"A medical intervention that could further prolong life can also, directly or indirectly, inflict significant suffering without proportionate benefit to the patient. A physician might conclude that making further interventions on a patient near the end of life, in a medical situation with no meaningful prospect for cure or recovery, would inflict only harm on the patient-violating one of the oldest and most deeply held principles of medical ethics. Medical providers in that position face not only an ethical dilemma but also feel moral distress over being the instrument used to inflict that non-beneficial suffering on a patient."
The amici curiae brief called TADA a "carefully balanced statute" that should be upheld by the appellate court.
It added that striking down TADA would constitute judicial activism, stating that "disagreements about a policy decision made by the Legislature, however deeply felt, do not state a constitutional claim."
In explaining its interest in the case, the Texas bishops' conference said it rejects "medical decision-making based on flawed "quality-of-life" arguments which are often used to falsely justify euthanasia. "The bishops have consistently supported the truth that decisions regarding treatment should be made through this lens of the inherent sanctity of all human life while recognizing that underlying medical conditions can have an impact on the effectiveness or appropriateness of certain medical interventions."
"They believe that treatment decisions should be based on whether or not the expected benefit of the treatment outweighs the burden to the patient. Some may claim that this is a quality of life decision, or one that allows discrimination, but they are wrong-it is an assessment of the quality or effectiveness of the treatment or intervention, not the quality of life for the patient."
The Texas bishops' conference said it supports "continued legislative improvements" to TADA, "particularly those that safeguard against any discrimination in providing necessary and effective life-sustaining treatment," but it "generally supports" the law's framework "as a balanced dispute resolution process that respects both patient dignity and healthcare provider conscience."
Trinity Lewis is being supported by Texas Right to Life, which has said that "the 10-Day Rule has robbed countless patients of their Right to Life and right to due process."
Texas Home School Coalition is also supporting Trinity, in light of its concern for parental rights. In an amicus curiae brief of Jan. 27, it argued that "in permitting an ethics committee" to substitute their decisions regarding Tinslee's best interest for Trinity's decisions," TADA "violates the substantive due process rights of [Trinity] and potentially all parents seeking medical care for their children."
The home school group charged that "the quality of one's life is so personal that the decision must belong to the one living it or the person designated to make that decision. The doctors believe that pain and suffering without a medical probability of recovery is immoral. Mother believes that God still has a plan. The state cannot determine whose beliefs are superior."
Its amicus brief asked, "How can the state possibly have a compelling state interest in ending the life of a child for no other reason than the doctor no longer wishes to provide care for her?" It also characterized TADA as having "no limitations on the reason for the doctor refusing to honor the patient's directive," saying it "is so vague that a doctor could decide not to continue providing services for any reasons, such as the color of the patient's skin or the religious beliefs of the patient."
The state of Texas also filed an amicus curiae brief in the case Jan. 17 asking that the court declare TADA unconstitutional, arguing the statute "allows the government to deny an individual his or her life, and it does so without constitutionally sufficient process."
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It characterized the statute's dispute resolution process as denying patients and their proxies "sufficient notice and opportunity to be heard," as well as "a neutral arbiter to decide their fate."
TADA includes a '10-day rule' that says when the attending physician has decided and an ethics or medical committee has affirmed that a life-sustaining treatment is medically inappropriate, but the patient or their responsible continues to request the treatment, the attending physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the decision is provided to the patient or their responsible.
The rule says the physician is to make a reasonable effort to transfer the patient in such a case to a physician who is willing to comply with the directive.
TADA was adopted in 1999, without a dissenting vote. It passed the Senate unanimously, and the House on a voice vote. It was amended in 2003 and 2015. The 2015 amendment, which removed artificial nutrition and hydration from its scope, was adopted unanimously in the House, and by a voice vote in the Senate.
Joe Nixon, who is representing the Lewises, was a member of the Texas House of Representatives from 1995 to 2007.
Tinslee Lewis has Ebstein's anomaly, a congenital heart defect; chronic lung disease; and severe chronic high blood pressure, according to the AP. She has been on a ventilator since July, and also requires cardiac support, painkillers, sedation, and medical paralysis. She currently has severe sepsis.