Month: April 2022

Baby Tinslee Lewis Finally Goes Home after Beating the Texas 10 Day Rule

nancyvalko futility, law, medical ethics, pro-life, Simon's Law, ventilators/life support

In 2019, Baby Tinslee Lewis was born prematurely with a rare heart condition called Ebstein’s anomaly and underdeveloped lungs at Cook Children’s Medical Center in Texas. She needed life support, including a ventilator to help her breathe.

The medical team began talking to her family soon after her birth about possible end-of-life care. Eventually, the medical team met with the hospital’s ethics committee and the committee agreed that it would be inappropriate to continue to treat Tinslee.

As HALO (Healthcare Advocacy and Leadership Organization) explains, this met the Texas 10-day rule for removing Tinslee’s life-sustaining treatment:

TEXAS 10-DAY RULE
  The 10-Day Rule is a part of the Texas Advance Directives Act (§166.046). Basically, this “rule” allows a hospital ethics committee to decide to remove life-sustaining treatment from a patient against the patient’s or family’s wishes. The patient or patient’s decision maker (usually family)    most likely, not professionals and are generally ill-equipped to defend their position. The committee follows with a written notice of its decision that life-sustaining treatment is “inappropriate.” Receipt of this notice marks the start of a ten-day countdown. “The physician and the health care facility,” states the law, “are not obligated to provide life-sustaining treatment after the 10th day after the written decision.” Finding another facility that will honor the patient’s/family’s treatment wishes and transferring the patient—at the expense of the patient and/or family—are monumental tasks which often prove impossible within the ten-day window.

The family was told they had until Nov. 22 to find a new hospital willing to take Baby Tinslee.

However, Tinslee’s family fought for her and they won a last-minute reprieve from a judge to stop the Texas hospital from taking the now 9 month old off life support against their wishes.

The hospital spokesperson stood by the hospital’s decision to end life support, saying:

“In the last several months, it’s become apparent her health will never improve,” and

“Despite our best efforts, her condition is irreversible, meaning it will never be cured or eliminated.” and

“Without life-sustaining treatment, her condition is fatal. But more importantly, her physicians believe she is suffering.

In July 2020, the hospital again wanted to take Tinslee off life support while Tinslee’s mother asked for another specialist to see her. The specialist recommended a tracheostomy to help her.

With help from individuals, lawyers and groups like Texas Right to Life and HALO (Healthcare Advocacy and Leadership Organization), Tinslee’s case was eventually taken all the way up to the Texas Supreme Court. Finally, this court ruled to keep Tinslee on life support. The US Supreme Court upheld the Texas court‘s decision.

Now, Tinslee has so steadily improved (see the pictures) that the hospital released her to go home to her family. She is now on a portable ventilator with a tracheostomy and home health care.

Texas Right to Life states:

“Tinslee’s success story shows that in the absence of an anti-Life countdown, families and hospitals can work together for the benefit of the patient. Tinslee has received excellent care from Cook Children’s Medical Center. It is with their efforts that Tinslee will now transition to home health care. Meanwhile, Texas Right to Life is committed to doubling our efforts in the Capitol and with our full-time patient advocacy team to combat and stop the deadly 10-Day Rule from destroying the lives of more vulnerable patients like Tinslee. “

CONCLUSION  

I have been writing about medical futility problems for decades, especially about Simon’s Law to protect medically vulnerable children and their parents from medical discrimination, including my own daughter.

We need to send a strong message that medical discrimination against medically vulnerable or disabled people of any age based on subjective judgements of “medical futility” and/or predicted “poor quality of life” is wrong.

Homicide is a Leading Cause of Death During Pregnancy-How Can We Help?

nancyvalko abortion, domestic violence

A February 22, 2022 USA Today article “Homicide is a leading cause of death during pregnancy. These women are more likely to be killed.”, cited a 2021 study in Obstetrics and Gynecology that found that homicide exceeded all top cause of maternal death “by more than twofold” in 2018 and 2019.

Surprisingly, it wasn’t until 2003 that the United States required death certificates to include information on whether the person who died was pregnant at the time or had recently given birth. Then the CDC paused on releasing reports on U.S maternal mortality rates “over concerns that the data collect was incomplete and potentially incorrect” until 2017 when all 50 states included some type of checkbox on death certificates allowing officials to track maternal mortality.

Pregnancy-associated homicide covers the perinatal period (pregnancy and up to 1 year postpartum) and when the perpetrator of the homicide is identified, the assailant is most often an intimate partner. Most of the victims were found to be black or younger than 25.

The USA Today article states that:

“Experts say the alarming statistics reflect a grave nationwide public health concern, with the inequity adding urgency to widen the lens on maternal mortality causes, track them better and raise domestic violence awareness.”

Dr. Andrea Jackson, an obstetrician and gynecologist and professor at the University said the findings felt like a call to action for all of us in obstetrics” and that the “whole system needs to be built with the most vulnerable at the center”.

WHAT CAN WE DO?

While clinicians are encouraged to be “more proactive in screening for signs of domestic violence during prenatal appointments”, the rest of us should be aware that many women are afraid to tell others about domestic abuse-whether or not they are pregnant.

Both personally and professionally, I have seen women hide their domestic abuse problems from others with a happy face for years before the abuse was evident.

When we encounter women considering abortion, we need to be aware that some women may be in abusive situations and need help beyond food insecurity, lack of child care, transportation barriers to health care, etc.

Live Action, a pro-life group, published a March 2022 article “Love Them Both: How to help a pregnant mother in a crisis situation” that has helpful information on numerous resources available to help pregnant women facing a crisis situation like domestic violence, homelessness, drug addiction and more.

As Live Action says:

“Pro-lifers can help any woman considering abortion by helping her out of the crisis with real solutions.”

And we all need to know about the resources available to help women-pregnant or not-with these serious problems.