On Tuesday, March 19th, the Health and Human Services Committee of the State Senate heard testimony on two bills dealing with Advance Directives. Both bills would, in some ways, change the current statutory process by which patients are denied life-sustaining medical treatment in hospitals, but some of the proposed changes would further jeopardize hospitalized patients.
Current Texas law empowers physicians and hospitals to deny and/or withdraw life-sustaining treatment (including food and water) from any patient despite her advance directive, despite her expressed wishes, and despite the decision of a surrogate decision-maker. Once the ethics committee at the hospital approves this decision, the patient and/or family have only ten days to transfer to another facility or physician. After the ten days, the physician can legally withdraw any life-sustaining treatment, including basic nutrition and hydration, which can and has led to the death of patients.
Texas Right to Life’s bill, Senate Bill 675 sponsored by Senator Kelly Hancock, adds a patient protection to the statutory process of denying medical treatment. Senator Hancock’s SB 675 actually mirrors a provision from the Patient Protection and Affordable Care Act (also known as Obamacare) stating that medical treatment cannot be withdrawn or denied from a patient if that decision is made because of the patient’s age, disability, or terminal illness. In other words, if a patient suffers from cancer, a terminal condition, she should still receive life-sustaining treatment.
Texas Right to Life has assisted over 100 families whose ailing loved ones faced these discriminatory quality-of-life judgments. Regrettably, the current medical needs of a disabled patient (even if the need is food or water) are ignored or overlooked when that need is unrelated to the disability. There was little opposition to SB 675 in the hearing.
Senate Bill 303 has been promoted as an improvement to the current law, yet SB 303 specifies that treatment can be withdrawn from the disabled and terminally ill for subjective, moral reasons, rather than medical reasons. SB 303 empowers physicians and facilities to make quality-of-life value judgments about patients—decisions that will adversely affect the elderly, disabled, and terminally ill.
While SB 303 expands the transfer time to 14 days (hardly an improvement over the current ten-day law), several other provisions and definitions in SB 303 are quite troubling. Moral decisions about a patient’s treatment and life, such as the degree of suffering and discomfort, the responsibility of long-term care, and acceptance of living with a disability or terminal illness, should be left to the patient since she is in the best position to make these value judgments about the quality of her own life.
Texas law is silent on In-Hospital Do-Not-Resuscitate Orders. A revised version of SB 303 (considered during the hearing) abrogates the rights of patients to have any authoritative say about whether a DNR (DNAR in SB 303) is written for them. This bill puts all power—power unspecified under current law—into the hands of the physician and the ethics committee, leaving no appeal process for the patient whose life is at stake.
Serving as an expert witness in the hearing, President of Texas Right to Life, Dr. Joseph Graham, aptly summarized the situation: “We can presumably all agree that the Texas Advanced Directives Law is in need of reform; however, Senate Bill 303 is not the answer. In one broad stroke, SB 303 gives hospitals, physicians, and ethics committees the ability to impose quality-of-life judgments on patients.”
Standing with Texas Right to Life in advocating for SB 675 and opposing SB 303 (both the introduced and revised versions), were numerous other Pro-Life advocates, disability rights activists, and Texans with personal stories of dealing with the current unjust law. These bills were left pending in the Senate Health and Human Services Committee.