When Life Support is Futile

Texas 10-Day Rule

Few things are worse than having a spouse, child or other loved one kept alive by a ventilator or other life support equipment. A worse thing would be if you want to keep your loved one on life support, but the hospital refuses. Some people may not know that a hospital can remove your loved one from life support over your objection under the 10-Day Rule. Others may not know what to do when faced with this situation. This blog we will discuss the Texas 10-day rule and explain your rights when facing the "death panel."

In the News

The Texas 10-day rule makes the news every few years. Most recently, it was in the news when a Houston hospital refused to continue providing life support for a patient, which was against the wishes of the patient’s family. The patient had been on a ventilator for six months and the hospital decided it was futile to continue the treatment.

Texas Advance Directive Act

Death Panel

The Texas Advance Directive Act (Section 166.046 of the Texas Health and Safety Code) https://statutes.capitol.texas.gov/Docs/HS/htm/HS.166.htm sets forth the 10-day rule. It states that if the attending physician disagrees with the wishes of the patient or the patient’s representative regarding the continuation of life support, then the hospital is required to have a committee meeting to consider the attending physician’s decision. The meeting is sometimes referred to as a "death panel."

Pre-Meeting Process

The patient’s representative is provided a written description of the review process, copies of the policies and procedures relating to the process, and a list of health care providers and referral groups that have volunteered their readiness to consider accepting transfer or to assist in locating a provider willing to accept transfer. The medical committee must also notify the patient’s representative at least 48 hours prior to the meeting and invite them to attend the meeting. The attending physician is not part of the committee and life support must be continued during the process.

Post-Meeting Process

If the committee upholds the attending physician’s decision to discontinue life support, then the patient’s family has 10 days to arrange the patient’s transfer to a medical facility that is willing to continue providing life support. After 10 days, the health care facility is not obligated to provide life support. However, the patient is entitled to artificially administered nutrition and hydration, pain management medication, and medical procedures necessary to alleviate pain.

When most people think of a patient on life support, they think of a person in a coma and unable to communicate. However, the patient could be conscious, coherent and communicating that they wish to remain on life support, namely a ventilator. This could be a horrifying experience for both the patient and family to watch the patient struggle to breath after the ventilator is removed. Ten days is not very long to contact other facilities, discuss the patient’s medical condition, wait until the facilities decide whether to accept the patient, and then arrange for a safe transfer of the patient.

Death Kneel of Death Panel?

Senate Bill 2089, which is working its way through the Texas legislature, is an effort to overturn the 10-day rule. The Bill made it out of the Texas Senate Committee on Health and Human Services on April 30, 2019, and it passed through the Texas Senate on May 14, 2019. It will now have to make it through a House Committee and the full House before being presented to the Texas Governor for signature. In the meantime, Texans will have to wait to see if the pendulum swings back in favor of the patient making decisions about life support. Until the 10-Day Rule is abolished, Texans should educate themselves, so they know what to do if faced with this traumatic issue.

Conclusion

Although an advance directive cannot stop the application of the 10-Day Rule, it is a way to communicate your wishes about life support. When your family knows how you feel about having life support administered, they know how to represent you in these matters. Contact the Law Office of Hugh Spires, Jr. at www.TexasWillsLawyer.com, to have an advanced directive drafted that clearly states your wishes.