Posted on 08/08/2007 4:09:44 PM PDT by wagglebee
However, the efforts of hundreds of activists, including families whose ailing loved ones were victims of the law and the attorneys and doctors who offered benevolent services to the patients, were not in vain. The statewide and national awareness provoked by this battle will not be forgotten by Texas legislators and the citizens they represent. The end of life euthanasia war has only just begun.
Currently, Texas law allows for a physician to withdraw life-sustaining treatment (including food and water) from a patient despite the patient's advance directive or expressed wishes.
Once the physician's decision is approved by the ethics committee at the hospital, the patient and/or family have only ten days to transfer to another facility or another physician. The physician or facility is not obligated to treat the patient beyond the tenth day, which can and has led to the death of the patient. Rarely are transfers effectuated either by the family or the facility within the ten-day allotment.
Senate Bill 439 and House Bill 1094 would have changed the law so that a patient and the family are given sufficient time to locate a transfer during which time the patient would continue receiving life-sustaining medical treatment until a transfer is completed, thereby safeguarding against involuntary euthanasia. Eleven other states require that a patient be treated until he is transferred elsewhere, and Texas should have been the twelfth state to enact such patient protections.
On April 12, the Texas Senate Committee on Health and Human Services heard testimony on Senate Bill 439—Texas Right to Life’s proposed changes to the current Texas Futile Care law. Senator Robert Deuell, M.D., (R-Greenville), the bill's sponsor, explained that most physicians practice good medicine and communicate effectively with patients and their families.
He emphasized that this law only comes into play when there is a disagreement, and in those situations, the current law does not serve families well. The Senate committee then heard from concerned citizens and organizations, including nurses, doctors, disability rights groups, and Right to Life groups.
Many of the families affected by this ten-day law courageously recounted their experiences in battling against the ten-day clock. They discussed how they were shocked and dismayed that the people entrusted to care for their ailing loved ones would soon be the ones to pull the plug against the will of patients and families if a transfer was not found.
Catarina Gonzalez, mother of 18-month old Emilio who at the time was languishing in an Austin hospital, took time away from Emilio’s bedside to address the committee. She dramatically and tearfully shared that she knew her precious son was dying, but she thought he should die when God called him home, not when an ethics committee rendered Emilio’s life as value-less. (Emilio died on May 20.)
More families echoed her sentiments. Lanore Dixon, sister of Andrea Clark, told how her family should have been spending more time with Andrea during the last days of her life instead of fighting lawyers and ethics committees.
Due to the unjust balance of power conferred upon hospital ethics committees to make these life and death treatment decisions, even the Texas branch of the American Civil Liberties Union spoke in favor of SB 439. Will Harrell, Esq., director of ACLU Texas, stressed that patients are stripped of their due process rights and civil liberties when ethics committees make quality of life judgments and decide the fate of patients in the board rooms of hospitals.
Houston attorney, Robert Painter, played a shocking voicemail message left by a hospital administrator for the family of a patient. While Mr. Painter courteously omitted the name of the administrator and the name of the facility, the recording illustrated the quality of life mindset that has infiltrated some of these facilities.
The administrator pressured the family to agree with the hospital and let “your Daddy pass.” More shocking was this: “If we don’t hear from you by Monday, we're gonna make him hospice so he can go ‘head onto Glory,” threatening the family about the facility proceeding without their consent.
Needless to say, Mr. Painter’s testimony as an attorney who has helped several families through this process was quite compelling. (The patient who was the subject of the voicemail message was slated to be withdrawn from treatment and “made hospice” in January of this year, but was transferred to a skilled nursing facility where he is stable and receiving dialysis.)
On the House side, the Public Health Committee heard all the bills on advance directives on April 25th. The antagonistic tone of this hearing was dramatically different than the cordial tone set by Senator Deuell in the Senate committee.
The chair of House Public Health, Dianne Delisi (R-Temple) presented her own bill on advance directives and end of life care. While her bill, House Bill 3474, would have lengthened the ten days to twenty-one days, other provisions in her bill actually undermined what little protections for patients currently exist in the law.
