RX: Sack cloth and ashes for #SB303 opponents

Searching the news for stories on #SB303, led me to accusations that supporters of the Bill gossiped with Capitol staff and “maligned Texas Right to Life, stooping so low as to criticize our sartorial manners, footwear selections . . . “

When you stop laughing enough to read further, notice that the premise of the article, after turning private gossip into public gossip, is that elaborate conspiracies hidden within the minds of doctors, nurses, and entire staffs of “hospitals” and “facilities” judge the “futility of the patient’s life.”

“We agree that some treatments do stop achieving the intended goal of that specific treatment, such as dialysis no longer filtering uric acid from the blood.  When a treatment or therapy is in fact medically futile, no physician would ever continue that, and a properly informed patient or his surrogate would not want to continue futile or harmful treatment, and nothing in current law or in any of Texas Right to Life’s past or present proposals would require the continuation of such medically futile treatment.  Physicians would not continue medically futile treatment anyway.”

“Conflicts arise when the futility judgments are transferred from the efficacy of a medical treatment to a value judgment on the futility of the patient’s life.”

Isn’t the entire conversation about whether the doctor determines the “efficacy of a medical treatment?” No,thanks to articles like this one, the debate on medical conscience is all about pretending to read minds and gossip about the motives of doctors, hospitals, bald-faced claims that the Texas Conference of Catholic Bishops is only interested in the “$$$” from Catholic hospital systems. Every discussion I’ve attempted with the opponents of reform devolves into accusations that I “want to kill” patients.

In the grim tale told by TRTL,the physician’s conscience and medical judgment isn’t denied or even trivialized as equal to a lobbyist’s choice of suits or shoes. We, the doctors who are currently the only ones licensed by the State of Texas to write orders and administer treatments, are either ignored altogether or treated as a tool for some mythological eugenic “hospital committees that have decided by their own subjective standards that the lives of these patients have little or no value and should therefore be denied medical treatment.” They object that the physician’s finding that, in his or her  “reasonable medical judgment, resuscitation would be medically ineffective” is not defined in the law and accuse us of deciding “that imminent death is better than resuscitative efforts.”

Frankly, I have no idea what that last means, since resuscitation is only needed in the event of imminent or actual natural death, when the heart or breathing stop functioning.  Based on this statement and the note about failure of dialysis, I’m certain that no doctors were consulted by or gave feedback to the authors. Again, the lack of physicians who oppose SB 303 is not an indication that we are all involved in a conspiracy. Instead, it is proof of our medical judgment – and consciences.

The end sought by the opponents of SB303 is “treatment-pending-transfer,” including “resuscitative efforts” prescribed by law, not doctors, on every patient who has not specifically refused in advance. When the doctor’s medical judgement and conscience lead him to determine that such would be medically futile, they demand that the doctor set aside conscience and medical judgment and do exactly what they say no doctor would do.

Complete autonomy on the part of patients and their families awarded by legislation the ability to demand what they want, when they want, as long as they want and with as much legal liability as possible cannot turn around the failure of organ system after organ system, and physiological cascade after cascade. All of which we doctors can measure and predict with good certainty.

The authors of this article are proud of their “successful” campaign to ensure for at least two more years, that patients and their surrogates

• don’t have the right to be notified of DNR’s placed on their charts,
• have no protection against the removal of artificial nutrition and hydration,
• don’t have the right to medical records before the medical ethics committee meets,
• don’t have the right to be accompanied in the medical committee meeting, and
• don’t have an additional 7 days to prepare for the medical ethics committee and an additional 14 days to find another doctor willing to accept responsibility for the medical treatment of the patient.

If there is any clothing I’d suggest that the authors wear, it’s the sackcloth and ashes of the repentant sinner.