Right to Life backed law that allows hospital to kill spouse

HoustonChronicle.com

Right to Life backed law that irks wife
By RICK CASEY
Copyright 2005 Houston Chronicle

Jannette Nikolouzos is angry with the Texas law that allows St. Luke's Hospital to unhook her husband from life support tomorrow.

"I'm so ashamed of my state that it executes civilians without criminal history," she told reporter Todd Ackerman.

She may be surprised to learn that National Right to Life, the organization that is helping to lead the fight to keep a Florida hospital from removing life support for Terri Schiavo, helped write the Texas law.

Spiro Nikolouzos had been unable to speak for some time, and was fed through a stomach tube by his wife at home. But she said he was able to recognize family members and show emotion. A month ago she rushed him to the hospital, where it was determined he had bleeding related to a shunt in his brain. He has been on a ventilator since.

Doctors apparently determined further care was futile. Under the law, the hospital's ethics committee met last week to consider the case, with Mrs. Nikolouzos able to participate. The committee, over her objection, agreed with the doctors.

She then had 10 days to find another facility to take her husband, while the hospital made a good-faith effort to do the same. When she was unable to find such a facility, she went to court.

'20 to 25' meetings

Judge Tony Lindsay expressed "most sincere sadness and apologies," but said the law required Nikolouzos show a reasonable expectation of finding an alternative facility before Lindsay could order the hospital to continue treatment it did not feel was advisable.

It's the same law under which another judge denied Wanda Hudson's request to force Texas Children's Hospital to maintain Sun Hudson on life support.

The law was passed in 1999 and amended two years ago. Acting as a negotiator for Houston-based Texas Right to Life, Burke Balch flew in from Washington "20 to 25 times" to sit at a table with represent-
atives of the Texas Hospital Association and other parties to negotiate the law and its amendment.

Balch is director of National Right to Life's Robert Powell Center for Medical Ethics.

Right to Life was at the table partly because then-Gov. George W. Bush had vetoed a similar bill two years earlier at the request of some members of the religious right, according to its sponsor, then-Sen. Mike Moncrief, now mayor of Fort Worth.

Making compromises

After new negotiations, the bill went before a Senate committee without opposition. Balch testified in favor, as did representatives of the Baylor Health Care System and the Texas Conference of Catholic Health Facilities.

Balch said both the right to seek an alternative facility and the 10-day period to do so were negotiated compromises.

"When you're dealing with legislation, you make compromises," he said.

Two years later, his group won an Internet registry of doctors and institutions willing to consider accepting patients under the bill in order to make it easier to find them.

"Before this bill there was no legal requirement to provide treatment in these circumstances at all, so we found it an advance to provide this opportunity of a transfer," Balch said.

Before the bill, however, judges had little guidance from the law when families went to court to challenge the decision of hospitals, or of some family members pitted against others. Boston College ethics professor John Paris, a leading medical ethicist, said judges were extremely reluctant to allow life support to be removed.

He told the story of presenting a national seminar on the subject, with former Texas Supreme Court Justice C.L. Ray in attendance. He said he asked Ray how he would rule if, as a judge, a young lawyer asked for 30 days to research the legal questions in requiring a hospital to keep a child on life support and wanted him to order the hospital to do so while he did the research.

"I'd tell him, 'Son, take 60 days,' " Paris quoted Ray as saying. When Paris said he knew why, Ray continued, "You're damn right. I'm hoping the kid will die on his own during that time so I won't have to make the decision."

Now in Texas, judges don't have to make the decision as to who is right. They just have to decide whether the hospital followed the law and whether there is a reasonable prospect of finding another institution to take the patient.

And the law they follow was made in a manner that appears to be growing old-fashioned: by consensus.


This article was originally published on March 10, 2005