Robert Painter proposes removing ethics committee immunity for decisions to unilaterally withhold or withdraw life-sustaining treatment. (Interestingly, things seem to be moving in just the opposite direction. A new Texas bill, H.B. 531, would actually EXPAND provider immunity for noncompliance with patient wishes and instructions.)
Following Painter's suggestion and removing immunity would go a long way toward putting Texas in much the same situation as every other state. That is, given serious uncertainty over the standard of care with respect to inappropriate and non-beneficial treatment, most providers will be chilled from writing unilateral stop orders. Even in malpractice-reformed Texas, they will be too afraid of ex post facto sanctions or at least of proceedings and legal process.
I do not think that removing immunity is essential to reform of TADA. The internal process can be improved as proposed in 2007 and 2009 bills. But the prospect of addition, external review would make the process more fair. This could be a second-choice alternative to improving the quality of the ethics committee review process.
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