End of Life Care

Legislative Hotline March 4, 2021: TMA Opposes End-of-Life Care Bill That Poses Threat to “Do No Harm” - 03/05/2021

The Texas Medical Association is once again working to stop legislative attacks on a physician’s sacred creed to “do no harm,” which includes taking care of patients in their last days.

Wrong Directive: Legal Shifts on End-of-Life Care Concern Physicians - 02/27/2021

Challenges to Texas laws governing end-of-life care, whether through legislative rewrites or judicial override, are nothing new. The recent success of those challenges is. In particular, two recent erosions have physicians like Houston palliative care specialist Mark Casanova, MD, chagrined and concerned about the future of doctors’ role in end-of-life treatment.

Defend Patient Decisions at the End of Life - 02/11/2021

Perhaps no decision we make is more personal, difficult, or profound as choosing how we wish to spend our final days, and it’s one physicians encourage patients to make long before the need arises.

Texas Physicians Fight End-of-Life Bill With Passion - 05/10/2019

When the Texas Medical Association urged members to ask their state senators to vote “no” on a key bill regarding treatment disputes at the end of life, they didn’t hold back. Hundreds of Texas physicians took up the call, using TMA’s Grassroots Action enter to share very personal and passionate messages with their senators.

Death Certificate Problems Being Addressed, State Says - 03/06/2019

State health officials say they are continuing to address problems and long wait times associated with the rollout of the new TxEVER system for registering death and birth certificates. On Monday, DSHS officials told the Texas Medical Association that they significantly reduced wait times by shifting staff from other departments to handle customer service phone lines.

Dawn Duster Examines “Rubik’s Cube” of New DNR Law - 02/05/2019

The in-hospital DNR law, codified as Senate Bill 11 in the 2017 Texas Legislature, went into effect on April 1, 2018. Ms. Atwood and Jason Morrow, MD, medical director of inpatient palliative medicine at University Health System in San Antonio, examined the legal requirements of the complicated law and associated ethical considerations.

TMB Won’t Penalize Physicians For Technical Problems With Vital Registry - 01/28/2019

The Texas Medical Board confirmed Saturday that it will not take action against physicians who experience technical issues with Texas’ new vital statistics registry, TxEVER.

Problems With Texas’ New Vital Statistics Registry Fixed, Official Says - 01/07/2019

The new TxEVER system should be operating smoothly after experiencing technical difficulties in the days after going live, an official with the Department of State Health Services (DSHS) said Friday. If you weren’t already aware, the DSHS on Jan. 1 rolled out the system for processing death and birth certificates that it says will be easier and more accurate.

Get the Latest Palliative Care Information at Free CME Event - 11/06/2018

If you are interested in staying up to date on palliative care and how physicians can provide the best care for patients during this sensitive time, plan to attend a free continuing medical education (CME) event next week.

What Is It Like to be Dying? An Interview With My Dad - 06/22/2018

As I mentioned in a recent Fontenotes, my parents both went on hospice in March. In the ensuing months, we have had many talks about dying and all the physical, emotional, and financial needs that surround this last stage of life.

What the End-of-Life Bill Really Does - 05/03/2018

Putting our patient’s interest first sometimes means providing comfort care and allowing the patient to die a calm, peaceful, and honorable death. In the most cases, the patient, the physician, and the family agree on this course of action.

For End-of-Life Care, Fresh Challenges Begin - 04/02/2018

The logistics of entering a valid in-hospital DNR order are about to become considerably more complex. A law taking effect in April lays out new requirements affecting physicians in hospitals or health care facilities.

A Chance to Live Better: Integrating Palliative and Supportive Care - 11/17/2017

Commentary — December 2017 Tex Med. 2017 113(12) 13–14. By Gerard J. Voorhees, MD Let's face it When our patients are not responding to curative treatment or are nearing the end

Judge Tosses Suit Over End-of-Life Care Law - 10/02/2017

A Harris County district judge rejected a constitutional challenge to part of the Texas Advance Directives Act, siding with TMA and several other organizations who filed a brief in support of the law.

Website Provides Help for Palliative Care-Givers, Patients - 07/06/2017

The state of Texas has a new online resource that might help you the next time you have one of those most-difficult conversations with a patient.

Bleeding Out: Medical Futility of Transfusions in Cancer Patients - 06/01/2017

Medical residents are often placed in challenging situations that will make them better physicians. Medical futility is especially difficult within the context of terminally ill cancer patients.

Texas Hospitals and Physicians Oppose House Bill 995 - 04/11/2017

Our most significant concern is that HB 995 would make the medical power of attorney form permissive, by replacing “must” with “may” in the statute. The result will be that patients will be able to write anything, and physicians and health care providers will be left to interpret the validity without parameters or applicable standards.

Help Your Patients Plan for End-of-Life Care - 12/20/2016

Join a March 5 live webcast to learn how to talk to your patients about death or incapacity and help them plan for the end of life.

Medicare Pays for End-of-Life Consults - 11/21/2016

As of January, Medicare pays physicians for advance care planning as a separate service, a long-sought victory that promotes educating patients and physicians on the issue. The Centers for Medicare & Medicaid Services created two new payment codes that cover it as a separate service in physician practices and facilities, including hospitals.

Walking the Walk - 11/01/2016

A Houston palliative care and hospice physician shares her family's experience caring for her father, who had a terminal illness, in this special four-part series originally published on the Texas Medical Association's MeAndMyDoctor blog.

SB 675 Eviscerates Texas Advanced Directives Act - 05/20/2016

TMA opposes Senate Bill 675. Although the bill is quite short, its impact would be quite large. If passed as written, SB 675 would eviscerate a very good law – the Texas Advance Directives Act. It would subject terminally ill patients to unneeded pain and suffering, and expose physicians and caregivers to a very vague new cause of legal action.

Protecting the Patient-Physician Relationship at the End of Life - 05/20/2016

Senate Bill 303 and many of the other bills on this topic, alter the Texas Advanced Directives Act, which was written to provide families a reasonable process to resolve differences of opinion if difficult treatment decisions occur. This subject is so sensitive and thus must be handled delicately and thoughtfully. Changes to this law should be made only with support from patients and their families — as well as by the entire community of physicians, nurses, hospitals, nursing homes, and hospices who take care of patients near the end of life.

End-of-Life Care: The Long Conversation - 05/13/2016

California palliative care specialist, author, and consultant Ira Byock, MD, calls the issues surrounding end-of-life care "a public health crisis." But he says many of the same solutions to improving the health care system overall — shared decisionmaking, advancements in medical education, better payment and delivery structures — apply equally to this area of medical care. Dr. Byock is the General Session keynote speaker at TexMed 2015 in May.

Difficult Choices - 05/13/2016

Different circumstances bring different levels of complexity to end-of-life care decisions. Physicians must act in the best interest of the patient, but with the ethical responsibility of not doing any intentional harm. As end-of-life issues heat up again in Capitol debates, protecting physicians' ability to carry out that duty under the 1999 Texas Advance Directives Act is a key feature of legislation the Texas Medical Association developed in collaboration with the Texas Hospital Association, the Texas Catholic Conference, the Texas Alliance for Life, and other faith-based groups. The groups are also pushing for reforms they believe will improve transparency and communication for all parties affected by these decisions.