Feeling our way through the end of life

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In what has turned out to be an increasingly popular post in light of recent events, we criticized a recent Houston Chronicle editorial for what seemed like a callously indifferent regard for innocent (albeit impaired) life.

In that editorial, the Chronicle trumpeted a Texas law in which hospitals may decide to terminate care of certain patients without regard to the wishes of relatives:

Texas law is considered among the most progressive in the nation and was designed to keep such cases out of court. It requires a hospital’s ethics committee to approve a doctor’s recommendations to remove life support if the patient’s family or guardian disagrees. If the committee concurs, the hospital must wait 10 days before shutting off support in order to give the family time to seek an alternative institution willing to provide such care. The latest Texas cases occurred when no institution could be found to take over care of the patients.

This is touted by the same newspaper that gives us the Chron Eye for the Death Row Killer Guy as equitable, humane, and — yes — progressive.

Today, environmental writer Dina Cappiello weighs in to tell us this Texas law wouldn’t “help” in the Terri Schiavo case. That’s readily apparent, since the Schiavo case revolves around two parties competing to decide her care (with one working to terminate care) and courts trying to divine her intent without the benefit of a written directive, while the two Texas cases revolve around hospitals making decisions to terminate care against the wishes of family. Indeed, Cappiello later admits the law itself didn’t actually help in the case of one Spiro Nikolouzos:

Nikolouzos’ brain damage, on the other hand, is so severe he cannot breathe on his own or move, according to Dr. David Pate, St. Luke’s chief medical officer. Over his wife’s objections, the hospital’s ethics committee decided to remove his breathing tube, setting in motion the 10-day period in which his family could move him to another hospital under the 1999 law.

A judge extended that period as the family tried to find another facility.

His wife ultimately did find another facility willing to take him on, but the law strictly interpreted didn’t help him — rather, a compassionate judge who had doubts about terminating the man after ten days granted enough extra time for the man’s family to have him treated as they desired.

There’s been some back and forth on various blogs as to whether the Schiavo affair merited federal intervention, especially given the existence of this Texas law signed by then-Governor Bush in 1999, and whether some parties are being hypocritical. Readers are welcome check out this blog post, to follow the links, and draw their own conclusions on that.

We’ve been consistent (since March 8) in our criticism of that original Chronicle editorial for the seeming ease with which the editors advocate state sanction for the termination of innocent life based on the judgment of “experts.” When I was an undergraduate in Missouri, the “right to die” issue presented itself forcefully in the case of Nancy Cruzan. It’s only 15 years later, and unsurprisingly we’re still feeling our way through the legal and ethical issues involved in deciding about the end of life. In my mind, this Texas law does need to be revisited, in order more properly to balance the rights and desires of family members against medical corporations, and as Anne put it previously, to err on the side of innocent life.

UPDATE (03-22-2005): The Chronicle editorial linked above has vanished (despite working last night), and the newspaper does not archive its editorials. Fortunately, the google cache still has it (and my furl archive if that stops working).

UPDATE 2 (03-22-2005): Apparently, editorials are now archived, and are accessible if you have access to the archives. The google cache works as well.


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Kevin Whited is co-founder and publisher of blogHOUSTON. Follow him on twitter: @PubliusTX