Posted on 08/21/2006 3:43:35 PM PDT by wagglebee
DALLAS, Texas, August 21, 2006 (LifeSiteNews.com) – The children of a comatose woman are challenging in court the “compassionate reasons” for a Texas hospital’s decision to remove their mother’s life-saving treatment, asserting that their mother, a devout Baptist woman, never would consent to anyone but God ending her life.
On August 8, just days after 61-year-old Ruthie Webster's insurance stopped full coverage of her long-term care, the Regency Hospital’s bioethics committee in North Dallas, Texas, unanimously told the Webster family that they would discontinue life-preserving dialysis treatment for their mother within 10 days. The hospital claimed that Ruthie Webster's physician "has seen no appreciable change in your mother's medical condition" and that continued treatment was an exercise in futility.
The decision shocked family members, since their mother is not brain-dead, but comatose, and has been making slow progress, breathing now on her own without a ventilator, ever since she suffered a bad reaction after undergoing kidney dialysis in June rendering her mostly unresponsive. The family, however, has said their mother told them to take care of her in such a situation, saying that she believes only God has the right to take life away.
"My mom spent her life in the church. She always felt like, 'Who are we to decide? God decides,'” said Lacresia Webster on Thursday. "If this is the way she's going to be, she's still my mom. I'm not giving up on her."
However, the Regency Hospital board defends its decision citing a 1999 statute in Texas' Health and Safety Code that gives a hospital’s ethics committee the last word about continuing a patient's care. Under the law, if the ethics committee decides to end a patient’s medical care, including life-saving treatment, a family has only 10 days to transfer to another medical facility that will care for the patient.
Although Regency has offered to help find another medical facility for Ruthie Webster in Atlanta or Indiana, the family does not want to move their mother, unless they can help it.
"I find it hard to believe this is a law, because you're basically saying if this person is a burden to someone, let's just kill them, and that's unacceptable," Lacresia Webster told Dallas’s NBC 5.
"When God is ready for her, God will take her, not anyone else," Lacresia Webster vowed.
Intent on keeping this vow, Lacresia and her family have enlisted the aid of pro-bono attorneys who have filed a lawsuit against Texas Attorney General Greg Abbott challenging the constitutionality of the state's “end-of-life” law. The family then won a temporary restraining order imposed on Regency Hospital to keep Ruthie Webster alive there until a hearing set for August 28.
Robert Bennet, a lawyer for the Websters said the law “allows a doctor to completely ignore what I’ve told them I wanted to do.” He added, “Mrs. Webster was a Baptist. She told her daughters very clearly that God would take her when it's her time to go. This statute violates her freedom of religion."
"My mother, she's breathing on her own, just like you and I are today," said Helena Webster Hill, who lives in Atlanta. "As long as she's fighting to live, we believe we ought to stand with her and fight with her."
Hello, all.
I happen to know quite a bit about this case, more than 99.9% of you whose only source of information was the AP story. The truth is, you know NOTHING of the history of this situation and what you don’t know has EVERYTHING to do with the decisions that were made.
Modern medicine has become a contest to see how long we can make people suffer, regardless of the cost in resources, energy, and money. Technological advances have saved countless lives but have also led to the tragic circumstances involved in this case and thousands of others. Unfortunately we have not seen a commensurate advance in our understanding of dying with dignity and in peace.
In situations like this, you will see a number of consistent features:
1. There is no written living will in place, but plenty of people who claim to have heard what said individual wanted to have done.
2. There are family member(s) who are profiting from the perpetual illness of the said individual, through insurance or social services (ie: your tax dollars).
3. There are few, if any, visitors on a regular basis despite protestations of concern and care.
Please don’t feign indignation about the issue of cost here. It’s hypocritical to promote perpetual life support for futile medical conditions (as this is) and then complain about the soaring cost of private insurance and decreasing Medicare/Medicaid coverage.
Like it or not, situations of this nature are only going to continue as we as a society refuse to confront our mortality and communicate our wishes to our loved ones directly and IN LEGAL DOCUMENTATION.
First, if an end stage kidney failure patient does not go to dialysis, she does not commit suicide and no one kills her. The end stage kidney failure kills her.
Second, her insurance is Medicare, most likely. http://www.medicare.gov/Basics/Kidneypatient.asp
And that's where things get complicated.
She became Medicare eligible - whether she signed up or not - when she was diagnosed with end stage renal failure. Medicare is a stickler about proper diagnosis and standard of care, but the people who regulate Medicare can change their minds about how we treat Medicare-eligible patients. Her doctors and the hospital are at risk of felony charges if they don't treat her the same way as every other long-term care patient, eligible for Medicare.
I'm not even sure whether the family can pay in the hospital, without the hospital and docs becoming ineligible for Medicare and all Federal and State funds.
