“We’re doing things to her. Not for her.” (Wini King, spokesperson for Cook’s Children’s Hospital, January 3, 2020) This may be the best description of a very sad case.
Tinslee Lewis was born prematurely on February 1, 2019, with severe heart and lung defects. She had cardiogenic shock and was admitted to the Cardiac ICU at Cook’s Children’s Hospital immediately. ♡(See Cardiac Pathology ♡below.)
Even after three open heart surgeries, a fourth to close her sternum, a short time on ECMO (essentially, heart-lung bypass) and constant ventilator since July, of 2019, Tinslee’s enlarged heart and small, damaged lungs can’t keep up with the necessary blood circulation and exchange of oxygen and carbon dioxide, even with the assistance of multiple blood pressure medicines, diuretics and the ventilator on high, except when she’s still and quiet with the help of sedating and paralyzing drugs.
In response to a lawsuit against Cook’s Children’s Hospital, where Tinslee has been in the CICU since birth, Tinslee’s medical records were submitted to the Court. I’ve been able to review approximately 200 pages that are now public record, describing the constant, repetitive interventions necessary to keep Tinslee alive on the ventilator.
Tinslee’s doctors (and, the notes show, the nurses and staff) believe that they are being forced to cause Tinslee pain and suffering, while keeping her paralyzed and sedated. They report increasing difficulty with managing the ventilator so that her damaged heart & lungs can maintain oxygenation. She requires repetitive heart, lung and blood tests to guide adjustment of meds & treatments and has had several infections requiring treatment. In contrast to my earlier presumption, the notes in the records show that the ventilator and all its required meds and manipulations are indeed causing undesired problems, including fluid overload, infections and cardiopulmonary distress, in addition to her underlying lung disease. Even the baby’s growth, something we usually celebrate, increases her risk of cardiopulmonary insufficiency.
Those records also contain notes from many attempts to explain and council Trinity Lewis, Tinslee’s mother, about her baby’s underlying problems and prognosis and the reasoning behind, in contrast to some past media reports.
Ignoring the fact that doctors, not hospitals, practice medicine in Texas, Texas Right to Life Lawyer Joe Nixon is quoted, claiming that the “hospital ” has decided to withdraw treatment. Texas Attorney General, Ken Paxton, is shown to have Tweeted that the problem is a “legal issue,” rather than an ethics and justice matter of forcing doctors (and by their orders, nurses and other staff) to cause pain and suffering for a little girl who is dying as her body fails to heal, in spite of every intervention possible.
Many people, out of compassion, object that “the family ” should decide when to withdraw life support. Yet, the family members aren’t watching the oxygen levels drop while they rinse Tinslee’s airways with a bicarbonate solution to keep her lungs clear. And it’s certainly not the lawyers that are probing, injecting, measuring and adjusting constant, innumerable hourly interventions done to a baby who must be sedated and paralyzed to prevent cardiac and respiratory distress.
In spite of the diligent complicated interventions and care of the doctors and nurses at Cook’s, there have been comments in blogs and social media that the “hospital” wants to “kill” Tinslee. Startlingly, AG Paxton called the latest Court ordered, indefinite hold on removal of life support a “Stay,” as though the doctors, not her multiple medical problems, would kill Tinslee. He also misrepresents the process that Cook’s Children’s Hospital and Tinslee’s doctors followed,
“The statute fails to require that physicians provide an explanation of why they refused life-sustaining treatment and provide the patient’s family with adequate notice and opportunity to argue their position prior to the committee reaching a decision, effectively allowing the government to deny an individual’s right to his or her own life and to do so without due process.”
In fact, though, it is the lawyers, particularly at Texas Right to Life, who are turning a little girl’s tragedy into a continuation of their legal battle against the Texas Advance Directive Act. I’ve covered the benefits of and the struggle to improve the Act – repeatedly blocked by TRTL and their lawyers – for years on both WingRight.org and Lifeethics.org
The Act, TADA, was hammered out in 1999 by a group of stakeholders including patient and disability advocates, hospitals, doctors, ethicists and lawyers. Texas’ prolife organizations, including TRTL and the organization for which I served on the Board of Directors for 15 years, Texas Alliance for Life, and for whom I wrote this essay.
Briefly, TADA allows a balance and legal options when there’s a difference in opinion between a patient’s desire for a given treatment and the medical judgment (a combination of education, experience, and the standard of care) of the doctors who are tasked with the most difficult medical and surgical cases.
