A brain-dead Texas mother is being kept alive against her family's wishes in order to comply with a state law that prevents doctors from withdrawing life support from pregnant women.

Marlise Munoz, a 33-year-old paramedic, has been in the intensive care unit of a Fort Worth hospital since collapsing on 26 November. Her husband, Erick, a firefighter and paramedic, wants to take her off life support. He told WFAA News that four years ago, after the death of her brother, she told him that she would not want to be kept alive by a machine if she were ever in a vegetative state.

However, John Peter Smith Hospital is refusing to withdraw treatment, saying that to do so would be illegal under state law. Jill Labbe, vice-president of communications and community affairs for the JPS Health Network, released a statement explaining the hospital's position:

JPS has a responsibility to be a good corporate citizen while providing compassionate, quality care for our patients. In all cases, JPS will follow the law as it applies to healthcare in the state of Texas. Every day, we have patients and families who must make difficult decisions. Our position remains the same; we follow the law.

The Texas Advance Directives Act of 1999 provides a framework for families and medical professionals to convey their wishes and make decisions about end-of-life care, including allowing doctors to discontinue treatment they consider to be medically futile. But it contains the caveat that "a person may not withdraw or withhold life-sustaining treatment … from a pregnant patient."

A 2012 report by the Center for Women Policy Studies found that 12 states have laws that automatically invalidate a woman's "living will" if she is pregnant and force her to receive life-sustaining treatment until she gives birth. That was reduced from 22 states with similar statutes in 1992. The report says that such laws mean "terminally ill women may have been forced to merely exist as human incubators."

Munoz is about 20 weeks pregnant. She had got out of bed to tend to the couple's 15-month-old son, who was crying in the middle of the night. Her husband found her on the kitchen floor and performed CPR after discovering she had no pulse and was not breathing.

He told WFAA that his wife's collapse may have been caused by a pulmonary embolism and that tests on the fetus are too limited to determine its health and whether it can ultimately survive. Doctors may have to decide in about a month whether to attempt a caesarian delivery, since 24 weeks is generally considered the age of "viability" in the US.

"That poor fetus had the same lack of oxygen, the same electric shocks, the same chemicals that got her heart going again," Marlise Munoz's father, Ernest Machado, told the Dallas Morning News. "For all we know, it’s in the same condition that Marlise is in." Local firefighters have set up a benefit fund to help the family pay medical bills.

Right-to-life issues in Texas

The family's plight touches on two issues that have prompted intense debate in Texas: abortion rights and end-of-life decisions.

Last year, a split among "pro-life" pressure groups doomed to failure bills that would have clarified who has decision-making powers when it comes to end-of-life issues. One would have banned doctors from arbitrarily issuing do-not-resuscitate orders; another would have made it easier for patients or their surrogates to find an alternative provider and offered them help with the appeals process.

The influential Texas Right to Life group mounted a campaign against one bill, alleging it would make it easier for hospitals to make "value judgments" regardless of a family's wishes.

Wendy Davis's filibuster last June against strict new abortion regulations catapulted the Democratic state senator from Fort Worth to national fame and gave her the momentum to launch a bid for governor in this November's election.

The law, which requires doctors to have admitting privileges at a hospital within 30 miles of where they are performing an abortion, was eventually passed by Texas politicians. It has been challenged by Planned Parenthood and other reproductive rights groups who say that it has placed an undue burden on women seeking abortions that breaches their constitutional rights. Proponents of the measures argue that their intention is to make procedures safer.

A district judge ruled last October that the new rules were unconstitutional but another court decision that month allowed Texas to introduce the law. An appeals hearing was held on Monday at a federal court in New Orleans. Both sides made their cases to a panel of three judges, but there was no indication of how soon a ruling would be issued. Opponents of the legislation are expected to take the case to the supreme court if the law is upheld.

• A photo caption on this story stated that Texas senator Wendy Davis had gained "national fame for her efforts on right-to-life issues". This has been corrected.