8mm
Posted on 08/08/2007 4:09:44 PM PDT by wagglebee
However, the efforts of hundreds of activists, including families whose ailing loved ones were victims of the law and the attorneys and doctors who offered benevolent services to the patients, were not in vain. The statewide and national awareness provoked by this battle will not be forgotten by Texas legislators and the citizens they represent. The end of life euthanasia war has only just begun.
Currently, Texas law allows for a physician to withdraw life-sustaining treatment (including food and water) from a patient despite the patient's advance directive or expressed wishes.
Once the physician's decision is approved by the ethics committee at the hospital, the patient and/or family have only ten days to transfer to another facility or another physician. The physician or facility is not obligated to treat the patient beyond the tenth day, which can and has led to the death of the patient. Rarely are transfers effectuated either by the family or the facility within the ten-day allotment.
Senate Bill 439 and House Bill 1094 would have changed the law so that a patient and the family are given sufficient time to locate a transfer during which time the patient would continue receiving life-sustaining medical treatment until a transfer is completed, thereby safeguarding against involuntary euthanasia. Eleven other states require that a patient be treated until he is transferred elsewhere, and Texas should have been the twelfth state to enact such patient protections.
On April 12, the Texas Senate Committee on Health and Human Services heard testimony on Senate Bill 439—Texas Right to Life’s proposed changes to the current Texas Futile Care law. Senator Robert Deuell, M.D., (R-Greenville), the bill's sponsor, explained that most physicians practice good medicine and communicate effectively with patients and their families.
He emphasized that this law only comes into play when there is a disagreement, and in those situations, the current law does not serve families well. The Senate committee then heard from concerned citizens and organizations, including nurses, doctors, disability rights groups, and Right to Life groups.
Many of the families affected by this ten-day law courageously recounted their experiences in battling against the ten-day clock. They discussed how they were shocked and dismayed that the people entrusted to care for their ailing loved ones would soon be the ones to pull the plug against the will of patients and families if a transfer was not found.
Catarina Gonzalez, mother of 18-month old Emilio who at the time was languishing in an Austin hospital, took time away from Emilio’s bedside to address the committee. She dramatically and tearfully shared that she knew her precious son was dying, but she thought he should die when God called him home, not when an ethics committee rendered Emilio’s life as value-less. (Emilio died on May 20.)
More families echoed her sentiments. Lanore Dixon, sister of Andrea Clark, told how her family should have been spending more time with Andrea during the last days of her life instead of fighting lawyers and ethics committees.
Due to the unjust balance of power conferred upon hospital ethics committees to make these life and death treatment decisions, even the Texas branch of the American Civil Liberties Union spoke in favor of SB 439. Will Harrell, Esq., director of ACLU Texas, stressed that patients are stripped of their due process rights and civil liberties when ethics committees make quality of life judgments and decide the fate of patients in the board rooms of hospitals.
Houston attorney, Robert Painter, played a shocking voicemail message left by a hospital administrator for the family of a patient. While Mr. Painter courteously omitted the name of the administrator and the name of the facility, the recording illustrated the quality of life mindset that has infiltrated some of these facilities.
The administrator pressured the family to agree with the hospital and let “your Daddy pass.” More shocking was this: “If we don’t hear from you by Monday, we're gonna make him hospice so he can go ‘head onto Glory,” threatening the family about the facility proceeding without their consent.
Needless to say, Mr. Painter’s testimony as an attorney who has helped several families through this process was quite compelling. (The patient who was the subject of the voicemail message was slated to be withdrawn from treatment and “made hospice” in January of this year, but was transferred to a skilled nursing facility where he is stable and receiving dialysis.)
On the House side, the Public Health Committee heard all the bills on advance directives on April 25th. The antagonistic tone of this hearing was dramatically different than the cordial tone set by Senator Deuell in the Senate committee.
The chair of House Public Health, Dianne Delisi (R-Temple) presented her own bill on advance directives and end of life care. While her bill, House Bill 3474, would have lengthened the ten days to twenty-one days, other provisions in her bill actually undermined what little protections for patients currently exist in the law.
