Resolution of futility by due process: early experience with the Texas Advance Directives Act.
Every U.S. state has developed legal rules to address end-of-life decision making. No law to date has effectively dealt with medical futility--an issue that has engendered significant debate in the medical and legal literature, many court cases, and a formal opinion from the American Medical Association's Council on Ethical and Judicial Affairs. In 1999, Texas was the first state to adopt a law regulating end-of-life decisions, providing a legislatively sanctioned, extrajudicial, due process mechanism for resolving medical futility disputes and other end-of-life ethical disagreements. After 2 years of practical experience with this law, data collected at a large tertiary care teaching hospital strongly suggest that the law represents a first step toward practical resolution of this controversial area of modern health care. As such, the law may be of interest to practitioners, patients, and legislators elsewhere.
Fine
Robert L
RL
Baylor Health Care System and Southern Methodist University/Dedman School of Law, 3434 Swiss Avenue, Suite 330, Dallas, Texas 75204, USA. robertf@baylorhealth.edu
Mayo
Thomas Wm
TW
D016223:Advance Directives / Q000331:legislation & jurisprudence*; D000368:Aged; D000369:Aged, 80 and over; D002961:Civil Rights / Q000331:legislation & jurisprudence*; D017041:Ethics Committees; D004991:Ethics, Institutional; D005260:Female; D006801:Humans; D018447:Medical Futility / Q000331:legislation & jurisprudence*; D013781:Texas