End-of-Life Issues in VT and TX

Mar 26, 2013 | 0 comments

I’m always monitoring news about end-of-life issues. Ironically, in Texas and Vermont, two states where I’m speaking soon, there are currently legislative actions on right-to-die questions.

This recent story in the Austin American Statesman, “Legislators Struggle Again with End-of-Life Decisions,” details an emotionally and politically delicate issue — how to resolve end-of-life disputes when doctors seek to let a patient die against the family’s wishes. A process put in place in 1999 needs reforms, and crafting a plan that is acceptable to all parties is proving impossible.

Some of the issues, as detailed in the article:

In Texas, if doctors believe continued treatment would inhumanely extend suffering in a way that violates their oath to do no harm, they can overrule family wishes by asking the hospital’s ethics committee for approval to halt life-sustaining care — which can include withholding dialysis, ventilators, food and water.

If the committee — often comprising uninvolved doctors, social workers and clergy — agrees, treatment can be halted in 10 days, theoretically giving the family time to accept the inevitability of death or, if they still disagree, to locate a caregiver willing to accept the patient.

The process is intended to shield doctors and hospitals from wrongful death lawsuits while protecting the rights of patients and their families. But in practice, according to testimony at legislative hearings, families can be left scrambling in an unfamiliar system, with an impractical deadline, to find other sources of care.

I’m speaking this Thursday to the North Texas Region of the Texas Funeral Directors Association.

Meanwhile, up north in Vermont, this recent USA Today article “Support Grows in Vermont for an End-of-Life Bill” looks at how terminally ill patients with a prognosis of less than six months to live want to have the right to request and take life-ending medication.

The bill “Patient Choice and Control at End of Life” passed the Vermont Senate in February and goes to the House in March. Although assisted dying is illegal in most states and opponents have been fighting proposals for the past 15 years, support is growing in Vermont and other parts of the Northeast. Connecticut and New Jersey legislators are also examining measures.

Vermont would be the first state to pass a doctor-assisted-death bill through the legislative process. Oregon and Washington voters passed similar bills in voter referendums. Massachusetts voters defeated a measure, 51% to 49%, in November.

Compassion and Choices, a non-profit group dedicated to protecting the rights of the terminally ill, has been actively involved in promoting the Vermont legislation. The organization provides end-of-life counseling, advance planning, and legal casework on end-of-life issues.

Compassion & Choices

Full Disclosure: The New Mexico chapter of Compassion and Choices is a sponsor of my TV series, A Good Goodbye: Funeral Planning for Those Who Don’t Plan to Die. I admire what they do to help start end-of-life conversations.

I’ll be speaking to the Vermont Funeral Consumers Alliance’s annual meeting on Saturday, May 4, 2013.

A Good Goodbye