Proposed Legislation Would Eliminate 10-Day Rule for Withholding Treatment From Patients

Sen. Bryan Hughes (R-Mineola) and Rep. Tan Parker (R-Flower Mound) have filed legislation to protect patients and their families by altering the “10-day rule” that currently allows hospitals to remove life-sustaining treatment from patients, even against the patient’s directions or family wishes, as part of Texas Advance Directives Act.

The “Respecting Texas Patients’ Right to Life Act of 2021” would still allow hospitals to recommend the removal of life-sustaining treatment, but families would no longer be bound by a 10-day countdown as they frantically search for an alternate health care facility to treat their loved one. Furthermore, the legislation requires that treatment must continue until the family can secure a transfer for the patient.

Texas Right to Life (TRTL), a pro-life advocacy organization, supports the change. The group believes the removal of the countdown will “incentivize hospitals to collaborate with families to transfer their ailing loved one to a more appropriate facility.” 

“We believe this bill will save lives,” Katherine Pitcher with TRTL told The Texan. “The goal is not to force hospitals who do not want to treat a patient to continue treatment.” She explained that they have seen, in cases where they were able to stop the 10-day countdown, that hospitals and doctors were more inclined to help the family move the patient elsewhere.

TRTL regularly assists families who find themselves in situations like these, where a hospital wishes to remove life-sustaining care against the patient’s or family’s wishes, having assisted eight families in 10-day rule situations in 2020. 

“I’m very sure we are just getting the tip of the iceberg,” Pitcher said, adding that Texas does not require hospitals to report how often they are invoking the 10-day rule.

Tinslee Lewis’ story illustrates this point. Against her family’s wishes, in November 2019 Cook Children’s Hospital in Fort Worth scheduled to remove her when she was nine months old from the ventilator that was sustaining her life. Tinslee suffers from Ebstein’s anomaly, a rare and often terminal heart disease that has required constant intensive care. 

TRTL provided the family with legal assistance, which resulted in an order prohibiting the removal of care. Her right to care has withstood court challenges all the way to the United States Supreme Court. Tinslee is still living today and celebrated her second birthday last month. 

Most often, a desperate family member will contact TRTL, having never heard of the 10-day rule before, facing a countdown in order to find a hospital or other health care provider who will treat their loved one. According to TRTL, some of the most common treatments being withheld from patients are dialysis, ventilation, and intravenous blood pressure medication.

“These decisions are often based on quality-of-life ethics, but we don’t hear any acknowledgment that life itself is a benefit. We’ve heard very callous comments from doctors,” Pitcher told The Texan.

The bill has not yet been referred to a committee for a hearing.

Neither Hughes nor Parker responded to The Texan’s request for comment before the time of publication.

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