HOUSTON – A woman recovering from a stroke at a local hospital has less than one week to be transferred to a new facility or faces death.
Carolyn Jones, 61, is conscious, although intubation prevents her from communicating. Jones is on dialysis and uses a ventilator to help her breathe.
Her husband, Donald, serves as her primary caregiver, tending to her bedside at Memorial Hermann Southwest Hospital, where she’s been a patient since November 2018.
Her struggles, however, stretch one year prior: Jones has lived in health care facilities since she suffered a stroke in 2017. While her family said she has shown signs of improvement, Jones’ life is scheduled to end May 13.
It’s a decision made by her doctors, as well as the hospital’s medical ethics committee – and it’s legal under Texas law.
At issue is a portion of the Texas Advance Directives Act, which outlines certain provisions allowing a health care facility to discontinue “life-sustaining treatment,” thus ending a patient’s life. The statute calls for a 10-day written notice of the decision if doctors providing life-sustaining treatment deem it futile – and upon review by the medical ethics committee, the opinion is upheld.
The law is often referred to as the 10-Day Rule. Under the law, dialysis, a form of kidney treatment, is considered “life-sustaining treatment.”
Donald Jones is fighting the decision, along with help from Texas Right to Life.
Donald Jones "mentioned he felt things were tightening around him once the 10-day countdown began,” said Emily Cook, an attorney representing the Joneses, through Texas Right to Life.
Carolyn Jones received her 10-day notice Thursday. The 10-day window includes weekends, making the rush to save Jones shorter, Cook said.
Cook told KPRC2 she is hopeful Jones’ life can be saved, thanks, in part, to mandates included in the law.
If a hospital’s medical ethics committee decides the continuation of “life-sustaining treatment” is futile, a patient has to be given the chance to seek treatment elsewhere -- within those 10 days. Moreover, the committee’s report must include a list of options for the patient, including other facilities that can treat the patient instead. A new facility has been secured for Carolyn Jones; however, her legal team is in the process of securing funds to cover living expenses. In Jones’ case, that requires approval by Medicaid. Cook said a separate attorney is handling that aspect, but they fear resolving the Medicaid quagmire may require more time than the 10 days allow. In this case, a court could approve an extension.
"Such a short time frame but there is a provision that allows for a motion to extend time and that's something Mr. Jones is considering," Cook said.
The Advance Directives Act became law in 1999, under then-Gov. George W. Bush. Critics allege it empowers hospitals to assemble “death panels,” deciding the fate of a patient’s life, without the need for approval from a court of law.
There have been several reform efforts since its passage, including a current bill that would repeal the law.
KPRC2 reached out to Memorial Hermann Hospital for comment regarding Carolyn Jones. The hospital issued a statement, included below in full.
“Due to patient privacy laws, and out of respect for our patients and their families, we are unable to comment on specific patient cases. As a health system, we are committed to delivering patient-centered care and respecting the rights of our patients and their loved ones.
"We understand how painful it can be when difficult medical decisions must be made and our hearts go out to families in these circumstances. End-of-life decisions are made by physicians after careful and thorough consultation with patients, their families, the healthcare team, and a medical ethics committee. The decision-making process is outlined in Texas law and can take many months. The law provides a tool to balance the tough choice between carrying out patients’ and families' wishes and the ethical duty not to increase or prolong patients’ suffering.
"We are committed to providing compassionate care that follows the standards of evidence-based medicine and best practices. We understand that these decisions are never easy, but we follow Texas law, as written, and our ultimate goal is always to make medical decisions that promote comfort, compassion and dignity for our patients.”