of morphine in hospice care, as much as it took to give her real relief. We four children agreed with her wishes, that no heroic efforts be made -- we and she had had enough of doctors and hospitals and other caregivers trying to pump a few more shreds of "life" into a body that was crumbling away. So she was able to slip away in peace, in her own bed at the assisted living that had been her home for several years, and finally, finally escape her agony.

      Contrast that with the animals I've owned over the years: horses and cats who, when longer life wasn't worth the unrelenting pain of living it, were allowed to go quietly into the release of death. I know my mother wanted the same merciful release; she often said so; but she had to go on suffering till taken by a death too long prolonged.

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  67. Words cannot express how much I agree with you, Jim.

    The pigs who made this sort of thing a matter of state law, imposing their religious bullshit on a grieving family like this should be frogmarched to this woman's funeral and have to fill her grave with dixie cups.

    I live in one of the states that treats pregnant women like Texas does. Until this case, I was unaware of that fact.
    Now that I *am* aware of it, every day I am more and more grateful I was surgically sterilized some years ago.
    I was asked repeatedly by my physicians why I wanted to be sterilized when I had listed my birth control method as 'abstinence' for several years... and all I could tell them at the time was 'I don't trust Roe vs Wade to hold them off much longer. I don't want to ever be pregnant, and while I reduce the chance of accidental pregnancy to zero with my abstinence, this is the only way I know how to reduce the chance of accidental pregnancy to zero in the event my own will on this matter is circumvented through rape.'
    This was some ten years ago now, and as I watch these psychotic fucksticks force their religion into these deeply personal, private decisions, I am more and more confident that I made the right decision.

    Being a woman in this country is becoming more and more terrifying by the day.

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  68. I had not heard about this case. The vileness of some people astounds and dismays me. How on Earth anyone could imagine that the government must intercede in such a case, when the person has been dead for too long ... fools, damned fools, and I am not charitable enough not to wish that they somehow learn just how weighty that decision is.

    Also brought back memories of my father's death last September. He made it through the fall and the massive subdural hematoma and the brain surgery - 18 hours after being told that he would likely never wake up, he'd pulled out his vent tube and was sitting up asking for pudding. It was two weeks later, the same day the hospital called to discuss releasing him to rehab, that the pneumonia overwhelmed him. Lungs failing, kidneys failing, heart failing, he wanted to be let go and I held his hand and told him I would be okay, that he could rest. I watched the last breath flutter in his throat and felt the faint thrum of life in his hand stop.

    You're right, it's the hardest thing of all.

    If someone had told me I had to keep him on the machines and drugs, I probably would've ripped that person's throat out with my teeth. And he was CONSCIOUS, he was alive by anyone's definition, it was just that his body was very clearly trying to die and he did not want to go through the pain and the struggle anymore. Once we pulled the plug he was gone in under fifteen minutes. Quiet, gentle, surrounded by loving family.

    My heart goes out to Erick Muñoz and his family. May he have peace.

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  69. Well said, Jim. From the heart.

    Thirty years ago, my mother was diagnosed with terminal cancer, told to expect to live about six months. If she opted for chemo and radiation, she might extend it to a year, but she declined. She was brave, and my mother was not a brave woman. A couple of weeks after she was released from the hospital, she slipped into a coma. I was across the country, but her sister called me and her husband was there. Her doctor wanted her brought to the hospital where he thought he could reverse the coma. We talked it over, my aunt, my step-father, and I. We concluded that would be a cruel thing to do to her. She passed away at home, on the couch, with her sister holding her hand. I got there a couple of hours later, too late to say goodbye, but how do you say goodbye to someone in a coma?

    I believe we made the right decision. I would hope that my family, my children and my husband, would make a similar decision for me. That is not to say that it was easy, and that I don't think about it from time to time and second-guess myself. But I still think it was the right thing to do for her.

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    1. Pogonip, my family came very close to having to make this decision when my father, during treatment for cancer, got up in the middle of the night and slipped and hit his head on the hospital room floor. (We won't discuss why he wasn't being restrained even though he was clearly non compos mentis and was being treated for the complication that was causing it.) His condition deteriorated all that day, and finally he got an MRI, which revealed a massive bleed. Despite the fact that all of this was playing out in a Catholic hospital, no one gave us any trouble when we honored my father's wishes by refusing life support, and most of his family was able to get to the hospital to say goodbye. He died at 5:30 the next morning, just over 24 hours after sustaining the injury that killed him.

      What I really wanted to say to you, Pogonip, was that the neurologist we dealt with that night would not discuss Dad's condition and prognosis in front of Dad even though he'd been unconscious for hours. That kind man was adamant that hearing was the last sense to go, and so we held our grim little conference in the hallway outside his room. I believe that he heard our goodbyes, heard us tell him how much he was loved and how much we would miss him, heard us tell him it was all right to let go.

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  70. I have never commented on this before, but this one touched a nerve, because I may someday soon be faced with a similar situation to yours. My father is 91 year old, in a nursing home, and has paranoid dementia. I am his guardian. He has told me he wants no extraordinary measures should something happen. I'm not looking forward to having to make the decision you had to make, and am hoping it won't happen, but not betting on it. You have my deepest sympathies on your father, and so does Erick Munoz.

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    1. Please consider that, should something happen to your father, *he* has already made his decision about his own medical care, as is his right. You would just be informing the doctors. Does he have a DNR order on file at the nursing home?

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  71. For some reason when I read the story of the Munoz family tragedy, I could not help but think of the Monty Python Dead Parrot sketch. Except with Mrs. Munoz as the parrot.

    The Texas law never had anything to do with this case. The Texas law was about a pregnant woman in a coma, a woman still alive. This woman was dead. A stiff. A corpse. Gone to meet her maker. Pushing daisies. Bereft of life. This lady was a former lady. The Texas law mandates life-sustaining medical intervention. But there was never any life here to sustain. The woman was dead. D.E.A.D.

    But beyond that, there is, of course, the problem that there should have never been a Texas law to begin with. I remember when we made the decision to DNR my own father, who died of aspiration pneumonia due to Alzheimer's. The ICU doctor suggested it, given my father's condition and the fact his heartbeat was irregular and if it stopped they'd have to crash-cart him, complete with all the abuse to the body that involved. It was a hard decision, but it was our decision.

    Similarly, my own death, when it comes sometime in the next thirty years (I am fifty years old and no man in my family has ever made it to eighty), isn't for someone to second guess. If I am diagnosed with some life-ending illness and want to die like an Eskimo and simply walk north on some ice flow until I fall over and freeze to death, that is by god my own decision to make. It beats what the medical profession has in store for me and I don't need someone second-guessing it. I've seen too many people die in hospitals -- my grandparents, my father, various uncles and aunts -- to have any illusions about what happens at the end. Our end of life system here in the United States is pure torture and I want nothing to do with it.

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  72. 5 years ago I nursed my Mother through her last days of Pancreatic Cancer. 6 Months previously she had had to have a duodenal bypass (since the cancer was occluding her small intestine). At 78 years old I didn't believe she would pull through that, but she did. Then it went horribly wrong with internal bleeding. The Drs put her under a DNR Notice (DO Not Resuscitate). Fortunately (or unfortunately given the terminal nature of the disease?) she pulled through that.

    So yeah, I too have been there too and I wouldn't wish it on my worst enemy.

    It never ceases to gob-smack me how so called 'Christians' can be such hypocrites within their own attitudes.

    Sanctity of life? Bloody sanctimonious crap more like!

    We don't seem to have such silliness this side of the Pond. I guess it's because we sent all our religious nutters over there 400 years ago.

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    1. Gee, thanks. Want 'em back?

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    2. Erm?

      No thank you!

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  73. My much beloved grandpa went two years ago. Massive stroke, looked like he'd been hit in the face with a baseball bat. He lay in the hospital bed completely braindead, moaned and vomited up bile for a day. I couldn't take it and left it to my father who let him die easy. Pap was a Guadalcanal NZ Airforce veteran and my best friend. I love him and my dad, and no one has the right to tell us how we sort out our own business.

