Human Exceptionalism

Feeding Tube Removed Despite Court Order

Texas has a medical futility–what I call Futile Care Theory–law permitting doctors to remove wanted life-support that works from a patient based on their views about quality of life. 

Before that is done, patients/families are supposed to receive due process–such as it is–e.g., a hearing before a bioethics Star Chamber committee. Then, if the committee decides the treatment should end, the patient has 10 days to find a new hospital.

But here’s the thing: I believe that once a society determines that doctors can refuse wanted efficacious life-sustaining service–that becomes the meme–and eventually the due process part goes away. 

That may be part of what happened in a case out of a hospital near Austin. As recounted by Thaddeus Mason Pope, an estranged wife (of 5 years!) authorized pulling the feeding tube of Terry Mace. His parents won guardianship and a court blocked the dehydrate decision.

But the hospital did it anyway. From the Austin State Journal story:

Stephen Casey, one of the attorneys for Mace’s parents, said doctors at Seton Medical Center Williamson surprised the family by removing the feeding and hydration tubes for Mace sometime within the past few days. The 43-year-old Killeen man had been hospitalized since March 6, when he went into cardiac arrest and hit his head on a concrete floor.

After receiving a phone call Monday morning from Mace’s father, Casey went to the hospital and saw the tubes had been removed. Mace’s father got a doctor to reconnect the hydration tube Monday afternoon, Casey said. Mace died about 1 a.m. Tuesday. The hospital’s director of communications, Adrienne Lallo, released a statement Tuesday afternoon saying the hospital had cooperated with Mace’s family. 

Some cooperation.

Apparently the hospital didn’t adequately explain that “comfort care” actually meant in Mace’s case, ”dehydrate to death:”

Doctors had told Mace’s family over the weekend that they were providing “comfort care” to him, meaning they were keeping him sedated and making sure he wasn’t choking, said Casey. Mace’s parents might have been confused about what kind of treatment their son was receiving, their lawyers said.

This is how trust in our health care system is being steadily destroyed.

Some might expect lawsuits to be filed. But I would probably advise the family not to risk adding insult to injury.

In my experience in this field, once a seriously disabled patient dies, juries tend to apply a “no real harm, no foul” invidious judgmentalism. In other words, imposition of futile care can sometimes be stopped before death, but afterwards, it ceases to matter very much outside the family’s mourning.

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