"Culture of Life"

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Media reports have the facts wrong, I think. I dont think this law applies if the patient is conscious. If the patient is unconscious, and the patient has not filed an advance healthcare directive, and the medical facility makes a determination of futility, THEN they can pull the plug. They cannot do so over the wishes of a conscious patient.
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Your link doesn't actually say that. This account says specifically that she was conscious and responsive when the doctors shut down the respirator.

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Sorry, follow the internal link to the statute.

I skimmed it, but didn't see anything that said that. Can you give a direct quote?

Basically, this chapter deals with medical directives, which are instructions for what care you want in the event you can't presently communicate those wishes (e.g., in a coma).

The controversial section that the hospital used in opting to terminate treatment, was § 166.039(a). That section states, in relevant part:

"If an adult qualified patient has not executed or issued a directive and is incompetent or otherwise mentally or physically incapable of communication, the attending physician and the patient's legal guardian or an agent under a medical power of attorney may make a treatment decision that may include a decision to withhold or withdraw life-sustaining treatment from the patient."

This requires that: (a) there be no directive; and (b) the patient must be incompetent or incapable of communications.

Thus, the patient cannot have been conscious when the hosptial made this decision. The media reports got it wrong.

What about in instances where the patient has made an advance directive to request life sustaining care, but the hospital disagrees? Goto § 166.046.

"If an attending physician refuses to honor a patient's advance directive or a health care or treatment decision made by or on behalf of a patient, the physician's refusal
shall be reviewed by an ethics or medical committee. The attending physician may not be a member of that committee. The patient shall be given life-sustaining treatment during the review."

If the review process still says no treatment, there is a transfer process: "If the attending physician, the patient, or the person responsible for the health care decisions of the individual does not agree with the decision reached during the review process under Subsection (b), the physician shall make a reasonable effort to transfer the patient to a physician who is willing to comply with
the directive."

If no transfer is possible, "The physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the written decision required under Subsection (b) is provided to the patient
or the person responsible for the health care decisions of the patient unless ordered to do so under Subsection (g)."

This all applies where the hospital is trying to go against the patient's advanced directive for life sustaining care. The advance directive isn't even effective, however, unless the patient is unconscious.