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  74. Fantastic piece, and I liked your list of provisos at the end. Very well done, Sir.

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  75. Thank you! I live in this world and see painful decisions day in and day out...I do what I can to help patients and families in their journeys...but it's so hard.

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  76. You echo my thoughts on the subject so perfectly, but I can't imagine I'd be able to put pen to paper quite so eloquently. Well said sir...as per usual.

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  77. In the sanctity of life spirit I always watch George Carlin http://www.youtube.com/watch?v=AvF1Q3UidWM . Your post have that similar deep profound impact.

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    1. Much needed at this point, thank you.

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    2. That Carlin routine is the first thing I thought of while reading this.

      This sort of pathetic duplicity needs to be called out whenever possible. Note that it's in no way limited to so-called "pro-lifers".

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  78. A year ago today, my husband and I - together with a wife, son and another close friend - stood next to the hospital bed of our dear friend Charles and said good-bye. Four days earlier he fell out of a bathtub shower and sustained a massive brain injury. The five of us all knew that Charles would not want to have his life artificially extended by machines. A horrible three days for the 5 of us, but no conflicting views as to the correct course of action. I cannot imagine adding more to the pain his wife and son were enduring if the hospital had disputed their wishes.

    Man, Jim, you just get better and better. One of your best.

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  79. I have family in Texas who is an active member of the "right to life" crowd. She is obsessive about it and I've wondered how she can be so tearfully emotional about every fetus, and yet so cold hearted about the poor, access to health care, inequality of income, and every other "feed, clothe, care" request of her self proclaimed Lord and Savior. You have expressed what I've been mulling over myself - that "saving the innocent" is a way to make them feel better - smugly self righteous - about all the other non-Christ like behavior and beliefs they have.

    Our mother was dying from Alzheimer's after many years of a slow and sad decline. She refused food and drink, and was barely conscious. The nurses at the care facility advised us to let her go. One sister, who had guardianship over her, discussed our options. She and I decided to let our mother pass with no interference. No tubes. The DNR that our mother had signed years ago was not clear on feeding tubes so we had to make a judgement call. Our right to life sister was in disagreement. It is a touchy situation when family members disagree about the right course of action. We talked her around. I was there when my mother died, and it was definitely the most haunting experience I have ever had. And I feel the responsibility of it. But it was the right thing to do, even if it was hard. Death is hard, no matter what.

    Thank you for your post.

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  80. I had to make the decision for my mom and everything you said - it was the right thing, but you still wonder what if - is spot on. I KNOW I made the right decision and don't regret it for an instant and yet, those niggling ifs will always be there, even when I STILL know. It was Mr Munoz's decision and no one else and I'm glad he had the support of her parents rather than having to fight them too. I keep thinking about this and the Jahi McMath case, wonder where her body is now, how the family can still think she is going to wake up even as her body decomposes. I guess that's also a case of the family having the final say and yet there is something very macabre about them painting the fingernails and tube feeding a dead body.

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  81. My mom had a DNR. We never got there-she died in my father's arms 5 years ago. I have one, my husband has one. No one, especially a state that prides itself on how many people it kills, ever has the right to demand what Texas demanded of the Munoz family. Thank you for putting so eloquently what many of us have been thinking and feeling since hearing about this terrible situation.

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  82. Thanks for putting into words what a lot of us feel. Quite eloquent.

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  83. We had a similar situation in our family (though not as long lasting or involving a fetus). My sister-in-law was in a traffic accident in 1995. My infant nephew was killed in the crash and she suffered sever head trauma. She was kept alive for 6 days until she threw a massive clot in her brain, cutting off all blood supply to her brain. Except. Except for one, tiny vessel in her nose. One. In her nose. Her right to life doctor (we didn't have a choice on doctors, he was the one on duty at the hospital) wouldn't declare her brain dead. Therefore, my brother was unable to donate her organs. She was 24, healthy and in good shape. She was a perfect donor. So many people could have been helped and her death wouldn't have been in vain. However, this fundamental Christian asshat wouldn't declare her dead. The vessel in her nose stopped working 24 hours later, but by then it was too late for her organs. They were already damaged. What could have at least helped my brother bring some hope out of this devastating tragedy, just ended up being a complete and senseless tragedy.

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  84. "Those who condemned Erick Muñoz for his decision are like the robot described above, dogmatic, unthinking, inflexible in belief, and utterly inhuman, just following the program."

    From the very people always talking about "freedom" and claiming government should not get "between the doctor-patient relationship"…

    Freeportguy

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  85. Jim, this was heartbreaking, and very hard to read. I deliberately did not follow this case as the players and their shrill and sanctimonious claptrap were predictable. But I knew that here I would find a caring common sense. That poor man. My poor mother, and her mother before her, kept alive far too long, until they were nothing more than a battleground for side effects, and one organ savaging the other. My sister's inability to countenance any talk of "comfort" or hospice care, or indeed any hint that her will to keep them alive could not prevail. The doctors, who through long experience had given up arguing with family in denial. It's selfishness, pure and simple. It's hijacking someone's beloved for another's personal inability to deal with the gray areas. I'm babbling, but I hope you know what I mean. Thank you again.

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    1. "a battleground for side effects, and one organ savaging the other" is scarcely babbling.

      It is profound, concise and illuminative; all of the things our wonderful language can be. It is very well said. Thank you.

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  86. I've seen this happen in the worst way. Also in Texas. Tho about 20 years ago. A young woman, newly married, beautiful and strong, woke up one morning with a breast cancer that could not be beaten. She and her young husband tried everything. Including bone marrow transplant. Which was almost like dying for her. And the cancer came back. At the last, in desperation, she volunteered for a drugs trial down in Texas. The drugs trial in truth never really held out any hope of saving her, but it would add to the sum of medical knowledge. She ended up in an artificially induced coma, on a respirator, kept alive not because there was any hope of curing her, but because that was what she signed up for: the researchers needed to find out how certain of her cells reacted to a certain number of doses of the new meds, and they could still get that data from her even after her body's ability to live on its own was completely overcome by the cancer.

    So the docs got what they needed. Then they told her young husband that it was done. And time to let her go. So he agreed to shut down the life support and let her slip away.

    And then her mother and sisters showed up. Screaming that her husband and the godless doctors were killing her. That their god wanted her to live on the machines. Screaming so loud the docs didn't dare turn off those machines until the young husband had spent the time and money he didn't have to get a court order. He had to find a lawyer, and pay him, with money he hadn't got, to get an order from a judge allowing his wife to do what nothing on this earth was going to stop her from doing anyway, even with the life support machines.

    Luckily he found a judge who was a human being. And when he had got the court order, because he was a kind man, he allowed his young wife's mother and sisters in the room when the doctors turned off the life support. And as she died -as his beautiful young wife was dying- all they could do was scream and howl at him and curse him and call him a murderer.

    If only there was a Hell. I know who would deserve to go there.

    BB

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  87. Beautifully written. I wish more people could understand this. It goes beyond our constitutional rights. This sort of choice is a HUMAN right. For shame Texas.

    My father passed away 9 years ago from terminal cancer. He wasted away so fast. I was terrified that he would end up on machines, as you and others have described. He would have hated that and he was blessed in that he passed suddenly. He had washed and dressed himself, and got himself to his favorite chair. He experienced what might have been a sudden clot or stroke, and although he was breathing when they took him to the hospital. He was already gone. I had to return to the house where I was alone with my mother, who suffered from dementia, and my baby... my husband was at work in another state. He passed before I could get back to him, but he never woke up. He did not suffer... and selfishly perhaps... neither did I. If we believe in life after death, or angels, or whatever, I have to thank them for letting me off the hook. There were a lot of hard decisions anyway. Plenty of them. This is one that he did not leave to me. I am sorry that you had to go through this with your father... but I am glad that you had the right to make the choice that had to be made, and that you had family standing by you when you did.

