Spotlight on Texas' '10-day rule' in life support cases

News

Spotlight on Texas' '10-day rule' in life support cases

2019-11-13 13:04 Last Updated At：13:10

A Texas law that gives families 10 days to find a new hospital if they disagree with doctors who decide to take a patient off life support is once again under the spotlight after a judge halted a Fort Worth hospital's plan to remove a 9-month-old girl from a ventilator against her family's wishes.

Doctors at Cook Children's Medical Center planned to stop treatment Sunday for Tinslee Lewis after invoking the state's "10-day rule."

The hospital said Tinslee was born prematurely with a rare heart defect and suffers from chronic lung disease and severe chronic high blood pressure. She has been hospitalized since birth and has been on a ventilator since July. Not only is her condition fatal, the hospital said, but doctors believe she's suffering.

But on Sunday, a judge granted Tinslee's family a temporary restraining order that gives them until Nov. 22 to find a facility that will take her, said Kimberlyn Schwartz, a spokeswoman for anti-abortion group Texas Right to Life, which began helping the family over the weekend.

Cook Children's says it has reached out to nearly 20 facilities around the country and none felt the hospital's assessment was incorrect.

Tinslee's mother, Trinity Lewis, said her daughter likes to cuddle and is "a fighter."

Here's a look at Texas law in such cases:

WHAT THE LAW SAYS IN TEXAS:

Texas law stipulates if doctors believe life-sustaining treatment should be stopped but the family does not, the disagreement can be taken to the hospital's ethics committee. If the committee agrees with the doctor, the "10-day rule" can be employed. If the hospital or family can't find a willing provider in that time, and unless a court grants an extension, treatment can be withdrawn.

Experts say a committee rarely hears such disputes.

Typically, the family would first talk to experts including a palliative care specialist and an ethics consultant, according to Dr. Robert L. Fine, clinical director of the Office of Clinical Ethics and Palliative Care at Baylor Scott & White Health in Texas.

Trevor Bibler, a professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine in Houston, said "usually these types of impasses are able to be broken" through time and mediation.

The 1999 Texas law shields doctors who follow the procedure from lawsuits.

WHAT THE LAW SAYS IN OTHER STATES

Texas is one of only a handful of states with such a law. Virginia and California have similar ones.

In most states, the law is not as detailed on the matter, said Thaddeus Mason Pope, a professor at Mitchell Hamline School of Law in St. Paul, Minnesota. "The Texas law is very, very clear: You are absolutely allowed to do this," he said.

He said the same process basically occurs in other states that don't have specific legislation and that hospital staff would just assess the legal risk of getting sued before proceeding.

HOW TEXAS' LAW CAME ABOUT

The goal of the law was to give families and doctors a say but keep the debates out of the courtroom.

"I think it's important for families to know that they're being heard and to be given an opportunity to understand where the doctors and the hospital are coming from as well," said Tom Mayo, a law professor at Southern Methodist University in Dallas.

Lawmakers, attorneys, doctors and anti-abortion groups were among those participating in a task force that helped craft the law. Among those was Texas Alliance for Life, a group that opposes abortion except to save the mother's life and also opposes euthanasia.

Joe Pojman, the group's executive director, says they "strongly support" the law's dispute resolution process. He says the law balances the family's autonomy with doctors' rights not to give interventions that cause harm or suffering.

THE ETHICS COMMITTEES

The law doesn't stipulate who should be on a hospital's ethics committee, but at a large hospital it would likely include dozens of people from different backgrounds including doctors, nurses, lawyers and chaplains.

"We operate by consensus and we talk it out," Fine said.

WHAT THE GROUPS REPRESENTING THE FAMILY SAYS

Schwartz says her group believes "there shouldn't be a countdown placed on patients' lives."

In the 20 years that the law's been on the books, her group has helped more than 400 families, she said. It often takes "way longer" than 10 days to find a facility that will accept a patient, she said.

"Don't give the family just 10 days to navigate that complicated process. That's almost impossible for an average family to do," Schwartz said.