The testimony on HB 3474 and the other bills on advance directives lasted until 5:11am. Attorney Jerri Ward, Texas Right to Life’s 2006 Pro-Life Attorney of the Year Award recipient, and other attorneys who have helped many families navigate the ten-day transfer process buttressed the ACLU’s concerns about patients being robbed of their due process, not to mention the errors in medical judgment that can occur.
Chairman Delisi would not allow the attorney to play the “Send him onto Glory” voicemail message in her committee. (The recorded voicemail message is posted at http://www.texasrighttolife.com).
Some opponents to the Hughes bill argued by describing treatments that can be painful to patients and told of families insisting that doctors continue painful treatments that will not benefit their loved ones.
However, Burke Balch, JD, Director of the Robert Powell Center for Ethics (and our colleague from National Right to Life), reminded the committee that appropriate palliative care could resolve nearly all pain and suffering issues and also clarified that this bill does not include a requirement for futile treatment—treatment that is providing no medical benefit to the patient, but rather, HB 1094 would require treatment that is sustaining the life of the patient. He further explained medical groups in the states in which “treatment pending transfer” laws are in place have not complained that they cannot work within the law.
Kristina Harrison, mother of six-year old Klemente, told how doctors tried to pressure her three years ago into withdrawing treatment from Klemente, now disabled and in a wheelchair. Klemente was the star of the hearing and would not have stolen the show if his mother yielded to the pressure of the hospital.
LaCretia Webster stated that the only reason she still flies her Texas flag, despite Texas letting her down with our futile care law, is because her father and brother are military servicemen. Her mother, Ruthie, was transferred to a facility in Chicago after a Dallas area doctor personally intervened to thwart two confirmed transfers within the state. She now must travel from Texarkana to Chicago twice a month to visit her best friend, her mother.
Even though Senate Bill 439 had the support of the majority of the Senate committee members as it was written, the committee decided to vote out a substitute for SB 439—a substitute identical to the unacceptable Delisi bill in the House. Unfortunately, this substitute included six elements that rendered the bill even worse than current law while giving the family only an additional 11 days to find a transfer.
Lieutenant Governor David Dewhurst intervened and oversaw negotiations. He offered his own office for negotiations with the stakeholders, including Texas Right to Life, disability rights advocates, and the medical and hospital associations.
To his credit, Dewhurst would not allow the bill to come to the Senate Floor until the problems were remedied. Because of his assistance, SB 439 emerged from his office and then from the Senate Floor in a clean, acceptable form, albeit not close to the original strength of SB 439. Regrettably, when the bill reached the Public Health Committee in the House, the negotiated agreement masterfully orchestrated by Dewhurst was disregarded, and harmful amendments were added. Nonetheless, SB 439 emerged and was placed on the House Calendar, where it died on the last day of eligibility due to its low placement on the schedule.
HB 1094/SB 439 did not die due to a lack of support. In the House 77 out of 150 members co-authored the bill signifying their commitment to vote for the issue, and about a dozen more members firmly committed to support the measure while choosing not to co-author. Twenty of these House co-authors were Democrats who took active leadership, demonstrating the most bi-partisan effort in the history of Pro-Life bills in Texas. Likewise, 11 of 30 Senators co-authored SB 439 (2 Democrats and 9 Republicans).
Texas Right to Life hopes that such established support coupled with a new awareness of the issue will lay the foundation for a victory in the near future. As we continue to help families in the interim who are victims of this law, we will be reminded of the importance of our perseverance in this battle. And we pray that no one else will be the victim of this state-sanctioned, draconian involuntary euthanasia process.
Terri's murder was state sponsored. She should not have been eligible for Medicaid but they broke gobs of rules so they could take her away from rehab into a deathhaus. She was terminal for FIVE YEARS. What a farce. Poppycock. Medicaid works with health care providers and it is HUMAN TRAFFICKING.
Ask yourself this. Why is regular insurance ten times the cost per month than Medicaid? Is it perhaps because once the person is state sponsored, their time will be much shorter? Of course it will.