Medicare will not pay for indefinite stays in the hospital - or, more specifically, it pays a set price for any given diagnosis, regardless of the course of the patient. And they define "long-term care" patients. Again, if she's a Medicare patient, the docs and hospital are at risk for jail and triple fines if they try to work around the Medicare definitions, diagnoses and codes.
It doesn't sound like this woman needs to be in a hospital at all, now that she's off the ventilator.
She now needs "long term care," which is not covered by most insurance, including Medicare.
Medicare will pay for outpatient dialysis. In fact, all end stage kidney patients are automatically covered for dialysis. But most dialysis facilities are *out patient* - away from the hospital and aren't set up for comatose patients. She needs to be moved to a nursing home and changed to private pay or Medicaid. This isn't a matter for the "Advance Directive Act," but a simple discharge decision.
So, the woman needs a nursing home with the ability to dialyze her or one that can transfer her by stretcher to an outpatient dialysis center that can handle a comatose patient.
Why don't her children want her near them?
Dialysis.
I'm sure she'll have a Terri Schiavo-like euphoric and peaceful look on her face when she goes. /s
Ah, GEEEEEEEESH! Cue the smallest violin; life isn't fair.
For someone who knows EVERYTHING...99% to be exact?????. Don't make me laugh.
Please do not pretend to know 99% of the facts when you DON'T. Her daughter LIVES in Dallas and visits her on a regular basis. The article clearly states there are other children. Duh?
She does NOT have Medicare because Medicare PAYS for long-term care, some private insurance companies will not after a certain time in a hospital.
If there is a MONETARY award... for bringing a lawsuit against the STATE OF TEXAS to CHANGE THE LAW, the money will be used to care for Ruthie ---who walked into a dialysis clinic early this summer-2006 and ended up on a stretcher because of lack of oxygen and then slipped in a coma.
I hope nothing similar happens to you in these wonderful medical facilities. Who knows? You may need a lawyer to keep a doctor from pulling the plug on you too.
Most people do not think they will walk in a medical care facility and roll out on a stetcher. ..But thanks for reminding us all to handle our business just in case.
You are correct long-term care isn't generally covered by most insurance, however, Medicare does cover SKILLED NURSING which happens in a long-term care facility, this why on the MEDICARE website--it says "Medicare does not GENERALLY" care for long-term care. If Ruthie used Medicare, which she obviously does not have, then money would not be the issue. Her private insurance is unwilling to pay for long-term care.
But the bottom line is this.. she should not be forced to die because she of SOMEONE else's mistake. She began dialysis and somebody messed up. Oh well, let's just kill people when they go into a medical facility and the healthcare PROFESSIONAL makes a mistake.
Insurance shouldn't be the topic, somebody else should be taking responsibility for their actions. Instead, a Texas physician says, now that YOU have made her REALLY ILL, let's finish the job.
Lawsuit seeks to bar removal from life support
A lawsuit has just been filed in the County Court of Bowie County, Texas, asking the court to prevent Regency Hospital of North Dallas from removing 61-year-old Ruthie Webster from life-sustaining dialysis treatments.
“We were appalled at the amount of power given to health care providers,” says Allen Reaves of Gilmer, counsel for Mrs. Webster. “This statute enables a doctor to ignore the wishes of the patient and the family and substitute their own judgment as to who lives and dies.”
Section 166.046 of the Health and Safety Code was enacted by the Legislature in 1999, but has rarely been an issue on appeal.
“Usually when a situation like this develops an injunction is sought and the patient is transferred to another facility,” said Robert Bennett of Gilmer, co-counsel with Reaves. “When the transfer occurs, the suit is dismissed. In this case, we are asking the Court to declare the statute unconstitutional and against public policy, because there are no procedural avenues to allow oversight of the doctor’s decisions. We won’t be dismissing the case.”
Texas Attorney General Greg Abbott is also named in the suit.
“Texas Law requires us to name the Attorney General if we are trying to get a statute declared unconstitutional,” says Bennett. “This doesn’t mean that AG Abbott disagrees with our position on a moral level.”
“Ruthie Webster went into a comatose condition following a botched dialysis treatment,” Reaves added. “But it has only been a few months and she deserves a chance to try and heal.”
Lawyer and State Rep. Bryan Hughes (R-Mineola) also feels strongly about this statute.
“This should not be the law in Texas,” Hughes said. “It’s one thing for a doctor or a hospital to make a medical decision as to whether continued treatment will prolong the patient’s life. But when the question is one of quality of life — that is, whether the patient’s life is worth living — that decision belongs to the patient and the patient’s family. The medical people can and should give advice, but the final decision is not theirs.”
Bennett said that the Webster family found the Bennett law firm through an internet search. He said that he does many seminars, and that publicity for one of them was what attracted the family to his firm.
One daughter lives in Texas.
I believe that she is on Medicare, since all patients in the US who are diagnosed with end stage renal disease (all those who need dialysis)become Medicare eligible. Medicare would pay for acute hospitalization, dialysis and a portion of her Long Term Acute Care (LTAC) Hospital stay, but not more than a certain period and not for the nursing home stay.
