Human Exceptionalism

Bill to End Texas Death Panels

Texas has death panels. 

It’s “medical futility” law, what I call Futile Care Theory, permits hospital bioethics committees to order patients off wanted life-sustaining treatment based on committee/doctors’ belief in the value of the patient’s life and their opinions about the subjective “appropriateness” of the treatment.

In other words, saving life–when that is what the patient wants–can be vetoed legally in Texas by what can accurately be labeled death panels.

Efforts to repeal this law have failed at least twice in the past. Now, legislation has been filed to try again. From SB 1163:

A physician or other health care professional, a health care facility, or an ethics or medical committee shall not override or refuse to honor and comply with a patient ’s advance directive or a health care or treatment decision made by or on behalf of a patient that directs the provision of life-sustaining treatment and shall not consider life-sustaining treatment to be inappropriate treatment under Section 166.046 based on:

(1) The lesser value the physician or professional, facility, or committee places on sustaining the life of an elderly, disabled, or terminally ill patient compared to the value of sustaining the life of a patient who is younger, not disabled, or not terminally ill; or

(2) A disagreement between the physician or professional, facility, or committee and the patient, or the person authorized to make a treatment decision for the patient under Section 166.039, over the greater weight the patient or person places on sustaining the patient ’s life than the risk of disability.

The legislation forbids the current practice of ethics committees forcing patients off of wanted care.

It also places reasonable parameters around a patient of family demanding treatment that should not be rendered. Thus, if the request is “physiologically ineffective,” e.g., it won’t do anything to treat the patient’s illness or injury, it does not have to be provided. I approve.

Also, if the treatment is more likely to “bring about” or hasten the death of the patient if the requested intervention is withheld or withdrawn. Again, a reasonable approach.

This should be an easy call. But repealing and replacing the existing law would be a strong pushback against the growing utilitarian morality that has infected our healthcare system–and the patients pushed out of the life boat are the most expensive for whom to care.

I am rooting for SB 1163 to become law. Let’s hope the third time is the charm.

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