Wednesday, December 30, 2015

Chris Dunn, TADA, & Euthanasia: Working through the Issues

As I predicted in my last post, there is plenty of Monday-morning quarterbacking (for lack of a better term) going on in the wake of Mr. Dunn's death (notably by those who are in favor of TADA (the Texas Advance Directives Act) and otherwise uninvolved in helping the victims of this draconian law). A number of people have contacted me about what they are seeing, hearing, and reading and are quite concerned. 

Let me set some things straight and provide information for those who truly want to understand what is at stake here. This post got a bit lengthy, but the implications are serious. If you are to work through this issues, it will take some time and effort on your part. Also feel free to read my other posts on TADA and go over to as there is a vast library of information there to help you along to understanding TADA as well as the bigger ethical and moral considerations related to it and the push to normalize (and mandate) euthanasia. 

I know many are desperate for others to understand TADA, come to a pro-life view of it, and understand the larger end-of-life/denial-of-care issues. Information is the key to everything. You need solid information to make any decision in life. I have always sought to bring information and analysis to the topics I take up on this blog. Many others do the same. As always, some will be convinced by this. Some will take issue with it. Some will begin working through the issues only to arrive at an opinion later. Some will continue to miss the forest for the trees. Then there are some who believe they are "100% pro-life but..." have fallen victim to supporting a form of euthanasia apparently without realizing it. The latter ones are also seemingly unreachable. I am not sure how this happens, but I have seen it happen repeatedly. 

As St. Bernadette said, "My job is to inform, not to convince." (That is a big reason I do not allow comments on this blog.) For my friends who are working hard to spread the pro-life message, keep this in mind. Do not become discouraged. The truth shall prevail. Just keep getting the information out there. And keep praying. 

Let's get started.

Be Wary of Non-Firsthand Sources

In my prior posts about Mr. Dunn, I provided links to plenty of sources from those who had firsthand knowledge of what was going on at the time. The first post about Mr. Dunn was here. The second post about him was here. The Monday-morning quarterbacks do not have firsthand knowledge and were not involved in helping Mr. Dunn, nor have they been involved in helping any victim of TADA to my knowledge. You can also go to Texas Right to Life's various posts about it on their website and pull the documents from the court's website if you wish. I have tried to distill this down as much as possible, but there is vastly more information out there that you can access about Mr. Dunn specifically and about these moral issues in general. In my posts about legislation, I have always encouraged you to read the source documents yourself, rather than the pro/con talking points that various sides will put out. Do your own analysis and homework beyond talking points provided by advocates. I can provide sources and analysis, but ultimately, this is really on you. 

No Due Process under TADA

As a starting point, please note that among the biggest concerns about this law overall is the lack of due process for the patient and his or her family when TADA is invoked, and that TADA imposes a death sentence on a patient against their will and by means that are inhumane or in opposition to their faith. Do not lose sight of that. A patient has no right to have the underlying decision of the doctor or panel reviewed under this law. Once the medical professionals determine that care will be terminated for any reason, there is nothing more to do but to try to find another facility - and fast. Sometimes a judge will grant some additional time. But that is the only recourse to court a victim of TADA has, begging for more time. The underlying decision cannot be challenged. Also, there is total immunity for a facility and doctor as long as they operate under TADA. This is a problematic law. There is simply no question about that. 

The particulars of this case or that case changes absolutely nothing about the lack of due process in this law. We give more due process rights to a convicted murderer than an ill person in the hospital. That is a fact.  

Those supporting TADA will not discuss the denial of due process. In this instance, they focus on Mr. Dunn's alleged condition or prognosis as a justification for what the hospital wanted to do, that is, remove his life-sustaining treatment to hasten his death. They will focus on forcing a doctor to continue treatment against the doctor's conscience. They will make accusations against those trying to help Mr. Dunn. None of these justify this law, but it does avoid the real issues and muddies the water. If the real issue can be avoided, perhaps then, there will not be enough support to overturn the law or substantially reform it. I want you to be informed because I think if one is truly informed and truly pro-life, one cannot support TADA in any intellectually honest way. I will take each pro-TADA argument (whether related specifically to Chris Dunn's case or not) I've seen or heard in turn.

Speculation on Dunn's Condition: One's Prognosis or Diagnosis Is Still No Justification for the Lack of Due Process & Withdrawal of Ordinary, Basic Care

There is undue speculation about Mr. Dunn's alleged condition by those with no firsthand knowledge. As I have written, as it has been reported in the news, as the court documents show, his exact condition is simply unknown. A proper diagnosis was not made. But even if it had been, that does not decide the issue. An individual's diagnosis or prognosis is not a moral justification for the existence of TADA and its denial of due process to patients. An individual's diagnosis or prognosis is not a pro-life justification for the existence of TADA in any way. We do not remove ordinary care for people just because their prognosis may not be great. We continue to provide them with food, nutrition, and air.* That, it would seem to me, would be very basic.**

Next, you should be aware that proponents of what the hospital did to Chris Dunn and who support TADA are looking almost exclusively to the self-serving affidavit that the doctor at the hospital filed as part of the court records. That affidavit cites to no tests and references no exhibits or documentation. Please note that there was no independent medical examination conducted. What is being called a "diagnosis" was done without certain tests being performed. This was addressed in my prior posts about Mr. Dunn. Any doctor who has admitting privileges with the hospital is bound by the determination of the ethics panel. Mr. Dunn's mother requested an IME (independent medical examination), but that determination was not to be made until January 6, 2016, when the court would have heard the motion. The judge refused to hear the case in an expedited manner, although that was requested.