I’ll admit that it’s my opinion – and only my opinion – that the lawyers hate that TADA provides a safe haven from lawsuits if doctors follow the law (!). I slowly came to this conclusion over the years because at virtually every Legislative hearing and stakeholders’ meeting about any changes to the Act, the lawyers bemoan the fact that doctors don’t have to go to court over each of these cases and that they face no legal penalty or “liability.”
Poor Tinslee Lewis will most likely never leave the hospital alive. Disease and death don’t respect “due process,” but, they are predictable and an inevitable part of life. Hopefully, we will see her mother and those who love her come to find peace with her death, celebrating the time they’ve had to be with her, especially these last 2 months. However, I fear that the lawsuits will continue for years, adding to their grief.
Edited 1/19/2020 for a typographical error: in the secondparagraph, “cardiogenic” replaced “carcinogenic.” BBN
♡Ebstein Anomaly – Cardiac Pathology 101, about as simple as I can make it (and understand, too);
Babies born with Ebstein Anomaly have a malformed right and atrium and ventricle and misplaced (tricuspid) valves between the right sided ventricle and atrium. The larger right ventricle can’t pump efficiently.
In addition, the blood the right ventricle tries to pump into the lungs leaks/flows/churns (risking blood clots) back into the right atrium, which grows even bigger, with even thicker walls. The ventricle also grows bigger. When the muscle fibers of the chamber walls get stretched apart enough, they are less inefficient. (Think of two hands gripping at the fingers. The farther out the grip, palm > 1st joint > fingertips, the less strength and pull on the opposite hand.) (For the geeks: Frank-Starling law.
The lungs aren’t efficiently filled with blood, they don’t expand, the pressure builds up in them and efficient exchange of gasses doesn’t take place.
In the meantime, the blood backs up in the body, the liver, kidneys and extremities & eventually the left side of the heart, which can hypertrophy , too.
The enlarged heart puts pressure on the lungs and nearby soft tissue, including the blood vessels coming to the heart.
The combination of leaking high pressure blood vessels and the body’s increasing fluid in order to try to pump what oxygen there is, leads to edema or swelling of the body.
Sometimes, the fetal atrial-septal defect stays open, allowing mixing of the un-oxygenated blood from the right, with the oxygenated blood. This malfunction can help, temporarily.
With the high pressure, poor flow, and actual physical damage due to the mass of the heart, none of the organs can function well. Increased activity, stress, and growth will increase the demand for oxygen, kidney & lung function.
Texas Right to Life General Counsel Emily Cook is attacking Texas Medical Association on Facebook, even though virtually every other pro-life, medical, nursing, hospital, and disability group in Texas oppose SB 2089 by Hughes, that would change the “Texas Advance Directive Act, “TADA” will harm patients and attack the right of doctors to refuse to act against our conscience.
There’s no leeway, at all, in the new Bill.
If you believe that even doctors have the right of Conscience, and that infringement of the right not to be forced to act against your will is wrong, please contact your Texas Senator and Lieutenant Governor Dan Patrick and respectfully ask that SB2089 not be brought up.
You can let me know if you disagree on my Facebook page.
I’ve sat on this for 4 days, hoping for a response to the questions I sent to 2 of the ‘co-founders” and an editor of the website. (They only use those online forms, so I can’t follow up by email.)
So far, no response from any of the 3.
I’m not going to link to the website, but the address is in the photo.
Unfortunately, the division in the Texas prolife community is deep. The article I attempted to comment on quotes – and disputes – an article I wrote for Texas Alliance for Life a few years ago.
All I wanted to say was that I hope the readers will read that article.
Praying for peace.
(BTW, that case ruling came down in favor of Houston’s Methodist Hospital and the Texas First Court of Appeals refused to declare the Texas Advance Directive Act unconstitutional.)
Calling allies “cancer” and divisive is about as malignant and divisive as it gets!
Mark Crutcher and Troy Newman have co-authored a blog piece over at Life Dynamics that does exactly what they accuse others of doing. They manage to insult sidewalk counselors and Crisis Pregnancy Centers and groups like New Wave Feminists and And Then There Were None. Add in the dark graphics and the sanctimonious, unyielding tone to the accusations, and it’s no wonder our movement hits wall after wall.
What differentiates these two from their designation of “Grandstanders?” Talk about your purity test!
My instinct as a proponent of “Can’t we all just get along?” was to remember my Mama’s advice: if you haven’t done the bad things they talk about, the scolders aren’t talking about or chastising you.
And let’s face it, there’s a kernal of truth there: some people are all about power and fundraising and we’ve got to continually educate both new and old activists to focus on our goal of ending abortion.
