Texas Senate Bill 303 – allows hospitals to impose “do not attempt resuscitation” (DNAR) orders against patients without their consent and even without their knowledge, passed the Texas Senate today despite opposition by the Association of American Physicians & Surgeons (AAPS) and by virtually every other leading pro-patient group.
Our Senator Glenn Hegar opposed this Bill. Here is a summary of what the bill does:
1. Allows hospitals to issue a “Do not attempt Resuscitation” (DNAR) and other power to impose denial-of-care directives, against patients without their consent and without even giving them written notice.
A. This would put the burden on the patient or family member to find out if the hospital plans to deny care.
B. The bill further makes a verbal objection by the patient or family member insufficient or not effective. This requires the patient or family member to file a written objection, and even then a hospital death panel can overrule the patient and/or families wishes and reject the objection refusing to abide by their wishes regarding their own family member.
2. Grants hospitals the power to withhold medical records from patients for five (5) days as time-sensitive life-or-death decisions are being made. This will create a situation whereby when you or your family need the information the most to make an informed decision, the hospital can refuse to provide you your own records.
3. Grants hospitals the right to deny the ability of independent patient advocates to speak on behalf of a patient and defend the patient’s interests, and instead limit patients to hospital-chosen patient advocates. The same hospital which denies you your records and issues a DNAR order over your objections gets to select who is going to speak on your behalf. Does anyone else see a problem with that?
4. Grants hospitals the power to create their own death panels, stacked with their own employees, to make “ethics” decisions to deny care to patients. Ok, they will probably call them something like medical ethical advisory panels or something similar, but again it is the same hospital which has the power to do 1-3.
5. Grants hospitals the power to transform physicians from being advocates of patient care into becoming adversaries of patients in implementing denial-of-care decisions based on hospital policies.
6. Limit patient options to a request for transfer of the patient to another hospital, at the patient’s own expense and without any guarantee that the other hospital would not also use this law against the patient. This ignores that tax-exempt hospitals have a duty to act in the best interests of patients rather than the self-enrichment of multi-million-dollar compensated hospital administrators. Also you have the issue of not being able to get the necessary medical records.
7. Grants hospitals complete immunity from legal accountability for denying care under most circumstances. You wouldn’t want to have the hospital having to answer to their actions in violating a patients or families rights and wishes regarding their care.
The bill does not establish a right to a second independent opinion; the second opinion which is discussed under this bill will typically be to another hospital employee controlled by hospital policy.
The end result of this bill would be to create death panels which would determine whether you or a family member lives or dies and prevents you from having access to the very medical records which would provide you information to make an informed decision. This bill is all about the profit over people.
Senator Hegar made the following response when asked why he voted against SB 303:
“This bill leaves potential for the burden to be placed on grieving families due to the subjectivity of the physicians.”
What are your thoughts about this bill?
This should be posted to the Health Law Section of the State Bar.
Senator Hegar is correct. Wonder what the house will do with it.
Still, as it stands now, if the patient is demented and the family wants the full court press and the surgeon is saying “surgery is the last thing this patient needs” that surgeon is not in a position to refuse.
I guess everything Texas has done regarding Medical Futility can be round filed . About six years ago South Texas College of Law did a symposium on Medical Futility. That was interrupted by a bomb threat! I don’t know that they ever apprehended or determined a suspect, but it had a certain irony to it as I wondered if it was related to the conference, and, if so, was the caller pro or con?
I can only speak as a family member and not a person of in depth knowledge of the Medical Industry or Health Care Law. I have twice now lost a family member that I was given the gift to be in charge of. I possessed their POA and Medical POA. The decisions I made were in line with the best interest of my family member and no other reasons. If this is taken away and given to either the Medical Industry or Government it would in my opinion not be constitutional or in the best interest of the Individual, Family Members and “We the People.
While I understand that the greatest expenses of (particularly an elderly patient’s) life may be accrued during the last week of a hospitalization, I cannot see whereby the right of the family (or the patient) to request continuing care can be compromised. If the physician cannot convince the family that hospice or equivlent care is appropriate, then maybe it isn’t yet time. In any case, the hospital certainly should not have the right to make a life or death determination based on financial criteria- and that is what it would be, regardless of what title they give the committee.
An issue that I was made aware of is that some Hospice facilities that are owned by doctors. Yes it happens and I have first hand experience with this. While my 91 year old Aunt was at the end of life and I was helping her; one of her doctors was a principal party with a Hospice Company. They approached me a year early saying my Aunt should be put into Hospice. Had a meeting with them at my home and found out they were encouraging me to place her into their facility. We declined and my Aunt lived another year.