Compassion Legal: The End of Life Justice Center at Compassion & Choices, If/When/How: Lawyering for Reproductive Justice, and Irigonegaray & Revenaugh applauded a ruling by Douglas County District Court, in Kansas, denying a motion to dismiss their state lawsuit on behalf of three Kansas women and two Kansas physicians. The lawsuit, Vernon v. Kobach, challenges the constitutionality of a Kansas law that invalidates a person’s end-of-life treatment decisions in their living will if they are pregnant.
The Court ruled that all plaintiffs have standing to bring their individual claims now, and that their case presents viable legal claims, allowing for the case to move forward.
“We welcome the Court’s decision and the opportunity to move forward and prove that our plaintiffs are entitled to the same fundamental rights the Kansas Constitution guarantees to every Kansan,” said Jess Pezley, senior staff attorney at Compassion Legal.
She continued, “Stripping people of their right to make deeply personal end-of-life decisions simply because they are pregnant is offensive, discriminatory, and blatantly inconsistent with the Kansas Constitution.”
“The deeply personal decisions we make about how we will birth and how we will die should belong to us, not the state. We are excited to continue fighting to ensure all Kansans are afforded the same fundamental rights,” added Farah Diaz-Tello, Senior Counsel and Legal Director at If/When/How. “Everyone deserves to be able to make decisions about their body and their life. Pregnancy is no excuse to deny someone their fundamental rights and basic dignity.”
Kansas’ Natural Death Act recognizes that, “adult persons have the fundamental right to control the decisions relating to the rendering of their own medical care, including the decision to have life-sustaining procedures withheld or withdrawn in instances of a terminal condition.”
Kansas law denies this fundamental right to pregnant people, automatically invalidating their living wills through the Pregnancy Exclusion.
In his May 22, 2026 opinion, Douglas County District Court Judge Mark Simpson found that the state’s preemptive invalidation of pregnant individuals’ advance directives injured the plaintiffs by infringing “their constitutional right to refuse unwanted medical treatment” and their “fundamental right to control the decisions relating to the rendering of their own medical care.”
Plaintiffs include three individuals capable of becoming pregnant – each of whom either have children, were pregnant at the time of filing, or want children in the future – and two Kansas OB-GYNs who regularly provide care to pregnant and pregnancy-capable patients.
The plaintiffs are:
Patient-Plaintiffs argue this law violates their fundamental rights of personal autonomy, privacy, equal treatment, and freedom of speech by categorically disregarding their clearly expressed end-of-life decisions if they are pregnant. Plaintiffs ask the court to permanently prohibit Defendants “from enforcing the Pregnancy Exclusion by invalidating otherwise valid health care directives based on pregnancy status or bringing any adverse action against a provider for following the directions in a pregnant, incapacitated individual’s validly executed [living will].”
The issue of Pregnancy Exclusions in advance directive laws gained national attention in 2013 with the tragic case of Marlise Muñoz — a Texas woman who was approximately 14 weeks pregnant when she was declared brain dead. Even after her death, the hospital refused to cease medical interventions, citing Texas’s Advance Directive Act, which – like Kansas’ law – invalidates a pregnant individual’s refusal of life support. A court ultimately ordered the hospital to disconnect the machines from her body, but only after Ms. Muñoz’s family endured months of trauma from the prolonged and unwanted treatment and the loss of Ms. Muñoz’s baby.
While the facts of that case were unique, it stands as a stark and extreme example of how Pregnancy Exclusions can be used to override the decisions of individuals and their families, even after they have died, stripping them of the right to make deeply personal end-of-life decisions.
Compassion Legal and If/When/How have successfully challenged pregnancy exclusions in other states. In 2021, an Idaho federal district court ruled that the state’s interpretation of its pregnancy exclusion unconstitutionally deprived plaintiffs of their rights to refuse unwanted medical treatment and free speech. In April 2026, a Michigan state court found the state’s pregnancy exclusion was facially unconstitutional under Michigan’s recently-enacted Reproductive Freedom Amendment. Because of these lawsuits, pregnant patients in Michigan and Idaho have the same rights to dictate their end-of-life decisions as all other people in the state.
Currently, more than 30 states have advance directive laws containing a Pregnancy Exclusion.
Mail contributions directly to:
Compassion & Choices Gift Processing Center
PO Box 485
Etna, NH 03750
Compassion & Choices is a 501 C3 organization. Federal tax number: 84-1328829
