Medical futility in Texas: myths and misconceptions
Mayo, Thomas Wm.
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Ever since the enactment of Texas's Advance Directives Act in 1999, its so-called "futility provision" has been controversial. Indeed, "medical futility" is the subject of world-wide debate, from the problem of defining "futility" to the question of how best to respond to claims by physicians that a requested treatment would be futile. Texas law on this subject has attracted widespread attention because (1) it creates a time-limited process that includes (2) a mandatory consultation with a hospital ethics committee, at the end of which (3) the health care providers will probably receive complete legal immunity. The combination of these three elements is unique in American law and has led to criticisms of the Advance Directives Act on a number of grounds: theoretical, legal, and practical. This presentation considers some of the criticisms of the Texas statute and concludes that most are based upon myths about "medical futility" and misconceptions about the meaning and application of Texas law (including its recent application to a brain-dead pregnant patient in Fort Worth). It then offers some challenges in the law that are based upon the speaker's experiences with the law while serving on five hospital ethics committees over the past fifteen years.