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


Under The Rotunda

Opponents to physicians’ exercise of their conscience and medical judgment in end-of-life care decisions have proven relentless, both in the Texas Legislature and in the courts. And they’re at it again.

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.

Bills filed this week in the legislature, Senate Bill 917 by Sen. Bryan Hughes (R-Mineola) and its companion, House Bill 2609 by Rep. Tan Parker (R-Flower Mound), would take away a key physician protection in the Texas Advance Directives Act (TADA). The measures would require a physician to provide potentially indefinite life-sustaining care to a patient, even if the physician believes the care is medically inappropriate and making the patient suffer.

Currently under TADA, if a hospital’s medical ethics committee reviews a dispute over the patient’s continued care and agrees that the care is inappropriate and harmful to the patient, the physician has 10 days to find another facility who will accept a transfer. After that, the physician does not face liability for withdrawing the life-sustaining treatment.

But SB 917/HB 2609 would require physicians, hospitals, and other health care workers to continue the care until a transfer facility can be found –  no matter how long that takes, and even if it never happens. Essentially, the bill would potentially mandate medically inappropriate, harmful care for an unlimited period. It also would discourage facilities from accepting the transfer of critically ill patients.

TMA and medicine’s advocates successfully defeated a 2019 measure with identical intent. After recent erosions of parts of TADA through legislative and judicial activity, protecting the ethics-committee procedures is as critical as ever.

Such erosions “strip the essence of who we are as a physician and everything that lives outside of a textbook,” Dallas palliative care specialist Mark Casanova, MD, recently told Texas Medicine. “All it does is say, ‘Read the menu, and follow the menu; read the textbook and follow this criteria. That’s all you’re supposed to do, doctor.’ And I think that … is becoming a bridge that is way too far. I do not personally feel that we in medicine should allow ourselves to be relegated as such.”

End-of-life discussions – and potential intrusions on physicians’ conscience – are becoming more prevalent than ever as the COVID-19 pandemic take over intensive care units, adds Robert Fine, MD, clinical director of Baylor Scott & White’s Office of Clinical Ethics and Palliative Care also told Texas Medicine.

Which is why the Texas Medical Association continues to meet every challenge to TADA with a full-throated defense of the law. 

TMA opposes SB 917 and HB 2609, and will need your help to ensure this key reinforcement of “do no harm” remains intact in Texas law.

Easy Ways to Get Involved in TMA Advocacy 

Your participation is a vital component of our legislative success. Please help strengthen the voice of medicine by joining our advocacy efforts.

Stay up to date on TMA’s progress in the legislature. And take advantage of other opportunities to get involved with our advocacy efforts.

Last Updated On

July 17, 2023

Originally Published On

March 04, 2021