Tag Archives: texas

Life support is a reproductive justice issue, too

27 Jan

It’s a story that by now most of America has already heard, and no matter what side of the fence you sit on, it is heartbreaking. In the early morning of November 26, 2013, 14-week pregnant Marlise Muñoz of Texas was found unconscious in her home and rushed to a hospital. Her husband Erick was told that she most likely suffered a pulmonary embolism, she was brain-dead, and that the fetus may have been deprived of oxygen. Marlise and Erick were both trained paramedics, and Erick believed that she would never choose to prolong her suffering, so he and her family chose to terminate her life support.

The hospital, however, had different plans, and informed the family they would not remove her ventilators and respirators, citing a Texas law that hospital spokesperson Jill Labbe says prevents them from “withhold[ing] or withdraw[ing] life-sustaining treatment for a pregnant patient”. The law was passed in 1989 and amended in 1999, and while the hospital maintains that it has followed the letter of the law, medical ethics experts say they are misinterpreting it. Legal experts and Muñoz’s family are speaking up to change the law. The essential question is whether the law applies to brain-dead patients or whether it was intended for pregnant women in comas or vegetative states.

While my effort to research the history of this particular law to trace anti-choice influence failed, a New York Times article did attribute Drexel University bioethicist Katherine A. Taylor with the information that this and similar laws nationwide were adopted in a period in which the public was concerned with “advance directives about end-of-life care like living wills and health care proxies…The provisions to protect fetuses, she said, helped ease the qualms of the Roman Catholic Church and others about such directives”. Another medical ethics expert, Jeffrey P. Spike of the University of Texas – Houston, said in the same article that other brain dead women had been kept on life support to keep the fetus alive, but every case he was aware of was supported by the family’s wishes.

While this is not a case that involves abortion, it is interesting to note that at 14 weeks gestation, Marlise Muñoz, had she been conscious, could have legally chosen to obtain one for any reason. Yet after brain death occurred, her husband who legally would hold power of attorney rights could not make an end of life decision for her and their unborn child, who most likely would either not live or have gravely impacted quality of life due to lack of oxygen.

And let me clear, because the fetus we now know has been very seriously harmed. At 14 weeks gestation, all the doctors knew was that the fetus had a heartbeat. They said they could do more testing between 22 and 24 weeks, and this week, at 22 weeks, they have now conceded that the fetus is not viable. It has fluid build-up on its brain, its lower extremities are so deformed that gender cannot be determined, and it may have a heart problem. The suffering of Marlise Muñoz and her family has been mercilessly prolonged while the state forced her to be an incubator for a fetus that could not survive anyway. This was hardly a guessing game; medically there was very little chance that the fetus would survive. NYU bioethicist Arthur Caplan wrote an editorial for the LA Times detailing why John Peter Smith Hospital was misinterpreting law and also argued that the law was unconstitutional. In a later exchange with Emily Bazelon at Slate, he says there are “almost no cases of trying to bring a 14-week-old to term in this circumstance”.

The story does seem to be coming to a just but sad end, as a Texas judge on Friday, January 24, ordered the hospital to remove Marlise from life support by 5:00 p.m. on Monday. The hospital may appeal but Labbe has said, “the courts are the appropriate venue to provide clarity, direction, and resolution in this matter”. The judge declined to speak to whether the law in question was constitutional.

While the Muñoz family is hopefully reaching the end of this terrible battle and can lay to rest Marlise and the once potential child they had looked forward to welcoming into the family, this case must serve to open the eyes of those concerned with reproductive justice issues. This law is the sort that sounds good on paper but is pushed by anti-choice zealots to further the precedent for giving the fetus rights that supersede those of women. Thirty-one states have laws on the books restricting end of life decisions for terminally ill pregnant women, and Texas is one of 12 with the most strict laws, requiring life support even in earliest pregnancy. Let me rephrase that: in more than 60% of states, women, their families, and even their doctors may have no say-so in a decision to be removed from life support if the woman is pregnant. In almost one-quarter of states, it does not matter if the pregnancy just began and the fetus has been harmed to the point of having no quality of life. It seems to me that when a woman has the legal right to terminate a pregnancy, a woman who is legally dead should not be kept mechanically alive to incubate a fetus despite her next of kin’s wish to remove life support.

Marlise’s family has said several times they don’t view this as a pro-life or a pro-choice issue, and while I must respectfully disagree, it is important that we respect her memory and do not take part in continuing to make their experience so painful. While anti-abortion protestors congregated outside of the courthouse on Friday and Marlise’s family had to push through them, reproductive justice advocates should honor Marlise as a woman and mother and beloved family member. Marlise and her unborn child deserved a more dignified end of life than what they have had and her family deserves peace and healing. This law robs everyone involved of their dignity and does nothing to protect or respect the people facing such devastating experiences.
The hospital announced Sunday morning that it would comply with the judge’s order and not appeal the decision, removing Marlise Muñoz from life support by 5 PM on Monday. Less than an hour later, the family released a statement that she had been removed from life support.

