On July 7, 2016, Texas’s Office of the Secretary released proposed rule changes to the Department of Health Services’ (DHS) Approved Methods of Treatment and Disposition of Medical Waste. The changes would require health care-related facilities to cremate and bury fetal tissues regardless of its gestation period. The government defends these changes because it thinks cremating and burying tissue remains respects the sanctity of life. However, these new rule changes were problematic for numerous reasons.
First, the proposed disposal methods would be more expensive. Previously, hospitals sanitized the tissues through steam, chlorine, and heat disinfection, and they had to pay only $50-$100 weekly for a third-party medical waste disposal company to pick up the tissues and deliver them to a sanitary landfill. Now, every fetal tissue could cost $1500-$4000 for each cremation, and $2000-$10000 for each burial, which is 8000%-10000% higher than before.
Second, the cremation and burial additions do not make waste disposal methods more effective at sanitizing tissues. In fact, cremation and burial are harmful to the environment. The average cremation produces about 250 pounds of CO2, or the equivalent amount of how much a typical American home produces in six days. Ashes also have a high pH value that prevents good nutrients within the cremated ashes from releasing into the soil naturally. Plants also cannot tolerate the ashes’ high sodium content. Burial sites also require ongoing maintenance such as lawn mowing and grounds upkeep.
Photo Credit: Florida Hospital Graduate Medical Education
Third, these proposed rules would put financial and administrative burdens on anyone affected. They did not specify who pays for the cremation and burial costs. In addition, if these fetal tissue disposals were treated like deaths, funeral directors would need electronically filed death reports, obtain burial-transit permits, issue death certificates, and file the certificates electronically. These electronic certificates would violate women’s privacy because information about their lost fetuses would be online and potentially available for public view. Moreover, the rules do not state where or how the fetuses will be buried.
Fourth, women who would already be suffering from their lost fetus through cases such as miscarriages would have to take their tissues at the designated health care facilities for disposal if they lose their fetus at home.
Finally, these proposed rule changes are so unclear that nobody knows what the consequences for improper disposal would be. If Texas follows similar states who already have these rules in places, such as Ohio and Georgia, health care providers could be charged with first-degree misdemeanors and serve up to 180 days in jail.
Photo Credit: Austin Chronicle
Due to the proposed rules’ ambiguity, financial strains, and intrusion on women’s health choices, numerous organizations such as the Texas Medical Association, the Texas Hospital Association, ACLU Texas, and the Funeral Consumers Alliance of Texas wrote statements explaining how the rules would hurt their clients and industries they represent. In September 2016, 5,687 people signed a petition to oppose the changes as well.
Consequently, DHS edited the proposed rule changes again. This time however, DHS claimed that the rules would not increase costs because some private parties have offered to bury fetal remains for a discount or for free. Women who experience miscarriages at home would not have to bring their fetal tissues to a hospital for disposal. Finally, DHS admitted that the new rules are not intended to protect the environment or reduce risks to human health from environmental exposure.
But even with DHS’s edits, many problems linger. Nobody knows where these fetal remains will be held. DHS did not specify whether fetal tissue disposals require death certificates. Why are women who experience miscarriages at home exempt from this rule when the rule’s objective is to treat fetal tissues like the deceased? What happens if the women who miscarried choose to dispose their fetal tissues through previous disposal methods? What happens to health care providers who do not follow these new rules? Are they all going to jail?
Overall, these rule changes should not be implemented. They create more financial and bureaucratic headaches for health care providers and women than solutions for people who want fetal tissues to be disposed through respectful methods. The previous disposal methods did not cause any of these burdens. If it ain’t broke, don’t fix it.
For more information, please read:
1.Updated Proposed Rules as of September 30, 2016 Pg. 3-9
2. DePillis, Lydia. The Economics of Fetus Disposal. The Houston Chronicle (2016)
3. Bates, Jim. Public Comment to Proposed DSHS Rule. Funeral Consumers Alliance of Texas (2016)
5. Combs, Shanna M. Comment Regarding Waste Disposition Rules. Texas Medical Association
5. Rastogi, Nina. The Green Thereafter: How to Leave an Environmentally Corpse. The Green Lantern (2016)
6. Why Burying Ashes Is Harmful To Your Environment