"Morally, these decisions should be left with patients and families," she said, adding that quality of life shouldn't be the only consideration.

OTHER CASES THAT HAVE GAINED ATTENTION:

Last year, a 9-year-old girl in Texas at the center of a three-week court battle with Cook Children's Medical Center to keep her on life support died after an appeals court allowed her parents more time to find a facility to maintain her life support.

Doctors had declared Payton Summons brain-dead and beyond hope of recovery after her heart went into cardiac arrest.

Information from: Fort Worth Star-Telegram, http://www.star-telegram.com

New storms pummel the South as a week of deadly weather marches on

2024-05-09 22:16 Last Updated At：22:21

COLUMBIA, Tenn. (AP) — A wave of dangerous storms began washing over parts of the South early Thursday, a day after severe weather with damaging tornadoes and large hail killed at least three people in the region.

A heavy line of storms swept into Atlanta near the end of the morning rush hour. Busy hub airports in Atlanta and Charlotte, North Carolina, reported delays Thursday morning. Tornado warnings were issued for parts of Tennessee and Alabama.

The storms continue a streak of torrential rains and tornadoes this week from the Plains to the Midwest and, now, the Southeast. At least four people have died since Monday. The weather comes on the heels of a stormy April in which the U.S. had 300 confirmed tornadoes, the second-most on record for the month and the most since 2011.

Storms had already left more than a quarter-million customers without power Thursday in North Carolina, Tennessee, South Carolina, Georgia, Alabama and Missouri, according to PowerOutage.us.

A storm Wednesday in northeastern Tennessee damaged homes, injured people, toppled power lines and trees, and killed a 22-year-old man in a car in Claiborne County, north of Knoxville, officials said. A second person was killed south of Nashville in Columbia, the Maury County seat, where officials said a tornado had likely touched down and homes were blown off their foundations.

Bob Booth had just gotten home to Columbia from Georgia and was sitting down to watch television when he heard a “crazy racket.”

“I get up and look out, and it was all hell breaking loose outside,” Booth said. “Then the top half of one of my trees goes down across the road.”

Booth said he was told it would be a while before his power was restored. One neighbor, he said, lost all trees except one that would have destroyed his house: “So that guy is blessed."

Schools were closed Thursday in several Tennessee counties. Some districts north of Atlanta canceled in-person classes or delayed start times because of storm damage overnight that included fallen trees on houses and vehicles around Clarkesville. No injuries were reported there.

“We’re just trying to clean up right now and wait for the next round,” said Lynn Smith, director of the Habersham County Emergency Management Agency.

Torrential rains led to a flash flood emergency and water rescues northeast of Nashville. The Federal Aviation Administration issued a temporary ground stop at Nashville's main airport, and the weather service issued a tornado emergency, its highest alert level, for nearby areas.

In North Carolina, a state of emergency was declared Wednesday night for Gaston County, west of Charlotte, after a storm that toppled power lines and trees, including one that landed on a car. One person in the car was killed, and another was taken to a hospital, officials said.

The storms followed heavy rain, strong winds, hail and tornadoes in parts of the central U.S. on Monday, including a twister that ripped through an Oklahoma town and killed one person. On Tuesday, the Midwest took the brunt of the bad weather. Tornadoes touched down in parts of Michigan, Ohio and Indiana, according to the weather service.

Michigan's Kalamazoo area was hard hit as a FedEx facility was ripped apart, with downed power lines trapping about 50 people.

Tornadoes were also confirmed near Pittsburgh, in central Arkansas and in northern West Virginia. The West Virginia twister was at least the 11th tornado this year in the state, which sees two tornadoes in an average year.

Both the Plains and Midwest have been hammered by tornadoes this spring.

Cappelletti and White reported from Detroit. Associated Press journalists around the country contributed to this report, including Jeff Amy, Joey Cappelletti, Ed White, Rio Yamat, Heather Hollingsworth, Colleen Slevin, Jim Salter, Kathy McCormack, Sarah Brumfield, Beatrice Dupuy, Alexa St. John, Adrian Sainz, John Raby and Lisa Baumann.

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.