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

Robert L. Fine, MD; and Thomas Wm. Mayo, JD
[+] Article, Author, and Disclosure 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@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.

Ann Intern Med. 2003;138(9):743-746. doi:10.7326/0003-4819-138-9-200305060-00011
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Every U.S. state has developed legal rules to address end-of-life decision making. No law to date has effectively dealt with medical futilityan 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.





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