Life support may be cut based on ability to pay, prognosis in Texas

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" Zepp " <zepp

Sun, 20 Mar 2005 15:42:44 -0800

[Zepps_News] Life support may be cut based on pay, prognosis

in Texas

 

 

 

 

<http://www.chron.com/cs/CDA/ssistory.mpl/metropolitan/3073295>

 

[The significance of this story is that the law that permits Texas

hospitals to turn off life support using a prognosis and patient's

ability to pay as factors was signed into law by then Governor George

W. Bush. Just think: if Terri Schiavo was in Texas, we would never

have heard of her]

 

 

 

Hospitals can end life support

Decision hinges on patient's ability to pay, prognosis

By LEIGH HOPPER

Copyright 2005 Houston Chronicle

 

Bill Olive / Chronicle

(L-r)Mario Caballero, Spiro Nikolouzos Jr. and Jannette Nikolouzos. St.

Luke's notified Jannette Nikolouzos in a March 1 letter that it would

withdraw life-sustaining care of her husband of 34 years, Spiro

Nikolouzos, in 10 days.

A patient's inability to pay for medical care combined with a prognosis

that renders further care futile are two reasons a hospital might

suggest cutting off life support, the chief medical officer at St.

Luke's Episcopal Hospital said Monday.

 

Dr. David Pate's comments came as the family of Spiro Nikolouzos fights

to keep St. Luke's from turning off the ventilator and artificial

feedings keeping the 68-year-old grandfather alive.

 

St. Luke's notified Jannette Nikolouzos in a March 1 letter that it

would withdraw life-sustaining care of her husband of 34 years in 10

days, which would be Friday. Mario Caba-llero, the attorney representing

the family, said he is seeking a two-week extension, at minimum, to give

the man more time to improve and to give his family more time to find an

alternative facility.

 

Caballero said he would discuss that issue with hospital attorneys today.

 

Pate said he could not address Nikolouzos' case specifically because he

doesn't have permission from the family but could talk about the

situation in general.

 

" If there is agreement on the part of all the physicians that the

patient does have an irreversible, terminal illness, " he said, " we're

not going to drag this on forever ...

 

" When the hospital is really correct and the care is futile ... you're

not going to find many hospitals or long-term acute care facilities

(that) want to take that case, " he said. " Any facility that's going to

be receiving a patient in that condition ... is going to want to be paid

for it, of course. "

 

Patient showed emotion

Caballero said he believes the hospital wants to discontinue care

because Nikolouzos' Medicare funding is running out.

 

Spiro Nikolouzos, a retired electrical engineer for an oil drilling

company, has been an invalid since 2001, when he experienced bleeding

related to a shunt in his brain. Jannette Nikolouzos, 58, had cared for

her husband at their Friendswood home, feeding him via a tube in his

stomach. Her husband couldn't speak, she said, but recognized family

members and showed emotion.

 

On Feb. 10, the area around the tube started bleeding, and Nikolouzos

rushed her husband to St. Luke's for emergency care. Early the next

morning, she said, the hospital called and said he had " coded " and

stopped breathing and had to be placed on a ventilator.

 

A neurologist told her, she said, that he is not brain-dead and the part

of the brain that controls breathing is still functioning. Although his

eyes were open and fixed when he first was placed on the ventilator, he

has started blinking, she said.

 

A missed opportunity

Dr. Marcia Levetown, director of palliative care at The Methodist

Hospital, said moving Nikolouzos to a nursing home or other type of

facility may not be an option if his body is dependent on several types

of technology, such as mechanical ventilation and kidney dialysis.

 

Levetown said when families and hospitals take their disagreements to

court, it often means the hospital has missed an important opportunity

in the family's emotional healing.

 

Often missing from aggressive medical care is empathy for family members

and acknowledgment of grief, she said.

 

" The acknowledgment of 'You clearly love your husband very much. You've

done the good fight' " makes a difference, she said. Levetown also tells

families, " Whatever might be beneficial, you've made sure he's gotten

that. We all wish he could get better ... How can we best honor this

man ... as we accompany him in his next journey? "

 

Law allows removal

State law allows doctors to remove patients from life support if the

hospital's ethics committee agrees, but it requires that the hospital

give families 10 days to find another facility.

 

A similar case is still in the courts. Texas Children's Hospital wants

to discontinue life support on 5-month-old Sun Hudson, who was diagnosed

shortly after birth with a fatal form of dwarfism. His mother, Wanda

Hudson, wants her son's care to continue at the hospital.

 

On Wednesday, a judge will consider whether Harris County Probate Court

judge William McCulloch may remain on the Hudson case. Caballero, who

represents Wanda Hudson, filed a motion that McCulloch remove himself

from the case after making what Caballero said were biased statements.

 

leigh.hopper

 

--

 

Election 2004

The Triumph of the Swill

" The National Government will regard it as its first and foremost

duty to revive in the nation the spirit of unity and cooperation.

It will preserve and defend those basic principles on which our

nation has been built. It regards Christianity as the foundation

of our national morality, and the family as the basis of national

life. "

Adolph Hitler, My New World Order,

Proclamation to the German Nation

at Berlin, February 1, 1933

 

 

Not dead, in jail, or a slave? Thank a liberal!

Pay your taxes so the rich don't have to.

 

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