Medical Futility Cases – Importance of Written Decisions from California, Texas, and Virginia Appropriate Care Committees

I have repeatedly criticized the intramural resolution of medical futility conflicts as violating procedural due process. The most notable omissions are (1) a neutral decision maker, (2) appellate review, and (3) notice. But another missing element is a “written statement” of decision. This requirement to set out all the relevant facts and evidence serves several purposes. First, it helps assure that a factual basis supports the deprivation (or dispossession) of life, liberty, or property. Second, it enables the affected individual to understand the grounds for the deprivation. Third, it provides a record upon which to prepare for appeal. By enabling an appellate tribunal to review the review committee’s reasons, a written statement protects against arbitrary and capricious deprivations. I am not contending that all these conflicts must be adjudicated by courts. I specifically disclaimed that here. But whatever tribunal makes the decision should…

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