I did a bit more research on Long Term Acute Care Hospitals. I found out that Medicare will pay all of the Long Term Acute Care for the first 20 days or so, then the patient has a co-pay, and then the patients are responsible for full payment.
It appears that Mrs Webster had seizures (a complication for dialysis patients - it can happen when the poisons are removed from the blood faster than they come out of the brain or due to a reaction to something in the dialysis chemicals) on dialysis (I assume at her home town of Gilmer), was taken to another hospital (possibly in nearby Longview) where she was placed on a ventilator and her seizures were controlled, and then she was transferred to Regency in North Dallas to be weaned from the ventilator and for healing of her bed sores.
Patients go to the LTAC from another, acute care hospital, after they are stable, but when there is hope of improvement from the 8 to 12 hours of direct nursing care given there. Medicare requires the patient to be transferred to a lower level of long term care when there is no expectation of further improvement. (I've been involved with this sort of payment, years ago, when we decided not to send a man to a nursing home until he was strong enough for more intensive physical and occupational rehabilitation. Medicare rules change pretty often, but at that time they would only pay for a certain number of days, and would force the rehab facility to discharge the patient if there was no ongoing improvement.)
I've got links to some of this info on my blog.
The family needs to look into non-acute long term care where Mrs. Webster can be transported to dialysis. If the care at Regency has enabled her to be weaned from the ventilator and to heal the bedsores she had when she was admitted there, then I don't understand why she would be eligible under Medicare rules for the LTAC hospital or even "skilled nursing."
Medicare regulations rule for Medicare-eligible patients. Even when a patient needs some medicine or care - such as a tetanus shot after a dirty wound - Medicare decides what is and is not deemed "medically necessary" according to their own arbitrary rules. At the risk of "exclusion," fines, jail, loss of license, etc., doctors and hospitals must follow these regulations.
Take a look at http://www.ssa.gov/OP_Home/ssact/title11/1128.htm
(especially #6 and #12) and The Association of American Physicians and Surgeons at http://www.aapsonline.org/
(No more Olmert! No more Kadima! No more Oslo! )
Eligible doesn't mean 'You automatically' get Medicare, you hav to qualify, not just be eligible. If she were on Medicare she could go home and get IN-HOME dialysis. Medicare definitely pays for that.
It would be very odd if Mrs Webster is not covered for dialysis. She really should be on Medicare and possibly Medicaid if she's not already. Virtually everyone qualifies for Medicare who has end stage renal disease, either through Social Security or SSI/disability.
See Collier's post number 148 and that link I gave above,
http://www.medicare.gov/Basics/Kidneypatient.asp
Here's even more information:
http://kidney.niddk.nih.gov/kudiseases/pubs/financialhelp/
And, even for those who aren't on Medicare, Medicare rules and regulations will probably be dominant.
Evidently, the problem is not the availability of another place and dialysis, it's the decision not to continue care at the hospital that the family objects to. But, (from what little we know) she doesn't need to be in a Long Term Acute Care Hospital.
If the docs have invoked the Advance Directive Act, I don't think they needed to do so - they just need to discharge her to one of those options they've given the family and bill the family in the meantime. And if they haven't, then I don't understand the fuss.
For the record, I believe your post #167 should be directed to KnowtheFacts in post #161.
For one thing, the comments I made in my post about the situations you commonly see with these patients was not a specific reference to the Webster case.
For another, there will NEVER BE A DIME received from any action taken against the attorney-general on this case. Do you think this law was just concocted yesterday for this case? It was hammered out after years of dealing with ridiculous situations like this one and has stood the test of time...and most certainly will stand up to this pro-bono attorney who's obviously more interested in getting his face on the news than winning this case. Lots of luck to him...he won't pay many bills jousting this windmill.
The point to be made here is for each and every one of you to stop for a minute and imagine this scenario: you are fully alert and oriented but cannot move a muscle, respond to pain, ask for help, scratch an itch, or anything else. How long would you like to live like this? A year? Two? Ten?
That is the absolute best you could ever expect Webster to reach. Much more likely, she has sub-ten-percent cortical function with no consciousness whatsoever.
If this were to happen to me, I'd embrace hospice and comfort measures and 'follow the light.'
Like it or not, health care in the US is in a shambles right now due to rampant cost overruns and poor use of resources. This is only going to continue as our "technology" improves and we're able to diagnose more and more conditions in the super-elderly. Choices will have to be made and should be made. Thirty years ago this wasn't nearly the issue it is today because of the limited technology available then.
If people want their wishes carried out without question, they need to establish it in an advanced directive and living will. If they choose to be irresponsible and foist this decision upon others, then so be it.
This case has ABSOLUTELY no similarity to Schiavo and if the Webster family members routinely posting on this forum would tell the WHOLE STORY, you'd see it very clearly.
Why would they oppose moving their mom...
I wouldn't trust the care they gave after that.
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