Cook Children’s Motion in Tinslee Lewis Case Denied by Texas Supreme Court, Child to Remain on Life Support

The legal fight with Cook Children’s over Tinslee Lewis’ life support will continue at the district level after the state supreme court declined to weigh in.
October 19, 2020
The Texas Supreme Court declined to take up a case about continuing life support for Tinslee Lewis, a 20-month-old child who was born with a rare heart defect, leaving in place an appellate court ruling that was critical of Texas’ “10-Day Rule.”

Tinslee’s case has been disputed in courts since last November when Cook Children’s Medical Center invoked the state statute to cease life-sustaining treatment.

In July, the Second Court of Appeals in Fort Worth issued a lengthy opinion that concluded Cook Children’s decision to cease Tinslee’s life support violated the due process rights of Trinity Lewis, Tinslee’s mother.

With the state’s highest court staying out of the matter for now, Tinslee’s case will return to the 48th District Court where Judge Sandee Marion will hold a new trial.

Marion previously ruled in favor of Cook Children’s, but the decision of the new trial will need to be consistent with the appellate court’s ruling.

The Texan Tumbler

Attorneys representing the hospital argued that the 10-Day Rule under the Texas Advance Directives Act (TADA) protects doctors, who are acting in a private role apart from the state, from liability for ending treatment of a patient, especially when continuing care would violate their conscience.

But in Tinslee’s case, the appellate court ruled that the hospital was not acting in a strictly private role, but assuming the state’s role.

In the court’s opinion, Justice Wade Birdwell wrote, “Both traditionally and exclusively, a medical treatment decision made for a minor child, contrary to the desires of the child’s parents, is the sovereign prerogative of the state as parens patriae.”

Birdwell reasoned that since Cook Children’s was making a treatment decision contrary to what Trinity Lewis wanted for her daughter, they were state actors and responsible for providing due process rights.

Consequently, the court determined that Trinity Lewis had a probable right to relief from potential violations of the rights to life and due process.

“If [Cook Children’s] were allowed to withdraw life-sustaining treatment from [Tinslee] before a trial on the merits can be had, [Trinity and Tinslee Lewis] will suffer permanent, irreparable damage,” wrote Birdwell. “Thus, we conclude that the trial court abused its discretion by denying [Trinity Lewis’] request for a temporary injunction.”

In their petition to the Texas Supreme Court, Cook Children’s argued that the appellate court “essentially struck down a Texas statute on federal constitutional grounds, radically expanded the concept of State action, recognized a constitutional right to medical care, and sharply departed from settled precedent of the U.S. Supreme Court, the Fifth Circuit, and other federal courts of appeals.”

Two amici briefs were filed with the Texas Supreme Court, one supportive of the 10-Day Rule and one opposed.

The brief in support of the rule was filed by several medical and hospital organizations, the Texas Catholic Conference of Bishops, and Texas Alliance for Life.

Those calling the 10-Day Rule unconstitutional included several disability advocacy organizations, pro-life groups, and two Texas Catholic bishops.

Texas Right to Life has also been supportive of Tinslee receiving treatment since the dispute with Cook Children’s began last year.

“No patient should be robbed of due process and civil liberties once admitted to a hospital,” said Kimberlyn Schwartz, the director of media and communication of Texas Right to Life in a press release. “Texas Right to Life is thankful that the Texas Supreme Court and Second Court of Appeals recognize the injustice of hospital committees deciding whose quality of life merits treatment and who should die.”

A detailed overview of the case can be found here.

Timeline of Events:

February 2019: Tinslee Lewis is born prematurely, diagnosed with Ebstein’s anomaly, and cared for at Cook Children’s Medical Center.

October: Cook Children’s decides to remove Tinslee from life support and sends the required 10-day notice to the family in accordance with the Texas Advance Directives Act.

November: Tarrant County Judge Alex Kim issued a temporary restraining order requiring Cook Children’s to continue providing life support and extended it, giving the family more time to search for an alternate care provider.

December 4: Kim is recused from the case after a request from Cook Children’s.

January 2: Justice Sandee Marion, who was assigned to the case after Kim’s recusal, denied a temporary injunction requested by the family, allowing Cook Children’s to continue with the process of taking Tinslee off of life support.

January 3: The Second Court of Appeals in Fort Worth granted emergency relief to the family, requiring Cook Children’s to continue life support.

February 4: The appellate court heard oral arguments from the parties involved in the case.

July 24: Appellate court issues an opinion reversing the denial of the temporary injunction and remanding the case to the trial court for a new ruling.

August 20: Cook Children’s files petition with the Supreme Court of Texas requesting a review of the appellate court’s opinion.

October 16: The Supreme Court of Texas denies Cook Children’s petition for review.


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Daniel Friend

Daniel Friend is the Marketing and Media Manager for The Texan. After graduating with a double-major in Political Science and Humanities, he wrote for The Texan as a reporter through June 2022. In his spare time, you're likely to find him working on The Testimony of Calvin Lewis, an Abolition of Man-inspired novel and theatrical podcast.

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