Texas Law Signed by Bush Enters Debate

A Texas law signed by then-Gov. George W. Bush in 1999 allowing an end to life-sustaining treatment for certain patients became a point of contention Monday in the Terri Schiavo case, sharpening the focus on the president’s eleventh-hour intervention in the question of the woman’s fate.

The law that Bush signed as governor sets conditions for how a patient’s relatives or other surrogates may make end-of-life decisions, and it spells out procedures for cases where the surrogates and medical providers disagree on whether to continue or to suspend life-sustaining care.

Critics have said the Texas law is inconsistent with the measure Bush signed in the early hours of Monday that forced the Schiavo case into the federal courts, a bill that Bush said later in the day would give the parents of the brain-damaged woman “another opportunity to save Terri Schiavo’s life.”

Speaking on the House floor Sunday, Rep. Debbie Wasserman Schultz (D-Fla.) said the Texas law “liberalized the situations under which a person in Texas can avoid artificial life support.”

“It appears that President Bush felt, as governor, that there was a point at which, when doctors felt there was no further hope for the patient, that it is appropriate for an end-of-life decision to be made, even over the objections of family members....There is an obvious conflict here between the president’s feelings on this matter now as compared to when he was governor of Texas,” Wasserman Schultz said during a late-night House debate Sunday on the Schiavo legislation.

That measure, which Bush signed about 1 a.m. Monday outside his White House bedroom, was intended to aid family members fighting to reinstate Schiavo’s feeding tube.

“If the president of the United States really cared about the issue of the removal of feeding tubes, then why did he sign a bill as governor in Texas that allows hospitals to save money by removing feeding tubes over a family’s objection?” asked Rep. John Conyers Jr. (D-Mich.) during the House debate.

White House Press Secretary Scott McClellan said Monday that the Democrats had made “uninformed accusations” and that the president was consistent in signing both the Schiavo legislation and the 1999 legislation in Texas.

“The legislation that he signed into law actually provided new protections for patients.... Prior to the passage of the ’99 legislation that he signed, there were no protections,” McClellan said.

Questions about Bush’s consistency on end-of-life issues have been in focus in part because of the increasing importance of religious conservatives to the Republican base. Democrats have accused White House and Republican leaders of a political ploy in seizing on a case that began as a family dispute and has been litigated for years in Florida courts.

People familiar with the Texas law said that both the White House and the Democratic lawmakers seemed to have grounds for their comments.

As Wasserman Schultz said on the House floor, the Texas law lays out procedures for physicians to follow when they think a patient’s condition is hopeless, even if family members disagree. Doctors can make a case to their hospital’s ethics committee. If the ethics committee agrees, life support can be removed.

But first, dissenting families are given 10 days to find another facility willing to care for the patient.

“That was a law that President Bush did not just allow to become law without his signature. He came back from a campaign trip to sign it,” Wasserman Schultz said.

The White House countered that the bill added patient protections that had not previously existed in Texas law, such as the 10-day waiting period and the hospital ethics panel review. McClellan said that Bush had vetoed a 1997 bill that would have afforded a patient no such protections.

“Prior to that legislation being passed, I think there was a 72-hour period where if the hospital notified a patient, or the family that represented the patient, that they were going to deny life-sustaining treatment, then they had just that 72-hour period to find a place to transfer the patient that would provide the treatment,” McClellan said.

Former Democratic Texas Rep. Glenn Lewis, the law’s principal author, said he wrote the bill after consulting with a group of physicians and court-appointed guardians for the terminally ill.

“We were trying to make it easier for everyone,” said Lewis, who is now a Fort Worth lawyer. “We tried to write a comprehensive piece of legislation that accounted for everyone’s interest.”

It is unclear how the law would be applied in the Schiavo case, he said. Schiavo’s husband wants to withdraw life support but her parents do not.

Bush was not a central player in the Schiavo case until Saturday, when the White House abruptly announced the president was cutting short a vacation at his Crawford, Texas, ranch to return to Washington and wait for Congress to pass the bill giving the woman’s parents standing to take the case to federal court .

The president could have signed the measure in Texas, but by flying back he won praise from some, including religious conservatives -- a voting bloc pivotal in his reelection last year and crucial to the GOP’s hopes of expanding its majority and retaining the White House in future elections.

Bush might have benefited from the Schiavo case already, thanks to a 2003 Florida law designed to keep Schiavo alive pushed by Gov. Jeb Bush, his brother. The state law was overturned in court, but analysts credited the measure at the time with helping to mobilize evangelicals in that battleground state to back the president.

Bush did not publicly address the Schiavo case, apart from written statements, until Monday.

“This is a complex case with serious issues,” he said in Tucson, where he was making an appearance to promote his Social Security plan. “But in extraordinary circumstances like this it is wise to always err on the side of life.”

McClellan told reporters Monday that Bush was awakened by a White House operator after Congress passed the Schiavo bill. An aide walked the bill to the White House residence, where the president stepped into the hallway outside his bedroom and, standing up, signed it.

The law Bush signed in 1999 has been invoked twice in recent weeks by Houston hospitals, to opposite conclusions.

At Texas Children’s Hospital, a 6-month-old boy, born with a fatal form of dwarfism in which his lungs were too small to support his small body, died shortly after his breathing tube was removed. His mother objected but could find no facility willing to care for the boy.

A 68-year-old man so brain-damaged that he could not breathe on his own was transferred from St. Luke’s Hospital, which said further treatment was hopeless, to a facility in San Antonio that agreed to keep him alive.

Havemann reported from Washington and Wallsten from Tucson.