Games Being Played by St. Luke's?
Andrea Clark's sister was assured (she says) by St. Luke's that Andrea would be maintained through Tuesday. But Jerri Ward, the attorney for the family, just e-mailed me: "I have not been able to get St. Luke's to agree on the record that care will be continued after the weekend. It probably will, but that's not been conveyed to me either in writing or orally."
I will continue to update as more information comes in.
posted by Wesley J. Smith @ 2:52 PM
8 Comments
8 Comments:
The futile care protocols state that once the ethics committee says no to wanted life sustaining treatment, it can no longer be provided in that hospital even if another physician is willint to provide the care. That is why the transfer becomes so urgent.
It is quite remarkable that a woman who needs life sustaining treatment to stay alive is not apparently wanted by any hospital in Texas. Scandalous.
Andrea Clark is fully insured. Futile Care Theory is about money in the general sense, but probably not in this specific case.
If we are going to argue about whether someone in extreme circumstances should have his or her health care covered by the public, it should be in open democratic debate, not decided by bioethicists and committees behind closed doors.
I've covered these questions at my blog.
Specifically, the law does not say that " can no longer be provided in that hospital even if another physician is willint to provide the care."
Mr. Smith, I would really like to know where this idea came from. Is it from 166.046 (g)?
Really, do you think that ICU nurses and doctors caring for patient are like this? Does this scenario - accross an entire city and state - fit with what you know of reality?
I could have told you why other doctors and hospitals will not accept the patient in transfer yesterday, if the radio people hadn't unexpectantly cut me off: because we understand the medical realities and probabilities: the heart failure, the brain damage that led to the ventilator and the ventilator itself, the kidney failure and the side effects of dialysis, and the loss of integrity of blood vessels that require constant readjusting of the pressors (medications to maintain blood pressure), as well as the endocarditis (which also aggravates all of the above) are too many complications to disagree that repeatedly subjecting this woman to dialysis and intensive pressor therapy is cruel to her.
I have been wondering if the doc had first suggested stopping the dialysis and moved to his only apparent recourse -refusal of the ventilator - when the family insisted on continuation of ever increasingly intensive treatments.
Also, as to the reason that the transfer was cancelled: It's not clear at all why any facility that could manage a ventilator and dialysis of a patient could not handle other medications that the patient needs. St. Luke's must have found out that the facility could not actually continue dialysis and or manage the ventilator and the pressors.
Wesley:
Yet another opportunity illustrate the importance of ADVANCE DIRECTIVES.
Had Andrea Clark put her wishes in writing would this battle be raging? At a minimum, we would have had a much clearer understanding of her wishes.
I advocate a DETAILED, precise, illustrative advance directive. I recommend that people include as many hypotethicals and descriptions of potential conditions/levels of disability in which they might find themselves so as to provide guidance.
Every time I speak publicly on this subject, I have medical folks argue with me about the above. They insist that broader language is better and gives the doctors and hospitals more room to assist familie with decision-maker.
I say "baloney." We don't need broad language in such documents. We need as much specificity as possible so as to inform the family and allow them to draw analogies if the precise situation was not contemplated by the patient.
Janie: Yes it would. The Texas statute is about when a hospital does not have to comply with an advance directive. Check out the link at my earlier post and scroll down.
I'm not buying it. I don't think this law could hold up if challenged on the basis of a patient's WRITTEN advance directive.
Has it been attempted?
Be patient, my pretty. I think the law is open to a constitutional assault. We'll see if it comes to that.
Good!
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