Wednesday, May 25, 2011

Texas Futile care laws must change.

Recent articles concerning the "futile care" laws in Texas indicate that many families of patients who are deemed to be dying or in a PVS state are demanding that the system for deciding to withdraw life-sustaining medical treatment needs to be improved to improve the respect that is given to people in these conditions and to bring a greater level of caution to these irreversible conditions.

The Euthanasia Prevention Coalition recently obtained intervener status in the Rasouli case in Ontario. The Rasouli case is about who has the right to decide to withdraw life-sustaining treatment.

The doctors have argued that they have the unilateral right to withdraw treatment. The lower court decision by Justice Himel stated that the doctors cannot withdraw treatment without consent and if consent cannot be obtained they are obligated to bring their case to the Consent and Capacity Board for a decision. The family argued that Mr. Rasouli is not PVS, he is improving, and that they would accept the decision if it is made by the Consent and Capacity Board and the Euthanasia Prevention Coalition argued that withdrawing life-sustaining treatment is not a purely medical decision, that it should not be treated lightly, that consent must be obtained before withdrawal and if consent cannot be attained, the proper body to decide is the Consent and Capacity Board.

A recent article
stated that a proposed amendment to End-of-Life care legislation in Texas appears to be dead. The bill was titled "treat or transfer."

Representative Bryan Hughes stated:
"As time has passed, more and more families have come forward and told us their horror stories of how they were treated, how their loved ones were treated in this process," Hughes said. "We’re very thankful that most hospitals and most doctors are not abusing the law, but some are. And real people are being affected."

The author of the article concluded it by stating:
Currently, doctors and hospitals, in conjunction with an ethics panel, can decide that continuing to treat a patient is futile or, in some cases, injurious to the patient. They can give families 10 days to find another placement for the patient, or else discontinue treatment. Hospital data show it costs between $60,000 and $80,000 a year to provide life-sustaining treatment for a patient in a vegetative state.

The Texas House voted 96 - 47 to study the issues related to end-of-life treatment decisions.

While sitting in the courtroom listening to the legal arguments in the Rasouli case, one of the justices made a statement that appears to also apply to Texas. He asked the lawyers for the doctors if the case was really about money. Mr Underwood, the lawyer for the doctors stated that it wasn't. The Justice did not appear that he accepted that answer.

In many of the cases concerning end-of-life treatment decisions - the elephant in the room is the cost of medical care. Cost of medical care is a reality, especially in Canada where there is a universal health care system. But society must obtain a balance where decisions are being made in the best interests of the patient and not based on money, futile care theory, or the values that the doctor is choosing to impose on the patient.

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