Posted on 02/13/2013 8:25:19 PM PST by penelopesire
Forced Do Not Resuscitate Orders Coming to Texas? by Wesley J. Smith | Austin, TX | LifeNews.com | 2/13/13 12:23 PM
Good grief! The state with the worst futile care law in the nation now has legislation pending that would enable doctors to place DNR (do not resuscitate) orders on a patients chart without notice or permission–even if the patient is competent! From the text of S.B. 303:
Sec.A166.012. STATEMENT RELATING TO DO-NOT-RESUSCITATE ORDERS.
(c) Before placing a do-not-resuscitate (DNR) order in a patient ’s medical record, the physician or the facility ’s personnel shall make a reasonably diligent effort to contact or cause to be contacted the surrogate. The facility shall establish a policy regarding the notification required under this section. The policy may authorize the notification to be given verbally by a physician or facility personnel. (d)The DNR order takes effect at the time it is written in the patient ’s chart or otherwise placed in the patient ’s medical record. (e) If the patient or surrogate disagrees with the DNR order being placed in or removed from the medical record, the patient or surrogate may request a second opinion at the patient ’s or surrogate ’s expense.
The notification requirement only applies to patients not expected to die within weeks or days. If the patient is expected to die imminently, the obligation to attempt notification and the right to a self-paid second opinion does not exist:
(f) Subsection (c) [the notification section quoted above] does not apply to a DNR order placed in the medical record of a patient:(1) whose death, based on reasonable medical judgment,is imminent despite attempted resuscitation; (2) for whom, based on reasonable medical judgment, resuscitation would be medically ineffective and there is insufficient time to contact the surrogate;…
Subsection (e) [right to obtain second opinion] does not apply to a DNR order placed in the medical record of a patient with respect to whom, based on reasonable medical judgment, death is expected in days to weeks and resuscitation would be medically ineffective.
What does “medically ineffective” mean? It isn’t defined. Moreover, it couldn’t be the same as “imminent despite attempted resuscitation,” or that language would have been repeated. Given the justifications for futile care arguments, this could reflect a judgment based on “quality of life” rather than the resuscitation being physiologically useless.
Doctors who impose DNRs on charts without permission would be accorded extraordinary legal protection for their mistakes or unilateral inactions:
(i) A physician, health professional acting under the direction of a physician, or health care facility is not civilly or criminally liable or subject to review or disciplinary action by the appropriate licensing authority if the actor has complied with the procedures under this section…
So, even if the physicians are negligent in their diagnoses, so long as they follow the procedure, they are home free? This would mean that there would be no checks and balances in an issue of life and death!
Don't bet too much. Progressives come in both flavors.
This is just the natural progression of socialized health care, why are you surprised?
No it is worse, when even freepers do not see what is happening. Trains will have to be running regularly I guess, before people will wake up.
Ping...
Considering Rick Perry and the Texas GOP gave in-state college tuition to Illegal Aliens, and wanted to spend 150 Billion to build the NAFTA SuperHighway for Communist China and Mexico...do not be surprised if you find a lot of GOP involved on this
Here in Florida, during the Terri Schiavo state-sanctioned execution, the state GOP leaders were involved in making it easier for people to be shipped to hospices and prepped to die. In fact, the judge who ordered her execution was GOP
More and more you find the GOP is working with the Dems on some of this bizarre individual-rights denying legislation
Yep. Look at Colorado--seriously Californicated. Western Montana got it, too.
If the Governor has to sell California business on the move based on fiscal benefits, the move won't likely be for philosophical reasons, but just the money. Beware that.
I guess that depends on the market for spare parts...
(i) A physician, health professional acting under the direction of a physician, or health care facility is not civilly or criminally liable or subject to review or disciplinary action by the appropriate licensing authority if the actor has complied with the procedures under this section…
Just as I was considering a move to Texas, I now see that liberals have succeeded in infiltrating the state.
Yep. People are so ready to believe any given politican is conservative.
Rick, bless him, is NOT so whe faced with immigration from Mexico or California.
Watch out.
For what it’s worth department......
http://www.txcatholic.org/news/300-bishops-applaud-advance-directives-reform-bill
Texas Bishops Endorse SB 303 To Improve End-Of-Life Care
January 31, 2013
Texas’ Catholic Bishops joined a coalition of the state’s largest pro-life organizations, healthcare providers, and religious denominations to endorse legislation introduced by state Senator Robert Deuell (R-Greenville) to improve the state’s handling of end-of-life care in a way that balances the protections of human life and a medical provider’s conscience (SB 303).
Senate Bill 303 would reform the Texas Advance Directives Act of 1999 (TADA), to improve the statute’s clarity and consistency about many ethical decisions amid the complexity of end-of-life care. For instance, the current statute contains definitions that could be interpreted to allow for the premature withdrawal of care for patients who may have irreversible, but non-terminal, conditions; fails to ensure that all patients are provided with basic nutrition and hydration; and falls short in ensuring the clearest and most compassionate communication between medical professionals and patient families when disagreements arise.
The reforms set forth by Sen. Deuell’s bill address those shortcomings by empowering families and surrogates, protecting physicians and other providers from having to provide morally unethical treatment, and avoiding the continuing threats of frivolous lawsuits. Senate Bill 303 also earned the endorsement of the Texas Medical Association, Texas Hospital Association, Catholic Health Association-Texas, Texas Alliance for Life, and the Baptist General Convention of Texas.
