Second Court of Appeals
Summaries of Civil Opinions and Published Criminal Opinions Issued - Week of July 20, 2020.
NOTE: Summaries are prepared by the court's staff attorneys and law clerks for public information only and reflect his or her interpretation alone of the facts and legal issues. The summaries are not part of the court's opinion in the case and should not be cited to, quoted, or relied upon as the opinion of the court.
Links to full text of opinions (PDF version) can be accessed by clicking the cause number.
T.L. v. Cook Children’s Medical Center, No. 02-20-00002-CV (July 24, 2020) (Birdwell, J., joined by Wallach, J.; Gabriel, J., dissents with opinion).
Held: In this suit seeking to enjoin the discontinuation of life-sustaining treatment for T.L., a minor, pursuant to the procedure set forth in Section 166.046 of the Texas Advance Directives Act (TADA), Appellants—T.L. and her mother on T.L.’s behalf—pleaded, and showed a probable right to recover on, a Section 1983 civil-rights-violation claim, thus entitling them to temporary injunctive relief pending trial on the merits. Section 166.046 of the TADA empowers physicians to unilaterally withdraw life-sustaining care from patients upon the approval of a hospital review committee against the wishes of the patient, patient’s parent, or patient’s surrogate decision maker; in so doing, Section 166.046 implicates functions traditionally reserved to the state—the state’s sovereign authority to supervene a parent’s fundamental right to make medical decisions for her child and the state’s sovereign authority to define what is and is not a lawful means of dying—rendering any hospital that makes a decision to allow the unilateral, involuntary withdrawal of life-sustaining treatment according to Section 166.046 a state actor. As a state actor, a hospital has a duty to afford sufficient procedural due process to the patient, patient’s parent, or patient’s surrogate decision maker before discontinuing care. Because Appellants pleaded a probable right to recover on a claim that the Section 166.046 process—as implemented by Cook Children’s in this case—did not afford them sufficient procedural due process before encroachment on T.L.’s right to life and her mother’s right to make medical decisions for her daughter, they established a probable right of recovery that justified the imposition of a temporary injunction. The trial court therefore erroneously denied that injunction.
Dissent: Even though life-sustaining medical-care decisions involve the public good or the public interest, they are not the traditional and exclusive province of the state such that a private actor making such a decision is effectively acting as the state. Accordingly, a private hospital making these decisions cannot be considered a state actor under the public-function test for purposes of § 1983 liability. Because Appellants failed to raise a bona fide issue regarding the private hospital’s status as a state actor under § 1983, the trial court did not abuse its discretion by denying Appellants’ request for a temporary injunction.