Tuesday, March 19, 2013

Texas Bill Clarifies End-of-Life Care

Dr. Weltge
“Physicians are bound by an oath and that oath reflects our goal and our promise to put patients first,” Arlo Weltge, MD, a Houston emergency physician, told the Texas Senate Health and Human Services Committee today. “It’s our goal to act in the interest of the patient. Sometimes the best I have to offer to a patient is not necessarily intervention but care for physical and emotional suffering.”

Dr. Weltge testified in support of a bill by Sen. Bob Deuell, MD (R-Greenville). The bill amends the Texas Advance Directives Act (TADA) to allow patients to make their care preferences known before they need care and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process.

"I have come to realize that this is an issue that requires the wisdom of Solomon and the patience of Job," Senator Deuell said at the outset of the hearing. "Lacking that, we must simply do our best to do right by patients and their families."

When families or surrogates of terminally ill patients disagree with the patient’s or doctor’s wishes for treatment, current law gives these families or surrogates 10 days to find a different health care provider. Senator Deuell’s bill increases that period to 14 days. If disagreements on medical treatment go before an ethics committee, current law requires physicians give families 48 hours notice. Senator Deuell’s bill increases that notification period to seven days and would allow the patient’s family a liaison to help through the process.

“This bill protects the patient-physician relationship; it protects patients from unnecessary suffering; it protects against the provision of potentially unethical, inappropriate, or outside-the-standard-of-care treatment; it should bolster the confidence on use of Do Not Attempt Resuscitation (DNAR) orders; and it expands the families’ rights during the rarely used dispute-resolution process of the TADA,” said Dr. Weltge.

For more on what Texas physicians have to say on this difficult and controversial issue, check out TMA’s Healthy Vision 2020.

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