I had to work yesterday and couldn’t attend the hearing before the Human Services Committee of the Texas State House of Representatives, in Austin. I wasn’t even able to watch on the internet until about 5:30 PM. But, I still saw some of the most interesting testimony, and am very impressed that the meeting continued until about 11 PM.
The testimony that I saw was heart-wrenching. It convinced me that we need to teach our doctors how to communicate better and to look more closely at the make up of the hospital ethics committees. There was at least one story about a miracle recovery, too.
I am concerned that any amendment of the Act will be used as evidence against “conscience clauses.” The portion in dispute, 166.046, appears to be a way for the physician to follow his or her conscience and professional judgement as to what is medically appropriate care. If the patient or surrogate is demanding that the doctor intervene to cause death, this law would protect the physician.
However, the (highly) publicized effect of the law is to allow doctors to refuse to provide interventional care that the patient or surrogate wants. All of the disputed cased that I heard about yesterday involved technological procedures in patients with multiple organ failure and who appeared to be within the last week or so of life.
Among those testifying were the sister and son of Andrea Clark, the doctor who took over her care and prevented the necessity of moving her to another hospital, and the families of others who have been affected by the Advance Directive Act.
As I listened to the families’ stories, I believe that I could see where there was a breakdown of communication between the family and the doctors. I wish that I could fix that. Far too often it sounded as though both doctors and family members both become defensive and/or angry.
Sometimes, it appeared that families were, indeed, expecting miracles. And, in one case of a 91 year old woman, it looks like they got it: without dialysis and the immediate placement of a permanent feeding tube, the patient is recovering. (And “firing” nurses who don’t behave!)
Also, from the testimony, some of the hospitals in question do need to reevaluate the members of their ethics committees. There can be no excuse for some of the behavior that I heard about.
More on this, later. (Gotta go to work!)
Edited 4/27/13 for formatting problems from switch from one blog host to another – BBN