May 9, 2019

Mayo researchers find states sometimes invalidate pregnant women’s medical directives

By Karl Oestreich

Star Tribune
by Jeremy Olson

State policies differ dramatically on what to do if pregnant women are dying and are too incapacitated to express their wishes, Mayo Clinic researchers found. Twenty-five states would invalidate advance directives and continue life support in incapacitated pregnant women, in some cases regardless of whether their babies are likely to be saved, the researchers found. Nineteen states also would restrict surrogate decisionmakers in these scenarios. While the variation was surprising, the researchers said they were concerned about the lack of transparency. Out of 30 states that would restrict decisionmaking, only 11 required disclosure of such restrictions on advanced directive forms. “To not have that disclosed, that when you are pregnant the form you are signing carries no force … is really troubling,” said Dr. Erin DeMartino, the Mayo critical care specialist who led the study along with a national group of bioethicists.

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Context: Half of all U.S. states have laws on the books that invalidate a pregnant woman's advance directive if she becomes incapacitated, and a majority of states don't disclose these restrictions in advance directive forms, according to a study by physicians and bioethicists at Mayo Clinic and other institutions.

The report, published this month in the Journal of the American Medical Association, reviewed statutes in effect as of February in all 50 states and the District of Columbia. All states have laws regarding decision-making for individuals who can't make their own medical decisions, but the content of statutes and advance directive documents for “decisionally incapacitated” pregnant women nationwide varies widely. You can read more about the study on Mayo Clinic News Network.

Contact: Kelley Luckstein

Tags: advanced directive, Dr. Erin DeMartino, Journal of the American Medical Association, pregnancy, Star Tribune, Uncategorized

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