Emails (excerpted), Melissa L. Conway, director of external relations; John Seago, legislative director, Texas Right to Life, May 21-28, 2014
12:48 p.m.
May 21, 2014
Attached is a response to your inquiry. The response is provided to you by John Seago, Texas Right to Life Legislative Director.
Likewise, Texas law (Chapter 166.046 of the Health and Safety Code) allows a physician to override and ignore a patient’s advance directive or expressed wishes. A doctor or hospital can withdraw life-sustaining treatment (including food and water) from a patient after giving ten day’s notice. Once the physician’s decision is made and then approved by the ethics committee (aka the death panel) at the hospital, the patient and his family are thrust into a frenzy of legal skirmishes, quibbling with the facility over medical records, and blindly searching for new health care facilities that will treat their ailing loved one—all to beat the ten-day clock! There are numerous instances where Texas Right to Life has walk had to intervene on behalf of the patient to advocate for a transfer and continued medical care.
Please let me know if you have any questions.
Melissa L. Conway
Director of External Relations
ATTACHMENT
The law being discussed here is Section 166.046, Texas Health and Safety Code. Link: http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.166.htm#166.046
Subsection (a) clearly indicates the purpose of this section is to give the hospital and physician a protocol to follow if the physician refuses to follow the medical decisions of the patient or patient’s proxies. Subsection (a) also shows that the protocol is a review by the “ethics or medical committee,” which is defined in 166.002(6) as “a committee established under Sections 161.031-161.033.” Sections 161.031 – 161.033 clarify that the committee could be any committee of the hospital staff and administrators and that all the members of the committee are not liable for damages to a person on the recommendation to the family (Section 161.033).
Subsection (e) of 166.046 clarifies that this process can be used if a physician is refusing to provide “life-sustaining treatment” that a patient or patient’s proxy is requesting. “Life-sustaining treatment” is defined in Section 166.002(10), as
“treatment that, based on reasonable medical judgment, sustains the life of a patient and without which the patient will die. The term includes both life-sustaining medications and artificial life support, such as mechanical breathing machines, kidney dialysis treatment, and artificial nutrition and hydration. The term does not include the administration of pain management medication or the performance of a medical procedure considered to be necessary to provide comfort care, or any other medical care provided to alleviate a patient's pain.”
Subsection (e) of 166.046 continues by stating that if an ethics committee agrees with the physician refusing to provide a ventilator or food and water then,
“The physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the written decision required under Subsection (b) is provided to the patient or the person responsible for the health care decisions of the patient unless ordered to do so under Subsection (g).”
This means that once the written decision of the committee is given to the family, and ten days passes, a ventilator or food and water can be legally withdrawn from a patient against the will of the family or the patient.
There is only one limit or criteria in the entire chapter that prohibits specific patients from being subject to the process in 166.046. The one exception is in Section 166.049 that prohibits the withdrawing or withholding of life-sustaining treatment under this subchapter from a pregnant woman.
There are no other medical or ethical limitations on what type of patients can have their life-sustaining treatment removed from them.
Texas Right to Life serves as patient advocates for families going through this ethics committee process and helps them transfer to a willing facility during the 10-day countdown. We have seen firsthand a wide spectrum of patients be subjected to this ethics committee process including all ages (17 months – 90 years old), all ethnicities, differing insurance coverage, disabilities, and levels of consciousness.
There is no protection in Chapter 166 of the Texas Health and Safety Code that keeps a conscious patient from having his or her ventilator, food and water, or dialysis removed against his or her will.
We have seen conscious patients with a disability that prevents them from orally eating and drinking, and this law allows them to be dehydrated to death against their will. This is a grave injustice and as an organization that seeks to protect innocent human life from fertilization until natural death, we are committed to substantially reforming the Texas Advance Directive Act.
4:27 p.m.
May 22, 2014
Nothing in the law clarifies what the make up of the ethics committee is supposed to be not does it require the identity of the participants be made known to the family.
As patient advocates Texas Right to Life has attended meetings where not only was the family greatly outnumbered but the identity of all those sitting on the committee was not revealed.
Furthermore, You can contact any of the following attorneys who have personally been involved in these cases:
Bill Collins (Ft Worth): billcollinsjr@charter.net
Jerri Ward (Austin): jward@garloward.com
Robert Painter (Houston): rpainter@painterfirm.com
John Seago
Legislative Director
Texas Right to Life
9:56 a.m.
May 28, 2014
Thank you,
John Seago
Legislative Director
Texas Right to Life