Life, death and small government
Syndicated columnist Leonard Pitts Jr. writes about the role of small government in health decisions. “Sometimes small government isn’t nearly small enough.”
Marlise Munoz was 33 when she died.
She was at home when she collapsed from an apparent blood clot in her lungs. It was an hour or more before her husband, Erick, found her. He says doctors pronounced her brain dead, though John Peter Smith Hospital in Fort Worth, Texas, citing privacy concerns, has declined to confirm that diagnosis.
It is, at any rate, nearly a month and a half since this happened, yet Marlise remains hooked up to life support. Her mother wants her removed. Her father wants her removed. Her husband wants her removed. He says his wife — like him, a paramedic — specifically said she never wanted to be kept alive by artificial means.
But the hospital has refused the family’s requests, citing a Texas law that prohibits taking a pregnant woman off life support. And Marlise, the doctors found, was 14 weeks along.
As it happens, this family’s plight is the inverse of another that has recently transfixed the nation. Marlise’s family wants her removed from life support, but the family of 13-year-old Jahi McMath fought to keep her attached. McMath was declared brain dead by a hospital in Oakland, Calif., after complications from surgery to remove her tonsils. This triggered a legal struggle that was resolved last week when the hospital released Jahi to the coroner and the coroner released her to her mother’s custody. Jahi is now receiving “treatment” at an undisclosed facility and her family says her condition is improving.
It seems unlikely. The cessation of neurological function is not some “technical” death. Experts say that in such cases, the brain liquefies, which would seem to be about as dead as you can get. So one suspects Jahi’s family is simply seeing what it needs to see.
That said, who can blame them? Who among us has the right to foreclose their prayers or the wisdom to draw some hard and fast line beyond which faith becomes foolishness and steadfastness an excuse to ignore reality? Who among us in the same situation would want somebody to substitute their judgment for ours — particularly if that somebody was some politician who’d never met us or our loved one?
This is what makes the situation in Texas particularly galling. Why is the state — not a doctor, not a faith leader, but the state — interposing itself in one of the most wrenching and intimate moral choices a family can ever make? What gives it the right?
There is a political paradox here. Texas, of course, is a very red state. As such, it prides itself on small government. The idea that citizenry functions best under the least government interference is an article of faith and the prime directive of the Republican Party.
But the state’s interference in this family drama highlights the loophole in that ethos. Its advocates want small government when it comes to regulating firearms, the environment, education, business and taxes. But when it comes to regulating your personal morality, the same people suddenly want government to be the opposite of small. They want it big enough to peek over your shoulder, the better to ensure your choices line up with its ideas of right and wrong.
Thus it is no accident the party of small government is also the party of anti-gay legislation and transvaginal ultrasounds. Or that, in making the most anguished decision of his life, Erick Munoz finds himself saddled with help he did not ask for and does not need.
His father-in-law, Ernest Machado, told The New York Times the state has made his daughter “a host for a fetus.” Indeed. In seeking to protect a life not yet viable outside the womb, it has reduced its mother to a thing, and robbed her family of its right to say a dignified and proper farewell.
And that paradox glows like neon. Sometimes small government isn’t nearly small enough.
© , The Miami Herald
Leonard Pitts Jr.'s column appears regularly on editorial pages of The Times. Email: email@example.com