Two sad cases, in different parts of the country, illustrate an enduring truth of American politics: that abortion never goes away, even if the word itself is not uttered.

On December 9th, a thirteen-year-old girl named Jahi McMath underwent minor surgery to remove her tonsils, adenoids, and extra sinus tissues in an effort to alleviate sleep apnea. Something went terribly wrong, and she suffered cardiac arrest. She was declared brain-dead on December 12th. The coroner issued a death certificate, and in light of that physicians at Children’s Hospital & Research Center, in Oakland, sought to have her removed from a ventilator. Her parents, believing there was still hope for her recovery, objected.

A different, equally tragic story unfolded in Texas. On November 26th, Marlise Munoz, a thirty-three-year-old woman who was fourteen weeks pregnant, suffered a seizure in her home in Fort Worth. She was taken to John Peter Smith Hospital, where doctors informed her husband that “Marlise had lost all activity in her brain stem, and was for all purposes brain dead,” according to a civil-court petition filed last week by her family. Here, in contrast to the McMath case, the hospital refused to remove Munoz from life support. The hospital said it was required to keep her on the ventilator because of the Texas Advance Directives Act, which says, in part, “A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.” Marlise remains on the ventilator today, though her family has gone to court to try to allow her to die in peace—or, rather, rest in peace, if she is indeed already brain-dead and there is nothing truly “life-sustaining” about the ventilator. (Gary Greenberg explored the medical aspects of the cases here.)

The stories have a grim symmetry. Both patients are brain-dead. In one, the family wants the machines kept on; in the other, the family wants them turned off. Alas, both family tragedies are bound up in abortion politics, specifically the definition of “life.”

McMath’s family has no apparent politics; they are simply grieving. But their cause has been taken up by the anti-abortion movement, especially those members of Terri Schiavo’s family who sought to keep feeding her years after her brain activity ceased. As in the Schiavo case, the effort is to expand, or at least confuse, the definition of “life.” Brain death, though defined slightly differently throughout the country, has been accepted as actual and legal death for decades. There is no controversy about McMath’s status; the doctors and the coroner agree. Dr. Heidi Flori, a critical-care physician at the hospital, said in a declaration, “Mechanical support and other measures taken to maintain an illusion of life where none exists cannot maintain that illusion indefinitely.”

Still, McMath’s parents and her lawyers managed to remove her body, while it was still attached to a ventilator, and have taken her to an undisclosed medical facility, where she apparently remains. There is no hope for her there. It is hard to avoid the sad view that her relatives, aided by lawyers and driven, no doubt, by love, are simply extending their own torment and adding to the already vast expense of her tragic situation. (It’s unclear who will be paying for her continued hospitalization.)

The painfulness of McMath’s story suggests a legal controversy where there is none; California’s law is quite clear. In Texas, by contrast, there is a genuine legal controversy, thanks to abortion-rights opponents in the Texas legislature. The Advance Directives law, which is in effect in slightly different forms in about a dozen states, is an almost perfect distillation of the anti-abortion mindset. The woman—the would-be mother—is just a vehicle, an incubator, without autonomy. Both Munoz and her husband, Erick, were E.M.T. technicians, so they were unusually well-versed in the reality of how life ends. Erick, as well as Marlise’s parents, were thus sure that she would not want her body to be used in this way. But, under the hospital’s interpretation of the law, the decision about whether to remove Marlise from the ventilator belongs to the members of the Texas legislature, not to the people who knew her best and loved her most. This is true even though it’s far from clear whether a fetus could even survive to term in these circumstances, and in what condition after apparently being deprived of oxygen for some time. If the Munoz’s child did somehow survive, then he or she would likely require lifelong medical assistance. As in the case of McMath, the anti-abortion forces are vague about who should actually pay the bills for the imposition of their views. This reflects Barney Frank’s famous quip that the pro-life movement believes that “life begins at conception and ends at birth.”

Controversies, even intense ones, come and go in American politics. At the turn of the twentieth century, no issue was more passionately debated than prohibition. Now it’s a non-issue. (A decade or two hence, thanks to the experiments now starting in Colorado and Washington State, it’s possible to think that marijuana legalization might also become uncontroversial.) Certainly, same-sex marriage is heading in this direction: it’s not yet legal everywhere, but it will be before too long. And the passion is draining out of the opposition.

But, forty years after Roe v. Wade, the intensity of the abortion debate has not waned. Indeed, as these cases illustrate, the controversy grows and spreads into new areas that are logically unrelated to abortion itself. This American struggle never ends.

Photograph: Ben Margot/AP