I say the TADA proponents were relying "almost exclusively" on the affidavit because they also look to a comment after a news article as proof-positive of his condition. The commenter claims to be a member of the family and to be speaking for the family. There is no proof of this. Anyone can claim anything in a combox. To my knowledge, none of these family members intervened in the courts. This commenter also does not claim to be Chris' father who is reported to have disagreed with his continued treatment. There are two problems with looking to this comment as proof: 1) as noted, it has not been verified or authenticated; and 2) it is irrelevant what anyone wanted, including various alleged family members, because Chris spoke for himself. We have video evidence of this which TADA proponents ignore. (Moreover, his mother was closest to him, was by his side night and day, and would best know what he wanted.)

And what about when there is a dispute among the family and there are no documents providing for the patient's wishes? 

We err, if we err at all, on the side of life. Always.

In addition, TADA proponents say that Mr. Dunn had "high quality health care" and that the hospital did everything it could to treat him the entire time he was there. This is absurd given that a proper diagnosis was never made, as discussed above, and the fact that the hospital would have withdrawn his life-sustaining care (his ventilator) if a court challenge had not been lodged. 

The Legal Challenge: The Reason Life-Sustaining Care Was Continued
Contrary to what pro-TADA people say, the hospital only agreed to continue providing care after legal proceedings were started and the media got involved. This was not entirely voluntary on the hospital's part. Had the hospital not been challenged, Mr. Dunn's life-sustaining care would have been removed a month ago. The hospital had to be sued to keep them from taking Mr. Dunn off of life-sustaining care. The hospital agreed to a TRO (temporary restraining order) which says that Mr. Dunn had a likelihood of success on the merits of his case in challenging the hospital in that it, the hospital, violated the statute because the hospital did not follow proper procedures for finding a transfer hospital. 

Also, contrary to what is being disseminated by TADA proponents, the hospital did in fact seek custodial guardianship of Mr. Dunn. I covered this in the first blog post.

Note also, as I have written in the past, that the only legal proceedings one is entitled to under the Act is to beg for more time from a court to try to find another facility. In Mr. Dunn's case, a challenge was also made to the constitutionality of TADA itself, something that has never been done before. TADA was challenged under the 14th Amendment of the U.S. Constitution, as being in violation of the due course of law provision of the Texas Constitution, and a Section 1983 (federal statute) claim under color of state law. 

As Texas Right to Life noted in its announcement of Mr. Dunn's death: "Although the hospital refused to treat Chris’s illness based on a discriminatory 'quality of life' judgement, Evelyn and Chris’s family take solace in the fact that Houston Methodist continued life-sustaining treatment and cared for him in his final days." It should not be a legal fight for basic care to be administered. Decisions to deny treatment should not be based on "quality of life" determinations made by medical professionals who do not even bother to consult with the patient or family.

The Invocation of TADA Is Not Limited to Conscientious Objections & Family Disputes

Again, TADA can be invoked whenever a doctor decides that further care, in his opinion, is futile. It is not only when the family disagrees, as TADA proponents are claiming. It can be invoked for basically any reason at all. We often see it invoked when the medical staff decides that there is no "quality of life" for the patient in their opinion, which is what was the case with Mr. Dunn. This is a nebulous, subjective reason that would differ for each person. But it is not for a doctor, nurse, or medical ethics panel to decide. It is not a moral reason to withdraw ordinary care either, certainly not against someone's will with no due process.

Some TADA proponents claim that it is only invoked when a doctor has an objection based on conscience that continuing care is harming the patient. Meanwhile, they also say it is only invoked when the family is in dispute. It cannot "only" be both of these and neither is true. I have been in attendance at a medical ethics panel hearing where an entire family - unanimously - wanted care to continue and had doctors tell that family no. I have never heard a doctor invoke his conscience. I have never heard of such a case where that was the basis for invoking TADA. In fact, the neurologist in the hearing I attended told the family that "Man was not meant to be sedentary this long; if he were an animal in the wild and had been still this long, he would have been eaten." That is the attitude and philosophy of too many that are in the position of making these life and death decisions. It is unfortunate; perhaps a result of the Hippocratic oath not being taken anymore. 

But even assuming a doctor has a conscientious objection, it would be a simple matter to transfer care to another doctor. Doctors' consciences are differently formed. The most obvious example is that some perform abortions and many do not. We can expect the same difference in opinion on these matters. Why must it be either Dr. A treats or death in the event Dr. A's conscience tells him not to treat? That question has never been answered when I've raised it. It has always been ignored. 

So I contend that conscience is not the reason invoked for TADA, and, in my experience even "a" reason. And it wasn't invoked as a reason for the hospital using TADA in Chris Dunn's case. Had it been, it would be a simple matter to address it. 

Rather, it seems to me that a quieter, slightly subtler path to euthanasia is at issue in the matter of TADA and similar laws worldwide.

Money as Justification for Invoking TADA

Now, some will say that money was a concern and such is a justification for the imposition of TADA, in this case and others. The hospital here used concern over resources as a justification. More troubling, some "pro-lifers" will say that anyone with an illness and no insurance should have the good grace to just die and not be a drain on the system. To that I respond simply: that is not a pro-life position. Money should not come before ethics and morality. That should go without saying. I'm pretty sure the Bible has something to say about that. And, there is a social safety net that can kick in, but it does take time to get approved for benefits. 

