The Controversy Over Medical Futility Laws in Texas

The New England Journal of Medicine July 2007 issue included an article by Robert D. Truog, M.D., addressing the ethics behind the Texas Advance Directives Act. This act allows hospitals to withdraw life support if an ethics committee has determined that life support is medically inappropriate, as long as the hospital gives 10-day notice to the family and attempts to find an alternate provider. The article addresses some of the ethical considerations that go into making such a determination. An October 11, 2007 Letter to the Editor in the Journal by Robert L. Fine, M.D., a physician and clinical ethicist who was involved in the development and use of the Act, attempts to refine some of Truog arguments and argues for the support the Texas act, stating that, ". . .the Texas process remains the best approach when family requests conflict with professional obligations at the end of life."