The right of self-determination is held dear by Texans. We believe in our bones that we ought to decide for ourselves how to live, where to live, and what to do with our lives. Unfortunately, Texans are denied self-determination in one very critical area. Under current health care policy, Do Not Resuscitate (DNR) orders on patients against their will and without their knowledge. That’s right, if a doctor determines that you or your loved one shouldn’t receive care, they can withhold it without you even knowing.
There is a bill that passed the Senate that would stop secret DNRs, but it still allows hospitals and doctors to withhold care against the wishes of the patients. So DNRs will no longer be secret, but they will still be coercive. The appeal process has serious problems — and you are appealing to the very institution that denied your loved one care in the first place.
Historically, doctors and other health care officials had a presumption for life: the idea that life ought to be preserved. That is being replaced with a “Futile Care” ethic. We must realize this: “Futility is not a medical determination; it is a value judgment. Treatment is refused based on “quality of life” judgmentalism and/or “cost-benefit” analysis.”
Let’s imagine for a moment this scenario: You have a severally disabled child who is susceptible to infection. She is hospitalized for an infection and requires antibiotics. This is the 4th time she’s been hospitalized in the last year, and a doctor or an ethics panel or some hospital administrator decides that it is “futile” to continue to treat a child who has a life that the doctor doesn’t think has much value. So he places a DNR on her and denies her antibiotics. To have a stay on the order, you’ll have to submit the request in writing — from your child’s bed side. There are pathways to appeal the decision — through the hospital’s bureaucracy, with deadlines that may not allow you enough time to find a health care facility which will accept a transfer for your child. In this scenario, antibiotics would save the life of that little girl. And that is the problem: doctors and hospitals substituting their judgment for the patient and her families on whether her life has value, whether it is a life worth saving.
Under the proposed bill, if a hospital doesn’t think your loved one’s life should be saved, they can withhold medical care —including nutrition and hydration (aka food and water) — against the will of the patient or her family.
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We cannot let this callous disregard for life and liberty be written into law. We can and should pass a law that protects patients and outlines how hospitals handle these situations, but we shouldn’t write into law the worst parts of an already bad situation, making it worse.
The Texas House Public Health Committee is hearing this bill today. Please call your representative and tell him or her that this bill is dangerous for Texas patients and urge them to vote against it.
For more information:
Here’s a thorough analysis of the actual text of the bill. You’ve got to scroll past a LOT of header, but it’s there.