Further, efforts were being (or would have been) made to transfer Mr. Dunn from the hospital. Thus, in the long term he would not have been a "drain" on their resources. He needed a procedure to help him be transferable. That was not done allegedly because his father objected. Rather, the hospital's focus was withdrawing his vent and administering medication. Recall what his mother said in a news report "'They want to come in and unplug life support [the term the hospital used] and administer a comfort drug, or comfort care,' she says, 'And he will pass within 3 to 4 minutes.'" This is not addressed by the pro-TADA forces. But this is euthanasia. Administering a drug to purposely hasten death cannot logically be called anything else.

Red Herring, Straw Man, Anyone? Arguments Made to Avoid the Real Issues

Now we get to some of the arguments flying around that seek to place blame for the situation not on TADA, but on those seeking to help victims of the law! Baffling, I know. Somehow, the pro-TADA pro-lifers will always eventually say that Texas Right to Life is: the reason we have TADA,  "supported" it, will not work to reform it, and that Texas Right to Life is otherwise the real issue here, not TADA or its supporters. Somehow this will be used as a justification for what was done to Chris Dunn by those who think the law is just fine. Yes, it's illogical. Yes, it's a sort of red herring so as to avoid the real uncomfortable issues surrounding TADA (such as the denial of due process) and the manner in which TADA came to be. But it is where the arguments eventually all go and then TADA proponents can avoid addressing the real issues. Thus, I must set that straight as well, as I was once also ill-informed about the history of TADA.

One argument I saw just today - as a justification for what happened to Chris Dunn and the short amount of time one has under the statute to find another facility - is that other pro-life organizations have tried to get more time, but Texas Right to Life has refused more time because they want treatment until transfer or nothing at all. Texas Right to Life does want treatment until transfer, as do I. But the rest of this is false. 

I do not and cannot speak for Texas Right to Life, but I feel pretty certain it would accept longer periods of time if such was part of a bill that was truly an incremental improvement. Why do I believe this? There are at least two pieces of such evidence: 1) the actions taken by Texas Right to Life when TADA was first enacted; and 2) that Texas Right to Life has accepted other incremental improvements to TADA. 

We have 10 days to transfer now only because Texas Right to Life fought for that morsel when the first version of this bill was signed into law. That is the most they could get. Read more here. Not only does this indicate that but for the efforts of Texas Right to Life, there would be NO grace period, but that Texas Right to Life would have accepted a longer grace period short of treatment until transfer had that been on the table. It most assuredly was not.

I will also say that while I support Texas Right to Life on TADA, I am critical of George Bush's involvement in this, whereas it is not. In my opinion, he forced this to be done and in so doing, gave the medical establishment the greater bargaining power which was to the detriment of patient's rights and a truly pro-life law. This may have been an incremental improvement over what was going on prior to this law's enactment, but that is only an indictment of the practice in hospitals at that time, not proof that this was a huge pro-life victory. 

You can also see by reading the words of Elizabeth Graham that Texas Right to Life did not fully support TADA. The existing situation was actually worse with no grace period, but the medical establishment would not budge on anything but a nominal grace period. Having seen this law in action, having seen the lobbyists do what they do, and proponents testify as they testify, I wholeheartedly believe this account of what happened during negotiations. But even if Texas Right to Life had supported TADA then (and there is no evidence that it did), how would that in any way diminish the efforts made to help families victimized by TADA now or efforts to repeal or make the law more pro-life? There is a reason that red herrings and straw men arguments are logical fallacies. 

It is also untrue that but for Texas Right to Life the grace period would be longer, or that other organizations are trying to increase it but are stymied by Texas Right to Life. In 2013 when SB 303 was proposed and pushed by a certain pro-life organization, the Texas Catholic Conference of Bishops, and the Texas Medical Association, among others, it would have increased the grace period to 14 days. For a brief period of time, a substitute version increased it to 21 days (still not enough time to get a transfer completed, but better than 10), but the final substitute version took it back to 10 days. The rest of the bill was a due process disaster, as the current law is. It would not have been worth four more days, or even 11 more days, only to have the law be worse in implementation than it is now. No due process gains would have been experienced under that bill. It lost support and died in committee. Those that came to testify against it were legion, vastly outnumbering proponents of the bill, and were not merely lobbyists which was the case for most supporters of the bill. Many had been personally affected by the current law which would have been made worse by that proposal. Many traveled great distances to testify well into the wee hours of the morning. 

The minor reform passed in 2015, HB 3074, avoided addressing many of the big problems with the law and end result has loopholes in it. (You can read my take on HB 3074 which became law here.) It also kept the 10 day grace period, (but at least it does not start until the medical records the patient or his family need to try to transfer are provided). Again, note that the 10 days was not touched, including by the groups proposing the bill. Note also that it was accepted by all groups ultimately, after the language was changed a good bit by the suggestion of Texas Right to Life. This also undermines the allegation that Texas Right to Life is somehow singularly responsible for the 10 day grace period and that but for Texas Right to Life's absurd (according to the pro-TADA crowd) insistence that there be treatment until transfer, Chris Dunn might have had more time. The evidence is no more supportive of this claim than any of the others.

Pro-TADA people will claim that it is almost never invoked. Only rarely, they'll say. This is not true. It is invoked very often. I know of four cases in addition to Mr. Dunn's that are ongoing right now. And this is not an unusual situation. Sometimes TADA is invoked when a patient actually can (and does) recover. Here is just one example. Let me be clear, I post this for the purpose of showing how often TADA is invoked when the circumstances do not warrant it. This patient was declared hopeless, futile, and yet he fully recovered. I post this to emphasize that arrangements were already being made to donate this man's organs even as the family was begging for his life. Sometimes people need more time to heal with proper treatment. Sometimes the body is not going to heal, but the person needs to be treated with the utmost care and undertaking actions to hasten the death against the person's will - removing a vent, withdrawing nutrition and hydration - is not moral, ethical, and should not be legal.

