Federal law has had little impact on the resolution of futility disputes. There have been notable exceptions like Baby K and EMTALA. But in general, federal statutes and regulations are not nearly as relevant as state law.
Most states have some statutory provisions that (purport to) permit healthcare providers to refuse to comply with instructions or decisions for treatment that are contrary to the provider's professional judgment and/or the professional's conscience. Most are ineffective, because they condition immunity on compliance with the standard of care. Texas law includes no such condition. But laws in California and Virginia come close. A few other states authorize unilateral DNR orders in their POLST laws.
Some states (like Texas) expressly permit cliicians to stop life sustaining treatment without consent. Other states (like Idaho) expressly prohibit it. But most states have no clear green or red light.
Increasingly over the past five years, states have been enacting red light statutes that prohibit clinicians from stopping life-sustaining medical treatment without consent.
I provide and organize some primary source materials on this page. But for a more thorough collection, organization, and analysis of the law in this area, please see my articles and book chapters.