Doctors vs. Parents: Who Decides Right to Life?

Following surgery, Sabrina Martin's condition went south. And then, her family says, Children's Memorial Hermann Hospital set about arranging for her demise.

The family is seeking tens of millions of dollars to help pay for what will now be a lifetime of rehabilitation and care for their daughter. For, while Sabrina Martin's life was saved, she will never be exactly right again.
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For more than three weeks during the early spring of 2006, Sabrina had been complaining of crushing headaches. At first her parents thought they might be related to stress.

Sabrina, a star athlete, was finishing up with basketball and was getting ready for track season. Plus, she was involved in a number of other after-school activities including the honor society and the yearbook. The teen was also starting to date, and was gearing up to take the TAKS standardized testing for eighth graders at Klein Intermediate School.

Sabrina's parents monitor their daughter at home.
Daniel Kramer
Sabrina's parents monitor their daughter at home.
Sabrina's parents say fighting for their daughter's life was the best decision they ever made.
Daniel Kramer
Sabrina's parents say fighting for their daughter's life was the best decision they ever made.

The family's pediatrician said the problem might be nutritional, so the doctor put her on a special diet and was supposed to see her again two weeks later. But Sabrina could not wait that long. She was desperate for relief.

One night while Lopez, a systems manager with AT&T, was in Beaumont working, Murray took Sabrina to the Houston Northwest Medical Center's emergency room. There, says Murray, doctors performed a brain scan and said they thought Sabrina had a tumor. In a hurry, the hospital loaded Martin into an ambulance and rushed her to Children's Memorial Hermann Hospital, located in Houston's Medical Center. As soon as Lopez heard the news, she raced back to Houston.

At Memorial Hermann, Lopez says, doctors determined Sabrina did not have a tumor but rather severe sinusitis and that the infection had leaked into the brain, causing an abscess. Doctors wanted to perform a craniotomy, drilling a small hole in Sabrina's head to drain the abscess.

"We never had any experience with anything like this," says Lopez. "Memorial Hermann, that's just where they drove her from the clinic. I always just thought that a hospital was a hospital and that all of the ones down there in the Medical Center were the same and quite reputable."

Memorial Hermann Healthcare System is a nonprofit organization comprised of 14 hospitals and dozens of specialty and outpatient centers. According to its Web site, the group has more than 19,000 employees and more than 4,000 medical staff members, with an annual payroll of more than $1 billion. Nearly 340,000 people visit its emergency rooms every year.

The Memorial Hermann system routinely wins numerous awards, including one in 2006 for its children's hospital, which was named the only healthcare facility in Houston and one of only six in the country to receive the Excellence In Life Support Award from the Extra-­Corporeal Life Support Organization in Ann Arbor, Michigan, which backs the development of new therapies for the support of failing organ systems.

When asked for comment about Sabrina's case, Memorial Hermann spokeswoman Beth Sartori issued a statement saying, "Sabrina Martin's story is a sad one, and everyone associated with her care at Children's Memorial Hermann Hospital is deeply sympathetic to her and her family. However, because of the lawsuit against the hospital and the physicians that cared for her, we are not at liberty to comment further."

Memorial Hermann was one of a host of hospitals across the state that along with doctors and right-to-life groups endorsed the Texas Advance Directives Act, which the Legislature passed in 1999 and which was signed into law by then-Governor George W. Bush. (The right-to-life groups have now backed off their support of the Advance Directives Act and say the law is unfair and gives too much power to ­doctors.)

In essence, the law gives doctors the ability to either continue or withhold life-sustaining treatment against the wishes of the patient or the patient's legal guardian. To do so, the doctor presents his case before the family and an ethics committee, and if the committee agrees with the doctor's decision, the family is given ten days to find another facility that will comply with their wishes before treatment is either continued or withdrawn. Families are given a list of lawyers and organizations to help facilitate a transfer.

Texas and Virginia are the only two states in the country that have a time limit as part of such laws, Virginia's being 14 days for the family to find a transfer.

In Texas, the law has come under fire over the past several years. Families, their lawyers and right-to-life groups have battled doctors and health care facilities in the media and in court to try to prevent them from employing the act. In 2007, an attempt to lengthen the ten-day time period died in the Texas House of ­Representatives.

In general, opponents — ranging from rightwing, right-to-life groups all the way to the American Civil Liberties Union — say the law gives too much power to the hospitals and doctors and takes away individuals' civil rights to determine their own fate.

Proponents, mostly those in the health field, argue that it creates a necessary safe harbor for physicians when further medical treatment is deemed inappropriate and emotionally invested family members can't be objective. They say the law is only invoked when patients are terminally or irreversibly ill and when physicians believe that their treatment is merely prolonging the dying.

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