http://www.northcountrygazette.org/articles/042406HoustonLife.html

Houston Hospital Votes To End Woman's Life With Bush Law  

HOUSTON---The countdown has begun on the life of Andrea Clark, a
patient at St. Luke's Hospital.

Six days left.

No, she's not terminal, her family says and she's not brain dead. Her
sisters say that she wants to live. The Houston hospital is going to
unilaterally remove a woman from life support, apparently based on the
decision of a lone physician even though her family wants her to
continue to receive care.

The central issue in the Andrea Clark case is the same as that in the
Terri Schindler Schiavo case, whether the state should be able to
sanction the removal of a human being from life support.

What's even more significant in the Clark case is that the Texas bill
that allows health care providers to end a human life despite the
wishes of the patient and the patient's family was signed into law in
1999 by President George W. Bush as Texas Governor. However, in 2005,
he rushed back to the White House from Easter vacation to sign a bill
rushed through Congress which was designed to save the life of Terri
Schiavo because of his "presumption in favor of life".

The hospital's ethics committee has apparently decided they don't want
Andrea Clark to receive care anymore, saying its futile, and has
recommended that she be removed from life support despite her family's
wishes. If her family can't find another hospital to transfer her to
by Sunday, April 30, she will be removed from her respirator and
dialysis and die.

Andrea Clark, 54, has been a heart patient at the hospital since
November. In January, she underwent open heart surgery and in
February, she developed bleeding on the brain.

Clark's sisters, Lanore Dixon and Melanie Childers, point out that
under a little known Texas law, a self-appointed ethics committee can
decide to forcibly remove care from a patient. Once that decision is
made, the patient and family have 10 days to find another hospital to
provide care for their family member.

But they say the law also requires that the attending physician help
with the transfer which they say hasn't been done in Andrea's case.
They say that the hospital has unlawfully and unjustly transferred
responsibility to them, a denial of due process.

Andrea's sisters are racing to beat the clock but say the hospital is
working against them. Although the obscure 1999 Futile Care Law that
gave hospitals the authority to remove patients from life support
despite the patient's and family wishes says once such a decision is
made that the hospital must provide the patient's family with a list
of hospitals where the patient could be transferred, St. Luke's hasn't
done that. The sisters also claim that the hospital social worker
exaggerated the seriousness of Andrea's condition, exaggerating the
level of care that is needed in an alleged attempt to discourage other
hospitals from admitting her as a patient.
http://www.capitol.state.tx.us/statutes/docs/HS/content/htm/hs.002.00.000166.00.htm

Under Chapter 166 of the Texas Health and Safety Code, if an attending
physician disagrees with a surrogate over a life-and-death treatment
decision, there must be an ethics committee consultation (with notice
to the surrogate and an opportunity to participate). In a futility
case such as Andrea's in which the treatment team is seeking to stop
treatment deemed to be non-beneficial, if the ethics committee agrees
with the team, the hospital will be authorized to discontinue the
disputed treatment (after a 10-day delay, during which the hospital
must help try to find a facility that will accept a transfer of the
patient). These provisions, which were added to Texas law in 1999,
originally applied only to adult patients. In 2003, they were made
applicable to disputes over treatment decisions for or on behalf of
minors. One of the co-drafters in both 1999 and 2003 was the National
Right to Life Committee. Witnesses who testified in support of the
bill in 1999 included representatives of National Right to Life, Texas
Right to Life, and the Hemlock Society. The bill passed both houses,
unanimously, both years, and the 1999 law was signed by then Governor
George W. Bush. The statute was designed to keep these cases out of
court.

However, it appears on the face that the Futile Care Law is
unconstitutional, in violation of the Due Process Clause of the
Fourteenth Amendment in that Andrea's sisters say no fair hearing has
been held, no informed second opinion has been obtained by a physician
who has examined Andrea.

And no, she's not a Medicaid patient. Her private insurance is funding
her health care and hospitalization. However, no one knows what
dialogue those insurance officials may have engaged in with hospital
officials.

Dixon says the hospital dictate isn't based on a medical decision but
that they just say, "well, she's miserable". Dixon says that's a
quality of life decision that is up to Andrea and her family.

