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03/12/2015

Texas Advance Directives Act – 2015 Amendments

House and Senate bills both to improve and to eliminate the dispute resolution provisions in the Texas Advance Directives Act have been introduced in every Texas legislative session since 2003.  The first such bill in the 2015 session was introduced this week.  


Senator Kelly Hancock has introduced S.B. 1163.  Senator Hancock is described as pro-life and defending core conservative values.  Consequently, it is no surprise that his bill aims not to improve the fairness of TADA (like Senator Deuell’s bills over the past sessions) but instead to wholly eliminate its dispute resolution provisions.

S.B. 1163 adds a new section (Tex. H&S Code 166.0455) that specifies two reasons on which a review committee may not base a determination of medical inappropriateness.

“A physician or other health care professional, a health care facility, or an ethics or medical committee shall not override or refuse to honor and comply with a patient ’s advance directive or a health care or treatment decision made by or on behalf of a patient that directs the provision of life-sustaining treatment and shall not consider life-sustaining treatment to be inappropriate treatment under Section 166.046 based on:
(1) the lesser value the physician or professional, facility, or committee places on sustaining the life of an elderly, disabled, or terminally ill patient compared to the value of sustaining the life of a patient who is younger, not disabled, or not terminally ill; or
(2) a disagreement between the physician or professional, facility, or committee and the patient, or the person authorized to make a treatment decision for the patient under Section 166.039, over the greater weight the patient or person places on sustaining the patient ’s life than the risk of disability.”

S.B. 1163 also specifies (in a new a-1 subsection of 166.046) the only bases on which a review committee may determine life-sustaining treatment inappropriate: (1) physiological futility and (2) when “providing the treatment to the patient would clearly create a substantially greater risk of causing or hastening the death of the patient than would withholding or withdrawing the treatment.”

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