Human Exceptionalism

Forced Dehydration for 12-Year-Old Gunshot Victim?

Texas has an awful futile care law. It permits hospital bioethics committees to impose members/doctors’ values that a patient’s life is not worth living based on quality of life.  A story just out shows the injustice of the process–a terrible law about which I write here in more detail.

On August 6, a 12-year-old boy was shot in the head.  Even though a reliable diagnosis and prognosis for persistent unconsciousness requires at least 3 months, hospital personnel reportedly went in rapid succession from “donate his organs” to “end his life” mode. From the Spero News story:

But on August 13, the hospital convened an “ethics panel”, a legal entity where under Texas law medical officials can make a decision that care would be futile to restore the quality of a patient’s life. If they decide care would be futile, the hospital can terminate care after 10 days.

That’s only one week from the shooting.

Most patients who fall under a “futile care” decision are living with the assistance of ventilators and feeding tubes. But due to a mistake in procedure, the hospital said the panel didn’t technically convene. Informally, though, hospital officials told Zach’s parents that they didn’t want to treat their son anymore. Three days later, Zach was able to breathe on his own and no longer needed a ventilator.

But that improvement didn’t matter:

On the same day, a family member visited Zach in the hospital and asked the parents why Zach was on palliative care. To the parent’s surprise, Zach was not receiving food or water. When the parents tried to discover why the hospital was denying their son food and water, they found a “do not resuscitate” order in Zach’s chart. According to Texas law, doctors can insert DNR orders into a patient’s chart if the doctor considers care to be futile, overruling both the patient’s and the family’s wishes.

Do not resuscitate is not the same thing as do not nourish!  It only applies to not performing CPR in the event of a cardiac arrest, not a general do not sustain life directive.

Because the hospital broke the rules, care was restored.  But apparently not for long:

Rachel Bohannon, spokesperson for Texas Right to Life, said they advised the mother to confront the doctor. “The hospital broke the law when they withdrew food and water. That can’t be done without an ethics committe’s approval,” she said.

Reluctantly, the doctor removed the DNR order, reinstated food and water, but again told the parents that he didn’t want to treat their son. “She is the legal guardian and medical decision maker. But when care is considered futile, her rights are trumped by the hospital,” Bohannon said. Bohannon said she expects the hospital to reconvene the ethics panel. “This time they’ll follow all the rules so that it sticks. When that happens, Zach has 10 days to leave the hospital or risk having his basic medical care taken away.”

Remember the Haleigh Poutre case?  She was 12 when beaten nearly to death by her step father with severe head trauma. Doctors said she would never recover and ordered her food and water removed too.  But because the process took a few months, she recovered enough clear awareness that the dehydration was called off. Today, she eats on her own and when last written about, was in school receiving rehabilitation.

There are so many things wrong here that cry out for a lawsuit. Calling Alliance Defending Freedom!  Calling Alliance Defending Freedom.  There is a life to save.  Again.  Calling Alliance Defending Freedom!

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