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It’s ironic, maybe even macabre, that while Sarah Palin and some other Republicans raised the spectre of Health Plan Death Panels (even though they did not exist…see my previous post), actual Death Panels have lurked in the catacombs of the Texas Health and Safety Code (Section 166.046) for a decade.

A 1999 bill signed by then-governor George W. Bush allows an attending physician in Texas to refuse to continue life-sustaining treatment at his sole discretion, in which case “an ethics or medical committee” reviews the circumstances with the patient or representative present and makes a determination to uphold or deny the doctor’s decision. If the committee affirms that

“life-sustaining treatment is inappropriate…the patient shall be given available life-sustaining treatment pending transfer…[and t]he 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.”

Wikipedia describes the process in detail:

For the hospital personnel to take advantage of legal immunity from prosecution for this the following process must be followed:

• The family must be given written information concerning hospital policy on the ethics consultation process.
• The family must be given 48 hours’ notice and be invited to participate in the ethics consultation process. Family members may consult their own medical specialists and legal advisors if they wish.
• The ethics consultation process must provide a written report to the family of the findings of the ethics review process.
• If the ethics consultation process fails to resolve the dispute, the hospital, working with the family, must try to arrange transfer to another provider physician and institution who are willing to give the treatment requested by the family and refused by the current treatment team.
• If after 10 days, no such provider can be found, the hospital and physician may unilaterally withhold or withdraw the therapy that has been determined to be futile.
• The party who disagrees may appeal to the relevant state court and ask the judge to grant an extension of time before treatment is withdrawn. This extension is to be granted only if the judge determines that there is a reasonable likelihood of finding a willing provider of the disputed treatment if more time is granted.
• If either the family does not seek an extension or the judge fails to grant one, futile treatment may be unilaterally withdrawn by the treatment team with immunity from civil or criminal prosecution.

This part of the Texas Advance Directives Act, also known as the Texas Futile Care Law, is good legislation. It is designed to prevent a patient or her family from forcing a physician, nurse, or hospital do what they believe is not in the patient’s best interest or that causes the patient needless harm and suffering without benefit. If the family disagrees, this law creates a fair mediation procedure. Good idea, Gov. Bush.

Why am I still surprised when politicians serve hypocrisy as an entree?