However, Crutcher and Newman go too far to be too specific and don’t give any consideration – much less kudos – for the possibility that there are effective exceptions within the groups. While I could point out examples of each of the people they describe, I can easily name more exceptions.
Instead of the negative analogy to cancerous growths, I prefer the picture drawn by my friend, Joe Pojman, PhD., of Texas Alliance for Life.
Think of our pro-life efforts as attempts to rescue the unborn and their mothers from the sinking ship that is legalized elective abortion. We each have a boat which we use to make trips to bring as many to safety as we can. Every boat is different: Some boats are old and leaky, some are a bit nicer or newer,more or less efficient or are captained by people who wander around a lot and keep making detours, but none of the boats that we have today is big enough or fast enough to save everyone, so we make trip after trip as fast and efficiently as we can. If some of our sympathisers spend time on the shore shooting holes in everyone else’s boat – or anyone else’s boat – fewer lives will be saved. That’s real “mission drift.”
But we can bail water and plug those holes if they’ll just give us a chance.
Clichés are repeated because they prove true, time after time. Remember this one: “The enemy of my enemy is my friend.” But do we really “educate” with wide condemnation of the efforts of others who approach our goal from a different angle or do we create more of the very harm we are warning about?
Keep building those coalitions, looking for common ground, and plugging along!
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
I am glad that the rules are explicit about the duty to report sexual or physical abuse.
Here’s a statement from Texas Alliance for Life, with links to the ruling:
Austin, TX — Today the Texas Supreme Court released rules for how courts handle judicial bypass proceedings regarding secret abortions on minors girls without parental notification or consent. The rules were created in response to HB 3994, authored by Rep. Geanie Morrison (R-Victoria) and sponsored by Sen. Charles Perry (R-Lubbock) and strongly supported by Texas Alliance for Life.
The following statement is attributed to Joe Pojman, Ph.D., executive director of Texas Alliance for Life:
We are pleased with the Supreme Court’s strong rules regarding the judicial bypass process for abortions on minor girls. These bring to fruition a 10-year effort by Texas Alliance for Life and a coalition of pro-life organizations to protect minor girls in Texas from abortion. In 2005, the Texas Legislature passed a bill requiring doctors to obtain the consent of a parent before performing abortions on minor girls. In 2015, the Legislature passed, and Gov. Abbott signed into law, HB 3994 to reform the judicial bypass process by which a judge can allow abortions on minors without parental consent. The reforms closed loopholes and increased protections for the minors from abuse. The Texas Supreme Court has faithfully implemented House Bill 3994 in a way that will best protect the well being of minor girls.
Here is a link to the Texas Supreme Court’s order issuing the rules: http://www.txcourts.gov/media/1225647/159246.pdf.
HB 3994 was one of five major pro-life bills and numerous other pro-life provisions passed in 2015. Here is a summary.
“. . . graduate from high school, keep your first job for over 1 year, get married and stay married.”
Common sense, right? Okay, it’s not as easy as 1-2-3, and association doesn’t equal causation, but who would argue, right?
“Politifact Texas” would. The Politifact.com website claims to fact check political news and news makers’ comments, and has a Texas Edition. In my opinion, they tend to hit such comments from the Left of center. In this case, they seem to go out of their way to prove Texas Rail Road Commissioner Barry Smitherman wrong, but – even by stressing the importance of the economy in the equation – they prove him right.
Take a few steps, Barry Smitherman said, and you won’t live in poverty. Smitherman, seeking the 2014 Republican nomination for Texas attorney general, put his point this way in prepared remarks for an Aug. 26, 2013, appearance before the Texas Alliance for Life: “Several years ago, the Economist magazine published a piece which said that you only have to do three things to guarantee that you will live above the poverty line—graduate from high school, keep your first job for over 1 year, get married and stay married.”
The rest of the article traces the history of the publications that make the claims to which Commissioner Smitherman refers.
Please Contact the Texas Department of State Health Services to Register Your Opposition to Tax Funding for Planned Parenthood!
Deadline on MONDAY
Please immediately contact the Texas Department of State Health Services (DSHS) and register your opposition to tax funding for Planned Parenthood in a new state health program.
DSHS is creating a new state-funded program, called the Texas Women’s Health Program (TWHP), to provide preventative health care for low-income women. The services will including some STD screening and treatments, screening for breast and cervical cancer, and contraceptives. The new state program will replace the Medicaid Women’s Health Program, which is expected to come to an end in October. The new TWHP will provide the same or more services as the Medicaid program it replaces.