The testimony on HB 3474 and the other bills on advance directives lasted until 5:11am. Attorney Jerri Ward, Texas Right to Life’s 2006 Pro-Life Attorney of the Year Award recipient, and other attorneys who have helped many families navigate the ten-day transfer process buttressed the ACLU’s concerns about patients being robbed of their due process, not to mention the errors in medical judgment that can occur.
Chairman Delisi would not allow the attorney to play the “Send him onto Glory” voicemail message in her committee. (The recorded voicemail message is posted at http://www.texasrighttolife.com).
Some opponents to the Hughes bill argued by describing treatments that can be painful to patients and told of families insisting that doctors continue painful treatments that will not benefit their loved ones.
However, Burke Balch, JD, Director of the Robert Powell Center for Ethics (and our colleague from National Right to Life), reminded the committee that appropriate palliative care could resolve nearly all pain and suffering issues and also clarified that this bill does not include a requirement for futile treatment—treatment that is providing no medical benefit to the patient, but rather, HB 1094 would require treatment that is sustaining the life of the patient. He further explained medical groups in the states in which “treatment pending transfer” laws are in place have not complained that they cannot work within the law.
Kristina Harrison, mother of six-year old Klemente, told how doctors tried to pressure her three years ago into withdrawing treatment from Klemente, now disabled and in a wheelchair. Klemente was the star of the hearing and would not have stolen the show if his mother yielded to the pressure of the hospital.
LaCretia Webster stated that the only reason she still flies her Texas flag, despite Texas letting her down with our futile care law, is because her father and brother are military servicemen. Her mother, Ruthie, was transferred to a facility in Chicago after a Dallas area doctor personally intervened to thwart two confirmed transfers within the state. She now must travel from Texarkana to Chicago twice a month to visit her best friend, her mother.
Even though Senate Bill 439 had the support of the majority of the Senate committee members as it was written, the committee decided to vote out a substitute for SB 439—a substitute identical to the unacceptable Delisi bill in the House. Unfortunately, this substitute included six elements that rendered the bill even worse than current law while giving the family only an additional 11 days to find a transfer.
Lieutenant Governor David Dewhurst intervened and oversaw negotiations. He offered his own office for negotiations with the stakeholders, including Texas Right to Life, disability rights advocates, and the medical and hospital associations.
To his credit, Dewhurst would not allow the bill to come to the Senate Floor until the problems were remedied. Because of his assistance, SB 439 emerged from his office and then from the Senate Floor in a clean, acceptable form, albeit not close to the original strength of SB 439. Regrettably, when the bill reached the Public Health Committee in the House, the negotiated agreement masterfully orchestrated by Dewhurst was disregarded, and harmful amendments were added. Nonetheless, SB 439 emerged and was placed on the House Calendar, where it died on the last day of eligibility due to its low placement on the schedule.
HB 1094/SB 439 did not die due to a lack of support. In the House 77 out of 150 members co-authored the bill signifying their commitment to vote for the issue, and about a dozen more members firmly committed to support the measure while choosing not to co-author. Twenty of these House co-authors were Democrats who took active leadership, demonstrating the most bi-partisan effort in the history of Pro-Life bills in Texas. Likewise, 11 of 30 Senators co-authored SB 439 (2 Democrats and 9 Republicans).
Texas Right to Life hopes that such established support coupled with a new awareness of the issue will lay the foundation for a victory in the near future. As we continue to help families in the interim who are victims of this law, we will be reminded of the importance of our perseverance in this battle. And we pray that no one else will be the victim of this state-sanctioned, draconian involuntary euthanasia process.
Amen.
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“this state-sanctioned, draconian involuntary euthanasia process.”
Not quite. The family members have the option of moving their loved one home, and taking care of them as they see fit with whatever resources they can bring to bear from their own means, or voluntary assistance from their churches and extended community. What they are apparently demanding, however, is a right to have others take care of their loved ones indefinitely at state (or someone else’s) expense. There is no such right.
This law has NOTHING to do with a patient's ability to pay for medical care, you don't know what you're talking about. This is about whether or not a hospital to decide that further treatment is "futile" and to refuse to treat the patient, regardless of the wishes of the patient, their family or their ability to pay for treatment.
