Can Physicians in Texas Withhold Life Support Against Patient’s Wishes?

Most of the time, Directive to Physicians are signed by patients who do not want their lives prolonged by life-sustaining treatments; however, sometimes the situation is reversed.

For example, a Texas Tribune article last year featured the case of a 9 year-old girl whose parents wanted their daughter to continue receiving life-sustaining treatment despite doctor’s recommendation that life support be withheld.

The case was a sad one. Payton Summons had cancer and was hospitalized after a large tumor in her chest started to restrict her breathing. Despite emergency treatment, she suffered brain damage, and a test determined she did not have any brain activity. Doctors declared her brain dead and recommended that life support be withdrawn.

Her parents disagreed. Although Payton was on a ventilator, her organs were still functioning, and her parents wanted to give her time to recover. Her parents sought and were awarded an emergency court order to temporarily block the hospital from shutting off the ventilator for a couple of weeks while they attempted to find another facility that would treat her and maintain her on life support. Sadly, Payton died while on life support when her heart stopped beating.

A Texas law allows physicians the ability to withhold life-sustaining treatment against a patient’s (or his or her surrogate’s) objections when the attending physicians believes continuing life support is medically futile and life-sustaining treatment would exacerbate or extend a patient’s suffering.

If a physician determines that continuing life-sustaining treatment is not medically appropriate, the case is submitted for review by an ethics or medical committee. The patient and/or the patient’s family, as the case may be, are entitled to attend.

If the committee determines that life support is medically futile, the patient or family members are given 10 days to find another physician or facility willing to provide the requested treatment. If a transfer can be arranged, the patient would be transferred to the new facility at the patient’s expense.

If no facility can be found, life sustaining treatment can be withheld after the expiration of ten days, unless a court of law grants an extension.

It is very rare that Texas law results in a patient being denied life-sustaining treatment against the wishes of the patient or the patient’s surrogate. Most of the time, like In Payton’s case, the patient passes naturally while a court action is proceeding.

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