Britain's Charlie Gard case recalls Texas futile-care fights

Years before a European court ruled that a brain-damaged British infant should be taken off life support, Texas newspapers were full of headlines about end-of-life disputes.

The Texas cases, similar in many ways to the Charlie Gard case, were triggered under the state's so-called futile-care law, a 1999 statute that gives hospitals the authority to withdraw life-sustaining treatment against a family's wishes if an institutional ethics committee agreed with the doctor that continued care would be unethical. Only one other state has a similar law.

In 2005 and 2006, in the Houston area alone, five families engaged in very public fights about such decisions.

The fights included a case at Texas Children's thought to be the nation's first discontinuation of an infant's life-sustaining care against a parent's wishes; a 53-year-old heart patient who died still under treatment a few days after St. Luke's reversed its decision once a right-to-life doctor came forward to continue care; and a 68-year-old invalid who died months after his family successfully arranged a transfer to a nursing home.

The Charlie Gard case came to U.S. attention after President Donald Trump tweeted "if we can help...we would be delighted to do so." Trump offered no details.

Controversy about Texas' futile-care law led to repeated reform attempts in the Texas Legislature that always died until 2015, when a bill passed and was signed into law prohibiting healthcare providers from removing artificial nutrition and hydration.

The law was enacted in the aftermath of a 1993 article in the Journal of the American Medical Association that laid out guidelines for identifying futile care and eliminating it. Gov. George W. Bush signed the law, a compromise negotiated by opposing sides. Right-to-life and disability rights groups came to regret the decision.

Texas ethicists praised the law for keeping the cases out of the courts, where judges typically lack expertise on end-of-life matters. Two such ethicists said this week they didn't understand the European Court of Appeals' decision not to allow Gard, who suffers from an often-fatal rare genetic disease called mitochondrial DNA depletion syndrome. to be transferred for care, either to a Vatican-owned hospital or a U.S. neurologist willing to try experimental treatment. The Texas law gives families 10 days to find such transfers.

Public fights about the Texas law have declined in recent years, though a Texas Right to Life spokeswoman said Thursday that behind the scenes lots of families continue to seek their help contesting hospital rulings. In 2015, the family of a terminal cancer patient who battled Houston Methodist Hospital sued over its plans to discontinue care filed suit. Attorney General Ken Paxton subsequently said he thinks the law is unconstitutional and will not defend it in court.

You can read more about the Charlie Gard case here and the Texas law here.