Make People Listen With An Advance Medical Directive

March 6, 2014Articles

The recent Texas case of Munoz v. John Peter Smith Hospital highlights the need for all individuals to have an advance medical directive (known in Pennsylvania as a Health Care Power of Attorney and Living Will) in place to ensure their wishes are respected. Ms. Munoz was pregnant with her second child when she suffered a pulmonary embolism that left her brain dead. Despite being brain dead, the hospital kept Ms. Munoz on life support for two months because taking Ms. Munoz off life support would have resulted in the death of her fetus. Ms. Munoz had previously told her family of her wishes not to be placed on life support. Unfortunately, Ms. Munoz did not put her wishes in writing in the form of an advance medical directive.

Despite Ms. Munoz’s wishes, the hospital caring for her refused to declare Ms. Munoz legally dead and refused to withdraw life support. In support of its position, the hospital stated that the Texas Advance Directives Act prohibited it from withdrawing life support from a pregnant woman. Ms. Munoz’s family went to court to compel the hospital to withdraw life support. The Texas court ruled that the Texas Advance Directive Act prohibiting a pregnant woman from being taken off life support did not apply to Ms. Munoz because she was already legally dead.

Ms. Munoz’s unfortunate situation presents a unique set of facts. It's possible that an advance health care directive may not have helped her family resolve the case. Nevertheless, the case reminds us why everyone should have a written advance medical directive in place. An advance medical directive allows a person to refuse life support in advance and appoint an agent to act for the person with respect to medical decisions. Although courts do consider oral communications to friends and family in determining whether to remove life support, there is no substitute for a written advance medical directive. Every person age 18 and over should have one.