My last post shows one method they use in Florida. It is patient trafficking to make sure they end up in Medicaid. The insurance plans win. Medicaid wins and the patients get drugged, underfed and less water until they die. They do clean the patient - sometimes... Shampoo? not so much.
Some patients do not want dialysis. They cannot adapt to it. In that case, it’s the patient’s call imo. Some can tolerate it and some just cannot.
Is Gov. Perry (R) opposing it? Remember the prez signed the Futile Care bill into law in the first place. I don’t understand how our president flip flops on pro-life but he’s solid as a frozen embryo re: not funding them for stem cell research.
I would think twice before living in a futile care state. It sounds like once they've got you, you are the property of the state of Texas.
Another reality check: Once private plans (traffic) shift the patient to Medicaid, Medicaid takes the patients’ entire social security retirement check. So, the care is NOT FREE and neither is the patient. They become hostage to Medicaid until they die.
You know what I’m talkin’ about ping.
See my 14, 15, and 20.
In fact, the fuss divided the Right to Life groups. In fact, Texas Right to Life found themselves opposite 23 Catholic bishops in Texas.
There’s a Coalition that’s been meeting since before 1999, at least several times a year, to draft the original Act and to tweak it when flaws appeared.
TRTL and some trial lawyers were demanding a law that would have forced “treatment until transfer,” and purposefully removed all legal protection from doctors who would not follow the demands of patients and/or their surrogates - even when they demand that we with hold or with draw care.
For a pretty good review of how this played out, here’s some real time blogging (I don’t know who “wounded pig” is, but the information that he or she has leads me to believe that they’re from the hospital. JaquefromTexas is an RN who was brought in by the Lawyer, Jerri Ward. “Lifeethics” is me. Read the comments for the story.):
http://humanlifematters.blogspot.com/2007/03/my-last-blog-posting-was-about-small.html
http://www.wesleyjsmith.com/blog/2007/05/texas-catholic-bishops-support-futile.html
This is how the story began in February:
http://www.wesleyjsmith.com/blog/2007/02/why-texas-futile-care-law-must-fall_17.html
Do these stories sound like the nurses and doctors that you know? I know that Medicare and Medicaid will provide quite a bit of home care for these patients.
I'm just talking about falling down can kill people. I wonder if anybody in geriatric medicine is researching same because unfortunately, many falls occur in medical facilities.
After someone falls, they may not ever get back home.
Doctors diagnose and more often than not, overprescribe. Nurses follow doctors' orders. Family member input ain't what it used to be. We can thank the lawyers for that.
Medicine is an industry who doesn't want to get sued so the letter of the law (even bad laws) is strictly adhered to and further, too many meds kill people every day. Silent euthanasia...dispense and dispose so to speak.
Lurkers, media and freepers. This could happen to you and yours. Pls pay attention to any and all medical treatment or even palliative care and if in doubt, get a second opinion.
People have always had an increased risk of death soon after a hip fracture - one of the common results - and very common causes - of falls. 25% of people who break their hips die from the complications afterwards - usually it’s pneumonia.
The reason they fall is because of brain changes, that lead to muscle changes that include failure of swallowing and breathing, etc. In other words, a fall that causes serious injury is an indication of deterioration that has already happened, more than a *cause* of deterioration.
There’s lots of research in repair of brain deterioration due to blood vessel disease, hypertension, Alzheimer’s, etc., as well as in preventing loss of bone that results in hip fractures and vertebral fractures (that’s what causes the “widow’s hump” or bowed back in old people, not poor posture). And we’re making slow progress.
Over prescription is a problem - that’s one of the benefits of having a Family Doctor instead of a dozen or so sub-specialists.
One of our problems is that our meds have side effects and too many patients get new meds to treat the side effects. But that’s not “euthanasia.” It shows how much we don’t know, yet.
Remember, the patient who has 5 or 6 diagnoses and 12 meds to treat them is sick in the first place!
If the patient is overmedicated, causing loss of appetite and bodily functions, causing inattention, losing the ability to communicate, that is not a disease process but a poisoning event. It is imo, SILENT EUTHANASIA.
I agree. It is slow progress. Too slow.
