Honoring the Memory of Chris Dunn: Why the Texas Advance Directives Law must be changed

This Christmas will be difficult for one Texas family… Loved ones will remember Chris Dunn—the son, brother, and uncle—whom death was nearly forced upon by Houston doctors last year.  Chris landed in the ICU of a Houston-area hospital, where he fell victim to the Texas Advance Directives Act (TADA).  His mother intervened, stopped the hospital from withdrawing treatment from Chris, and has partnered with Texas Right to Life in efforts to nullify the law authorizing the tragic saga she and Chris endured.

The Texas 10-Day Rule, Chapter 166.046 of the Texas Health and Safety Code, authorizes physicians and hospitals to withdraw and deny life-sustaining medical care, even against the expressed wishes of patients and their families.  Even if a patient is conscious, as Chris was, and requests that his care be continued, Texas law empowers hospitals to withdraw, deny, and stop all care once the in-house “ethics” committee approves that decision.  Even if the patient presents a legal medical directive expressing his or her wishes, this so-called “ethics” committee comprised of hospital personnel can override the advance directive and withdraw life-sustaining care.  The decisions to do so are subjective “quality of life” judgments imposed on patients by the facility and the treatment team.

Chris’s mother, Evelyn, was stunned when Chris’s doctors told Evelyn that the decision was made to “let Chris go.”  Evelyn thought she misunderstood and asked for clarification, which only confirmed her worst nightmare.  The doctors had decided that Chris’s quality of life was too low to merit continued care and treatment.  Evelyn understood that the decision would prematurely speed the death of her son, a former law enforcement officer.

Sadly, Evelyn and Chris are not the only victims of the 10-Day Rule.  Texas Right to Life has assisted hundreds of families and patients through this futility process.  Subjective “quality of life” standards threaten the lives of vulnerable patients in our state every day.

In 2015 during the 84th Session of the Texas Legislature, a clarification to state law was enacted that prevents hospitals from denying nutrition and hydration.  Nevertheless, all other treatment can be withdrawn or removed against the wishes of the patient and family (or surrogate).  Once the decision is made, the patient has only 10 days to transfer to an alternative care setting or to another doctor who will provide the needed treatment.  With a mere 10 days’ notice, Texas hospitals can legally move to end the lives of vulnerable patients like Chris, who was captured on video praying to live.

The haunting footage shows Chris, hands raised in prayer, begging his attorneys to fight for his life.  The hashtag #HelpChrisSeeChristmas was used on social media thousands of times.  Chris’s story was covered on Fox and Friends and nearly 150 news stations around the country.  Letters and Christmas cards poured in from around the country urging Chris to keep fighting and assuring him and his mother of fervent prayers.  Tragically, Chris did not see Christmas, and he died on December 23, 2015, without a proper diagnosis or treatment.

In November of this year, Texas Attorney General Ken Paxton filed an amicus brief in which he stated that the 10-Day Rule is unconstitutional, and therefore, he would not defend the Texas law in court.  Paxton joins a host of other Pro-Life Texans and medical ethicists who have long argued that the 10-Day Rule is the most egregious violation of due process and deprivation of civil liberties in the United States.  Paxton echoed Texas Right to Life’s concerns that under this law, patients have no opportunity to appeal the decision of hospital administrators and “ethics” committee; patients do not have access to a neutral arbiter to argue their case; and in short, patients have no right to defend their own lives.  If the attorney general himself deems the 10-Day Rule unconstitutional, the Texas Legislature must act to overturn the law.

Most Texans never learn about this law until they face the terrifying process of imposed death of a loved one by hospital committee.  Chris was not the first victim, and he will not be the last.  Texas Right to Life is the only statewide organization that provides support to the victims of this law, and we have assisted countless families racing against the clock under the draconian 10-Day Rule.  In this sense, Chris’s story is not unique, sadly.  What makes Chris’s story different is the tremendous courage he and his mother showed in their desire to fight for other patients.

Chris’s family was blind-sided shortly before Thanksgiving last year with the devastating news that Chris was not protected under Texas law.  Chris’s attorney, Joe Nixon, iterated the injustice at a press conference the day before Chris passed away.  Nixon said, “In the end, criminals on death row have more rights than Texas hospital patients seeking to defend their lives.”  While Texas leads the nation in many Pro-Life ways, we fall embarrassingly short in protecting vulnerable patients who are hospitalized.

This Christmas, our hearts will go out to Evelyn and to Chris’s family as they commemorate a second Christmas without him.  We must fight to ensure that every hospitalized patient has the opportunity to see another Christmas.