Texas Legislature: Reform the Texas Advance Directives Act now

This past Friday, two members of Texas Right to Life’s legislative team served as patient advocates for two separate patients who found themselves victims of the draconian Texas Advance Directives Act.

Found in Chapter 166 of the Texas Health and Safety Code, the title, “Texas Advance Directives Act,” acts as a misnomer; the title leads Texans to believe the Act provides for advance directives to be honored, but in reality, Section 166.046 of the Chapter allows a hospital committee to override the wishes of patients and/or their surrogates.  Under the law, the withdrawal of requested life-sustaining treatment can be sanctioned by a hospital committee, giving patients a 10-day window before the hospital denies medical treatment.  The only recourse is attempting a transfer to another facility willing to care for the patient.

Last week’s cases occurred across the state – the DFW Metroplex and Houston – and spanned generations: a 3-month old baby and a 71 year old man, respectively.

In Houston, the family very acutely understood how the hospital process was stacked against their loved one.  Often, as was this particular case, a hospital committee’s meeting is scheduled for late in the afternoon on Friday.  If the committee decides to withdraw treatment, the first two crucial days in the ten-day countdown to find another facility are strategically taken up by the weekend.

Additionally, walking into a room of fourteen hospital employees is a daunting experience for families, as these families are already overcome with the pressures of trying to convince a hospital not to kill their loved one by withdrawing life-sustaining treatment, such as dialysis and blood pressure medication.

The statute is written to allow hospital personnel to make and impose quality-of-life judgments on a patient, and to make treatment decisions based on their subjective view of what “quality of life” the patient would desire.  The more appropriate person to make such quality-of-life judgments is the patient himself, through executed documents and previous medical decisions, and in the alternative, by the patient’s family, those who know the patient best.  There is also no guarantee under the law that the physicians requesting to remove treatment have treated the patient for long.  In some cases, the physicians requesting the meeting had only cared for the patient for five days.  Once, a physician recommending removal had only treated the patient for a single day.

In an ongoing case in Harris County challenging the constitutionality of the Texas Advance Directives Act, the Attorney General of Texas has submitted an amicus brief citing the numerous ways in which the current law fails to afford adequate due process to ailing patients. After fervent prayer from family and friends, and after discussion with physicians and the committees, both hospitals with which Texas Right to Life was communicating thankfully backed down and are continuing care for these vulnerable patients.  The Republican-controlled Texas Legislature must act swiftly to ensure even more Texans are not victimized further by this abhorrent, one-of-a-kind law.

No excuses.