As I recall and you must know, over medication via morphine is part of the Exit Protocol I read, that was used on Terri and others, to get the system to shut down sooner, to hasten the death process.
I witnessed morphine overdose up close with a friend/patient in France, right before my eyes. It did the trick.
I may not have known what I was seeing, but my friend with us, an MD, explained it.
I call it euthanasia. It seems to fit the definitions I can find.
There’s at least 2 issues here: doctors giving medicines for disease that causes symptoms, so more meds (high blood pressure, weak bladder, swollen ankles - a common progression that sometimes can’t be avoided) and meds intended to sedate or kill. (Not all morphine, by the way is intended to speed death. We use it to relieve symptoms like spasms in the lungs, pain, etc. Those patients should *wake up, not become sedated.)
On the other hand, maybe there’s 3 - Terri got the morphine to make everyone else feel good about refusing her food and water. In her case, the judge called oral feedings “medical experimentation.”
This hypothetical patient would already be dead. The decision to deliberately withhold treatment against the patient's or the patient's family's wishes would be morally wrong regardless of the opinion of any hack doctor who would describe a medical condition this way.
How about a mother who believes the Sun is her child’s father,and insists on ICU ventilator support even though the child’s genetic disease prevents his bones from growing?
I'm sure that there are many incompetent and corrupt medical professionals who think that anyone with stunted growth is worthy of death, but that doesn't make their withdrawal of life support any less murderous.
How about the family that insists on keeping the patient on a ventilator, dialysis, medicines to keep the blood pressure up as it also closes off blood vessels in the fingertips, toes, and is part of the reason that dialysis is needed?
Some people live fruitful lives for years in this condition, that is when lazy doctors don't conspire to bring about their early demise.
How about the family that insists on ventilator and dialysis in the ICU rather than Medicare-funded home care (with ventilator and dialysis) for a comatose patient when the daughter is an ER doc in the same town?
It's a shame her daughter is a physician or you could just off her too.
Or the family who refuses to transfer their mom to the state that the daughters live in - because they want mom in the hospital, rather than a nursing home?
Yeah, good thing this legislation allows cowardly doctors to cut off her food and water.
Or the patient with multiple complications due to HIV who demands blood transfusion after blood transfusion more and more often, when his bone marrow fails?
It's shameful what some people ask for just to stay alive. What could they possibly be thinking?
Putting your pathetic hyperbole in these extreme examples aside, none of your fallacious straw man arguments does anything to defend this vile statute that allows people to be denied food and water against their expressed wishes. Furthermore, your deliberately connotative language illustrates exactly why medical personnel should be the last ones to decide who dies. Despite their overt desire to play God in contradiction to their oath, some doctors are just too lazy and incompetent to be trusted with any human life. They simply prefer harming to healing.
Putting your pathetic hyperbole in these extreme examples aside, none of your fallacious straw man arguments does anything to defend this vile statute that allows people to be denied food and water against their expressed wishes. Furthermore, your deliberately connotative language illustrates exactly why medical personnel should be the last ones to decide who dies. Despite their overt desire to play God in contradiction to their oath, some doctors are just too lazy and incompetent to be trusted with any human life. They simply prefer harming to healing.
Actually, as I said, everyone agreed on the food and water. No one defended including it in a definition of "medical treatment" that can be withheld. We all agreed on a bill that would have made sure that this law was never used in the future to withhold or withdraw food and water. In fact, the current law has never been used to withhold or withdraw food and water in Texas.
Each of the cases I mentioned are actual cases, they are not fictitious.
While you may be willing to give up your bed in the ICU for a patient whose family refuses to care for their loved one at home or at the nursing home, sacrifice should be preceded by "self." The State cannot demand that doctors sacrifice themselves or other patients. Are you willing to sacrifice other patients? Are you willing to make every doctor a slave to the State?
The infant whose ribs and skull wouldn't grow was having lung damage due to the ventilator pressure needed to push the oxygen in his lungs that were compressed by those ribs.
