A woman writes that her sister is in a hospital in Houston, and that the hospital's board of ethics has determined that continued treatment is futile. They've informed the woman that she has 10 days to find another facility to take her sister before they pull the plug. Now, before lapsing into unconsciousness, according to the sister due to overmedication for pain, the hospitalized woman made it very clear that she wanted full life support until she died naturally. But Texas has a law that says that doctors do not have to take the wishes of the patient, or whoever makes medical decisions for the patient, into account if in their judgment, continued treatment would be futile.
Now, while there are a lot of questions surrounding this woman's case, there aren't many questions for me surrounding this law. Back during the Schiavo case, I wrote the following:
I'm guessing that the next fight will be similar to the Schiavo case, except with the sides reversed. The family will be fighting to keep the victim alive, but the doctors, or just as likely, the insurance company, will sue to remove a feeding tube, or stop a ventilator.
Boy did I miss the mark! Not only was there a law allowing involuntary euthanasia already on the books, it had been there since 1999!
Let's take a look at the law in question.
§ 166.046. PROCEDURE IF NOT EFFECTUATING A DIRECTIVE OR
(e) If the patient or the person responsible for the health care decisions of the patient is requesting life-sustaining treatment that the attending physician has decided and the review process has affirmed is inappropriate treatment, the patient shall be given available life-sustaining treatment pending transfer under Subsection (d). The patient is responsible for any costs incurred in transferring the patient to another facility. The physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the written decision required under Subsection (b) is provided to the patient or the person responsible for the health care decisions of the patient unless ordered to do so under Subsection (g).
And there it is in black and white. If the doctors decide you aren't fit to live, you don't live. If that isn't euthanasia, then what is it? Yeah, the law requires that the hospital help the patient find alternative care, but how many hospitals are going to take a transfer that has already been labeled futile?
None. Once an ethics panel (God the irony is so rich, isn't it?) determines that further treatment is futile, you're bound for the cemetery.
So, what are the ramifications of this law? Once a doctor has determined that treatment is futile, can insurance companies refuse to pay the claim? Also, the law intentionally refused to define just exactly what defines futility. There's nothing to restrict doctors and hospitals from extending the concept of "futile treatments" beyond life supporting/saving measures. If a patient has a history of severe heart trouble with multiple heart attacks and so on, could a medical panel determine that further treatment is futile, as he will certainly die of a heart attack eventually? How about treating illness in the elderly? If their life expectancy is only 5 or 6 years anyway, couldn't treating their illnesses be considered futile? Wow, insurance companies would save a bundle with that policy!
Again, there are a lot of unanswered questions concerning the case that brought this to my attention. It could turn out that the patient in question is much worse off than her sister is telling us, and further life support would indeed be futile.
But do you really want a panel of corporate ethicist making that decision for you?
Here's the real knee slapper.
§ 166.047. HONORING DIRECTIVE DOES NOT CONSTITUTE OFFENSE
OF AIDING SUICIDE. A person does not commit an offense under
Section 22.08, Penal Code, by withholding or withdrawing
life-sustaining treatment from a qualified patient in accordance
with this subchapter.
So in Texas, a doctor can kill you when you don't want to die, but he can't kill you when you do want to die!