‘This is about whether or not a hospital to decide that further treatment is “futile” and to refuse to treat the patient, regardless of the wishes of the patient, their family or their ability to pay for treatment.’
Physicians should not be required to perform abortions, nor any other procedure. Similarly for hospitals or other care providers.
If the patient and their family disagree with their current providers prognosis, the appropriate remedy is to find new providers who agree with their views or, absent that, provide the treatment themselves.
So now you are equating life-saving procedures with abortion? Most states allow doctors to refuse to perform abortion, sterilization and a few other procedures on moral or religious grounds. However, the hallmark of medicine, going back to Hippocrates, is that doctors do not refuse to give life-saving care.
“So now you are equating life-saving procedures with abortion? “
Whether a procedure is life-saving or not is frequently a matter of opinion. What I am saying is that neither your opinion nor mine should legally trump a particular care provider’s opinion. They may be wrong. You may be wrong. If you think they are wrong, you can either provide treatment yourself (or with help of extended family, volunteers in your community) or engage the assistance of other care providers who are in accord with your views.
You replied:
Whether a procedure is life-saving or not is frequently a matter of opinion.
LMAO!
You think that whether or not an abortion is a life-saving procedure is open to "opinion"?
.
What an absolute nightmare of a statute. I am at a complete loss how any prospective patient, regardless of their personal wishes, could support this HMO chief financial officer's fantasy. Time to steer clear of Texas!
Prayers said.
I was there, in the Lieutenant Governor’s office and in other meetings of interested parties for the last 2 years.
Odd, this article doesn’t say anything about the bills that included expanded time between the initiation of the process and after the ethics committee decision - about a month all told. Where’s the mention of the wording that would have prevented food and water from being a medical treatment - offered as an unexpected compromise by people who had opposed the same in the past. There’s no mention the only time any one has ever pulled the “plug” in the 10 days’ time was when there was no next of kin or no objection from the kin.
TRTL is demanding that the law be changed to “treatment until transfer.” The lawyers involved seem most bothered by the legal protections in the Texas Advance Directive Act and pushed a Bill that deliberately removed legal protection that is in the current law - which also protects me if I refuse to “pull the plug.”
While the lawyers would like to be able to sue the doctors, the real goal is to make sure that *I* and doctors like me are forced to indefinitely violate our consciences.
They would change the law to force me to write orders causing numbers of other people to do what I know is wrong - have me learn to follow orders and go against my conscience and medical judgment - first, here and in abortions, etc. - then when the State needs to cut money or when there’s not enough ventilators or vaccines.
And *that* is why the ACLU joined them.
The next “big” bioethics and public health ethics theme is rationing of care and determining who gets care in times of epidemics and other shortages. The goal is to remove the physician’s medical judgment and conscience in order to give the powers that be (PTB) the right to pick and choose. Next, we’ll hear about necessary regulations or statute to enable bean counters or lawmakers to force docs to act by the “consensus.”
There comes a time when what I have to offer can’t heal, and is known to cause cells and tissues to be injured in a person who is dying and who would already be dead if I hadn’t been interfering. The most obvious example is when a family insists on CPR for a person with ribs brittle from age.
In the case of the little boy mentioned in this article, the ventilator pressures were injuring the lungs. The baby’s lungs had “leaks” or collapsed several times.
They say that I am not to be trusted to determine when the technology and medications that I have to offer are causing harm without hope for healing - that I can’t say when more cells are dying due to my treatments than are helped to continue to live and divide and function.
And yet, they want to force me to determine how much potassium to put in the IV and how high to set the pressures on the ventilator, to put in new IV’s when the old one fail or become infected - or surgically implant more permanent tubes and devices. And to do it indefinitely - except when the PTB say I shouldn’t, of course.
Does this make sense?
See my post 14. We had this fixed in the Delissi/Duell bill.
What about the family insisting on ventilator support, over and over, for a patient whose lungs are eaten up with cancer, causing the need for multiple chest tubes?
How about a mother who believes the Sun is her child’s father,and insists on ICU ventilator support even though the child’s genetic disease prevents his bones from growing?
