Human Exceptionalism

Futile Care Cases Sprouting in Texas

I am now convinced that the opening salvo for pushing medical futility to the forefront, which I have been predicting for several years was on its way, has begun. This note was sent to me from Elizabeth Graham of Texas Right to Life, which I reprint here with her permission. Remember, this is just her take, and we don’t yet know all of the facts. But I know Elizabeth and she is not given to exaggeration. I have asked Elizabeth why the doctor thinks treatment for the patient is inappropriate and I will post her answer when I receive it.

“We have two new cases this week: one is a pediatric case in Dallas, and the other is in Houston. The Houston family is not ready to go public yet, or I would be shouting for assistance from the rooftops…I was invited to participate in the futility review process at the Houston facility, and it was disgusting and appalling. The attending physician stated that the patient was definitely NOT brain dead, simply brain damaged from a stroke. The patient is NOT experiencing organ failure, meaning her lungs, heart, kidneys, liver,…everything is working. The patient has a trach collar, but she breathes on her own, and she processes food and hydration appropriately. She is free from infection. During the meeting, I pointed out that the withdrawal of food and water would effectively starve the patient to death, and the doctors dismissed me as if I did not understand medical science. I am not sure what exactly is scientific about starvation, but the patient’s mother agreed and was bewildered at the discussion of withdrawal of treatment including food and water. Oh yes, did I mention that the patient has NO insurance? The medical folks involved in these cases adamantly avow that financial considerations never enter into the futility decisions; however, I have yet to hear from the family of any patients with good, adequate health insurance.

Our Dallas attorney is working on the pediatric case, and the family was granted some additional days because the facility did not follow proper statutory procedure. This patient has only Medicaid.”

One correction: The patient would dehydrate to death, not starve, if tube sustenance were stopped. Talk about a distinction with no meaningful difference! And yes. In the end, futile care theory is about money.