by Wesley J. Smith
May 5, 2007
LifeNews.com Note: Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide.
What if hospitals could put a sign over their doors stating, “We reserve the right to refuse life-sustaining care?” People would be outraged. Yet that is precisely what Texas law explicitly grants to hospitals — namely, to say no to wanted life-sustaining treatment, on the basis of subjective judgments about the quality of the patient’s life.
It is an example of a bioethical concept known as Futile Care Theory, a.k.a. medical futility.
How did Texas, of all places, become ground zero for futile-care impositions?
Back in 1996, a group of Houston hospitals adopted internal administrative protocols, called the Collaborative Policy, in which they granted themselves the right to refuse life-sustaining treatment even to a patient who still wants it.
As described in the August 21, 1996, Journal of the American Medical Association (“A Multi-institutional Collaborative Policy on Medical Futility”), if a doctor wished to refuse treatment, but a patient or family wanted it, the dispute was to be adjudicated behind closed doors by an institutional ethics committee; the patient/family would be given three days’ notice of the meeting. If the committee members decided that the patient should not continue to receive life-sustaining treatment, such treatment could then be cut off immediately, with only comfort care rendered thereafter.
Needless to say, the Collaborative Policy was controversial, and legislation was soon introduced in the Texas legislature to thwart the Houston hospitals’ futile-care scheme. Unfortunately, lawmakers were divided on the issue.
Eventually a compromise was worked out, giving families ten days to find an alternative institution to provide care once a hospital ethics committee ruled that treatment for a patient should be terminated. Governor George W. Bush eventually signed the bill into law in 1999 after right to life groups agreed to the compromise, never dreaming that patient transfers would become almost impossible to secure.
That is where matters sat for several years until a few Texas hospitals recently began exercising their prerogatives under the law.
Finding it impossible to obtain transfers within the allotted time, affected families resisted, unwilling to meekly submit to the value judgments of ethics committees and doctors that their loved ones’ lives were no longer worth sustaining.
For example, the family of Andrea Clark mounted a very public — and ultimately successful — campaign against an attempted futility imposition by St. Luke’s Hospital in Houston. Currently, another futile care controversy is raging in Austin, where the mother of the terminally ill “Baby Emilio” Gonzales has obtained a temporary restraining order preventing the Children’s Hospital of Austin from unilaterally cutting off his life-sustaining treatment.
In response to these and other controversial public cases, legislation was introduced in the Texas Legislature (SB. 439 / HB. 1094) to eradicate the ten-day rule; it would institute instead policies enacted in eleven other states that require hospitals, in futile-care cases, to continue wanted life-sustaining treatment until a transfer can be effected.
The bills looked as if they would quickly be passed — that is, until the Texas Catholic Conference unexpectedly came out in support of Futile Care Theory.
Read the rest of the article here.