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  88. Very thoughtful, personal, and supportive. Sometimes I don't know about you, Jim. Sometimes I think, "what an ass, why do I follow this guy?" Then. There are times like now. Cocksucker. jcollier Winslow, AR

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  89. Thank you Jim and I agree completely. You see- I had a baby daughter that choked at daycare when she was 7 months old. The caregiver was in a hurry to feed her because her assistant did not come in and she had too many babies to feed and care for that day for one person. So my daughter got about half a jar of baby food stuck in her airway. The paramedics took quite some time trying to put in an airway to get oxygen into her- to no avail. By the time she got to the hospital and her airway cleared and intubated she had been without oxygen for nearly 40 minutes. What followed was a parental nightmare. My daughter was in a coma for 6 weeks. She had a couple of emergency surgeries due to her organs failing and becoming necrotic. She felt pain- because even though she was comatose her brain stem functioned. She felt pain every time they took blood or they restuck her little head for an IV (babies get IVs in their scalp). She was on the vent as she could not breath. At some point it became evident that all of the gray matter in her brain had died and been absorbed by the body. I had said that my only concern for her was that she could communicate and find joy. Without those two things I did not feel she would enjoy life. It was apparent after 6 weeks she would never have those two things. I wanted to unplug her. I wanted to let her go. I was not able to- at first- because the state I lived in said she was not actually dead because she had random brain activity on her EEGs (from the remaining white matter and attempts to find live neurons to communicate with). In fact- I could not donate her undamaged organs anywhere because she did not have a flat line. I was unable to let my daughter go because she did not meet the state requirements. At some point a medical/legal expert spoke with me and told me if I got 3 of her doctors to concur that she had no chance of recovery, and that they would be present I would be able to have her d/c'd from life support. I called every one of her docs and they left the golf courses and barbeques on Memorial Day in 1996 to do this for me and for her. Not a dry eye in the room. It took less than 30 seconds for her to pass. I was finally able to get the tubes off of her and hold her- in my arms- like a sleeping baby. She looked so relaxed after she died I realized what trauma the body had been going through hooked up to all those machines. I got to bathe her and dress her before she went to the funeral home. It was so much better having closure and knowing she was not in pain or not being able to be held or rocked or to play. I was yelled at, pointed at, castigated, and told more than once I "killed" my own baby- what kind of monster was I? So yes- it is a highly personal and painful decision and only one a family member can make, in conjunction with a medical team. The government, the church, and nosy politicians and peeps can butt out. And park their insensitive comments at the door.

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    1. Oh, Kimberly, I can't imagine the trauma and pain you endured. Thank heavens for those doctors. Although you should not have had to go to such lengths. My heart is with you.

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    2. Kimberly... there are no words. (((((hugs)))))) I am so sorry for your loss.

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    3. I am so, so incredibly sorry for your pain and loss.

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  90. I had to make this decision once. As the husband it was, as you say, my right and my duty.

    I failed miserably.

    I walked out of a room full of parents, sisters, cousins, friends and left the decision in their hands. You could argue that I was distraught, that I was young and inexperienced. You could argue it... and you'd be wrong. I knew what I was doing and I knew that I was shirking a horrible responsibility. Thank God or whom/whatever you like that the correct decision was reached without me. It took me years to forgive myself for that. There are some out there who never have.

    My daughter is grown now, married and with a career that has her trotting the globe and interacting with people I never imagined existed and will never meet myself. She was already two months old on that day, thankfully. Already born and strong as any newborn babe is. I cannot and do not wish to imagine the nightmare that I would have been trapped in had that not been the case.

    I believe in a Creator. I subscribe to basic Christian theology because that is how I was raised and I'm too lazy to reinterpret my thoughts through any other system of belief. I understand the desire to give a newly sparked life every possible chance to live and grow and be strong and give and receive joy.

    What happened to this child and its family was wrong. Pure and simple.

    I'll never understand why a heart full of faith is not compatible with a head full of facts. Is a man created from the earth any more sacred than a man created from an ape? If one subscribes to the idea of a Creator, is not any material chosen by that Creator sacred? An earth-centric model was discarded for a heliocentric one and even that, in time, was discarded once enough facts had been gathered. How many more facts are needed before travesties like this become a thing of the past?

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    1. It's not the lack of facts that's the problem, it's the people who refuse to accept them and believe that their ignorance is just as important as an educated person's knowledge.

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  91. I should have known better than to read this essay at work. I need more kleenex. And as I start cancer treatment, I need a living will so no matter what, my husband will be able to prove to the lunatics running my state (and the Catholics running my hospital) what I wanted, if the worst happens. I'm pretty sure I didn't say anything at the time, and I don't know that it matters, but I'm sorry for your loss.

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  92. I followed this story from the beginning, kind of like watching a train wreck and you don't want to see it but you can't make yourself look away. After reading more comments than I really want to admit to, I think part of the problem may be one of vocabulary.

    It seemed to me that a lot of folk didn't understand two critical terms. The first was "brain dead". It seemed like many, many people confused that with the person being in a coma. Maybe if we called it brain failure, it would get the idea across that the entire brain isn't working, as opposed to part of the brain isn't working. Or brain stem failure? There's got to be a simple way to get the idea across, that when a doctor says brain death, it means even the autonomous functions aren't working, and at our current abilities, there is no going back.

    The other term was "not viable". Apparently a lot of people didn't understand that medically speaking, it meant the baby COULD NOT live. It seemed that people just didn't grasp that at that point, either the baby would die in the womb or would die upon being delivered. It wasn't going to be born with horrible disabilities, it was going to be born DEAD. Again, at our current abilities, that baby could not be saved even if it had been given 3 years inside the mother.

    How do we get this across to people? This was not the case of a woman who was six months pregnant who had an accident or stroke and fell into a coma, it was the case of a woman who was three months pregnant with a fetus that had so many problems that it could not live.

    And yes, that was the family's decision, and I hope the hospital doesn't have the balls to bill the poor Muñoz family for all that "treatment" that they never wanted in the first place.

    As far as the unborn being sacred until they become a drain on the taxpayer.... there's a bible verse that applies, for all that I am not religious.

    James 2:14-17

    14 What doth it profit, my brethren, though a man say he hath faith, and hath not works? Can faith save him?
    15 If a brother or sister be naked and destitute of daily food,
    16 and one of you say unto them, “Depart in peace; be ye warmed and filled,” without giving them those things which are needful to the body, what doth it profit?
    17 Even so faith, if it hath not works, is dead, being alone.

    Less praying, more action.

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  93. This situation was indeed a horror story. I couldn't help wondering how the child (if it was born able to think) would feel about being born from a dead mother? Fortunately, the mother was brain dead and aware of her body being kept somewhat alive by mechanical means.

    My greatest fear is being aware of such a situation, unable to speak or move and unable to die.

    Do not ever regret your actions for your dad. You did the right thing.

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  94. Jim -
    I had to make the same decision in September after the Medicos told me that the best my wife could ever hope for after her cerebral hemorrhage was to "maybe" watch a movie from her bed - - not her idea of "a life" at all.
    Thankfully, the system allowed me to see that her wishes were carried out. You cannot hold a loved one's hand as they die and not be changed.
    It was the hardest thing I've ever done (or probably ever will).
    Bear

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  95. Excellent points, Jim. It's quite shocking how politicians will stump on such morbid grounds to rile up their followers. During an NPR broadcast I was even more shocked when a women called in, insisting she was a "progressive woman" then went on to accuse Mr. Munoz of murder. Wow, Mr. Munoz has to be subjected to the opinions of the likes of this "progressive" woman. Obviously, a woman who had never had to make a decision harder than bacon or sausage with her pancakes, and she felt it her responsibility to demonize this man who has been drowning in emotional hell for the last 2 months thanks to Texas laws. Unbelievable.

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  96. Powerful message, excellently stated.

