Implications of the Tinslee Lewis Decision for Medical Futility Conflicts in California and Virginia

The Texas Court of Appeals has seriously questioned the constitutionality of the dispute resolution provisions in the Texas Advance Directives Act. What does this mean for California and Virginia which have similar dispute resolution mechanisms?

Statutes in those states do not specify the conflict resolution process as exhaustively as Texas, leaving details to individual institutions. But statutes in those states are similar to TADA in that they grant immunity to hospitals for unilaterally withdrawing life-sustaining treatment. Therefore, hospitals using those statutes could be considered state actors that owe constitutional due process.

Individual California and Virginia institutions should review their policies and procedures to assure that they: (1) afford families adequate notice, (2) provide them a meaningful opportunity to participate, and (3) specify ascertainable standards for the ethics committee (or other review committee) to use in determining the appropriateness of treatment.