Monday, March 21, 2005


Bush and the denial of life-sustaining treatment

Today Pres Bush signed a bill quickly thrown together in Congress. This is the one regarding the Terry Schiavo case. But let's review Bush's history on the topic of physicians and life-sustaining treatment. While Governor of Texas, he signed into law the Advance Directives Act, amending Chap 166 of the HEALTH & SAFETY CODE. To quote (see link for full version)

§ 166.046. PROCEDURE IF NOT EFFECTUATING A DIRECTIVE OR TREATMENT DECISION. (a) If an attending physician refuses to honor a patient's advance directive or a health care or treatment decision made by or on behalf of a patient, the physician's refusal shall be reviewed by an ethics or medical committee.

If the attending physician, the patient, or the person responsible for the health care decisions of the individual does not agree with the decision reached during the review process, the physician shall make a reasonable effort to transfer the patient to a physician who is willing to comply with the directive.

If the patient or the person responsible for the health care decisions of the patient is requesting life-sustaining treatment that the attending physician has decided and the review process has affirmed is inappropriate treatment, the patient shall be given available life-sustaining treatment pending transfer. The patient is responsible for any costs incurred in transferring the patient to another facility. The physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the written decision is provided to the patient or the person responsible for the health care decisions of the patient.

Life-sustaining treatment under this section may not be entered in the patient's medical record as medically unnecessary treatment until the time period has expired.

At the request of the patient or the person responsible for the health care decisions of the patient, the appropriate district or county court shall extend the time period only if the court finds, by a preponderance of the evidence, that there is a reasonable expectation that a physician or health care facility that will honor the patient's directive will be found if the time extension is granted.

Added by Acts 1999, 76th Leg., ch. 450, § 1.03, eff. Sept. 1, 1999. Amended by Acts 2003, 78th Leg., ch. 1228, § 3, 4, eff. June 20, 2003.

The idea of this law is the physicians and courts have the right to deny life-sustaining medical treatment, regardless of the patient or the responsible persons' wishes. Moreover, they are given 10 days before this treatment is considered medically unnecessary. And if they do find a physician to provide treatment, they have to pay for the transfer.

Now, I am not taking sides regarding the matter of Mrs. Schiavo. I just want to point out the current actions of Mr Bush are inconsistant with laws he agreed to as Governor of Texas. Will he and all those demanding to be involved in the Mrs. Schiavo's medical treatment decisions next demand changes to the above quoted Texas law?

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