Family members say that even though their sister can't speak, they
know her wish is to live. They say that she can communicate by moving
her lips and blinking her eyes.

"If their ethics committee makes a decision, it doesn't matter what
the patient wants," Dixon said. "It doesn't even apparently matter
what the patient's condition is, because our sister is not in a coma,
she's not brain dead," Dixon said.

"She's sick, but she's been sick before and she's proven doctors wrong
lots of times," Dixon said.

Dixon said that unless they can find another hospital by April 30, St.
Luke's will "pull the plug" on her sister and let her die.

"Andrea, until a few days ago, when the physicians decided to increase
her pain medication and anesthetize her into unconsciousness, was
fully able to make her own medical decisions and had decided that she
wanted life saving treatment until she dies naturally", Childers said.
"We have learned that this is part of the process, when hospitals
decided to declare the "medical futility" of continuing treatment for
a patient.

"Andrea, when she is not medicated into unconsciousness (and even when
she is, and the medication has worn off to some degree) is aware and
cognizant", her sister said. "She has suffered no brain damage to the
parts of her brain responsible for thought and reason or speech. She
has only suffered loss of some motor control. The reason that the
physician gave to medicate her so much is that she is suffering from
intractable pain in the sacral region (in other words, she has a
bedsore that causes her pain). This is not reason enough, in our
books, and we are trying, as we speak, to get Andrea's medication
lowered so that she can speak to us.

"There is also some disagreement as well as to whether Andrea is
really in that much pain. When she is not medicated to this degree,
and she sees her son, Charles, she smiles. She also mouths words
(Andrea is very vocal, normally, even with a trach, and asks for food,
etc., when she is not overly medicated) Andrea has voiced her wishes,
over and over again, an d if she were not on so much pain medication,
she would voice them again", Melanie says.

Houston hospitals have a policy in that once the medical treatment of
a patient has been deemed "medically futile" no other hospital in the
area will accept transfer of that patient to their facility. This
means that the patient, who is usually in a very delicate condition
anyway, has to be transported over a long distance, in order to
receive care, her sister explains.

When asked if Andrea is capable of being transferred to another
facility, the hospital hedges but reluctantly admits that she could
be, according to the sisters. Hospital representatives will not
discuss the case with media.

"Many, many people, even some medical professionals in Texas, and
other areas, don't know about this law", Childers says. "They have no
idea that this can be done, and it is being done every day in Texas
hospitals, but is not covered by the news media. This needs to become
common knowledge and this law needs to be overturned of course, but we
are fighting for the life of our sister. We are fighting to see that
her wishes about how she lives, and how she dies, are honored. Perhaps
these kinds of battles are fought in just this way, one by one, out of
love, and this is how the war is won, in the end".

St. Luke's is located at 6720 Bertner Ave., in Houston, Texas. Their
phone number is 832-355-1000.

Award winning author Wesley J. Smith, a senior fellow at the Discovery
Institute of Seattle, Washington, an attorney and consultant for the
International Task Force on Euthanasia and Assisted Suicide, notes
that "the treatment is apparently being removed because it works, not
because it doesn't---which means, in effect that the hospital ethics
committee has declared the patient's life to be futile.

Smith says that the proceedings of the ethics committee are closed and
that he is unaware of any records kept of the evidence presented at
the hearings or the deliberations, thus such a committee can decide to
end's a patient's wife anonymously and secretly without the family
even being a party to the decision.

"For years I have been warning that bioethicists are getting their
ducks in a row to permit them to refuse wanted life sustaining
treatment that is removed because it keeps the patient alive, not
because it doesn't provide medical benefit. These are value judgments,
not medical determinations", Smith says.

"These are life and death decisions and it seems to me that there may
be a significant constitutional issue here of immense importance. A
law permits private decision-making that will result in death without
even the right to a public hearing, to cross examine witnesses, or a
formal appeal. Someday, someone is going to attack this statute and
its constitutional implementation frontally in federal court. I have
already urged some attorneys in private that they do just that. Let us
hope that fairness and simple justice prevail".

The North Country Gazette learned late Monday that a lawyer has come
forward to try to assist the family in obtaining a temporary
injunction against the hospital and to stop the removal of life
support from Andrea. Efforts are still be being to locate another
hospital to which she can be transferred.