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  97. Having been in this position I still ask myself 20+ years later and go through the steps on what our family decided still being right for our family and for Dad. This case angered me, certainly made me cry and yet I am amazed no minister stood up and asked these so-called Christians if they believed in heaven. If they believe in eternal life then why the emphasis on keeping this woman on machines? I also wonder why the media doesn't begin to ask some of these questions instead of nodding sagely as if a buffoon managed to string words together is enough even though they are lies and make no sense whatsoever. MSM will let Cruz on national show saying "Democrats shut down the government, we did not" so I'm aware they will never point out the fact the GOP has cut aid to the poor and middle class that is directly opposed to the teachings they insist they follow. I asked my minster why the various religious groups didn't speak out (as the Pope now is doing) and he would say it's not the place of the church to interfere - and I'd say well they have no problem interferring with my rights so why not remind your "fellow believers" to SHUT UP? Still waiting for an answer. Marlene

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    1. Right you are, on the first part anyway:

      I Corinthians 15:54 But when this perishable will have put on the imperishable, and this mortal will have put on immortality, then will come about the saying that is written, "DEATH IS SWALLOWED UP in victory. 55 O death, where is thy sting? O grave, where is thy victory? 56The sting of death is sin, and the power of sin is the law;…

      There is a struggle for Christians in having faith for miracles and faith in a better afterlife. In this case, there is a baby to consider, a baby that isn't dead.

      As for your tangential babbling, feeding the poor is your job (from a biblical perspective), not the government's. Jesus didn't go to Pontius Pilat or Roman senate and tell them to implement a war on poverty. He laid that responsibility directly on his followers.

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  98. I watched my son die. I watched the monitors as the blood pressure dropped, the beeps that signaled his heart beating became irregular and then stopped. I held his hand as it became lifeless. The medical staff began resuscitation efforts, and you could tell it was heartfelt, sincere, no one wanted that boy to die. After what must have been around 20 minutes to half an hour one of them told me that I had to make the decision on whether they continued or not. The meningococcal septicemia had by that time destroyed his organs, it had ruptured his capillaries, destroyed his body. Still, I looked into the doctors eyes for any hope or optimism there. There was none. I told them to stop. Just writing this is killing me. No one makes a decision like that lightly, and it is not anyone else's to make either.

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    1. Yes. Many hugs. Took a lot for me to write about my daughter (above). Thank you for sharing this.

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    2. I am so very, very sorry.

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  99. There's a period missing after "mobs'" near the end, I believe. And very well said.

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  100. Thank you. That's all. Just, Thank you. Well stated.

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  101. I come at this from a slight different perspective--that of the fetus, who I've read was not viable because the length of time without oxygen. My daughter experienced brain damage in the first trimester (as this child was), and suffered oxygen deprivation when she was born 10 weeks early. As a result, she is severely disabled. At 26, she has the motor functions of a three-month-old child. She has joy and a limited quality of life, and she's beloved by all her know her. But her caregivers and I have spent 26 years doing everything for her, and the costs of her medical care is probably in the hundreds of thousands, mostly covered by the state.

    HAD that child lived, damaged as it was by that time, it would required the support systems that many of the activists labor hard AGAINST. It would also have required the sacrifices of many people, none of whom would have been those screeching activists. They are not just demanding "life" for that child but also dictating the future quality of life of everyone around it. How dare they!

    We have a DNR on my daughter. CPR would be useless on her as her organs are all out of place, and her heart is well out from beneath the sternum. I'm praying for a peaceful passing for her when the time come, but in the meantime how we care for her is absolutely no one else's business.

    And, no, your comments about God do not offend me as a Christian. Sometimes I think you're more spiritual and understanding of faith than most of the self-proclaimed Christians are.

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  102. Further to my last, and as someone who's first degree is in in Pathology, it doesn't take the brains of a Rocket Scientist to realise that: if Marlise Muñoz had been dead for some 30 minutes before her husband Erick got to her (and started CPR) that the chances are the foetus, if not already dead (as is likely given foetal needs in utero) was SEVERLY affected by the resultant hypoxia.

    So, here are my questions to the 'Lifers': Do you want to deliver a stillborn foetus (with the trauma that will place upon the Father)? Or, IF, the foetus was alive, you want to deliver a SEVERELY brain damaged foetus? And if you DO are YOU prepared to help care for that profoundly disabled child? Or, as I suspect, are you going to pat yourselves on the back and walk away leaving a broken family to pick up the pieces?

    Yeah, I thought so...


    People like that disgust me and challenge my belief in basic human goodness.

    It would also appear that there are few Rocket Scientists amongst the 'Lifer' types.

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  103. When my husband was in a coma and hooked up to more tubes than I had seen before and it was day four, everyone was starting to look at me funny and drop hints. He had been diagnosed with cancer two years before, responded to chemo and been declared in remission. Now, everyone was trying to "prepare" me. But, it was my decision and I knew he would be ok. He woke up the next day and had two more good years with us. Two years later, we made the decision for him to go to hospice and when it was time, that was also the right decision. I miss him every day. Every situation is different, every family is different, That's why these decisions should be in the hands of family/responsible person. Deciding who gets to make these decisions for you is probably the most important thing you can make clear to those around you.

    Jim, you didn't mention that the folks intruding in this decision are not big on putting money into support for the disabled either. Trying to determine what kind of life someone, particularly a child, is going to have is fraught with complications. In addition to what I've known with my husband, I have a 17 year old who has issues that make it highly unlikely that he will be able to work and live unsupported. I believe that each individual does have value. But, I have to acknowledge that one of the things that make those decisions hard is that caring for someone with disabilities, especially profound disabilities, can be horribly expensive in time and money. That is something the politicians who are talking about "the sanctity of life" could do something about. In Texas, they could accept the Medicaid expansion or put some of the "rainy day" money towards the long waiting lists of kids waiting on the Medicaid waivers (money a family can use for things a kid needs that insurance normally won't cover) or improve conditions in the TX state homes or fully fund the initatives to "make the money follow the person" to allow folks in those homes to go to their home with supports. I live in TX and my son just got to the top of one of those waiting lists after 10 years. Meanwhile the state has had a surplus for many of those years and the rainy day fund is at it's legal maximum. Yes, the fund they refused to raid to keep from cutting public education 3 years ago. The cuts that the state is now being sued over, and we are paying for lawyers rather than putting money in the schools. (ok, now I'm just ranting).

    My point is that the folks talking about how every life is important are NOT putting their money where their mouth is particularly when it comes to services for the disabled in Texas.

    Angela

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    1. My extended family has a profoundly disabled member who's been on the waiting list for services for 22 years now. She lived with her widowed mother who is herself deemed an elder in need of emergency services--she's also on the waiting list. Caring for a disabled family member is incredibly hard on a family. They've been on the waiting list for 38 years now for an-hour-a-month respite care, but there aren't enough respite workers, so she's yet to have even an hour.

      This is where the anti-choice people need to put their time and money; to the countless children and adults who need help.

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    2. HOLY CRAP! I thought 10 years was bad. My sympathies to your family.

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  104. Everything you said is right on the mark. I've been following this case for a while now & have been increasingly concerned because of the number of states that have the same law that TX used here. MI is one of them. Kind of wondering if this s another crazy ALEC production. Thank you for your words & thoughts.

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  105. I live in fear of the Right-to-Lifers, and so, I read your piece with avid gratefulness. Sanctity, indeed. Thank you Jim

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  106. Wow! You actually succeeded in changing my mind. Not about the Munoz case, but about whether a career military officer could be a humane and enlightened politician. If you ever decide to run for office, you've got my vote.

    This is positively brilliant and well-written. Thank you.

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  107. Three and a half years ago I and my family faced a situation similar to Erick's. As with you Jim, and I'm very sure Erick, it was one of the most difficult things I've ever faced. I can't begin to imagine being in such a grief-stricken state, racked with emotion, then have the situation explode by being bombarded with very vocal opinions from people who don't count and shouldn't be in the decision process... many of whom injecting themselves for some sort of gain. Ghoulish. This blog reopened the a partially but never fully healing scar. Thanks for writing this.

