Bioethics Blogs

Texas Advance Directives Act – House Debate Today

Today, the Texas House is set to consider legislation to re-evaluate the state’s health commission. The Texas Tribune notes that a number of amendments could set the stage for a fiery debate over the futility provisions in the Texas Advance Directives Act.

Republican lawmakers have filed amendments to Senate Bill 200 that would limit medical professionals’ abilities to override patients’ advance directives or their families’ wishes to continue life-sustaining treatment.

The fight over end-of-life care has been a perennial one at the Legislature as lawmakers have struggled to decide whether families or medical professionals should make the final decision to end life-sustaining treatment for a terminally ill patient.

Texas law allows physicians to discontinue treatment they deem unnecessary. But if a physician’s decision to halt treatment is at odds with patients’ advance directives — or if their families or surrogates disagree — patients or their families have 10 days to find an alternative medical provider.

They can also appeal the doctor’s decision to a hospital ethics committee.

Some lawmakers want to prohibit physicians from discontinuing care against a family’s wishes, while others want to give patients and their surrogates more discretion but preserve a physician’s ability to make a medical judgment to end treatment.

The pre-filed amendments would give more weight to a family’s wishes over physicians’ recommendations.

One pre-filed amendment by Republican state Rep. Bryan Hughes of Mineola would direct the state’s executive health commissioner to develop rules that would prohibit a health care facility or hospital ethics committee from ending life-sustaining treatment based on the “lesser value” the health care facility may place on an elderly, disabled or terminally ill patient versus a young patient who is not disabled or terminally ill.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.