What is the 10-Day Rule?
The 10-Day Rule is a provision in the Texas Advance Directives Act (Chapter 166.046 of the Texas Health & Safety Code) that allows a hospital ethics committee to withdraw basic life-sustaining care, like a ventilator or dialysis, from a patient against her expressed will, her advance directive, or the instruction of her surrogate decision-maker. Ten days after informing the patient or surrogate of the committee’s decision, the hospital can remove basic life-sustaining care from a patient.
Committees can withdraw care for any reason and the patient cannot appeal the decision. Even if the patient is conscious, coherent, and actively requests to stay alive, the 10-Day-Rule allows the hospital to overrule the patient’s will.
Who are Donald and Carolyn Jones?
Donald and Carolyn Jones have been married for 40 years, live in Beaumont, have an adult daughter, and enjoy riding motorcycles and fishing. Carolyn (61-years-old) suffered a stroke in December 2017 and has transferred between different rehabilitation facilities since, landing in Memorial Hermann Southwest in November 2018. Donald has stayed by her side throughout her recovery and setbacks.
Why did Memorial Hermann invoke the 10-Day Rule on Carolyn Jones?
The hospital is not required to provide a reason for invoking the 10-Day Rule. Such reasons can include non-medical reasons, like financial reasons, discrimination, or subjective quality of life judgments.
What is Carolyn’s prognosis?
Carolyn suffered a stroke in December 2017 and has transferred between different rehabilitation facilities since, landing in Memorial Hermann Southwest in November 2018. She has undergone dialysis for years and began receiving breathing assistance through a ventilator in February 2019. She has made progress in being weaned off the ventilator over the last two months.
Carolyn is conscious but cannot communicate verbally due to intubation. She tracks movement with her eyes and responds to stimulus. She can move the right side of her body, cries, and expresses frustration when uncomfortable.
Is the hospital starting the 10-day process because treatment isn’t working?
No. Carolyn’s ventilator and dialysis are benefiting her health. Two months ago the hospital attempted to withdraw her ventilator and dialysis, scheduling her to die on March 17, but because Donald Jones found a lawyer to help him fight the 10-Day Rule, Carolyn is still alive and her condition has improved since then. Her health could improve in the future if the hospital stops the 10-day countdown.
Can Donald transfer Carolyn to another facility?
Yes, three facilities in Houston have already agreed to accept Carolyn and provide care. The transfer depends on Donald’s ability to secure Medicaid coverage. For middle-class Americans like Donald, the hurdles of the health care system are more complicated and require more time, making the 10-day countdown even more unjust for the average citizen.
For two months, Donald has navigated the red tape of the Texas Department of Health and Human Services, legal aid, and visiting a private lawyer to transfer his wife to a willing provider. Donald’s court date to become his wife’s financial power of attorney (his last step before securing Medicaid coverage) is two days before the hospital has scheduled Carolyn to die.