January 31, 2013
Texas' Catholic Bishops joined a coalition of the state's largest pro-life organizations, healthcare providers, and religious denominations to endorse legislation introduced by state Senator Robert Deuell (R-Greenville) to improve the state's handling of end-of-life care in a way that balances the protections of human life and a medical provider's conscience (SB 303).
Senate Bill 303 would reform the Texas Advance Directives Act of 1999 (TADA), to improve the statute’s clarity and consistency about many ethical decisions amid the complexity of end-of-life care. For instance, the current statute contains definitions that could be interpreted to allow for the premature withdrawal of care for patients who may have irreversible, but non-terminal, conditions; fails to ensure that all patients are provided with basic nutrition and hydration; and falls short in ensuring the clearest and most compassionate communication between medical professionals and patient families when disagreements arise.
The reforms set forth by Sen. Deuell's bill address those shortcomings by empowering families and surrogates, protecting physicians and other providers from having to provide morally unethical treatment, and avoiding the continuing threats of frivolous lawsuits. Senate Bill 303 also earned the endorsement of the Texas Medical Association, Texas Hospital Association, Catholic Health Association-Texas, Texas Alliance for Life, and the Baptist General Convention of Texas.
Reforming the Advance Directive Act has been a top priority for the Texas Catholic Conference in the 83rd Texas Legislature, as the Catholic Church strongly believes that respect for life is lifelong – from conception to natural death.
"The bishops of Texas have long sought to reform end-of-life care laws in a way that promotes and protects the life of individuals in the natural process of dying. We believe that in end-of-life decisions, any legislation should prioritize the patient, while also recognizing the emotional and ethical concerns of patients, families, and health care providers, to provide the most compassionate care possible," said Daniel Cardinal DiNardo, of the Diocese of Galveston-Houston.
"Respect and care for the life and personal dignity of the dying patient should be the goals of every individual and institution involved in the process. We are pleased that Senator Deuell’s bill accomplishes these goals by explicitly excluding any form of euthanasia and rejecting an abusive extension of the death process," Cardinal said.
The reforms suggested in Senator Deuell's address a number of principles, including:
• Improving notification and appeal processes for families or surrogates when a Do-Not-Resuscitate Order is used;
• Ensuring that artificially administered nutrition and hydration cannot be withdrawn from a patient, unless continuing to provide that treatment would harm the patient;
• Ensuring the process is applied only to patients for whom life-sustaining treatment would be medically inappropriate and ineffective, and are difficult for the patient to endure;
• Respecting the conscience of physicians and other health care providers so the law does not require them to provide unethical treatment;
• Extending the notification time to a family or surrogate from 48 hours to seven days in advance of an ethics committee meeting;
• Extending the time to find an alternative willing provider from 10 to 14 days;
• Providing the family or surrogate with a patient liaison to help guide them through the process;
• Providing the family or surrogate with a free copy of the patient’s medical record;
• Inviting the family or surrogate to attend the ethics committee meeting at which future care for their loved one will be discussed; and,
• Creating reporting requirements for hospitals or hospital systems that have one or more ethics committee meetings on the process outlined in the bill.