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  108. It is a hard decision to make or contemplate. Dad had CHF and was 85, so we don't know how much longer he might have lived. He was starting to not be able to do the things he enjoyed and he told my mother that he'd never expected to live this long and that he was ready to go. My father died 4 years ago and my mother's primary emotion is one of anger and I can't blame her. My father's death was ruled an accident due to falling. He was too stubborn to use a walker and had fallen several times. On Xmas Day my mother noticed he was having trouble speaking so she called the paramedics because she wass afraid he was having a stroke. He had suffered 3 bleeds in his brain due to the falls, so they had to operate to relieve the pressure on the 26th. He survived the procedure but was unresponsive and the hospital wanted to discharge him to a rehabilitative facility. If he went to a nursing home they'd implant a feeding tube to keep him alive, something we knew my father would not want. On the night of Jan 3, after speaking to my sister and myself she opted to have him transferrred to hospice and let nature take its course but due to the holiday he couldn't be moved until Jan 4. That night his heart stopped and couldn't be restarted.

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  109. I had to make the same decision for my dad and my brother. I know exactly where you come from on this one.

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  110. Damn Jim. you say it so well. After I read your posts, I often time re-read them aloud to my wife with emphasis. This one was a killer! Hard not break out a tear. I'd love to read this aloud on a video with pictures and whatever as back drop. More people need to hear stuff like this! Really!

    Ken

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  111. Well, once again I regret the subject of another SS post emanates from Texas. The post has quite obviously touched on a shared experience of many of the commentariat and for that I offer condolences. I, too, had a similar experience with my Dad and we were fortunate that my sister had medical training enough to educate us about a DNR. For that we have absolutely no regrets. After the fact, we felt fortunate that his death occurred fairly quickly and he did not linger on in a steady decline as so many other end of life situations.
    For what its worth, there was in this case a district judge, a Rick Perry appointee, who made the correct decision to allow the family to pull the plug. Not all elected officials in Texas have been blinded by religious fervor, though this judge will likely be blessed with a primary opponent.

    Modern medicine seems to be attempting to disconnect us from the reality that is death. I wonder how much of the current healthcare crisis and expense comes from the largely futile attempts to prolong terminally ill patients' lives?

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  112. A couple of years back my wife and I lost three of our four parents in a space of about 200 days. None were particularly unexpected - the warranties had mostly run out - but the timing was surprising for a couple of them. My father-in-law had Parkinson's, and a fall at his apartment precipitated a system-wide crash about three weeks later. My Dad succumbed to a rare tropical fungal infection he picked up in the Pacific shortly after WWII, exacerbated by having CLL for a decade. My mother-in-law just faded away until she was gone.

    We, along with associated siblings and spouses, had to make the hard decisions for my Dad and father-in-law. I had to go screaming across the continent to get to my Dad's side, where the ICU people brought him out of a medically-induced coma for his last four days - the old hard-head was still able to largely exert control over his own fate by removing his NG tube, twice. My father-in-law was too far gone to make those decisions himself when his time came.

    In both cases, the ICU and hospice people were completely glued together, bomb-proof, and incredibly professional. They consulted with and advised us, listened carefully, and then followed our decisions to the letter, which in both cases was to let them go. (The hospice nurse for my father-in-law remarked to me, my wife, her brother, and his wife that it was nice for a change to see a family acting so calmly, with such civility towards them and towards each other - they must deal with a lot of hysteria.) I can't speak for everywhere, but the nurses and staff that we dealt with were consummate professionals: these are dedicated people who get up every day to do an impossible job under impossible conditions, with grace and aplomb, calmly and skillfully, and then get up the next day and do it all over again. I have nothing but respect for these people. They're awesome.

    Hairy Doctor Professor

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  113. Well and eloquently said Jim.
    This post brings back the memory of one of the first blog posts I ever did when Terri Schiavo was finally unplugged. It wasn't very good but did come from my heart.
    Ironically I found myself in a similar situation in 2009 when I woke up and realized that something had gone terrably wrong with the surgery I had undergone when I woke up six weeks later with a feeding tube, multiple IV's kidney failure and a machine breathing for me. My wife spent every one of the 59 days and nights by my side in the ICU refusing to give me up though the Doctors had. It was a near thing but I never lost my brain functions contrary to the opinions of a lot of my friends and family. The Doctors and Nurses still look at me like I am a ghost. I am now disabled but still able to enjoy my Grand-kids and life in general. Almost the only thing my wife says about the whole thing is that she is going first because she refuses to go through that again. I really can't blame her and am constantly chastened by what I put her through.
    I often wonder what I would have done in her place and secretly pray that I never have to find out.
    Selfish of me.

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  114. God bless you. My husband has a near-untreatable cancer. We've already made our plans, and while I may hesitate to tell the doctors to end it, I will do it. How could I do any less for the man I've loved for 30 years?

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  115. God bless you. My husband has a near-untreatable cancer. We've already made our plans. I may hesitate to tell the doctors to end it, but I will do it. What else could I do for the man I've loved for 30 years?

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  116. Thank you, Jim, and all of you who have commented, for your brilliance, compassion and courage. I send love to all of you.

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  117. We all have to make the tough calls at some point in our lives, and those calls should be ours to make. This is the core of your eloquent post, and I support your decision, and that of Eric Munoz. It takes strength, courage and plenty of love to come to the realization that pulling the plug is the right, the moral, the sane choice. No one speaking for political gain should have the right to make that decision for you, Eric Munoz or any other person. In my opinion, that is all Dewhurst, Patterson et al were doing.

    As ever, Jim, well thought-out, well-written. Here's to your dad, for whom you and your family made a tough choice. May each of us be loved as much as he was, as as much as Eric Munoz loved his wife.

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  118. When my Mom was a healthy & active 80, she took a fall & broke her hip. In the year following, she made a remarkable recovery, but not nearly 100%. She was frailer, she'd lost weight. She had been talking about her imminent demise for a good 20 years before she was even sick. Every spring & fall, she'd order an outfit from the Blair catalog, and show me where it was. "Now this one is in case I die," she'd tell me. My brother and I knew she did not want to live a life without quality- she beat that into our heads.
    When I entered her room on "that" day, Mom was on a machine that was blowing 100% oxygen into her face & she looked the most frightened as I have ever seen her. When I arrived and she saw me, she noticeably relaxed. The team of doctors (who had her living will & knew they were going against her wishes) were about to move her to the ICU, where they could put her on a ventilator because they could do no more for her on the medical unit. Mom was still alert, and able to whisper. I asked Mom "Do you want this big scary mask off your face?" and she replied by nodding. I removed it, while the "team" started twittering and quacking that I couldn't do that. I asked her (without the mask on), "Mom do you want to go to the ICU?" and she whispered "No." "Do you want some oxygen through the little nasal cannula?" "Nodded." And the very last question that broke my heart because I knew the answer- "Are you ready to rest now? I will stay with you, I promise you." And she took a calming breath & nodded. My heart was crying out selfishly, I WANT MY MOMMY! Not many daughters are able to have their parent there to ask when the time comes, but if not for our open minded "end of life" talks, I wouldn't have known how to ask. The team backed off, the nurses went into action. Mom was brought to a quiet, one bed room at the end of the hall, on gentle oxygen; we bathed & positioned her comfortably & a morphine drip was started. Mom was anoxic and not responsive by then, and me and my fiance, my brother and my children took turns holding her hands and talking to her. She passed at the dawn of the new day. She got her wish because she was not forced to be alive, and she was not alone. She taught us to be her advocate when she needed us. More people need to STOP avoiding having these talks with their kin. My heart was at peace when Mom passed, and I have no regrets about the way we worked

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  119. Years and years ago, I attended a university run by the Jesuits, I took a course on ethics and we discussed when is it right to pull the plug. (It was long enough ago that the Karen Ann Quindlen case was in the news. Look it up.) The Jesuit priest teaching the course pointed out that Catholic teaching is that you do not have to go to extraordinary means to prolong your life, but that what constitutes extraordinary means changes with medical technology. At one time, amputating a limb was extraordinary means. Keeping a dead woman breathing and her blood flowing just to keep her fetus going? That is definitely extraordinary means in my book. I am curious that none of the articles I read on this case consulted with any theologians, Catholic or otherwise, on the matter.

