Via Texas Right to Life come these two entries giving the story of a man named Willie who had not only his ventilator support but also his food and fluids withdrawn, despite having insurance and family financial support and against both his own wishes and his family's wishes, and subsequently died.
It is unfortunate that the story is unclear on a few points. Specifically, when it refers to Willie's receiving sedation, what was the purpose of this? (There is a reference to surgery, but it looks like perhaps he never received the surgery.) How long was Willie without food and fluids, and, if it was only for twenty-four hours or less (which seems possible based on the stories), what is the family's evidence that withholding food and fluids significantly hastened Willie's death? He had previously been ventilator dependent (or so I infer) but appears to have been breathing on his own after his vent support was removed. Still, it is entirely possible that he was not able to get enough oxygen that way and died pretty much entirely for that reason.
Texas hospitals' policy of kicking you out after a death panel rules that you should no longer receive life support and after a ten-day wait has been known now for some years. Please, liberal commentators: Do not waste my time blah-blahing about how this was a "Republican policy" and how G.W. Bush signed it. The real story is that previously Texas hospitals were kicking people out with only a day or three's warning, and what got pushed through was a ten-day waiting period to give a chance to try to find a transferring institution. This hasn't worked out well, because apparently the hospitals and hospices are either in cahoots with one another or else share a remarkable unanimity of perspective and hence will almost never actually accept transfers during the ten-day waiting period, but the ten-day wait was an improvement over what had been going on.
Anyway, there have been several high-profile cases in connection with this policy (which at the moment I'm not going to go and look up). One thing they have shared in common is that the patients have all died very, very shortly, if not immediately, after having ventilator support withdrawn. Since ventilator support has a stronger claim to be an "extraordinary means" than the mere provision of food and water, the hospitals thus minimized their bad press by presenting these as truly extreme cases where actual life support (that often abused word) was withdrawn.
I have, however, always suspected that a parallel movement was going on. Namely, that food and fluids were in fact withdrawn and that, if the patient proved able to breathe on his own after all and even lived for days thereafter, he would simply be dehydrated to death. While, if my interpretation of TRTL's releases is accurate, Willie does not seem to have lived for days, the firm withdrawal of food and fluids against family wishes in Willie's case does go to confirm what I've always thought. It's just that until now there hasn't been (as far as I know) a high-profile case like this in the Texas system. And (again, if I'm understanding the story correctly) we're still waiting for one in which the patient lives for a sufficient number of days after withdrawal of food and fluids for it to be undeniable that this was a significant contributing cause of death.
But it looks like the TX hospitals aren't going to be fazed if and when that happens.
Here are some salient features of Willie's case that should give us all pause:
--Willie's family was unanimous about his receiving life-preserving care.
--Willie himself had clearly stated that he wanted to live and didn't want his family to give up on him.
--Willie had insurance, and his family was willing to pay extra costs.
--The hospital insisted, apparently purely for ideological and "futile care" reasons, on withdrawing not only ventilator support but also food and fluids.
--No other TX institution would accept Willie as a transfer patient within the ten-day window of time.
The hospital is said to be located in north Houston, but the family has withheld the name of the hospital (fear of lawsuit?).
I guess not everything is better in Texas. (See this interesting summary document on variations in state laws in this area.)