Who gets to make decision on end of life?-`Futile-care law' in Texas under fire
Long, but worth reading. A friend of mine faced this not too long ago in TX. She got past the doctors by asking for them to consider if they would treat the infection if it were HER, not her mother that had it. The doctors treated it, and she had a few days more with her mother, who was able to sit up and talk to her.
God bless!
---------- Forwarded message ----------
From: Nancy Valko
Date: Sep 17, 2006 9:58 PM
Subject: From Ron: Who gets to make decision on end of life?-`Futile-care law' in Texas under fire
To: nv333@mindspring.com
http://www.chicagotribune.com/news/nationworld/chi-0609170386sep17,1,7814849.story?coll=chi-newsnationworld-hed
Who gets to make decision on end of life?
`Futile-care law' in Texas under fire
By Howard Witt Tribune senior correspondent September 17, 2006
HOUSTON -- If it had been up to her doctors, the Houston hospital where
she was treated and the laws of the state of Texas, Kalilah
Roberson-Reese would be dead by now.
Instead, the severely brain-damaged 29-year-old woman is being cared for
in a Lubbock nursing home, where she's become a focal point in a growing
struggle over a controversial Texas law that permits hospitals to
withdraw life support from patients whose conditions they deem hopeless
-- even if family members object.
Under the terms of the state's "futile-care law," a hospital seeking to
discontinue treatment must give a patient's family 10 days to find an
alternate facility willing to accept the patient. After that, the
hospital can legally pull the plug.
To its supporters in the medical and legal communities, the Texas law,
one of only two in the nation that set such a transfer-or-perish
deadline, is a sensible and compassionate solution to one of the most
vexing end-of-life questions posed by modern medicine: How long should a
patient be kept alive when there is no hope of recovery?
"When a loved one is dying, none of us wants to let go of that
situation," said Garnet Coleman, the state legislator who co-authored
the law, formally titled the Texas Advance Directives Act. "But
ethically, a physician should not be forced to do harm to a patient by
continuing treatment. With this law, they have the ability to say, `I
can't do any more for this patient, and it's wrong to do more.'"
To the growing ranks of critics, however, including disability-rights
groups, right-to-life organizations and family members of some of the
terminal patients, the Texas law is an outrage that grants hospitals
immoral power over life and death and forces beleaguered families into
an 11th-hour scramble to save their loved ones.
"This law allows doctors and hospitals to abandon patients and provides
them safe harbor and immunity to do it," said Jerri Ward, an Austin
attorney who has filed several lawsuits to prevent doctors from ending
treatment. "The Hippocratic oath has morphed from treating illness and
saving people's lives to allowing doctors to make subjective
quality-of-life decisions about ... who should die."
That's what Cynthia Deason, Roberson-Reese's mother, believes happened
in the case of her daughter, whose cascading medical tragedy started
with pregnancy complications and led to the loss of her premature baby.
She suffered an embolism in her lung, and kidney and heart failure. Her
breathing tube became dislodged, and by the time nurses noticed the
problem, she had suffered irreversible brain damage.
In late June, Memorial Hermann Hospital informed Deason that further
treatment would be medically futile and gave her the required 10 days to
find an alternate facility. Deason balked and sought a court order to
block the hospital from discontinuing life support. The hospital
relented, and by late July, administrators had found a nursing home in
Lubbock willing to accept Roberson-Reese.
Today, Deason reports, her daughter has regained some consciousness,
responds to familiar voices and can sit upright in a chair.
"Nobody has the right to determine whether my daughter should live or
not," said Deason, of Long Beach, Calif., whose son is autistic and
whose husband recently suffered a stroke.
Memorial Hermann Hospital officials are guarded in their comments about
Roberson-Reese's case, because Deason has said she may file a medical
malpractice suit. But they say they followed the procedures required by
the futile-care law, including convening a futility review committee of
independent physicians and nurses to examine the case.
"The futility review committee affirmed the treating physician's
judgment that continuing life support is medically inappropriate," the
hospital said in July.
In many ways, the controversy over the Texas law is a mirror image of
the "right-to-die" struggles in the 1970s and '80s, when patient-rights
advocates worked to persuade hospitals to honor the wishes of the
terminally ill who did not want extraordinary measures taken to prolong
their lives.
Now it's often the hospitals seeking to discontinue treatment, but many
states have yet to grapple with the turnabout. Only 10 states have
passed laws forbidding hospitals to withdraw treatment if family members
or guardians object and requiring treatment to continue until a patient
can be transferred, according to a study by the National Right to Life
Committee in Washington.
Only two states impose deadlines for family members to find alternate
facilities for their loved ones: Virginia allows 14 days and Texas 10 days.