Same As It Ever Was: The incremental denial of abortion access in Texas

11 Nov

A guest post from Sarah Tuttle, Lilith Fund Board Member. 

The recent HB2 decision by the 5th Circuit Court of Appeals has meant a busy week in abortion access circles in Texas.  Many of us on the ground were unprepared for such swift action.  We were just adjusting to the 20 week ban which had come into effect, and were working to prepare for whatever came next.

Both the summer of action at the Capitol, and the swift motion of the court case, has awoken many people to the cause. We made jokes over the summer about taking a ship to international waters off the Gulf of Mexico where we’d have a doctor available to perform abortions. Joking was one of the only ways to shake the feeling that we were traveling back in time in an unexpectedly cruel way. It has been fantastic to see so many people rally, realizing a right we thought was secured by the Supreme Court was in such a vulnerable position.  For many people it was the first time they stopped to think about the effects that could ripple through the lives of Texans.

I serve on the Lilith Fund board and run our hotline committee. I’ve been with Lilith for a year and a half. And I’m here to remind you of something that I feel is lost, even when we talk with our allies.  Our clients are people. This isn’t just a cause. These are people’s lives, people’s families. Our clients are not just patients, stories, plantiffs, witnesses or data.

Passionate, well-meaning people from all over the country are calling and emailing Lilith to help, to donate,  and we are beyond grateful.  But when we get suggestions that we should start an “Abortion Underground Railroad,” we cringe.  This is not slavery.  This is not the time to appropriate the pain and suffering of generations of African Americans to try and comprehend our own.  Many of our clients our Latina and African American. We refuse to add insult to injury.

People are calling the Lilith Fund to offer rooms and rides to support abortion access.  We’re not the right people to talk to. There are practical support networks slowly growing around Texas to pool these resources.  These networks will be critical in the next few months, especially with the danger of the “Ambulatory Surgical Center” requirements looming in September. We could be down to a handful of clinics, and travel will become an even larger problem.

But the scope of the issue, of people being denied abortion because of lack of resources, this is not new. It is exacerbated by HB2, not created.  In just the last three years, we have been able to raise over $100,000 per year. Last year we provided over $80,000 in direct assistance to people who needed abortions. We do not come even close to meeting the state-wide need for financial assistance.

Even before HB2, Lilith was unable to meet the need of all our callers. We serve a portion of Texas (the rest is served by the Texas Equal Access fund).  Our hotline is open 3 half days a week. Each shift we get between 15-30 calls. We can usually fund less than half of them.  Our funds only cover a fraction of their abortion. For those who are earlier in pregnancy, perhaps we can cover a third of their procedure. For those further along we might only be able to cover a fifth, or a tenth. Our clients mostly get referred to us by clinics. We never even see those unable to reach a clinic.

The Lilith Fund has operated for over a decade. We work with our data to try and best meet our clients needs. We recently saw a dip in our redemption rate (how many clients actually redeemed their financial aid vouchers).  Data analysis revealed what you might have guessed: higher voucher amounts lead to higher redemption rates. Giving higher vouchers means helping fewer people. But obviously an unredeemed voucher implies no help at all.  We raised our voucher amounts.

Even this year, which has been an incredibly good fundraising year (for deeply frustrating reasons), we have nowhere near enough resources to meet the growing need for abortion funding. We talk to our clients to assess what their situation is, what other pressing needs they have. They may have a long way to travel.  They may have children that need looking after.  They may be struggling to get enough hours at work. There is not enough money to cover all their needs. When they call us they are already borrowing from friends, already pawning prized possessions. They are postponing their procedure a few more days till they get that next check, or taking from grocery money for a few weeks running.

When I give clients financial assistance vouchers, I am also giving practical support. My voucher frees up money for other things – maybe it is gas, or childcare. Maybe it is to pay rent.  When I give a client funding for an abortion, I am trusting her to decide what she needs. I am respecting her. As a person.

I understand the urge to give things, to share resources. But I think it is crucial to examine our motivations, especially when we reach out to those in need. One of the biggest indignities of poverty is the loss of choice. Not being able to choose the food you feed your family, not being able to choose the gifts you give your children at Christmas.  When I fund abortion, I hope that one of the things I’m giving is agency.  I respect you to look at your available resources and do what is best.

Our clients are people. They are not just stories, or placeholders, or ways for us to channel our activism. They are people who deserve respect, kindness, agency, and support while they live their lives. This isn’t just a cause, or something they can walk away from or take a break from. This is their life. In this moment, I hope we can provide the support they need.

Wendy Davis, SCOTUS, and Me

28 Jun

This week was supposed to be a week that my identity dreams of. In a courageous, willful and extremely humane act, I saw Texas state legislator Wendy Davis stand on the Texas State Senate floor for 12.5 hours, at one point requiring a back brace to continue the marathon filibuster that was felt around the country and for that matter the world. As an abortion provider I really have not seen this type of activism in the Texas legislature for abortion rights so blatantly in my time. Yesterday the Supreme Court of the United States (SCOTUS) struck down DoMA (Defense of Marriage Act) and I cried. Literally felt a piece of my humanity touched upon and acknowledged as an equal. So why am I not shitting puppies and pissing rainbows? What more could I want as a queer abortion provider from my country at this point? I mean literally what more can I say?