"Natural" Death vs. Hastened Death

Finally, I see some accuse Texas Right to Life, myself, and others, of advocating that treatment go on forever even when the treatment is ineffective. We have been accused of not accepting that people do die and that some treatments do not work. This is another logical fallacy implemented. (Also beware of the appeal to authority fallacy. Several have MDs or PhDs and rely on that more than than facts  or logic.) Call it a straw man argument or a red herring (both definitions fit), but do not call it anything but a fallacy. I am unaware of anyone that has ever advocated that. 

There is a huge difference, however, between someone dying of a terminal disease even as they have artificially administered air, nutrition, and/or hydration as they die versus the patient who dies, not of the underlying illness, but of suffocation, starvation, and/or dehydration, because those treatments have been withdrawn.

The term "natural" death is often used. When I use it, I mean that nothing was done to hasten the person's death and that ordinary, basic care was continued. For example, in the case of one actually diagnosed with terminal cancer, perhaps a feeding tube would be used because they can no longer take in food by mouth, but chemotherapy (extraordinary care) is stopped because it is not helping anymore. The cancer is taking over the person's body and killing them. But they are not dying from starvation or dehydration. 

I think that some, including some proponents of TADA, argue in a way that indicates that they believe that when one is ill, any intervention that allows the person to live a bit longer - including air and artificially administered nutrition and hydration - is unwarranted and is, in terminology I have seen them use repeatedly "prolonging death." Thus, it seems when they say "natural death" they mean a death where both ordinary and extraordinary care is withdrawn (except high doses of pain medication) so as not to "prolong death." (I have written about the problem with this terminology before and how it is definitely the language of euthanasia advocacy.) 

If an otherwise ill person is denied food, water, and/or air, that denial of life's basic necessities will often kill the person faster than the underlying illness. Thus, this was not a natural death, but a hastened death through the denial of ordinary care. Hastening a death through administering medication to do so is also euthanasia and wrong. It is not allowed under Texas law at this time. So-called physician assisted suicide is allowed in some states and in some countries and is being expanded to where it is not so voluntary. Abyssum covers this a great deal. 


We should in no way - especially under the guise of being pro-life - support a law that allows a doctor and hospital to decide to withdraw ordinary or basic care against a patient's or his family's wishes and certainly not without due process of law(!) and certainly not based on someone else's view of what that person's "quality of life" will or will not be.

We can NEVER support any sort of euthanasia (passive, active, doctor-assisted, etc.) in law or theory and call ourselves consistently or 100% pro-life.

I hope this helps you work through not only Mr. Dunn's situation, but the tremendous problems with TADA as well as end-of-life and denial-of-care issues in general. These are not issues that are going away. I have read that efforts are being made to model a federal law after Texas' law. Please work through this in a detailed, independent, and meaningful way. It has far-reaching implications. 

Thanks for reading!

*I am not a theologian, but I have had long conversations with those who are well-versed on these matters and I have done my own reading. It is my understanding that ventilators may be a bit of a gray area in Catholic bioethics. As one studies the issue more, one sees that the use of ventilators indicates that the process of breathing is partially working. Ventilators move air. But the body has to be functioning for respiration (the exchange of oxygen and carbon dioxide) to occur. When nutrition and hydration are artificially administered, the body still must be able to digest and assimilate the nutrients. It seems to me that ventilators might be considered ordinary care as artificially administered nutrition and hydration are. See, e.g., this post. Note also that Stephen Hawking has had breathing support for 30 years, including a ventilator. At one point in the 1980s (!), he was so ill the hospital wanted to turn off his ventilator to hasten his death. It would be hard to argue that he has had anything less than a full life (even if that were an appropriate metric to determine whether care is continued or not). He would not argue otherwise given that he said in that article:  "For the last three years I have been on full-time ventilation but this has not prevented me from leading a full and active life." As I have said, if we are to err at all, we err on the side of life.

**Now, there are some that will talk about when artificially administered nutrition and hydration is actually more harmful than not for the patient. That is a rare occurrence. That was not an issue here. Proponents of TADA will claim this is the only reason why such care would be removed, that it happens more often than we realize, etc. They are wrong. In those rare instances when the body cannot assimilate nutrition and hydration, then, yes, I would not advocate for that. However, when the removal of such life-sustaining measures is just to hasten death for a patient the "experts" have determined is futile or the quality of life is not as the medical professional believes it should be to keep one alive, it is not moral or ethical, and should not be legal.

Wednesday, December 23, 2015

Chris Dunn Will Not See Christmas

I have a very sad, distressing update for you about Chris Dunn

Today a Texas hospital has blood on its hands, as does everyone and every entity - including at least two "pro-life" organizations and the Texas Catholic Conference of Bishops - who have supported the Texas Advance Directives Act and thwarted every effort made to truly reform it. We had a real opportunity to change this law last session based on legislation supported by Texas Right to Life, but those efforts were co-opted by others whose agenda was not to make this law more patient-centered and pro-life, but rather, to carry the water of the Texas Medical Association and Texas Hospital Association, neither of which is pro-life. 

Texas Right to Life posted this tribute a little over an hour ago:

Make no mistake about it: This man died because a hospital refused to treat him properly. This man died because Texas law allows a hospital to do that without any due process for that patient or his family. Hospitals and doctors want the power to say whether you live or die. The power, but not the responsibility. There is no responsibly when they answer to no one. The only responsibility they might feel would be liability, but they are immune under this law. Texas law has allowed this since 1999. This is not Obamacare. Yet. This law must be changed. Hundreds have been affected by this law. It must stop.

