Andrea Clark’s becoming the “unwanted patient” began with Houston hospitals creating a collaborative policy on medical futility back in the 1990s. That led to the Texas law which sought (impotently, in my view) to limit the damage that can be caused by medical futility.
Here is a very telling part of the article describing the policy in the August 21, 1996, Journal of the American Medical Association (JAMA), page 571 (“A Multi-institutional Collaborative Policy on Medical Futility”). After noting that it is difficult to define medical futility or cases in which continued life-sustaining treatment would be “inappropriate,” the authors, write:
“We concluded that we need to treat futility as courts treat pornography, acknowledging that while it cannot be defined, we certainly know it when we see it. This approach to value laden, context dependent judgment has recently been eloquently defended.”
In other words, it is what we say it is. Sweet.