    What many right-to-lifers and anyone else who thinks that life must preserved no matter what the emotional cost forget is that at some point you have stopped keeping someone alive and you are just keeping them dying.

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  120. Dear Mr. Wright, I have been a nurse since 1976, and worked mostly in long term geriatrics & traumatic brain injury "rehab". The saddest place in the world to work, caring for the people who are breathing by way of a ventilator, with the thousand mile stare. I look into eyes as deep as a bottomless well. I look into the eyes of a young mother who had a pulmonary embolism after giving birth, and was now brain dead. I was the same age as she was, and pregnant with my first child. I watched as her grieving husband brought their baby to "visit" mommy every month or so, and how the child was afraid of this non-speaking thing in the bed who smelled funny. I looked into the eyes of the young police officer who had a heart attack while in foot pursuit, and the officer with the gunshot wound that took a good portion of his head right off. I looked into the eyes of the 14 year old boy, who was playing under the tree his Dad was trimming at the wrong time. The heavy limb left a terrible dent. The 16 year old girl who had to be restrained to keep her from injuring herself while having grand mal seizures (which caused her brain injury in the first place). She died because the tracheostomy tube to her lungs & connected to the machine that kept her breathing eroded tissue, until it nicked a major blood vessel, and she bled out. The room looked like a gory movie set. My geriatric patients were lovely to work with & I fell in love with many of them, but inevitably, they passed on; some peacefully & some in the most painful ways possible, and all alone.

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  121. Religion is attached to the Right Wing as a distraction so that the corporate take over can be completed. It's just another kind of war.

    As for the loss of a "young life", your points are solid. The decisions these asshats try to make for others is not freedom, but oppression. They want freedom of their religion, and I have to say I agree, but they need to keep it between them, and their God. It's not my God! Isn't live and LET live supposed to mean run your life as you see fit and I will run mine the way I see fit? It works if we all abide by the law of the land. I want their "extra laws" out of my schools, out of my decisions, and OUT of my bedroom! Now they want to be in my family and make decisions of life and death for me too? No.

    The main thing I would try to get through their thick skulls and into their tiny little brains is this: "If you have a strict religion, live by the law of the land AND your own religious rules and laws. As long as your religious laws don't break the law of the land, no problem. I don't have those extra strictures on my life. Go live yours, and leave me alone." BUT I don't think they can wrap their tiny little minds around that concept.

    Your writing skill is excellent, and your perspective on the issue is clear. Be well.

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  122. You have an absolutely amazing way with words, this was a fantastic essay!

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  123. Jim, thanks you so much for sharing this. Life works in strange ways, and it wasn't until after reading your blog that I really understood what my father was trying to tell me what it was like 3 years ago when my 86 year old mother died. She got up in the middle of the night, didn't come back to bed, and he found her on the bathroom floor dead. He is a retired doctor and knew she was dead. The paramedics came, the ER doctor confirmed she was dead and that was it.

    Thanks you as well for your clear writing about the right to impose whatever it is you believe on others. History, both ancient and modern, has demonstrated there is a tremendous difference between religious freedom and theocracy.

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  124. First to Marc B. above. Your phrase "I'll never understand why a heart full of faith is not compatible with a head full of facts". A profound and exceptional statement - thank you. You were not a coward, your body was under a stress response of which there is no road map or choice. Please be at peace and do not beat yourself up, if others try, don't even waste the breath on them.
    Jim, you continue to use your gift of writing and accurate thought to engage us as humans and work to change this lunacy. I am a medic of 23 years, seen death more than I wish. Shared with shattered families words last spoken, the patient asking me to do this for them. I have pieced together the obliterated bodies of teen lovers vaporized in a head on collision then tending to the parents who arrived at the scene and went unconscious.
    Death happens to us all, it is not fun, it is not glamorous. These bastards that dictate what a family should do need to ride with me or those who deal with this frequently. I love our country but we have gone way off the rails. You and many of those commenting have brought forward our only source of good ammo against these bastards - A Living Will and securing Power of Attorney.
    If and when a sizable portion of Americans finally pull their asses out of their pulpit asses, maybe we won't need to do this. Until then, don't give up the fight.

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  125. I wish you'd run for President, I don't comment here often, but I have to say this is one of my favorites. You are a gifted writer, gifted human being. Thanks for offering up sanity in midst of crazy.

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  126. Thank you for this, you said it much better than I've tried to over the past weeks. Part of respect for life has to be knowing and accepting that life ends, even if it's barely begun yet. We cannot escape that inevitability, and to force others to try out of fear is cruel and cowardly.

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  127. Thank you for this essay, Jim. You nailed it. Especially when you provided your analysis of why the protesters protested. You said

    "This isn’t about life, it’s about them, it’s about their guilt at their repeated and deliberate failure to live up to the tenets of their own belief, their abject refusal to feed the hungry, to clothe the poor, and to heal the sick. These people aren’t in it for Marlise Muñoz’s unborn baby, they’re in it to make themselves feel better and make no mistake about it – because if they weren’t, if they really truly actually believed in the sanctity of life, well then they’d actually do something about the lives they could save. All of them."

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  128. Just to illustrate how the differing laws in two states can change the entire picture I offer the following:

    In 2006, my 79 year old Dad suddenly took ill. Hospitalized, he needed a risky operation to have any chance at all of survival. Against all odds, he made it through the procedure but then, in quick succession, his internal organs began shutting down.

    Among the many blessings bestowed upon my family are my cousin and my Dad's then-living older sister, both of whom are/were nurses. They consulted with the doctors and explained to the family that there was no hope of Dad recovering- he was too weak for transplant surgery and a poor candidate anyway. Almost all of Dad's relatives were there and we all knew the same thing. The hospital could keep him "alive" with machinery almost indefinitely but the man we all loved had already relocated elsewhere.

    We are also blessed with living 150 years away from Texas so the hospital staff was helpful, respectful and utterly professional. The staff recommended the in-house hospice care, which proved to be precisely what Dad and the family needed. Dad died in peace, surrounded by those who loved him.

    Our family felt secure in knowing that our decisions were correct and his death both inevitable yet painless. Our gratitude for the doctors, nurses and the rest of the staff is unending. We also are indebted to the laws of our state, which permit a dignified death without all the drama, dishonesty and blatant hypocrisy that too often accompanies this situation in other locales.

    Should I look like kicking the bucket in some unfortunate place like Texas, I am going to amend my living will to insure that I get shipped back home so my loved ones can make the final decisions.

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  129. Jim, your post was amazing. It touched me deeply and I thank you for sharing a most personal, painful time in your life with all of us. My deepest condolences on the loss of your father. I have to add that reading all of the comments succeeded in fully demolishing me, as I sit here with tears running down my face. You are ALL amazing people and once again, thank you for sharing your painful, personal memories with us all. My mother had to go through this while honoring my stepfather's wishes after he aspirated while she was at work. She came home to find him on the bathroom floor and by the time they got him to the hospital his O2 stats were below 60. He had been extremely specific in his Living Will about what diagnostic tests had to be done and what the results had to be before he could be taken off of life support. I truly believe having those steps to take made things easier on my Mother. As easy as such a situation could possibly be. All of HIS criteria had been met, he was brain dead. I got the call and drove from Montana to MASS. as fast as I could get there, but was a day too late to be with my Mom while she had to let him go. I want to ask my Mom if I can see his Living Will so that I can write mine like that, but even 7 years later, I don't want to put her through that. My heart goes out to everyone here and to Mr. Munoz and his family. May the people who tortured him (and are still continuing to do so) rot in their Hell.