It should also interest you to know that Texas Right to Life staff was threatened with arrest by Methodist Hospital when they attempted to go in and comfort the grieving family who had called them to come. The depths to which this hospital will stoop is literally infinite.

Texas Right to Life, Trey Trainor, Joe Nixon, and many others tried hard to help this man. Every Texan owes them all a debt of gratitude. 

They were working for Chris and all of us. But the system is stacked against them. God help you if you land in a Texas hospital.

Please keep Chris and his family in your prayers. Pray for those that worked so hard on his behalf, and on behalf of all of us. Also, please pray that this law is changed in the next session. I know I will do everything I can in my own small way toward that end. I pray that you will, too. I will let you know when those opportunities arise. Right now, the efforts are all about getting the right people in office, which I mentioned in my last post (see especially the post script).

In the coming days, and already in some news reports, you are going to hear people say: "Well, this is proof he was going to die anyway" or "But he had no insurance" or "Well, he'd not have had any 'quality of life'" or "Well, one family member wanted care to be withheld" or other such nonsense. As to the first, this is not proof of that. It is proof only that medical neglect can certainly kill people. (You can read more about what Methodist Hospital could have done to allow him to be transferred to another facility not set on killing him here and what would happen if that procedure was denied.) He may have had a condition that was treatable. We will never know because we do not even know what his condition was. As to the second, do you want to live in a society that kills for the sake of financial expediency? This is health care rationing coupled with mandatory euthanasia. That is a dangerous path to continue down. It is already being done, but we cannot have this as our medical or social ethic. Third, no institution or doctor or organization should make health care decisions based on what they think your quality of life is or will be or will not be. That is a nebulous term that varies from person to person and opens wide the gate to withholding health care based on discriminatory, meritless reasons. Fourth, family members sometimes disagree. But we err, if at all, on the side of life. Do not forget that Chris himself was able to ask to be cared for when he was not sedated. There is video of this. He asked for his life. That his father disagreed is, frankly, irrelevant and provided convenient additional cover to the hospital which was already using TADA as a legal justification for its acts and omissions.

Be very careful if you find yourself going down any of these paths. Be wary of those who feign compassion, but are really supporting euthanasia (though they almost always deny it). And, while we're on the subject, be wary of those who claim to be pro-life and/or are in a pro-life organization but support any version of what this hospital did or what this law allows. They are wolves in sheep's clothing. 

"God can write straight with crooked lines," I have always heard. I am a Catholic. I believe in God and that He has a purpose for all of us. I refuse to believe that Chris' death - as tragic as it is - is in vain. That poor man suffered at the hands of this hospital and this law. He and his family brought awareness to a law that many are totally unaware of. I wish his outcome could have been different. The hospital, using this law, made sure it would not be. But the battle for the right to life in these cases is not over. Not by a long shot.

Thanks for reading!

Monday, December 7, 2015

Texas' Advance Directives Act Is Being Used to Kill a Patient

This blog as been almost entirely devoted to the Texas Advance Directives Act ("TADA") because it is something that I think is so incredibly vital and affects everyone. It is also something that few know about, much less understand. End-of-life or denial-of-care issues, while just as much a part of the pro-life movement as abortion, are the stepchildren of that movement (stepchildren locked in the basement, that is). I think this is a crime. It is short-sighted and there are precedents being set, and laws that are in place now, that are killing people. This is not hyperbole, but the cold hard facts.

From the very beginning, I have written about TADA, the efforts made to reform it, and the work that remains to be done. It is clear that although there were very limited reforms made in the last session (that some overstate and claim fixed this law entirely, making it a model for other states to emulate), this is still a very dangerous law in need of tremendous re-writing if not outright repeal. There is much left to be done and tremendous effort will have to be undertaken to address this draconian law in meaningful and substantive ways.

Of course, there are many good, pro-life doctors and medical staff. However, there are some that have what can only be described as a philosophy in favor of euthanasia. Related to this is a philosophy that medical professionals should be able to make decisions about whether you receive care at all, that is, whether you live or die, regardless of what you want. I wrote about that philosophy when PolitiFact wrote a hit piece on the subject of SB 303. Using the medical profession's own words, it was easy to expose this not-too-subtle support for euthanasia of those who the professionals declare are unworthy of life. Even if they are few, it only takes a few doctors and staffers who think like this and a medical ethics committee that will back them, to take lives under color of law in Texas. This must be stopped.

Let me give you a very clear and current - as in happening right this moment here in Texas - example of all that is wrong with this law and this mentality that so often exists within hospitals and the medical profession. 

Meet Chris Dunn, a man who has served Texas as an EMT in the Harris County Sheriff's Office and a Homeland Security employee. Methodist Hospital and Dr. Marc L. Bloom have decided that he has no right to life and have been seeking to withdraw care from him (his ventilator) which would kill him and/or administer medication to him that will kill him within 3-4 minutes. Methodist Hospital has decided to do this against his will and against the will of the family member who is making his medical decisions for him when he is unable to, his mother. This hospital - like every other hospital in Texas - is able to do this under TADA's Section 166.046. 

Texas Right to Life has been on the forefront of this battle against TADA for more than a decade. No other organization is more directly involved in trying to right the wrong that is TADA than Texas Right to Life. It is the only pro-life organization that helps patients and their families navigate this process. It is the only pro-life organization that helps find facilities willing to take these patients when the facility they are in decides their lives are worthless and attempts to withdraw care so as to kill them. 

