Sarah Palin's warning that the Obama administration’s health care reforms may result in "death panels" should be heeded.
Although the proposed legislation does not exactly create such an entity, it would create an environment where planned deaths could thrive. Governments could pull the trigger through rule-making power. Some hospitals, like those in the Memorial Hermann Hospital System, in Houston, Texas, are already doing so through involuntary guardianships and medical futility committees, which are allowed by the Texas Advance Directives Act of 1999.
Current Texas law allows a physician to withdraw life-sustaining treatment (including food and water) from a patient despite the patient’s directive or expressed wishes. Once the physician’s decision is validated by the ethics committee, the patient and/or family have only ten days to find a transfer to another facility or another physician.
At Memorial Hermann hospital, a patient was in his 40s and had suffered a stroke and required inpatient dialysis. His family visited him daily at the hospital and was very involved in his care. As his government health care benefits were approaching the deadline of running out, the hospital administration approached the family and urged that further care was unnecessary and medically futile.
The hospital suggested that the family take the patient home to let him die, or agree to place him in hospice.
Based on his condition, the patient could not receive outpatient dialysis. Thus, the family was faced with a decision: cave to the hospital's demand for discharge and face certain death, or insist on further humane care. When the family disagreed with the hospital's recommendation, the hospital got aggressive and downright nasty.
Listen to this voicemail audio of a Memorial Hermann hospital administrator threatening to use a legal court proceeding to send this patient "on to glory."
"Hi Chris, this is Renee Jumper. I’m the Director of Case Management at Memorial Hermann Northwest. I’m calling you concerning your daddy, Mr. Stafford. You guys need to get in contact with us Monday, as soon as possible. You guys cannot use the hospital to leave your father here, because you guys don’t wanna make a decision for what’s appropriate for your father. Now, it is your decision not to want to pay for this dialysis, but it is not ya’lls decision to leave him here. So, administration and corporate wanted me to call you. On Monday we’re gonna move forward with gettin’ guardianship, and trying to get the courts to petition to make your daddy hospice. So, it’s not what you think, and that way we will make the decision to put him on hospice care, and we will let, basically, uh, him go ahead onto glory. But, you guys got to…need to contact me on Monday. You do not get to sit and not look for a place to put your father. That is your problem. If you guys don’t want to take care of him, that is your decision as well. But, you do not get to get what you want by keeping him in the hospital, and having it on Memorial Hermann Northwest. So, we were nice. We gave you guys ‘til after the first, and now you guys have took our niceness as for a weakness. So, I’m telling you now, there are many families that can’t take care of their loved ones, but they make decisions appropriate to what they can and can’t do. You guys are gonna have to do that. If not, you guys are gonna have to take your father home. So, you have a blessed weekend. We will talk on Monday. If you guys are still not able to make a decision, then you take your daddy home. Have a blessed day."
Under an agreement, the hospital eventually transferred the patient to a nursing home across the street from the hospital and the government paid for his long-term care. The hospital also agreed to pay the bill until the next phase of the benefits started. The patient died six months later with his family by his side.
Robert W. Painter, an attorney at Painter Law Firm PLLC, handles medical malpractice and other litigation matters and has testified on the Advance Directives Act in the Texas Legislature.