-----Original Message-----
From: Justice For All Moderator [mailto:[log in to unmask]]
Sent: Monday, December 04, 2006 8:56 PM
To: [log in to unmask]
Subject: Critics Oppose Stop-Treatment Law
Critics Oppose Stop-Treatment Law
Dear JFA Readers,
What is the debate regarding "futile care" all about?
"Futile care" laws emerged about 20 years ago as a result of
doctors who did not feel comfortable withholding life-sustaining
treatment from individuals who had directed such actions. In
recent years, the laws have been significantly altered and are now
associated with quite the opposite phenomena.
Today's "futile care" statutes often place control of end-of-life
matters in the hands of doctors and hospital ethics committees,
despite the desires of the family and/or the direction of the
patient in a valid advanced directive.
Currently:
* 10 states will not allow doctors to withdraw life-sustaining
treatment from patients who desire its continuance who are
seeking to transfer to the care of a willing provider.
* 2 states impose a time limitation for transfer to a willing
provider after which point life support may be withdrawn despite
the express wishes of the patient.
* 38 states have laws which are too vague to accurately predict an
outcome when a patient and doctor disagree over the efficacy of
a particular life-sustaining treatment.
In addition to state laws, most medical facilities have their own
futility policies which typically contain strong deference to
hospital ethics committees regarding the quality of the patient's
life and their appraisal of the likelihood of a treatment's
efficacy.
Disability advocates condemn the notion that a care provider or
ethics committee could know better than the patients themselves
about the quality of their lives. Advocates' main concerns with
these laws are their disregard for the rights, independence, and
self-governance of patients in critically vulnerable circumstance.
________________________________________________________________
By Kelley Shannon
ASSOCIATED PRESS
Saturday, December 02, 2006
A horrific minivan crash left John Morris paralyzed, his neck
broken in three places. Later in the hospital, his organs began to
shut down. Medical tubes protruded from his body. He couldn't
speak and could barely see.
"I was given 24 hours to live, for three to four weeks," Morris
said, recalling the trauma of 14 years ago and his day-to-day
battle for life.
Today, living in Austin and certainly not dead, Morris is fighting
another fight: to change a state law that allows hospitals to stop
life-sustaining treatment with 10 days' notice for patients whose
cases are deemed futile.
"Why do they get to play God?" said Morris, who thinks he might
not be alive if such a law had been in place at the time of his
crash.
The 1999 law is increasingly under fire from patient advocates,
disability rights groups and Texas Right to Life, best known for
its anti-abortion efforts. Those varying interests want to change
the law once the Legislature meets in January.
The powerful Texas Hospital Association and other medical
organizations largely support the existing law. The hospitals are
open to some changes but don't appear willing to budge on the 10-
day provision.
Texas is one of the few states with a timetable for cutting off a
patient's life-sustaining treatment, according to studies cited by
activist groups.
"Most people don't know this law exists in Texas. It's our dirty
little secret," said Lanore Dixon, whose 54-year-old sister,
Andrea Clark, died in a Houston hospital this year after her
family clashed with hospital officials over whether to keep her
alive.
Clark, who had open-heart surgery and was on a ventilator, told
her family several times she wanted to live as long as her brain
functioned, Dixon said.
A few weeks after Clark's surgery, the hospital decided to end
life support. It backed away from that decision and continued
treatment after the family's public protests and once a new doctor
took over her case, Dixon said.
Clark died about a week after what would have been the scheduled
treatment cutoff date.
Dixon becomes tearful at times talking about her family's battle
against the state law. She said she'll work to change it, using
the Internet to tell her sister's story and post information about
the Legislature.
Such Texas cases attracted heightened attention following the case
of Terri Schiavo, a brain-damaged Florida woman who died last year
after her feeding tube was disconnected.
Under the current law, a doctor may refuse to honor the wishes of
the patient to continue life-sustaining treatment. That decision
is subject to review by a hospital ethics or medical committee.
The patient and family get 48 hours' notice of the meeting.
If the committee agrees further treatment is inappropriate, the
patient can seek a transfer. But the original hospital can stop
life support after the 10th day.
The patient can ask a court for more time.
Groups opposing the Texas law say 10 days isn't enough time to
arrange a transfer of a critically ill person to another facility
willing to continue treatment. They want the law to require
treatment be continued indefinitely until the patient can be moved
to another facility.
"Any extension of the 10 days would be helpful, but our goal is
treatment pending transfer," said Elizabeth Graham, director of
Texas Right to Life.
Dinah Welsh, a lobbyist for the hospital association, said her
group is willing to change the law to provide for better
communication "on the front end," so patient care agreements are
reached between families and hospitals before the 10-day limit is
ever invoked.
Legislators easily passed the law in 1999 and it was signed by
then-Gov. George Bush. Texas Right to Life agreed to the 10-day
provision but since has realized that's not enough time, Graham
said.
Despite worries voiced by disability rights activists, hospitals
don't apply the law to conscious patients or paraplegics or
quadriplegics, they said. Opponents of the law disagree.
"This is not a quality-of-life issue," Welsh said. "It's the
ability to sustain life."
The coalition that meets regularly to debate the issue probably
will arrive at a consensus during the 2007 legislative session,
but there's no agreement now, said lobbyist Greg Hooser, chairman
of the coalition.
"Right now both sides are advocating strongly for their viewpoints
and testing the waters with the Legislature," he said.
State Rep. Bryan Hughes, R-Mineola, plans to be involved. His
amendment to a Medicaid bill last year proposing life-sustaining
treatment until the transfer of patients was ultimately stripped
from the bill, but the House Public Health Committee leader
pledged the panel would study the matter before 2007. In August,
dozens of advocates showed up for a committee hearing on the
subject.
Rep. Garnet Coleman, a Houston Democrat who put forth the 1999
law, which also addressed the details of advance medical
directives, said the goal of the legislation was to help families
in how their ill loved ones are treated. He said the 10-day limit
for transferring patients has proven to be too little time in some
cases, and he said he's willing to change it.
________________________________________________________________
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http://www.aapd.com/docs/news.php
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--
This was interesting - and disturbing.
Kendall
An unreasonable man (but my wife says that's redundant!)
The reasonable man adapts himself to the world; the unreasonable one
persists in trying to adapt the world to himself. Therefore, all progress
depends on the unreasonable man.
-George Bernard Shaw 1856-1950
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