Hear from Texas Right to Life and the attorneys for Chris Dunn, Trey Trainor and Joe Nixon, two most excellent attorneys, about this case and Texas law. In just a few minutes, you will know all you need to know about your risk in Texas hospitals and Mr. Dunn's case:

People, this is NOT Obamacare. It has nothing to do with Obamacare, although that this would be an excellent roadmap for how to implement death panels in Obamacare. It surprises almost everyone to learn that this has been the law in Texas since 1999. Under this draconian Texas law there is no real due process for patients when a doctor and hospital decide to withdraw care. There is no appeal of the merits of a case to court. The most any patient can attempt to do is get more time to find another facility to take the (families are given only 10 days' notice), but that is not always possible for a myriad of reasons.

The Texas Medical Association has a strong lobbying arm as does the Texas Hospital Association and both fight every attempt at reforming TADA. I have covered this before. Tragically, certain pro-life groups and the Texas Catholic Conference of Bishops (with the lone exception of Bishop Emeritus Gracida) have also opposed meaningful, substantive, and more comprehensive reform that would make this law more patient-centered and more pro-life. You can read just about everything I've written about this, as well as Bishop Gracida's blog, and learn more about what true reforms have been offered, what faux-reforms have been offered, and what organizations supported which.

In the case of Chris Dunn, not only is the hospital fighting to kill him through denying care and/or administering medication to hasten his death, it is also fighting to take over legal control of him by fighting to obtain custodial guardianship over him. Let me restate that: the hospital wants custodial guardianship over the man they are seeking to kill through denial of care which is what they have done so far by refusing to find out what is causing his illness, removing his ventilator, and/or outright administering medication to him that will kill him almost instantly. This hospital seeks to control his fate through a legal guardianship despite the fact that Mr. Dunn's MOTHER is the one who can do this task and has been. Why on earth would a hospital fight for this right? It is not as if this man has no family to do this job. 

In an article about this case, Mr. Dunn's attorney clarified life-support versus life-sustaining treatment: 

Trainor insisted on a distinction between life support, which is a life-and-death situation, and life-sustaining treatment. Chris is "not being fully kept alive by artificial means" and therefore technically not on life support. "They cannot tell you what is conclusively wrong with Mr. Dunn. ... [T]hey say he shows signs of having pancreatic cancer," Trainor said. "But they have not done a biopsy." 
Trainor also noted that if Chris has pancreatic cancer, such a condition is treatable. In cases where pancreatic cancer is fatal, the prognosis is a very short time. "But Chris has been in the hospital for nearly eight weeks now," he noted. So, one might ask, why is the hospital opting to withdraw treatment instead of trying to determine Chris' condition and treat it? Why is the court even considering the possibility that the hospital should be gaurdian?

You can read more here about the procedures the hospital will and will not do and how often the reasons they give for denying needed care are illogical and inconsistent. But let's be clear about this: Mr. Dunn is not on life support. He needs life-sustaining treatment which the hospital not only does not want to give, but wants to prevent him from getting elsewhere either by not giving him enough time to transfer to another facility or by taking over his medical decision making so as to kill him. Moreover, what the hospital claims is wrong with him, but will not confirm, may very well be treatable but is being allowed to get worse by the hospital's delay while it tries to kill him. (Incidentally, the hospital is unlikely to face any medical malpractice claim for this blatant negligence because of the protections in TADA.) This is evil. This is not pro-life. This must stop.

Make no mistake about it - the hospital is seeking to euthanize this man. 

His mother explains what the hospital told her: "'They want to come in and unplug life support [the term the hospital is using] and administer a comfort drug, or comfort care,' she says, 'And he will pass within 3 to 4 minutes.'" The hospital wants to administer a drug that will kill him in 3-4 minutes. That is euthanasia which is supposed to still be illegal in Texas. This is such a dangerous precedent but what we have all known goes on pursuant to TADA. This is why we fight it so hard against it.

Note please: When a medical professional says "comfort care" understand that increasingly is code for what the hospital here seeks to do - administer medication so as to hasten death. It is not merely pain medication given at a dose to alleviate pain. And it is not merely an unfortunate secondary effect of it. Increasingly, pain medication is given at a dose so as to hasten death as its primary purpose. We have seen this time and again. The two uses of pain medication are not the same in intention or morality.

Understand also that this is not a comatose man (even if the comatose state made euthanasia against your will morally or legally appropriate - it is not), this is a man on the video above who wants to live. He has clearly expressed that. HE IS, WITH FOLDED HANDS, PRAYING FOR THAT. The hospital does not care. The doctor does not care. Texas law does not care. 

Trey Trainor and Joe Nixon are fighting a valiant, necessary fight - not just for Mr. Dunn but for every Texan - in challenging the constitutionality of this law. 

But you can help, too. 

First, pray, pray, pray. 

Pray for a change of heart among those who make these decisions. Pray for a change in Texas law next session. Pray that those who support TADA - the TMA, THA, some pro-life groups, and the Texas Catholic Conference of Bishops - have a change of heart and mind about the matter and work with us to change this law if it is not declared unconstitutional before the 2017 legislative session. Pray for good legislators to be elected who will see this law for what it is, introduce real reform legislation, then pass it.

Second, while you are doing all this praying, you can spread the word about this law, about this case, and make this call:

Third, you can also tell Houston Methodist to keep Chris Dunn alive by commenting on their Facebook page and/or emailing their president, Dr. Marc L. Boom, at

As to the comments in the picture above, yes, we have been told we were alarmist by anti-lifers. We have tragically been told (by pro-lifers and pro-life orgs.) that this issue takes up too much time and energy from the "real" pro-life issues. We have been told that when this as made an issue in the primaries in 2014 that it was not that big of a deal and we had lost our way. 

