Special session preview: Requiring patient consent for do-not-resuscitate orders

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This is the fourth in a series of articles previewing Pro-Life issues and debates expected for the Special Session of the 85th Texas Legislature that begins on July 18, 2017.

 

For two decades, Texas Right to Life has pushed for policy reform protecting patients’ rights in the Texas Legislature as an extension of our belief that all Life is inherently valuable.  Texas now has the draconian 10-Day-Law, a process whereby a hospital committee can decide to withdraw life-sustaining treatment from a patient without consent or explicitly against the decision of patients or their surrogates if the committee simply gives a patient 10 days’ notice.  At the time, such a move was heralded by leading bioethicists, which marked Texas as the “model to follow.”

While Texas Right to Life assisted more than 90 patients advocate for their lives in these circumstances, another alarming violation of medical ethics was revealed – the lack of statutory guidance on the issuance of Do-Not-Resuscitate (DNR) orders in a hospital setting.  Texas law does not specifically mandate a physician receive the consent of a patient or the patient’s legal surrogate prior to placing a DNR order on the patient.

Over the years, Texas Right to Life has been successful in raising awareness of this issue, evidenced by the delegates at the Republican Party of Texas convention voting favorably multiple times to include patient consent for Do-Not-Resuscitate orders in the party platform.

85th Regular Session of the Texas Legislature

This past Session, Texas Right to Life worked closely with State Representative Greg Bonnen (R-Friendswood) to file House Bill 2063, a measure requiring patient or legal surrogate consent, with a limited exception, prior to placing a DNR order in a patient’s medical file.  During the session, Representative Bonnen, a neurosurgeon by trade, worked diligently to wrangle other interested parties to support the bill, including the Texas Medical Association and the Texas Hospital Association (organizations that have historically opposed Pro-Life policies requiring consent).  Unfortunately, the Texas Hospital Association never offered their support of the bill.  Even after a powerful and moving committee hearing featuring the personal stories of patients who have been abused by forced or secret DNRs, State Representative Byron Cook (R-Corsicana), who chairs the powerful House Committee on State Affairs, waited until late in the session to pass HB 2063 out of his committee; likewise, the House Committee on Calendars placed the measure on the floor schedule too close to the Texas House’s deadline, ensuring the bill’s demise.  The Pro-Life priority ultimately died because of the House leadership’s delay of the bill.

First Called Session of the 85th Texas Legislature

Governor Greg Abbott called a special session to begin on July 18th, requiring the Texas Legislature to meet again and address issues left on the table during the regular session because of similar political games.  Many of the reforms on Governor Abbott’s agenda are measures that were passed by the Texas Senate, supported by Texas Republicans, but failed in the Texas House of Representatives.

On the special session call, Governor Abbott added HB 2063, telling the legislature he expects them to address and vote on allowing patients or their legal surrogates the ability to decide whether a DNR order may be placed in their medical file.

The Texas Right to Life legislative team is working diligently to ensure this measure is not watered down by interest groups aligned against protecting vulnerable patients.  Passage of a strong DNR law would be a life-saving win in the Lone Star State.

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