See a sample message and contact information below. Comments must be received by Monday, August 6.
Email — click here to email to CHSS@dshs.state.tx.us.
“Dear Ms. Garcia,
“This is a comment regarding the proposed rules for the Texas Women’s Health Program published in the Texas Register on July 6, 2012.
“Please assure that Planned Parenthood and other organizations that provide or promote elective abortion are not eligible for public funding under the Texas Women’s Health Program. Planned Parenthood runs 14 abortion facilities in Texas, and they promote elective abortion at every one of its sites in Texas even where they do not perform abortion. I do not want my tax dollars to go to organizations that perform or promote abortions as a method of family planning”
“—–Your name and address
For more information, visit Governor Rick Perry’s website, Fighting for Women’s Health: http://governor.state.tx.us/initiatives/womens_health/.
Here’s a (YouTube) video of Texas Alliance for Life’s executive director, Joe Pojman, Ph.D.: Joe Pojman, Ph.D., Executive Director. This video interviews Texas Alliance for Life’s board member, Dr. Beverly Nuckols: Beverly Nuckols MD, FAAFP, Family Physician
Texas Alliance for Life (TAL) is a non-sectarian, non-partisan, pro-life organization of people committed to protecting innocent human lives from conception through natural death through peaceful, legal means. TAL is a statewide organization based in the Texas capital.
twitter.com @TXAlliance4Life facebook.com/TexasAllianceforLife
Working within the 5 letters for the personalized plates was tough. “DR 4 LF,” “MD 4 LF,” etc. were not available.
Then: Standing at the counter at the Comal County tax office, today, it occurred to me that I could have used my initials.
The frame and the plate are worth a lot of bumper stickers, aren’t they? Just think, the regular plates cost $30 a year, with $22 of that going to support adoption services in Texas. This is an easy way to donate and much less messy than bumper stickers!
Order yours at the Choose Life link at Texas Alliance for Life.
In April, 2010, the Austin City Council passed an ordinance targeting Pregnancy Resource Centers (AKA “Crisis Pregnancy Centers”). The Liberty Institute , the Law of Life Project, the Texas Center for the Defense of Life and the Alliance Defense fund have filed a lawsuit on behalf of Austin Life Care and three other centers in Federal Court, citing free speech violations.
Disclaimer: These organizations are joined and supported by Texas Alliance for Life, whose Executive Director, Dr. Joe Pojman is shown in this photo. I’m on the Board of Directors of TAL.
(Seriously? The City of Austin doesn’t believe that it’s obvious to anyone that “Austin Life Care” is not an abortion provider??)
According to an article by “We Are Austin. com” published at the time, the ordinance was aimed at “limited services pregnancy centers,” and could result in fines:
The ordinance says two signs in black and white must read in English and Spanish, that states: “This center does not provide abortions or refer to abortion providers. This center does not provide or refer to providers of U.S. Food and Drug Administration approved birth control drugs and medical devices.”
Each sign must be at least eight and a half by 11 inches and the text must be in a minimum font size of 48 point.
Before the vote, council members questioned how the ordinance will be enforced. The city’s legal team said Austin police will not enforce it, no one will be arrested for not posting the sign, and that enforcement will be complaint-based only. Pregnancy centers that do violate the ordinance, however, can face a fine of $250 for the first offense, $350 for a second offense, and at least $450 for a third offense.
Joining Austin Life Care are the Austin Pregnancy Resource Center, the South Austin Pregnancy Resource Center and the Catholic Charities of Central Texas‘ Gabriel Project Life Center. ALC has posted the signs, but the other three haven’t done so.
The ordinance, which is the first of its kind in Texas, requires each PRC to post a sign at its entrance stating it does not provide or refer for abortions or birth control services. Two of the pregnancy centers refer married clients to primary physicians for birth control, and the third center provides information to women about natural family planning and abstinence, two recognized forms of birth control.
There is no requirement forcing abortion facilities to post signs or provide disclaimers stating what services they do not provide for women.
Pro-life groups around Texas all confirm the strong pro-life record of Governor Perry. Read the article for the examples of his actions in the name of protecting innocent life at all stages and ages.
The long record of pro-life accomplishments will serve the Texas governor well should he decide to seek the Republican nomination. He would face off against other candidates who are equally committed to pro-life values, but his pro-life track record will give him a chance to gain positive support from voters in places like Iowa and South Carolina. Should he ultimately become the nominee, Perry, like other Republicans seeking the nomination, would present a clear pro-life versus pro-abortion contrast with Obama that would rally the majority of Americans who are pro-life to his side.