The Texas House has approved a bill to amend the Texas Advance Directives Act (TADA), a change that would change the procedure for Texas patients who are on life-sustaining treatments with no hope of recovery. Controversy over the current Advance Directives Act focuses on the ability of hospitals to discontinue life-sustaining treatments after 10 days if the attending physicians consider the treatment to be futile and cannot find a different facility to care for the patient, even if family members disagree with the choice. The new bill will increase the time from 10 days to 25 and update the process for ethics committee meetings.
TADA has been on the books since 1999, when it was passed as a compromise between medical professions and Texas anti-abortion-rights groups. The Texas Right to Life organization has consistently pushed for the law’s repeal.
THADDEUS POPE; thaddeus.pope@mitchellhamline.edu
Pope is an expert on medical law and clinical ethics with a focus on patient rights, healthcare decision-making, and end-of-life options.
Pope told the Institute for Public Accuracy: “These changes have been called for for a long time. More than 40 bills have been introduced to amend this law since the early 2000s, and they almost all failed. This time is different; the amendment was pre-drafted and vetted by stakeholders, including Texas Right to Life and the Texas Medical Association. Those parties haven’t agreed on the bill since 1999.
“Across the country, states have increasingly acted to constrain the ability of clinicians to unilaterally take action to stop life-sustaining treatment over the patient or family objections. Fifteen years ago, there was a thought that more states would follow Texas and permit clinicians to stop treatment when it was futile, inappropriate, non-beneficial,” and so forth. “But in fact, the rights and legal ability of hospitals and clinicians to act over patient and family objections has been constrained in a number of states.” Until now, “Texas was unique in keeping that broad scope of permission for clinicians and hospitals to do what they thought was appropriate.”