Michael Hickson, husband to Melissa and father of five children, died at age 46 last June after he became ill with COVID-19.
Hickson was under the care of a temporary professional guardian while the court decided whether his wife or physician sister should be his decision-maker. The temporary guardian decided, in conjunction with physicians, to place him in hospice care and discontinue treatment, nutrition, and hydration, according to Melissa.
As his wife, Melissa believes her wishes for Michael’s treatment should have been a factor in the decision, and that is why she is advocating legislation to change things for other families in similar situations.
Hickson told The Texan that she struggles, wondering if there is something more she could have done. “If I had a voice to express what Michael wanted, what I and his children wanted, I believe he would be alive today. I don’t want people to feel powerless like I felt.”
House Bill (HB) 3063, authored by Rep. John Smithee (R-Amarillo), would require professional guardians to attempt to contact a ward’s next of kin to obtain consent before critical care or end-of-life decisions are made.
Smithee said that the bill attempts to solve the concern that the Texas Estates Code doesn’t have any standards in it for guiding professional guardians in making these end-of-life decisions.
He was especially troubled upon learning that apparently Hickson’s disability “played a big role” in the decision to end his treatment when the family was told that Hickson didn’t have a good “quality of life.”
“Some of the most vulnerable Texans are people under serious disability for whom guardians have been appointed. If I were a professional guardian, I’d want some standard to follow in making these difficult decisions,” Smithee told the members of the committee.
Some professional guardians and disability group representatives spoke in opposition to the bill as filed, but most were willing to work with the bill’s author on wording with which they have concerns.
Jeff Miller, a policy specialist at Disability Rights Texas, opposed the bill as filed because he is concerned that a family member who is not appointed as guardian for some reason — perhaps determined by a court not to have the best interests of the ward in view — would be able to interfere in medical decisions.
Several professional guardians spoke against the bill because of the time required to contact the next of kin and the fiscal impact they claim the bill’s notification requirements would have on them.
Emily Cook, general counsel for Texas Right to Life, served the Hickson family during the crisis last summer. She said it was an impossible situation where a temporary guardian was making a decision to end care, but she, representing the family, could find no way to stop the process.
In her testimony in response to the professional guardians’ objections that the bill is too burdensome with its requirements to contact next of kin, Cook replied that the bill has a priority list that is found elsewhere in law.
“This is a life or death decision for families. For professional guardians, this is their job. I don’t think a phone call or email is too cost prohibitive when you are dealing with someone’s life.”
HB 3063 requires that the hospital continue treatment that is reasonable and prudent until an agreement can be reached about how to proceed. Cook prefers this standard to a “medically inappropriate standard that is often a smokescreen for a quality of life judgment.”
She explained to The Texan that “medically inappropriate” doesn’t mean that the treatment isn’t working but is a euphemism meaning that the treating physician doesn’t believe the ward should continue living.
Speaking for the Texas Medical Association and the Texas Hospital Association, Cesar Lopez told the committee that he believed the bill added too much time to the decision-making process, that the term “critical care” wasn’t defined, and that he believed the reasonable and prudent standard mentioned by Cook was inappropriate.
Terry Hammond with the Texas Guardianship Association, suggested that Texas incorporate the standard for end-of-life decision making published by the National Guardianship Association. It includes the notion that “In making this determination there shall in all cases be a presumption in favor of the continued treatment of the person.”
The Texas Democrats with Disabilities Caucus supports the bill. “Paid strangers…are not qualified to make decisions about our quality of life or end of life,” Joey Gidseg, president of the caucus told the committee. “Every day doctors tell families that their loved ones don’t have a hope for their future when they are disabled.”
Gidseg was told she would be a vegetable when she came out of a coma. “They [doctors] doom people to hopeless futures and rush the process.”
“Had HB 3063 been the law, Michael would still be with us today,” said Gidseg. “We need this because guardians are supposed to be serving people with disabilities under their care. If it is too much for them to do that, they have too many people under their care to effectively provide service to.”
The bill was left pending in the committee. Smithee plans to continue working with stakeholders to refine the bill’s provisions in the coming days.
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Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.