NEJM Interviews NEJM Interview: Katie Watson on the interaction of abortion laws with advance-directive and end-of-life laws.
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Jul 23, 2025 Katie Watson dives into the complex intersections of abortion laws and end-of-life directives. She discusses the ethical quandaries surrounding the treatment of brain-dead pregnant women. Specific cases illustrate the tension between state regulations and family decisions. The conversation highlights the heavy burden on healthcare providers as they navigate these sensitive legal landscapes.
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Adriana Smith Brain Death Case
- Adriana Smith was declared brain dead while pregnant, and her baby was delivered by cesarean at about 25 weeks.
- Her mother reported the hospital said Georgia's abortion law prevented removing life support, though the hospital was not publicly explicit.
Marlies Munoz Legal Battle
- In Texas, Marlies Munoz was kept on mechanical ventilation despite family wishes due to a state law suspending advanced directives for pregnant women.
- The family successfully used a statute prohibiting abuse of a corpse to stop treatment in court.
Distinguishing Abortion and End-of-Life Laws
- Abortion laws typically do not govern decisions to withdraw life support in brain death; ending support is an omission, not commission.
- Advanced directive statutes suspending patient directives for pregnant women do not mean forced continuation of body support; surrogate decision-making still applies.