Patients in Texas may be legally deprived of basic life-sustaining treatment that is both wanted and working. This is not true for patients in most other states. And this uniquely devastating policy has attracted some attention one thousand miles to our east, where a Florida judge recently ruled that a hospital cannot remove life-sustaining treatment against a family’s objection. To quote: “[They] are not Texas.”
Enacted in 1999, the Texas Advance Directives Act’s 10-Day Rule permits a physician to remove life-sustaining treatment, like a ventilator, dialysis treatment, or blood pressure medications, against the instructions of a patient’s own advance directive or the patient’s surrogate. When the hospital ethics committee, typically and unfairly composed of that hospital’s own employees, sides with the physician, a 10-day countdown begins during which the family must frantically search for an alternative facility willing to continue the patient’s care. Upon expiration of the countdown, the physician and hospital are legally protected in removing the treatment, thereby hastening the patient’s death.
Critical to note is that the life-sustaining treatment in question is accomplishing the physiological ends intended. A ventilator is supplying the patient’s body with oxygen-rich blood; dialysis is removing toxins from the patient’s body, substituting for functioning kidneys. Here, the treatment is functioning as intended. The mere existence of effective treatment causes the conflict; there would be no treatment over which to dispute if the treatment wasn’t effectively sustaining the patient’s life.
Because the conflict concerns treatment that is working, the decision to forego that treatment is not an objective verdict rooted in medical facts but a subjective judgment premised on personal values. The hospital’s goal—which the law so egregiously protects—is to give their physician authority to supersede the patient’s values with his own, resulting in the patient’s death.
Florida has no such law. Fortunately for patients in Florida hospitals, state law does not allow hospitals to override the medical decisions of a patient. Instead, a person can appeal the decision of a surrogate if that person believes the decision is inconsistent with the patient’s wishes or is acting in bad faith.
However, in one such appeal this past May, a hospital lawyer argued that the patient’s life-sustaining treatment was futile because her condition was irreversible. Unconvinced, the Florida judge noted that Florida is not like Texas—they can’t unilaterally remove wanted life-sustaining treatment.
Texas’ 10-Day Rule is a notorious law in legal and ethical circles and a fundamentally unfair violation of a patient’s Right to Life, one reason Texas is ranked as only the 20th most Pro-Life state. Shockingly, some people endeavor to spread this policy throughout the country. We must quickly stamp out the disease, beginning now, during this special session.