Proposed Amendment to the Texas Advance Directives Act

Late last month, two bills that aim to amend the unilateral refusal provisions of the Texas Advance Directives Act were sent to committee.  H.B. 2964 is authored by Rep. Garnet Coleman.  H.B. 3325 is authored by Rep. Bryan Hughes.  If enacted, each bill would take effect Sept. 1, 2009.

H.B. 2964 is the more moderate bill.  It:

• Excepts ANH from the sorts of treatments that can be unilaterally refused if it is the only LSMT being provided
• Appoints a patient liasion to assist the patient/surrogate through the process
• Extends the transfer period from 10 to 14 days

H.B. 3325, on the other hand, proposes dramatic changes.  It:

• Allows the patient/surrogate to have legal counsel at the HEC meeting
• Removes the 10 day period, effectively requiring treatment until transfer
• Specifically authorizes no-fee judicial review of the physician's or HEC's decision

I think some features of each bill should be adopted to make the process more fair and thorough.  But ANH should not be treated specially.  And if judicial review is allowed, the standard of review should be carefully defined to mirror that in peer review and the business judgment rule.