Well, a lot. I have a terrible taste in my mouth and I cannot take the grimace off my face as my constituents celebrate their gains but why not me. Of all the identities what is keeping me quiet and in a somber state? The Voting Rights Act. Yes the VRA of 1965 section 4.

On Tuesday 06/25/2013 the SCOTUS struck down a key piece of civil rights legislation. Not only because of all the “other” things going on has this not been highlighted adequately, but also because I fear that it was intended to illustrate the lines and division I feel uncompromising about in these movements.

On Wednesday I walked into my office dragging, thinking about re-districting, gerrymandering, histories of people that have been silenced for too long. In my “radical” workplace this is normal, we are considered activists; even when we make copies, they are abortion copies. We are all about options and specifically I contribute to people with uteruses having more bodily autonomy (but that is another blog). But today my whole office is abuzz. “Don’t mess with Texas” is written on our white board. People are high-fiving and talking over one another, and I was excited for a second until I realized that there was a chance that no one knew that people of color and other marginalized groups lost their right to vote. I didn’t want to rain on the parade or make identity politics an issue, a common tool in avoidance, for me when I am just tired of being the one bringing it up. And I am not the only one too, ColorlinesCrunk Feminist Collective, Racialicious, black girl dangerous, and others are having this critical conversation. But I let it slide, this Wendy Davis situation was amazing and really white but still amazing. Early in my day I got Facebook messages, emails, texts, and even called my best friend! DoMA is done!!!! Maybe a half an hour later I realized the SCOTUS would be praised as equality driven, and this was untrue. The SCOTUS DoMA decision was a huge win for the lesbian and gay community and again somehow amazing and white but still amazing.
SCOTUS just did major damage to the Civil Rights Act which even George W. Bush didn’t debate in 2006. Congress re-authorized the act in 2006 after hearings that used data from 1975, however they still extended the preclearance for 25 years. I felt encouraged to know that Ruth Bader Ginsberg in her dispute stated powerful things from a powerful seat.

“Congress approached the 2006 reauthorization of the VRA with great care and seriousness. The same cannot be said of the Court’s opinion today. The Court makes no genuine attempt to engage with the massive legislative record that Congress assembled. Instead, it relies on increases in voter” registration and turnout as if that were the whole story. See supra, at 18–19. Without even identifying a standard of review, the Court dismissively brushes off arguments based on “data from the record,” and declines to enter the “debat[e about] what [the] record shows.” Ante, at 20–21. One would expect more from an opinion.

The record shows responses of where we are in the first few days of the decision. Racism is real and the fact that the VRA only effects 9 states is a red flag for the country. Those states have been identified as unable to provide a basic function inside of democracy, a vote. With Texas re-districting the day after the VRA was decided only further exasperates the issue. The crossfire of having the SCOTUS blow up a fundamental civil right and turn around and grant another seems devastating, confusing, and also splits the people for whom these issues are both/and. What reaction does a gay or lesbian person who is POC (people of color) have? This is where who you are and what you are connect. This is the crux of my internal debate, I am supposed to be happy, but deep down I know I did not win. In fact somehow I actually did not get seen at all.

So this is my point, many people need us and when we get hyper vigilant and focused on our own facets of our identity, we forget that our liberation is intertwined. Once we are able to bring our full complicated selves to the table we can stop feeling torn and lost in between these lines. Allies need to recognize that the SCOTUS also failed and some decisions were acceptable. I thought about why I am feeling out of sorts with this. What about having my intelligence played on is so irritating. Having a co-worker send me a statement about “ two steps forwards, on step back” feels belittling, people you care about say, “if I was you, I would be more upset” feels isolating, and the media not even mentioning Tuesday as a double whammy blow, and giving space to the Indian Child Welfare Act, is just another slap in the face.

I think we should all be concerned. A part of the country has had their voice returned to pre-1965 era, in direct correlation to race. We are all living here. This is our shared reality. It all impacts every one of us. I just wanted some intersectionality, and with that there is much more that I could say.

We Love You, Texas

26 Jun
Texas Feminist Army! Image via.

Texas Feminist Army! Image via.

Last night, hundreds of pro-choice Texans and a badass Senator stood for over 13 hours to make sure that a terrible anti-abortion bill DIDN’T PASS the senate. AND THEY WON. They fucking won.

If this has got you feeling inspired, support the local Texas organizations working every day to make abortion access a reality:

The Lilith Fund

The Texas Equal Action Fund

Planned Parenthood of Greater Texas

NARAL Pro-Choice Texas

Whole Woman’s Health

And of course, the inimitable Senator Wendy Davis.