Texas' futile-care law has been on the books since 1999, but it's only
in recent months that families of some terminal patients, often
supported by Texas right-to-life groups, have begun waging public
battles against it. More than a dozen cases like Roberson-Reese's have
now surfaced, which prompted lawmakers to hold hearings this summer on
possible amendments.
Among the changes being proposed: extending the 10-day transfer deadline
and introducing independent mediators in cases where hospitals and
family members disagree.
Texas Right to Life, the state's leading pro-life group, initially
supported the futile-care law as a compromise between the rights of
families to protect their loved ones and the rights of doctors to
withhold pointless treatments. But the group says some hospitals have
abused the law's provisions by seeking to withhold care from patients
whose conditions are complicated and expensive to treat.
Some cases in which the law has been invoked "do seem to be financially
motivated," said Elizabeth Graham, director of Texas Right to Life. "The
hospitals will say it is not, of course, but it does seem that the
majority of patients or families calling us for help are either
uninsured, underinsured or they have Medicaid."
Groups supporting the rights of the disabled also suspect hospitals'
motives.
"The way the medical community and society in general have valued the
lives of people with disabilities does not bode well when it comes to
doctors making decisions as to whether a life is worth living," said
Colleen Horton, public policy director at the Texas Center for
Disability Studies. "People who don't see the value of living with a
significant disability are determining whether your life is a burden and
treatment is futile."
Even supporters of the law, who see it as necessary to helping hospitals
deal with families that cling to false hopes, concede that some
provisions ought to be revised.
"There are situations where it's no longer medically appropriate to
continue procedures that have no therapeutic benefits other than to
prolong organic life," said William Winslade, a lawyer specializing in
medical ethics at the University of Texas Medical Branch in Galveston.
"But I am unhappy with the statute because of the way it loads the dice
in favor of doctors and hospitals," Winslade added. "The patients and
their families just don't have any resources ... We don't need a law
that appears to be railroading the families."
- - -
How the law works
Key steps in Texas' "futile-care law":
- If an attending physician refuses to provide life-sustaining treatment
to a patient because the doctor believes such treatment would be without
benefit, and the patient's legal guardian or family members object, the
case is referred to a hospital's medical review committee. Family
members must be given at least 48 hours notice of the meeting and are
allowed to attend.
- If the committee agrees that life-sustaining treatment should be
withdrawn, and the family or guardian still objects, treatment must
continue for at least 10 days while hospital administrators help the
family find a nursing home or other facility to accept the patient.
- If a provider cannot be found within 10 days, the hospital may
withdraw life-sustaining treatment unless a court orders an extension.
SOURCE: Texas Advance Directives Act
----------
hwitt@tribune.com
Copyright © 2006, Chicago Tribune
Who gets to make decision on end of life?
`Futile-care law' in Texas under fire
By Howard Witt Tribune senior correspondent September 17, 2006
HOUSTON -- If it had been up to her doctors, the Houston hospital where
she was treated and the laws of the state of Texas, Kalilah
Roberson-Reese would be dead by now.
Instead, the severely brain-damaged 29-year-old woman is being cared for
in a Lubbock nursing home, where she's become a focal point in a growing
struggle over a controversial Texas law that permits hospitals to
withdraw life support from patients whose conditions they deem hopeless
-- even if family members object.
Under the terms of the state's "futile-care law," a hospital seeking to
discontinue treatment must give a patient's family 10 days to find an
alternate facility willing to accept the patient. After that, the
hospital can legally pull the plug.
To its supporters in the medical and legal communities, the Texas law,
one of only two in the nation that set such a transfer-or-perish
deadline, is a sensible and compassionate solution to one of the most
vexing end-of-life questions posed by modern medicine: How long should a
patient be kept alive when there is no hope of recovery?
"When a loved one is dying, none of us wants to let go of that
situation," said Garnet Coleman, the state legislator who co-authored
the law, formally titled the Texas Advance Directives Act. "But
ethically, a physician should not be forced to do harm to a patient by
continuing treatment. With this law, they have the ability to say, `I
can't do any more for this patient, and it's wrong to do more.'"
To the growing ranks of critics, however, including disability-rights
groups, right-to-life organizations and family members of some of the
terminal patients, the Texas law is an outrage that grants hospitals
immoral power over life and death and forces beleaguered families into
an 11th-hour scramble to save their loved ones.
"This law allows doctors and hospitals to abandon patients and provides
them safe harbor and immunity to do it," said Jerri Ward, an Austin
attorney who has filed several lawsuits to prevent doctors from ending
treatment. "The Hippocratic oath has morphed from treating illness and
saving people's lives to allowing doctors to make subjective
quality-of-life decisions about ... who should die."
