Impasse puts do-not-resuscitate reform, an Abbott priority, at risk


Legislation would require specific patient approval for do-not-resuscitate orders in hospitals.

Late disagreements put reforms in jeopardy with special session half over.

Efforts to require specific patient approval for hospital do-not-resuscitate orders foundered Tuesday, adding another of Gov. Greg Abbott’s priorities to the special session’s endangered list.

The chairman of the House State Affairs Committee abruptly canceled Tuesday’s public hearing on a do-not-resuscitate reform bill, citing a lack of consensus on key aspects of House Bill 12 — disagreements that became evident during a long and contentious closed-door meeting with interested parties Monday.

“Right now, this bill is in a big mess,” said the committee chairman, Rep. Byron Cook, R-Corsicana. “Can they pull it together? They certainly can, but I’ll be blunt, too. The meeting yesterday was a good indication that this bill has major policy issues that have to be addressed because the issue itself is too important.”

With several proposed versions of the bill floating around, it would have done little good to take public comment, he said.

“Until or unless the major groups can come together, we shouldn’t be passing something that is detrimental to the citizens of this state, which is where we appear to be headed,” Cook said.

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With the 30-day session half over, the delay puts HB 12 — and an identical bill passed by the Senate — in jeopardy. But HB 12’s author, Rep. Greg Bonnen, a Friendswood Republican and neurosurgeon, said Tuesday that he was confident the impasse can be overcome.

“It’s a healthy process for people to voice their concerns and point out any potential weaknesses, and shore up those weaknesses, while maintaining the goal of allowing patients and their families to make these decisions” on do-not-resuscitate orders, Bonnen said.

The vast majority of Texas doctors don’t enter do-not-resuscitate orders without consulting patients, but that isn’t always the case, requiring the Legislature to step in, Bonnen said.

The Texas Medical Association and Texas Hospital Association fear the legislation could open doctors and hospitals to lawsuits, particularly if they follow a patient’s stated wishes in chaotic emergency situations when there hasn’t been time to meet the bill’s requirements of getting written patient permission or finding the necessary witnesses.

Catholic hospitals and the Texas Catholic Conference of Bishops have raised concerns that the do-not-resuscitate reform bills do not provide adequate conscience protections for health workers seeking to help patients with end-of-life care.

One proposal would let hospital ethics panels review do-not-resuscitate decisions, but that is opposed by Texas Right to Life, which argues that the review process has been abused in the past.

John Seago, legislative director for Texas Right to Life, said adding review panels would unnecessarily muddy a bill that seeks to correct the narrow problem of “secret DNRs.” He also faulted Cook for taking a position that gives doctors and hospitals “all the power in the negotiations.”

Although the impasse has persisted despite hours of negotiations, Bonnen said he is banking on widespread support for his bill, which has 72 co-authors, to carry the day.

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