Reforming the Advance Directive Act has been a top priority for the Texas Catholic Conference in the 83rd Texas Legislature, as the Catholic Church strongly believes that respect for life is lifelong – from conception to natural death.
“The bishops of Texas have long sought to reform end-of-life care laws in a way that promotes and protects the life of individuals in the natural process of dying. We believe that in end-of-life decisions, any legislation should prioritize the patient, while also recognizing the emotional and ethical concerns of patients, families, and health care providers, to provide the most compassionate care possible,” said Daniel Cardinal DiNardo, of the Diocese of Galveston-Houston.
“Respect and care for the life and personal dignity of the dying patient should be the goals of every individual and institution involved in the process. We are pleased that Senator Deuell’s bill accomplishes these goals by explicitly excluding any form of euthanasia and rejecting an abusive extension of the death process,” Cardinal said.
The reforms suggested in Senator Deuell’s address a number of principles, including:
• Improving notification and appeal processes for families or surrogates when a Do-Not-Resuscitate Order is used;
• Ensuring that artificially administered nutrition and hydration cannot be withdrawn from a patient, unless continuing to provide that treatment would harm the patient;
• Ensuring the process is applied only to patients for whom life-sustaining treatment would be medically inappropriate and ineffective, and are difficult for the patient to endure;
• Respecting the conscience of physicians and other health care providers so the law does not require them to provide unethical treatment;
• Extending the notification time to a family or surrogate from 48 hours to seven days in advance of an ethics committee meeting;
• Extending the time to find an alternative willing provider from 10 to 14 days;
• Providing the family or surrogate with a patient liaison to help guide them through the process;
• Providing the family or surrogate with a free copy of the patient’s medical record;
• Inviting the family or surrogate to attend the ethics committee meeting at which future care for their loved one will be discussed; and,
• Creating reporting requirements for hospitals or hospital systems that have one or more ethics committee meetings on the process outlined in the bill.
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This nothing new at all as far as I can tell. The “Houston Plan” has been in effect since 1999, and the hospitals in Texas were pushing since the mid-1990s for greater control of taking such health care decisions away from mere patients and families. At the moment, there are about 40 states where doctors are legally immune when placing such directives contrary to expressed wishes of patients in advanced directives. Repeat, this is nothing new and they are probably just tweaking the words.
DNRs are in the DNC’s DNA.
Does this give physicians the same power that the president has — to drone-strike patients?
Agree. I have seen them in action twice while helping my mom through cancer treatment. Once in Mississippi while she was going through throat cancer treatment and ended up in hospital. I saw a DNR tag on the foot of her bed, which neither she or I had ordered. When I questioned the nurses what would happen if her throat closed up, would they clear it in order for her to breathe, she said no, not with the order on her bed. We demanded right then and there that it be removed permanently from her record. Bear in mind that at the time, the radiation had eaten a hole practically all the way through her neck and it was quite possible that the swelling could have blocked her airways at any time. In that event, nothing would have been done to clear her airway with that order tag. I am happy to report that she made it through that round of treatment and hardship and lived another 4 years. She died from a massive heart attack at home. God rest her sweet soul.
We still have them outnumbered, but with our governor inviting the libs from every spoiled statist state in the union ‘to come on down’ and the dems pandering to the ‘illegal vote’, it probably won’t last much longer.
Back to this again.
“Resuscitation” is not one thing, it’s a bunch of things, sometimes done together, sometimes not. I assume this refers to the practice of automatic CPR when a hospitalized patient is found dead.
This automatic practice is wrong, and it never should have been allowed to take root in the first place. It was created and is sustained by a vitalist culture that sees the body as a machine, or a collection of electrical and chemical impulses, and it has no respect for transcendence.
Defibrillation is appropriate therapy for a patient with (temporary) cardiac ischemia. It is ALWAYS standard of care within 48 hours of the onset of chest pain, and it has a 95% success rate.
Intubation is ALMOST ALWAYS appropriate therapy for patients with respiratory failure that has treatable cause, and presuming effective treatment of the cause has an 85-95% chance of success.
Defibrillation/intubation of a dead body that has bled to death, or succumbed to metastatic cancer, or whose liver has failed and who is not high on the transplant list, or who has sustained non-survivable motor vehicle trauma, or any of the other innumerable non-survivable events that we deal with every day in the hospital is a macabre, barbaric ritual tha converts caregivers into technicians and converts the passage of the soul out of the body into a violent play that at times becomes medieval.
And if that wasn’t bad enough, resuscitation under the above referenced circumstances (which apply to AT LEAST 90% of hospital “codes” where there is no DNR order) is never successful, at least as measured by 7-day survival.
This is a therapy that should be used like every other one - implemented when it’s appropriate, witheld when it isn’t.
Please read my post 54 and then I would like your opinion if you don’t mind. Btw, are you a doctor? You made many good points here regardless, just curious.
If the condition of your relative was such that a four-year survival was possible after treatment, then no DNR order should have been requested.
Usually, tumors eroding into the airway lead to gory and spectacular death, and efforts to reverse the process end in disaster, with everyone in the room soaked in blood and the patient dead.
Glad you had such a good result.
Her throat cancer was cured. The radiation had caused some complications, but even that was temporary. She was operated on with no visible after effects and then underwent chemo and radiation. Yes, she was blessed with a cure but had that order not been discovered and she had swelling that temporarily obstructed her airway, I was told by the nursing staff that nothing...NOTHING..would have been done to open her airway with that order in place.
A cautionary tale that I hope all who read take to heart.
Thanks for your reply.
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