Editor’s note. The following is the testimony of Bobby Schindler to the Texas Senate’s Health & Human Services Committee delivered April 7. Mr. Schindler, president of the Terri Schiavo Life & Hope Network, was testifying on behalf of Texas Right to Life in support of S.B. No. 917 to repeal the Texas Advance Directive Act (TADA), also known as the “10 Day Rule.” As Texas Right to Life explains, “The current law, Section 166.046 of the Texas Health and Safety Code, sets forth the process by which a hospital may legally remove patients’ life-sustaining treatment despite their own written directive and over the objections of their family.”
Chairwoman Kolkhorst and Committee Members:
The Terri Schiavo Life & Hope Network serves as a voice for persons with disabilities, established in response to the death of my sister, Terri Schiavo, a cognitively disabled woman who was intentionally dehydrated to death by court order against the wishes of her family. The Life & Hope Network has advocated for thousands of patients who are facing the prospect of the denial or the withdrawal of care.
The 10-Day Rule of the Texas Advance Directive Act (Section 166.046) allows a hospital to unilaterally authorize the withdrawal or withholding of a patient’s life-sustaining treatment that is not based on medical determinations but rather value judgments focused on the patient’s “quality of life”.
Effectively, this law permits patients to be have their lives ended without due process of law. Moreover, it leaves the onus to transfer the patient from the hospital imposing their decision to withdraw or withhold treatment on those individuals advocating for the patient This past July, the Texas Second Court of Appeals wrote about the case of Tinslee Lewis who fell victim of the 10-Day Rule: “When a terminally ill patient or her surrogate decision maker (especially a parent of a minor patient with her own individual liberty interest) actively opposes the withdrawal of life-sustaining treatment, the right to life is clearly implicated.” While the final legal outcome of the case has not been decided, the court’s ruling is significant for all future victims and their families of the 10-Day Rule.
In my nonprofit work as a patient advocate for over 15 years, we receive regular calls from families in crisis who are confronted with exactly these types of scenarios. Sadly, it has become alarmingly evident that our health care system is now incentivized to impose death upon vulnerable patients, and the powers of law and medicine have become weapons rather than shields.
Families are the protectors of life, and healthcare is about what is best for the patients. Many patients have the capability to recover after 10 days, and it is not in the best interests of patients to put an arbitrary limit of when someone just needs time to recover.
For example, JAMA Neurology recently published their findings that patients who experience a moderate or severe traumatic brain injury (TBI) and lose consciousness —nearly half regain functional independence. Robert G. Kowalski, MD, MS, Department of Neurology, University of Colorado School of Medicine, remarked about the significance of this study and urged “caution” when deciding to “withdraw or hold care” to those with serious brain injuries.
Similarly, a new national study published by the University of Kentucky on hyperbaric oxygen therapy (HBO) shows that this treatment exhibits significant promise for the brain injured. This is important for many reasons, but primarily because there are no current FDA-approved treatments for TBI. If HBO can be FDA approved, it could afford a much-needed therapy for brain injury that is currently unavailable.
It is the promise of brain injury research that underscores the concerns opponents have about these types of intolerant laws that undermine the dignity and the rights of medically vulnerable patients to receive care, especially in situations where hospitals are given sole authority to override medical decisions explicitly expressed by patients and the families advocating for them.
No other state has laws that so flagrantly violate the patient’s right to life and places a stain on the constitutional right to due process. Texas needs to adopt comprehensive reform of the 10-Day Rule to protect patients’ rights, restore patient autonomy, and create an even playing field so that these critical medical decisions are not left in the hands of strangers.
In summary, no other state has laws as egregious as Texas’s laws, which violate the patient’s right to life and constitutional right to due process. Therefore, I respectfully urge a vote in favor of S.B. No. 917.