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  130. Dear Mr. Jim,
    I enjoyed the Essay. Sorry for your Loss of your Father.
    Hypocrites who bring the "God" argument into the situation that you were addressing entertain the Heck out of me. You are exactly right that "God has already made his decision" and continuation of Life at that point, is against Said entity's will. Hope for a cure is real, But unwarranted in Life support cases. "Independent Thought and Free Will" probably gave us the Tech that allowed the continuation of Life and that is the exact thing that kicked poor Adam and Eve out of Paradise. I know that you said the "A" word is off limits but isn't ANY "A" going against the natural course of Nature? So is any Cesarean section going against God's Will? So Are Cesarean's generally performed to save the life of the Child and or Mother? Free Independent Thought Has allowed us Save and Preserve Life if it's worth Living! Unfortunately Tech and Intelligence has out-paced a 2000 yr old written word (and most likely misinterpreted). Common Sense failed in those that thought that Life is worth saving after 30 min of oxygen Deprivation. I do not know the details of viability of the unborn child that was described, but the Father who Loved (and Listened to the Wishes of His Spouse) made the only decision that mattered. Everyone else is just an obstructionist and hypocrite.
    The Tears we cry for the Loss of True Love in every form, Should make us Rejoice that EMOTION FELT means that We are Alive and Emotional Response should be definition of Life worth Living. And the Greatest Tragedy of all is to Never Try to Love Again. And I hope that Mr. Munoz Finds Love again.
    And the next tear from your eye was inspired from your Father.

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  131. Your essay and the replies were heart wrenching but important to me to read. My first husband, David, died too early (although most deaths seem too early) at the age of 41. Due to his illness's progression he was on hospice. Nonetheless, I had some very difficult discussions with his step-mother earlier on when I had to make it absolutely clear his wishes would be honored and he did not want "life at all costs" as she fervently advocated for. She did become silent on the topic and I hope by the end she was able to understand why I would not torture him by forcing him to remain alive for me despite the cost to him. Carol Griggs

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  132. Your post had me in tears. And many, many of the commenters put me in the same place. My brother and sister and I, along with my Mom's brother, made the decision to take Mom off life support. I don't regret that decision. I knew, and know, it was the right decision. We talked when she was alive, and I know it is what she wanted.

    I also want to thank you for the care you showed us, the civil commenters, by moderating these comments. I know the ones you didn't let through wouldn't have been conducive to the emotions I've been feeling while reading your post and the comments after.

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  133. As a former special education worker, I can tell you that the piety also stops at actually supporting anyone with disabilities. People with moderate to severe disabilities can have pretty good lives if they are educated intensively and given supported housing and work--all of which has been ruthlessly cut, mostly by pious Republican politicians. Apparently people with disabilities are supposed to be born, canonized alongside their parents, and then dumped. The increasing scandals about the shitty treatment of veterans did not surprise me: I'd already seen it all done to kids with cognitive disabilities.

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  134. Well we all face death. And not always peacefully in our sleep. When someone who cares must make the final decision for me, I am comforted to know that it will be what I would want and not by some fanatic who intervenes. I have a DNR which I trust in my state will count for something. I also have a doctor who has not been brainwashed by fanatics and will not be cowed when the time comes to do what needs to be done. We are not talking about active euthaenasia but I am even open to consider when that might be ethical. Religion and ethics. Will the Texas godly righteous get caught up with science. No, but don't force your beliefs on me. Believe what you will, don't insist you own my life or my conscience. We consider moving to TX long ago, also North Carolina. Lucky we still live in Hawaii. I have a story of end of life, but I would have a tough time telling so I will not. Great piece. One that Neil De Grasse Tyson and Bill Moyers could not write better, Jim. Peace.

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  135. Jim, thank you for this.
    My daughter was diagnosed with early childhood on-set Sandhoff disease when she was 5 years old. Sandhoff is always fatal. At the time of her diagnosis, we decided our goal was to make her as comfortable as we could for the length of time we had left with her, balancing her quality of life with our need to keep her. When Jennie developed multiple pulmonary emboli when she was 10 years old, we knew it was time to let her go. So we took her home from the hospital, stopped antibiotic treatment, kept her comfortable with morphine and let her go. She died 2 weeks later, in her own bed, in my arms, after family got to come and say their good-byes. Making the decision to curtail treatment was, OUR decision to make. Heart-wrendhing and heart-breaking, but it was ours to make. I miss her every day, but I never doubt we did the right thing. Thank you for writing so eloquently on a topic that touches so many of us.

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  136. I went through pretty much the same thing, it will be ten yearsmago in Feb. My mother had a living will, order that if she was kept alive by machines, turn them off and let her pass, my father had one also. She was in a coma for about two weeks, she turned 63 while in a coma, and my father didn't want to go threw with it. So my two sisters came to me to talk me into, talking him into it (I was not brave enough to start this myself)so I finally went an talked him into it, that does not sound good, does it, it was not the way I did it, but I really put into word what I did. But, he finally agreed it was what she wanted, but not what he wanted, when they shut down the machine, she smiled before she passed after a couple of minutes.

    Actually, I think It would be harder for someone to lose a spouse, than a family member, a family member is someone that is chose for you...but spouse is someone you choose to live with as your partner for life(in my case).

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  137. Great post, Jim. Both of my parents were gone by the time I was 23 and though I will always wish I had had more time with them, I am not sorry I will never have to make the decision you and your family made. I've had to do that with pets but I can't imagine how much more difficult it must be for a family member. As far as this horror story goes, it never ceases to amaze and sicken me to see how these proponents of "life uber alles" whenever a fetus is involved continue to spout their bullshit about government infringing on our lives, blah, blah, blah. They continue to encourage and endorse intrusion of the worst kind by sticking their righteous indignation into the most personal of places, the most private of decisions. The hypocrisy of these so-called humans is astounding. They should all be rounded up and shot into space because they contribute nothing to the cause of humanity on this good Earth.
    Thank you for sharing your pain, all of you-though I believe I would have the strength to make the call, I know now, more than ever, how glad I am I was never in that position. I only hope someone will do that for me when the time comes.
    Pam in PA

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  138. I am a cancer survivor. .. For myself and my friends, especially those that have already made the decision that you discuss, I thank you, this is an honest and well written post.

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  139. Thank you for a beautifully written piece. As a pediatric physical therapist, I have seen programs for handicapped children cut year after year( my personal opinion is that children can't vote and their parents are so overwhelmed with caregiving tasks, that they can't bring any time/energy to fighting the "system" that is failing them)..."life at all costs" can be torture for all involved.

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  140. Thank you for this post. This is such a traumatic and critical decision for us to make and then we have to hope no one interferes with our decisions. Thank you also for reminding me that we need to do this and have such things decided just in case because you never know.
    Thank you again.
    M from MD

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  141. InCalifornia, we have the opposite situation going on. Jahi, age 13, suffered a cardiac arrest after throat surgery for sleep apnea. She has been declared brain dead, and the family wants to keep her alive waiting for some miracle. The court has said doctors can turn off the ventilator, but the family has successfully fought to keep her on a vent and feeding tube. Here becomes the opposite moral dilemma. When is a person really dead? Who is paying to keep her alive? Is the the public or the family or the money from the resultant law suit.Or does the hospital (you and I) pay the cost.
    These are difficult decisions. I know we had mom taken off the ventilator after the hospital postponed and postponed repairing her broken hip until she was so sick with pneumonia that she couldn't breathe on her own. WE made the decision that that would be what she wanted, and no one stood in the way (least of all the hospital as it was costing them to keep her alive). I have always been sad about that decision, but I know it was the right thing to do after we did all we could to get her better. There are no easy answers in this situation, and it will only get worse as technology gets better.

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  142. This is a great post. You give voice to my exact views.

    The idea that others, outsiders, can use the internet to spread their vile, gets under my skin something fierce. The fact that I currently reside in Texas, means that the ignorance pointed to in this post, mouthed by our "elected" officials: doesn't surprise me either.

    Surprisingly, this month, the male model Fabio had something rather enlightening to say... "...unfortunately when you mix the most spiritual things in the universe with money, many times you get religion." I'm still kinda shocked by that!