How about the family that insists on keeping the patient on a ventilator, dialysis, medicines to keep the blood pressure up as it also closes off blood vessels in the fingertips, toes, and is part of the reason that dialysis is needed?
How about the family that insists on ventilator and dialysis in the ICU rather than Medicare-funded home care (with ventilator and dialysis) for a comatose patient when the daughter is an ER doc in the same town?
Or the family who refuses to transfer their mom to the state that the daughters live in - because they want mom in the hospital, rather than a nursing home?
Or the patient with multiple complications due to HIV who demands blood transfusion after blood transfusion more and more often, when his bone marrow fails?
You have a point, but those surely are bizarre and extremely unusual situations. Even if they are not, they cannot be equated with depriving an otherwise viable patient of food and water, which really is nothing other than murder.
I wonder if we really have different issues trying to be addressed - one is a question of euthansia, which is always wrong, being murder; and the other is to what extent are ultra-exceptional methods justified for someone who would otherwise naturally die?
Deprive someone of water? Like the Terry Schiavo case, clearly murder.
Removing a dialysis machine? That’s harder to say, I don’t presume to know the answer, just making the distinction.
Texas info.
Who is OPPOSING this change?
Hospital administrators? Or the democratic we-demand-all-babies-die party? (Since it is promoted by the Right to Life groups)
I am standing in for T’wit, R.I.P on this issue. I won’t be arguing details as T’wit would have and will not answer anecdotal details by those of more precise vocabulary, but will regard such topics as truly ancillary, diversionary.
From the day Wampus SC brought the Texas Futile Care Law into the daylight with his first defense of Andrea Clark, we have seen a truth shine through, not yet to be refuted.
The Texas Futile Care Law was designed, we suppose, to serve the practical purpose of withdrawing useless, needless, or futile care from a patient when it no longer served any purpose. This ideal sounds so decent, it is hard to refute.
But.... the interpretation shifted. What we see is that authorities have shifted definitions. It is now interpreted not the care that is futile, but is the LIFE of the patient which is futile.
That is the core of my concern, that beneath all other brilliant explanations geared to distort the true aim of Pro-Lifers, the result is of this life cheapened in furtherance of the goals of the euthanasiasts. Hence, the resistance we see in Texas to reasoned change.
8mm
The Act has never been used to withhold or withdraw food and water - and food and water by mouth, as in Terri’s case, doesn’t come under the law.
It’s only been invoked on those cases that I laid out in my last post. The purpose of the ethics committee is to review the decision of the doctor to go against the family’s wishes.
Unfortunately, the problem is that some of the people mentioned in the original article believe that life should be sustained as long as possible, whatever it takes, and at all costs. I even heard arguments that the patient’s suffering has religious value and that I should inflict suffering on unconscious patients if the family demands it.
Those of us who had been working on the tweaks that the Bill needed had had an agreement from everyone to make sure that food and water could not be called a medical treatment,even before the session began - on paper by the time the Bill came up in Committee. The problem was some people kept demanding a bill forcing doctors to continue the treatment that the families demand until transfer, with all of the legal protection that we had had before stripped from the Act.
Finally we had a substitute bill that gave families 14 days instead of 2 to get together before the ethics committee met, and another 2 weeks to arrange transfer to another doctor. (Although, in reality, the transfer efforts have always been underway even before the doc asks the ethics committee to meet. The process has always been for cases like those I described, where families demand that the doctor do what they want, against his best judgment. The blood transfusion case is the only one that I know of where the patient was making his own decisions. The docs suggested continuing the transfusions for a specific period of time to get ready, then transfer to hospice care. He demanded non-stop transfusions, even as his liver failed and his kidneys were damaged by the waste products from the break down of the transfused red blood cells - in other words, even as the transfusions damaged his kidneys, risking a need for dialysis.)
The agreed-upon substitute Bill died because it made it to the House on the last day bills could be introduced. The Dems in the House were playing games - long conversations at the microphone about “dog parks,” etc., and made sure that a lot of legislation was stalled on the last days - legal deadlines passed and bills will have to wait ‘till ‘09.
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