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PERSPECTIVE

Resolution of Futility by Due Process: Early Experience with the Texas Advance Directives Act

Robert L. Fine, MD, and Thomas Wm. Mayo, JD

6 May 2003 | Volume 138 Issue 9 | Pages 743-746

Every U.S. state has developed legal rules to address end-of-life decision making. No law to date has effectively dealt with medical futility—an issue that has engendered significant debate in the medical and legal literature, many court cases, and a formal opinion from the American Medical Association's Council on Ethical and Judicial Affairs. In 1999, Texas was the first state to adopt a law regulating end-of-life decisions, providing a legislatively sanctioned, extrajudicial, due process mechanism for resolving medical futility disputes and other end-of-life ethical disagreements. After 2 years of practical experience with this law, data collected at a large tertiary care teaching hospital strongly suggest that the law represents a first step toward practical resolution of this controversial area of modern health care. As such, the law may be of interest to practitioners, patients, and legislators elsewhere.

Author and Article Information

From Baylor Health Care System and Southern Methodist University/Dedman School of Law, Dallas, Texas.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Robert L. Fine, MD, Office of Clinical Ethics, Baylor Health Care System, 3434 Swiss Avenue, Suite 330, Dallas, TX 75204; e-mail, robertf{at}baylorhealth.edu.

Current Author Addresses: Dr. Fine: Office of Clinical Ethics, Baylor Health Care System, 3434 Swiss Avenue, Suite 330, Dallas, TX 75204.

Mr. Mayo: Southern Methodist University/Dedman School of Law, 303 Storey Hall, 3315 Daniel Avenue, Dallas, TX 75275-0116.

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