TMA Supports Medical Ethics Committee Review Law in Latest Challenge
By Joey Berlin

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As one attack on the state’s medical ethics committee review law ends, another is in progress. Once again, the Texas Medical Association is telling a court medicine backs the law.

TMA has joined with Texas Alliance for Life, the Texas Catholic Conference of Bishops, the Texas Alliance for Patient Access (TAPA), and several other organizations on a friend-of-the-court brief in Lewis v. Cook Children’s Medical Center.

The brief in the Lewis case supports the ethics-committee process in the Texas Advance Directives Act, just as TMA and other organizations did in Kelly v. Houston Methodist. That case recently came to an end when the Texas Supreme Court declined to review an appeals-court decision in the hospital’s favor.

In the most recent challenge, the mother of a 10-month-old girl who since birth has been on life-support at Cook Children’s Medical Center in Fort Worth has sued the hospital and obtained a temporary restraining order to keep her daughter on life support. In the lawsuit, Trinity Lewis argues the ethics committee law violates her daughter Tinslee’s due-process rights and gives physicians and hospitals absolute authority to discontinue life-sustaining treatment.

Under the law, if a patient or patient’s representative wants to continue life-sustaining treatment, but the attending physician believes the treatment isn’t medically appropriate, the Texas Advance Directives Act allows the physician to take the case to the hospital’s ethics committee. If the committee agrees the treatment isn’t medically appropriate – such as if it’s making the patient suffer – the physician and hospital collectively have 10 days to make a reasonable effort to transfer the patient. After the 10-day period, the physician is immune from both civil and criminal liability for either withholding or stopping the treatment.

The Lewis lawsuit echoes the challenge posed in the Kelly case, claiming the law “allows doctors and hospitals the absolute authority and unfettered discretion to terminate life-sustaining treatment of any patient, despite the existence of an advance directive, valid medical power of attorney, medical decision determined by a surrogate … or expressed patient decision to the contrary.” The suit says there’s “no allegation that Tinslee only has a certain amount of time to live even with the assistance of life-sustaining treatment.”

Cook Children’s says in a court filing that the hospital’s ethics committee “concluded that there was no medical benefit to continuing treatment for Tinslee and, to alleviate her suffering, it is in her best interest to cease medical intervention and allow her to die naturally.” It informed Trinity Lewis of that decision in late October, after which she obtained the restraining order, Cook Children’s says in court documents.

TMA believes the ethics-committee law allows physicians to uphold their obligation to “do no harm” to patients. Its brief says a physician’s ability to abstain from “providing a particular medical intervention when her medical judgment or ethics demand it” is a foundational principle of medical ethics. The law offers a procedure by which a physician or hospital can resolve conflicts between physicians’ ethical duties and patients’ wishes, TMA’s brief says.

Texas Attorney General Ken Paxton has filed his own friend-of-the-court brief in the Lewis case opposing the ethics-committee law. In a statement he released in November, Attorney General Paxton said the “unconstitutional statute infringes on patients’ right to life and does not allow patients and their families sufficient notice and the opportunity to be heard before physicians override the rights of their patients.”

The highly publicized Kelly case, first filed in 2016, officially ended last week. The Texas Supreme Court, which initially declined to review the case in October, denied a motion for rehearing on Dec. 13.

Legal articles in Texas Medicine and Texas Medicine Today are intended to help physicians understand the law by providing legal information on selected topics. These articles are published with the understanding that TMA is not engaged in providing legal advice. When dealing with specific legal matters, readers should seek assistance from their attorneys.

Last Updated On

December 20, 2019

Originally Published On

December 20, 2019

Joey Berlin

Associate Editor

(512) 370-1393
JoeyBerlinSQ

Joey Berlin is associate editor of Texas Medicine. His previous work includes stints as a reporter and editor for various newspapers and publishing companies, and he’s covered everything from hard news to sports to workers’ compensation. Joey grew up in the Kansas City area and attended the University of Kansas. He lives in Austin.

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