We have also been told by the TMA and pro-life groups that support TADA that this law is rarely ever used and only in cases where continuing care would harm the patient. That is patently and demonstrably false. Mr. Dunn's case is just the latest and has received more publicity, but you would be shocked to learn how often this happens. There is nothing to stop a hospital from doing this. There are NO LEGAL RAMIFICATIONS. Hospitals and doctors operating under this statute are totally and completely IMMUNE from any liability whatsoever. 

As I have written before, and as I said in my testimony opposing the first version of HB 3074, the family and I were told by a doctor during one of these medical ethics committee hearings seeking to kill a patient that, “In nature, when people are immobile this long, they get eaten.” That is the mentality of so many doctors and hospitalists who use TADA. To doctors who say things like this, humans are merely animals that we euthanize like those at the pound who are not adopted. Humans have no other value, no souls, no worth if they are unable to work a 60 hour week with no disabilities, no difficulties.  If these human specimens are not perfect in every way, they are at risk. We have to combat this on every front we possible can.

I hope everyone can see now that the naysayers of our efforts to reform TADA as well as the supporters of it were and are wrong in everything they have said. This is a big deal. It is used often. It is not just used on people who are already in the throes of death. And, this is a very worthy and necessary part of the pro-life movement. (But only if those in the pro-life movement that seek to work on this will actually help make the law more patient-centered and pro-life. For those that have done more than their share to harm reform efforts and allied with those that are the source of the problem, please, stay out.)

What a shameful legacy TADA is for Texas! I love Texas and I say we can do better. Rather than having the worst such law on the books in the nation, we should be leading the way in patient protection.

You are only one hospital stay away from being the next victim of TADA and certain medical professionals who think they have the right to euthanize you. Texas law may not allow euthanasia directly, but the way that TADA is used very much results in the same outcome.

In the meantime, we must do everything we can to save Mr. Dunn and #HelpChrisSeeChristmas

You can keep up with his status by "liking" Texas Right to Life's Facebook page and also by liking this page dedicated to Chris' fight.

Thanks for reading!

P.S. There is one more thing you can do. Fourth, you can oppose any politician who has worked against efforts to make true reforms to TADA. I know of one district in particular where there is a very good chance for real change which will help all of Texas, that is, the district currently represented by Byron Cook. Cook sat on the committee last session that took up TADA reform. His attitude, demeanor, and words - before, during, and after the hearing - made it clear that he was and is no friend of those of us that work to reform TADA in a meaningful way to save lives. Consider his alliances with the organizations who also opposed true reform of TADA and that completes the picture. Fortunately, he is being opposed in the primary by Thomas McNutt who has received Texas Right to Life PAC's endorsement. You can help even if you do not reside in that district and cannot vote for him by spreading the word to those who can vote, volunteering in his campaign, giving financially, etc. 

Friday, June 12, 2015

An 84th Legislative Session Retrospective: "Robust Primaries in 2016; New Leadership in 2017"

I think it is pretty safe to say that this 84th Legislative Session was disappointing where pro-life measures are concerned. Some may be more diplomatic about it than that, but I don't have to be. It was not terribly successful, but not for lack of effort by pro-life stalwarts. Even those successes that were achieved took a great deal more effort than they should have to ensure even incremental improvement.

I am most concerned with end-of-life/denial-of-care issues on the pro-life spectrum these days. so let's start there. (Abortion is important, too, of course, but I feel most called these days to work (to the extent I can) at the other end of the spectrum.) HB 3074 was initially a deeply flawed bill that could not be supported as it was. Through a tremendous amount of work, particularly and especially on the part of Texas Right to Life and certain truly good pro-life legislators (listed here), it was substantively amended and could be supported as an incremental improvement. It is, however, just a beginning to the reforms necessary to this draconian law we know was TADA (the Texas Advance Directives Act). HB 3074 was signed into law today by Governor Abbott.

Another success was judicial bypass reform:
HB 3994 by Representative Geanie Morrison (R-Victoria) and Senator Charles Perry (R-Lubbock) substantially reformed the judicial process by which a pregnant teen may petition a judge for permission to undergo an abortion without parental knowledge or consent. Until now, pregnant teens have been ushered through the court system by attorneys often affiliated with the abortion industry; HB 3994 closes those loopholes and applies additional protections for minors – especially those suffering from sexual and physical abuse. (The full list of reforms included in HB 3994 can be found at
And, let me say, it was really interesting to watch the House floor debate on HB 3994 and then the Senate floor debate on it. Sen. Perry was a rock star. As an attorney, I was most impressed by how he handled himself, the questions posed to him, and his calm, informed demeanor throughout the lengthy debate. If you can, I encourage you to watch these debates and committee hearings online. (In the blue box to the right, you will see links for video broadcasts for each chamber.) I also encourage you - if you have a strong stomach - to venture onto Twitter during these events. It is good to see what both sides are saying about it. You learn a great deal about the mindset of both pro-abortion activists and politicians. 

There were other excellent, solid bills that were submitted that would have provided more patient-centered reform to TADA, but politics interfered. Texas Right to Life has the most comprehensive pro-life legislative retrospective and within it is a bit of the backstory as to why more pro-life legislation was not passed. The bottom line is that some in the House leadership (the same leadership problems do not exist in the Senate) proved to be a tremendous obstacle to pro-life legislation. I emphasize some in the leadership because there are a number of excellent legislators in the House who worked tirelessly to toward these pro-life victories. They worked in ways seen and unseen. They deserve our thanks, support, and prayers. Remember, there are internal party politics that are messy. When principle is put above that, these House members really need our support.

