Pregnancy and End-of-Life Care: An Example of the Medicolegal Junction Gone Wrong

Many state laws contain pregnancy exceptions to advanced directives. There is no uniform standard by which states decide when pregnancy should override a patient’s advanced directive. The issue of the pregnancy exception was brought to public attention in the Texas decision in Munoz vs. John Peter Smith Hospital. Munoz focused on the pregnancy exception with respect to a pregnant but brain dead woman. This article addresses Munoz, in part through use of a hypothetical situation, in order to raise the question of whether or not the pregnancy exception might better be addressed through uniform laws that are in line with current abortion law. This article also touches on the impact of the pregnancy exception on pregnant women who are not brain dead but who are incapacitated and the ethical implications of these laws on patients and medical personnel.