People do not live on blood pressure increasing medicines - "pressors," such as dopamine and dobutamine - for years. For one thing, they are always and only used in the ICU setting. For another, the side effects kill the tissue in the fingers, toes, it puts every area that normally develops bed sores even more at risk and greatly, greatly increases risk of strokes, kidney damage and heart attacks.
In the case of the man who demanded frequent blood transfusions, the breakdown of the blood cells transfused were damaging his liver and kidneys and he required more frequent application of the harmful substance. How often will you force me to cause suffering, to make doctors slaves or automatons who follow orders to the radical autonomy of another?
Finally, there is no "oath." The Hippocratic Oath is sworn to Apollo and would prohibit surgery to remove a stone. Few medical schools have any sort of oath these days.
You are cross posting. My comments were limited to the description of the statute and the posts that have been directed toward me. I don't know or particularly care who everyone was or what they agreed on.
No one defended including it in a definition of "medical treatment" that can be withheld.
My criticism was of the statute as it is described in the article.
We all agreed on a bill that would have made sure that this law was never used in the future to withhold or withdraw food and water.
Good, but your droning hyperbole in your previous post to me made no such qualification.
In fact, the current law has never been used to withhold or withdraw food and water in Texas.
Irrelevant to my criticism of the statute or your weak defense of it.
Each of the cases I mentioned are actual cases, they are not fictitious.
They were extreme examples dripping with your pro-death hyperbole. It doesn't matter whether they were fictitious or not.
While you may be willing to give up your bed in the ICU for a patient whose family refuses to care for their loved one at home or at the nursing home, sacrifice should be preceded by "self."
Your logic is lacking. The real or make believe problem of an imaginary intensive care bed shortage and whether we need more beds is totally independent or your pro-death blather. Furthermore, personal qualifications are meaningless on an anonymous discussion forum like this one so your fallacious appeal to hypocrisy is completely fraudulent.
The State cannot demand that doctors sacrifice themselves or other patients.
This is nothing but a Red Herring. No state has ever done so. Keeping these people who want to live alive sacrifices neither the doctor or the patient. Anyone so perverse to even think this way is worthy of pity.
Are you willing to sacrifice other patients?
No, but based on what you have written here, you and other hack doctors like you certainly are willing to sacrifice patients.
Are you willing to make every doctor a slave to the State?
Your hysterics are comical. Prohibiting them from killing people who want to live is not enslavement.
The infant whose ribs and skull wouldn't grow was having lung damage due to the ventilator pressure needed to push the oxygen in his lungs that were compressed by those ribs.
None or your pathetic examples justifies killing innocent people who want to live.
People do not live on blood pressure increasing medicines - "pressors," such as dopamine and dobutamine - for years.
This doesn't in any way justify incompetent third rate doctors like you being allowed kill them.
For one thing, they are always and only used in the ICU setting.
So what. The more you write the clearer it becomes that you and your ilk are more concerned with costs than lives. You seem to be on the edge of calling these patients "worthless eaters."
For another, the side effects kill the tissue in the fingers, toes, it puts every area that normally develops bed sores even more at risk and greatly, greatly increases risk of strokes, kidney damage and heart attacks.
None of this justifies lazy and incompetent doctors like you being allowed to kill them.
In the case of the man who demanded frequent blood transfusions, the breakdown of the blood cells transfused were damaging his liver and kidneys and he required more frequent application of the harmful substance.
A sad side effect of living in this condition. If doctors in Texas spent more time trying to keep their patients alive rather than killing them, a more sustainable treatment might be found.
How often will you force me to cause suffering,
Giving people the life sustaining treatment they desire is not causing suffering. Only a lazy megalomaniac would make such an absurd statement.
to make doctors slaves or automatons who follow orders to the radical autonomy of another?
The natural desire to live is radical autonomy? If I knew where you lived, I would send you a Get Well Soon card!
Finally, there is no "oath." The Hippocratic Oath is sworn to Apollo and would prohibit surgery to remove a stone. Few medical schools have any sort of oath these days.
It sounds like your medical school required students to make an oath to Satan! Seriously, if you are really a medical professional and truly believe the rubbish you have written here, you are in the wrong line of work. May God have mercy on you, and especially on your patients.
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