As Texas Right to Life wrote:
While the Pro-Life movement celebrates our few hard-fought victories, the wins are soured by the vicious games and attacks orchestrated by some in House leadership to kill and stifle many other Pro-Life measures, which would have easily passed on the House floor and in the Senate –if they were only allowed a vote. Republicans hold almost two-thirds majorities in both chambers. Multiple, substantial Pro-Life bills should have sailed through the House and on to Governor Abbott for a signature. 
The 84th Session of the Texas Legislature ultimately proved that the few Republicans who control the Texas House of Representatives view Pro-Life issues as optional political props. Protecting life is a moral priority for most Texans, especially the primary voters who sent these lukewarm men and women to Austin to enact policies that reflect their values. 
Very, very true.  (Emphasis mine.)

One of the most indefensible and spectacular failures in my book was the House leadership's refusal to take up SB 575 which would have removed insurance coverage for abortions. In other words, you and I would not have our premiums go to subsidize abortions (except in the case of medical emergency) either through private insurance or the insurance exchanges resulting from Obamacare. A woman who wanted abortion coverage could buy her own supplemental policy. As Texas Right to Life explains:
Another dramatic failure of House leadership during the 84th Session is the killing of Senate Bill 575 (SB 575). Lieutenant Governor Dan Patrick and Senator Larry Taylor (R-Friendswood) passed this strong bill to remove all insurance coverage for abortion, but Chairman Byron Cook refused to act on SB 575, stalling the bill for two weeks in his committee. Cook then demanded a weakening provision before moving the bill out of his House Committee on State Affairs.  Cook and the committee did finally move the weaker version of the bill on the very last day possible for the vote, setting SB 575 up for an easy kill by Democrats and moderate Republicans. While Chairman Cook blamed the Democrats for SB 575’s death, he is fully responsible. The blood of the innocents now stains his hands.
(Emphasis mine.)

SB 575 was about as basic a pro-life bill as the Choose Life license plate bill that took a ridiculously long time to be passed into law. Why should you and I be forced to further subsidize abortion through our (increasing) insurance premiums? (We already do so through our taxes.) Apparently, Chairman Cook thinks it is fine. He told the Texas Tribune that:
"And women sent a clear message that they weren’t comfortable with this legislation, probably weren’t comfortable with us men telling them what to do. And I respect that.”
I am a woman. I do not want my insurance premiums (or taxes) going to subsidize abortion, thank you. I would also like life at all stages of development and my conscience to be respected. Chairman Cook has, through words and deeds, forced his anti-life ethic on me. He has told me what I have to do and allowed abortions to continue in a manner they should not. (FYI - he is being challenged in the 2016 primaries - more on that in a moment.)

There were modest gains, but they were just that - modest. Moreover, the battles required to achieve these modest gains are indefensible. What can be done? Plenty.

Robust primaries in 2016;
New leadership in 2017!

Let this be our battle cry for the sake of the unborn, the elderly, the ill, and for truly conservative values in Texas! 

There are too many who, by claiming a particular party affiliation, imply (and sometimes flat-out claim) certain values and principles which are completely absent after they are elected. This cannot continue. There has to be principle over party and party politics. There has to be a willingness among the electorate to oust even an entrenched incumbent when that person fails to deliver. In many cases with some of the House leadership, we have many sessions of evidence that shows that that person is not a conservative and is unworthy of being awarded the privilege (not the right) of re-election. 

Let me be perfectly clear: The electorate must act. We must encourage individuals to run against the powerful, incumbent, entrenched, establishment - whatever label you want to use - politicians who have not fulfilled their campaign promises, who lost their way, who sold out, who are not committed to saving lives. Term limits are not the answer. An informed, active, involved electorate and robust primaries are the answer.

We saw some stunning changes to the Senate which made a difference this session....and it all began in the 2014 primaries. And, life issues mattered

The same needs to happen in the House. Straus was challenged this year in his bid to be re-elected Speaker. NINETEEN brave, committed souls opposed him. I have come to refer to them as "The Principled 19." It was not enough, but it was a start. We knew that once re-elected, Straus and his lieutenants, such as Cook, would harm pro-life legislation. And they did. The evidence is abundant. 

Let me also be clear that when I say "leadership" I am not only talking about the Speaker. Committee chairman positions are very powerful. The members of the Calendars Committee are very powerful.

For those who would point to successes such as HB 2 (recently upheld in the Fifth Circuit), as some evidence that Straus is pro-life or that pro-life gains were made under his leadership, I remind you that it took TWO special sessions to get it passed. TWO. Special sessions can only be called by the governor who is the sole person who determines what issues will be taken up during that session. HB 2 should have passed in the regular session.

Straus, those who identify closely with him, and any who serve to undermine, if not outright oppose, substantive pro-life legislation, must be removed from office and/or their positions of leadership. 

One more word on this: Be very careful which groups you look to for endorsements in the coming primaries. Many groups will give their endorsements. At least two other pro-life organizations in the state endorsed or were otherwise apologists for Cook, Straus, and the rest of that part of the House leadership responsible for the paltry pro-life gains we had with a nearly two-thirds Republican majority in both chambers. 

Let us be grateful for what was achieved, but let us also call it as it is. So, say it with me:

Robust primaries in 2016;
New leadership in 2017!

Thanks for reading!