That's what Cynthia Deason, Roberson-Reese's mother, believes happened
in the case of her daughter, whose cascading medical tragedy started
with pregnancy complications and led to the loss of her premature baby.
She suffered an embolism in her lung, and kidney and heart failure. Her
breathing tube became dislodged, and by the time nurses noticed the
problem, she had suffered irreversible brain damage.
In late June, Memorial Hermann Hospital informed Deason that further
treatment would be medically futile and gave her the required 10 days to
find an alternate facility. Deason balked and sought a court order to
block the hospital from discontinuing life support. The hospital
relented, and by late July, administrators had found a nursing home in
Lubbock willing to accept Roberson-Reese.
Today, Deason reports, her daughter has regained some consciousness,
responds to familiar voices and can sit upright in a chair.
"Nobody has the right to determine whether my daughter should live or
not," said Deason, of Long Beach, Calif., whose son is autistic and
whose husband recently suffered a stroke.
Memorial Hermann Hospital officials are guarded in their comments about
Roberson-Reese's case, because Deason has said she may file a medical
malpractice suit. But they say they followed the procedures required by
the futile-care law, including convening a futility review committee of
independent physicians and nurses to examine the case.
"The futility review committee affirmed the treating physician's
judgment that continuing life support is medically inappropriate," the
hospital said in July.
In many ways, the controversy over the Texas law is a mirror image of
the "right-to-die" struggles in the 1970s and '80s, when patient-rights
advocates worked to persuade hospitals to honor the wishes of the
terminally ill who did not want extraordinary measures taken to prolong
their lives.
Now it's often the hospitals seeking to discontinue treatment, but many
states have yet to grapple with the turnabout. Only 10 states have
passed laws forbidding hospitals to withdraw treatment if family members
or guardians object and requiring treatment to continue until a patient
can be transferred, according to a study by the National Right to Life
Committee in Washington.
Only two states impose deadlines for family members to find alternate
facilities for their loved ones: Virginia allows 14 days and Texas 10 days.
Texas' futile-care law has been on the books since 1999, but it's only
in recent months that families of some terminal patients, often
supported by Texas right-to-life groups, have begun waging public
battles against it. More than a dozen cases like Roberson-Reese's have
now surfaced, which prompted lawmakers to hold hearings this summer on
possible amendments.
Among the changes being proposed: extending the 10-day transfer deadline
and introducing independent mediators in cases where hospitals and
family members disagree.
Texas Right to Life, the state's leading pro-life group, initially
supported the futile-care law as a compromise between the rights of
families to protect their loved ones and the rights of doctors to
withhold pointless treatments. But the group says some hospitals have
abused the law's provisions by seeking to withhold care from patients
whose conditions are complicated and expensive to treat.
Some cases in which the law has been invoked "do seem to be financially
motivated," said Elizabeth Graham, director of Texas Right to Life. "The
hospitals will say it is not, of course, but it does seem that the
majority of patients or families calling us for help are either
uninsured, underinsured or they have Medicaid."
Groups supporting the rights of the disabled also suspect hospitals'
motives.
"The way the medical community and society in general have valued the
lives of people with disabilities does not bode well when it comes to
doctors making decisions as to whether a life is worth living," said
Colleen Horton, public policy director at the Texas Center for
Disability Studies. "People who don't see the value of living with a
significant disability are determining whether your life is a burden and
treatment is futile."
Even supporters of the law, who see it as necessary to helping hospitals
deal with families that cling to false hopes, concede that some
provisions ought to be revised.
"There are situations where it's no longer medically appropriate to
continue procedures that have no therapeutic benefits other than to
prolong organic life," said William Winslade, a lawyer specializing in
medical ethics at the University of Texas Medical Branch in Galveston.
"But I am unhappy with the statute because of the way it loads the dice
in favor of doctors and hospitals," Winslade added. "The patients and
their families just don't have any resources ... We don't need a law
that appears to be railroading the families."
- - -
How the law works
Key steps in Texas' "futile-care law":
- If an attending physician refuses to provide life-sustaining treatment
to a patient because the doctor believes such treatment would be without
benefit, and the patient's legal guardian or family members object, the
case is referred to a hospital's medical review committee. Family
members must be given at least 48 hours notice of the meeting and are
allowed to attend.
- If the committee agrees that life-sustaining treatment should be
withdrawn, and the family or guardian still objects, treatment must
continue for at least 10 days while hospital administrators help the
family find a nursing home or other facility to accept the patient.
- If a provider cannot be found within 10 days, the hospital may
withdraw life-sustaining treatment unless a court orders an extension.
SOURCE: Texas Advance Directives Act
----------
hwitt@tribune.com
Copyright © 2006, Chicago Tribune
posted by WI Catholic @ 9/18/2006 04:07:00 AM
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