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  143. This
    "That God? The one that sent Marlise Muñoz a blood clot as a baby shower gift? Is that the God we’re talking about here? Because if that’s the case, and if you really believe in this stuff, then it would appear on the face of things that Patrick’s God has made His decision brutally apparent: pull the plug. "
    reminds me of the McCaughey septuplets. They were conceived with the use of fertility drugs. If anyone remembers, they were CONSTANTLY saying how "God had blessed them." Um, no. "God" actually said "Yeahno, you've got all the kids I'm going to give you." It was science that said "Sure, we can help."

    In addition, they had a ton of help from friends, neighbors and strangers for childcare and donated stuff. But every time you saw them on the news it was all how "god" had provided for them. If I had been one of those neighbors, I would have stopped helping double-quick. Used to piss me off to no end!

    Jim, I love all your writings, but this was in a class by itself! And to all of you who wrote about your own heartbreaking tragedies, you have my deepest, and most sincere sympathies.

    My mom died when I was 11, (and my dad was never in the picture) and while, of COURSE, I wish I had had a mom these past almost 50 years, I guess the one good thing about her early death is that I won't have to make this decision for a parent.

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  144. Oh, and one more thing...when I talk with anti-choice people they will ALWAYS say "Well, what if your mom had A-ed you?" and I always reply "She probably would have lived longer (she died of a stress-related disease. Being a single mom in the 50's was really hard!) and definitely better, and I wouldn't have known the difference.

    April

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  145. Jim,
    Thank you for your hard-headed moderation. Your firewall has made this comment section one where it is possible to read and deeply ponder each comment. It is a peaceful, respectful space. And thank you to all the commenters for your stories. While I hope and pray that I will not need to make the difficult decisions that you have had to do, your stories give me hope that I will be able to be as strong as you have been if the necessity does happen.

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  146. I've been a reader for a long time, Jim, and always nod an "amen" to what you have to say. Here, no exception. These fanatics will employ any science if it serves their own purpose (keep a dead woman alive so a fetus lives, use fertility drugs, etc) but will suddenly cry "God's will" if others use science to an alternate purpose (contraception comes to mind). You said it's to feed their egos, and that really struck me as being absolutely true.

    Keep up the good work.

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  147. Mr Wright:

    I used to be a hospice nurse. I am not now, but have been thinking about returning to it, as it is often heart rending, but never unfulfilling.

    I never once saw a family make a wrong decision about a dying relative. Never. Not to say that even with all the legal paperwork in place and the presence of hospice they were without hesitation or doubt, but ultimately their decisions were guided by love and compassion. That a government would choose to remove that from this family is horrifying. How sad that their grief was interrupted by having to fight a legal battle for the right to perform the final loving act for a woman who was wife, daughter, and mother.

    Thank you for your thoughtful post.

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  148. I discovered when going to bed one night 3 years ago that my wife had died in her sleep. I was in the position of having to do CPR, but not wanting to, because her lips and nail-beds were blue, and she wouldn't have wanted to live brain-dead, which she would have. Luckily the issue didn't come up. It's a horrible position to be in. People should mind their *own* business.

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  149. I must have been so lucky in the doctors I have known - for my darling Mom they told us "it is time to turn off the machines" and for her loving husband - just a few months later we were told it was pointless to turn on the machines, we should give him peace to leave quietly.

    I cannot imagine ever being in the place that Eric Munoz found himself - the people that should have cared the most lost all sight of reality - the fear of retribution from a state that is so far outside of the harm they do - that cares only for the unborn at the expense of all others - led them down a path of absolute failure.

    Your ability to expose the truth of the tale is in a class of its own - many thanks

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  150. Couldn't have said it better if I tried. Well written. Too bad those that need to read it, with comprehension, will not. Or, they will read it and have the opposite reaction because they are blinded by religious doctrine. Cases like this make it clear that there must be separation of state and church. I have no problem with religion, any religion, but when it interferes in the life of others it has gone too far, because religion should only ever be a personal experience.

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  151. Spectacularly well said, and thank you again, Jim. I am out of Texas, but have sisters, cousins and nieces there whom I fear for daily - as females, their rights are increasingly precarious.

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  152. I really, really wish that issues about personal medical matters (of all kinds) could be kept out of the media. But provocation is what the media (especially cable news) feeds on. So I won't be holding my breath waiting for anything to change.

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  153. Wonderful read. Having the same experience with my 90-year-old mom... You brought it and spoke it true.

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  154. Thank you Mr Wright and all who have commented here .
    I agree this should have been Mr Munoz' decision and his alone.
    When this story first hit the news, I felt that Mr Munoz went through the first stage (hoping for a miracle to restore his beloved wife to him ) of dealing with this heartache when he performed CPR and that he honored her when he accepted her brain death and requested withdrawal of life support. That this turned into a frickin circus makes me sick.
    Sometimes I don't agree with folks' decisions but that doesn't change that I think they have a right to make those decisions- with very few exceptions.
    The exceptions do not include what happened to this poor man and his dead wife.
    The willful refusal of the hospital to declare brain death for so long, alongside the refusal to deal with the damage done to the fetus Mrs Munoz was carrying made a sad and horrible event into a tragedy I can hardly get my mind around.
    I can ignore the doofs , though I'm sure Mr Munoz couldn't/can't, who called him a murderer and worse but I cannot ignore the politicos who want to "strengthen" this misapplied law in sicko interpretations of the sanctity-of-life and protecting-innocents.
    Both of those terms have meaning in law and meaning in religion . Confusing the line between law and religion is unacceptable. The long battle to accept , in law, advance directives, DNRs, and the like as relates to terminally ill folks turned on sorting out whether the state had/has a compelling reason to intervene in private lives. What we have now in most places in the country is a wary set of compromises and a generalized notion of what one commenter above called the sanctity of death.
    The constitutionality of Texas' law, as it stands now, was not sorted out by the court. The judge simply said that that Mrs Munoz was legally dead and therefore the law did not apply.
    I think the law stinks for various reasons,many of which others have touched on, but am horrified that that some of these idiot politicos think it should be beefed up to cover what happened here in favor of a deeply flawed notion of "life"
    IF this was at the base of this public hospital's behavior:
    "The law protects the hospital from all liability as long as it keeps the pregnant patient on life support. It doesn't actually forbid the hospital to remove support, but the hospital loses its legal immunity if it does. And that seemed to be the guiding light for the lawyers representing John Peter Smith Hospital."
    http://www.npr.org/blogs/health/2014/01/28/267759687/the-strange-case-of-marlise-munoz-and-john-peter-smith-hospital
    I hope something real is done to censure/remove/slap the hands of decision makers there.

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  155. Jim, I know that you are probably shoveling away drivel-filled comments by the dozen, but I think it is sad comment in itself that there have been no intelligent (or at least semi-grammatical?) comments taking the opposing side on the matter of Marlise Munoz.

    For what it is worth, since I posted here yesterday I googled on "Catholic response to Marlise Munoz" and came up with a couple of articles, both of which commented on the Jahi McMath case and the Munoz case and which both are about 2 weeks old:

    http://ncronline.org/news/people/ethicists-criticize-treatment-brain-dead-patients
    http://www.catholicnews.com/data/stories/cns/1400137.htm

    But it is one thing to have serious theologians weigh in and politely disagree with each other, and another completely to have asshats like Operation Rescue and similar groups protesting outside the clinic and publicly accusing Erick Munoz of wanting to kill his wife and child. And Christians wonder why some people view us as idjits?

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    Replies
    1. I have received exactly ZERO intelligent, reasoned, and well written counters to this post. Zero.

      EVERY SINGLE ONE is composed of screaming, illiterate, hate filled religious bile. I've been called things you can't begin to imagine. Every single counter response - and that's about 350 or so now - is completely nuts, disturbingly so. Frankly, given the sample, I have to wonder if religion, and particularly religion driven right-to-life, isn't some kind of rage disorder or a cult on the order of Westboro Baptist Church. These people are functionally insane, there's no other way to describe it.

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