(Austin) The state law that determines when a doctor is permitted to withdraw life-sustaining care from terminally ill individuals is confusing, unfair, and doesn’t provide enough time for the family to seek other alternatives, according to two Senators who offered bills to change that Wednesday. The Texas Advance Directive Act permits a physician or hospital to override advance directives, such as a living will, or wishes of the family when continued medical care is considered futile. The bills offered by Mineola Senator Bryan Hughes and Conroe Senator Brandon Creighton before the Senate Health and Human Services Committee seek to give families more power, more clarity, and more time in the process.
Under current law, the process to withdraw life support for a terminal patient begins when the treating physician determines that further treatment is “inappropriate”. Though not defined in Texas statute, the American Medical Association says that means interventions that, in the physician’s judgment, cannot be reasonably expected to result in clinical benefit or goals for care. If this decision conflicts with the wishes of the family or an advance directive from the patient, the case goes before the hospital’s ethics committee. If that panel concurs with the doctor, the family has 10 days to find another facility who will continue life-sustaining care. “This ticking clock is not conducive to doctors and patients and hospitals working together,” said Hughes. His bill, SB 2089, would strike that time limit and give families as much time as necessary to find a new facility. Some members asked if this could cause a situation where a facility has to provide care indefinitely, but Hughes said in the vast majority of cases, the patient’s family is able to eventually find another provider or the patient passes from natural causes. “We just haven’t seen that case where a person lingers on and on for a lengthy period,” he said. “Normally once an advocacy group gets involved on behalf of the patient and some light is shone on the situation, then the transfer usually gets done.” Hughes said his bill is intended to address those cases, however rare, where that doesn’t happen.
Creighton’s bill proposes more comprehensive reforms and would give families more access to the process that could determine the fate of their loved one. He said the current process is confusing, overly bureaucratic and biased. “The legal process leading up to removing treatment has been criticized by legal experts, bioethicists, physicians, families as being unfair and slanted towards the physician and the hospital,” said Creighton. SB 2129 would clarify that the family of a patient facing this process has the right to attend the hospital ethics committee meeting, the right to bring an attorney or patient advocate to the proceeding and that they or their representative are entitled to speak on behalf of the patient. Hospitals would be required to provide to a family or other designated representative written notice of an ethics committee meeting at least seven days before it takes place. The committee would have to explain to the family why the requested treatment wouldn’t result in the desired outcome and the family would have the right to appeal the decision in court.
On the floor Wednesday, the Senate approved a measure that would ask voters in November to approve the permanent dedication of funds collected from the sales tax on sporting goods to the operations of the agencies that maintain Texas natural parks and historical sites. If approved, SJR 24, by Brenham Senator Lois Kolkhorst, would ensure that 100 percent of state revenue brought in from this sales tax would go to fund the Texas Department of Parks and Wildlife and the Texas Historical Commission in perpetuity. Currently a matter of policy, the Senate budget passed Tuesday does appropriate the full amount of sporting goods sales tax revenue to the two agencies, a projected $342 million through the end of fiscal year 2021. Kolkhorst’s legislation would ensure that funding keeps flowing, even in lean years.