Human Exceptionalism

Competing Medical Futility Bills Introduced in Texas–One to Stop It, One to Defend it

The current Texas Futile Care law is a disgrace, permitting star chamber ethics committees to force patients off of wanted life sustaining treatment, with family given a mere 10 days to find another hospital. This often proves impossible because these are expensive patients for which to care.

The last effort to revoke the law, which appeared to have a good chance of passage, was surprisingly blocked when the Catholic bishops of Texas supported a competing bill. (Some Catholic hospitals promote Futile Care Theory, which would seem to be contrary to Catholic moral teaching, as I exposed in this NRO piece two years ago.)

The resulting impasse doomed the revocation, and the same political paradigm may presage the same political paralysis this session, as two competing futile care bills have been introduced. The first bill–the one I support–is HB 3325, which would permit an attorney to represent the family/patient at the committee hearing, give the patient/family a list of volunteers willing to help, and most importantly, require life-sustaining treatment to continue pending transfer (however long it took). From Section 3 of HB 3325:(4)(b)(e):

If the patient or the person responsible for the health care decisions of the patient is requesting life-sustaining treatment that the attending physician has decided and the review process has affirmed is inappropriate treatment, the patient shall be given available life-sustaining treatment pending transfer under Subsection (d). The patient is responsible for any costs incurred in transferring the patient to another facility.

In contrast, HB 2964 retains the right of hospitals to cut off treatment over patient/family objection, but extends the time limit from 10 to–gasp how courageous–14 days. The only good thing I see in this bill is the establishing of tube-supplied sustenance as a treatment that cannot be withdrawn after 14 days if that is the only life-sustaining treatment being provided. From the bill:

The physician and the health care facility are not obligated to provide life-sustaining treatment, except for the provision of artificial nutrition and hydration, unless providing the artificial nutrition and hydration would hasten death or seriously exacerbate other major medical conditions and the risk of serious medical pain or discomfort that cannot be alleviated based on reasonable medical judgment outweighs the benefit of continued artificial nutrition and hydration, after the 14th calendar [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.

I would prefer a total revocation of futile care empowerment altogether, but that isn’t politically feasible, apparently. But here’s a compromise to support: Roll the food and fluids provision of 2964 into the requirement of continued care pending transfer provided in 3325. Then, you wouldn’t have futile care imposed where the only life supporting treatment is providing sustenance, while at the same time, no patient could be abandoned to forced withdrawal of wanted treatment.

But don’t hold your breath. 2964 is an explicit defense of Futile Care Theory! The only bill that would eliminate most of the injustice that is the heart of futile care is 3325. My worry is that like last time, the real point of 2964 is to cynically confuse and divide the anti futile care forces, thereby allowing the current unjust law to remain firmly in place.

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