Death Politics

Someone named Rich DeOtte has written a Facebook piece attacking friends of mine. Rich mocks Dr. Joe Pojman as “a rocket scientist” and “knucklehead” (needless to say, that’s not popular in the Nuckols household) and takes a slap at Kyleen Wright, of Texans for Life Coalition and the Texas Medical Association.

Dr. Joe Pojman, Ph.D., is indeed a “rocket scientist,” who gave up his original career path of aerospace engineering to sacrifice as founder and Executive Director of Texas Alliance for Life, an organization I’m proud to support and serve as a Board member.

Joe wrote the op-ed that Rich attacks in direct response to the “misrepresentations” in another, political op-ed piece by Emily Kebedeaux Cook on the Texas Right to Life Website. Joe only wrote about issues, and did not engage in name calling or derision. The only reason Emily and TRTL are mentioned is because she’s the author of the political opinion piece about the “decline in the Texas Legislature’s efforts to protect human Life.”

As Joe points out, the very document to which Emily refers refutes her position: Texas was named one of three “Life List All-Stars” for 2016 by the Americans United for Life.

Joe laid out the case that our Texas Legislature’s pro-life laws are most definitely not at a standstill: we are ahead of the Nation. Joe’s position that Texas leaders gave us many successes in the 2015 84th Legislature is supported by the similar list of “Wins” reported by the Texas Catholic Conference, representing the Bishops of Texas. In an earlier letter, TCC notes that many of the criticisms Emily makes in her February 8th blog post were not previously scored “equitably” by TRTL. For instance, Senator Bob Deuell received no credit for authoring much of what became HB2.

In fact, Texas’ Legislative leadership in passing pro-life laws is why many of us are going to Washington, DC on March 2nd to bear witness when the Supreme Court hears testimony on the abortion facility regulations in HB2.

Emily and Rich focus most of their criticism on the efforts of pro-life groups, including doctors like me, to reform end of life care and the Texas Advance Directive Act (TADA). Session after session since it was passed, we in the pro-life community have had our efforts repeatedly blocked by the “death panel” accusations Rich makes and the demands in Emily’s op-ed.

I was one of the doctors appointed to the Texas Medical Association ad hoc committee that evaluated last sessions’ end of life Bills for TMA approval. Our group of doctors agreed to and helped fine tune HB 3074, what Emily called a “modest protection”: prohibiting the removal of Artificially Administered Nutrition and Hydration, including food and water by invasive medical methods like IV’s and “Total Parenteral Nutrition.” We were called anti-life and pro-“death panel” (Rich’s words) for including medical exceptions for the rare circumstances when the patient can’t process the AANH and/or when it actually caused harm.

Those “three strongest Pro-Life bills” that Emily mentioned were included in the “Wins” listed by the TCC. The Bills not only would have forced doctors to continue to indefinitely perform acts that we believe are not medically appropriate as long as a patient or his family demands it. They would have forced all disputes between the doctors practicing medicine and patients or their families into court and add “liability”(civil and criminal penalties) for the doctor.

Forget if you can, that if all disputes go to court judges would be required to determine medical care – to practice medicine – probably based on the testimony of dueling, paid medical expert doctors. Malpractice rates will go up for doctors taking on the most vulnerable patients – the elderly, the trauma victims and the victims of cancer. Those doctors will spend more time in courts, rather than in the ICU. And so will more grieving families.

We found out what happens when malpractice goes up in Texas, before tort reform was passed. Because of the malpractice crisis, there were no neurosurgeons west and south of San Antonio and Houston – none at all in El Paso or all of South Texas. We were losing obstetricians and family doctors willing to deliver babies and offer prenatal care, all over the State.

I don’t know how to translate past physician shortages directly into the possible shortage of doctors providing end of life care. However, I will predict that fewer family doctors, internists, pulmonologists and the ICU intensivists will be able to afford to practice in the ICU. Just as a patient had to be flown to Dallas, San Antonio or Houston from most of Texas for a head injury, only the tertiary medical centers in those cities will be able to staff their ICU’s properly.

Physicians, not hospitals – and certainly not courts – practice medicine in Texas. Doctors must be allowed to practice medicine according to our medical judgment, which is a combination of education and experience, under the watchful eye of the community; not “death panels,” but fellow physicians, nurses, ethicists, lawyers (who may be any of the former) and lay people. In the end, if you force the hands and minds of doctors against their judgment, you will end up with doctors practicing without judgment, and humans with inalienable rights forced to act against our will and in violation of our conscience.

And, now, back to Rich’s Facebook post. Think twice when you read political posts full of  personal attacks and name calling. We should be able to discuss politics without, as Emily said in her blog post, “unnecessary, vicious, and vindictive fights inside the Republican Party.”

Edited to fix a name glitch – BBN