This legal research guide provides information on topics such as elder care, wills and estate planning, and medical directives.
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Advanced directives are legal documents that state a person's preferences for medical care. They can be used if a person becomes ill and cannot communicate what they want directly.
These documents can address various aspects of medical and end-of-life care. They act as instructions for families, surrogates, and healthcare professionals.
This page covers four different types of advanced directives that address medical care:
Known as the Texas Advanced Directives Act, this chapter governs how and when three advanced medical directives (directive to physicians, medical powers of attorney, and do not resuscitate orders) may be issued, executed, and revoked.
This chapter governs declarations for mental health treatment.This article from Texas Law Help covers the basics of advanced directives with a brief overview the different types of directives available and their basic functions. Specific details and sample forms for directives to physicians, medical powers of attorney, and out-of-hospital do-not-resuscitate orders are provided.
The Texas Department of Health and Human Services has assembled several different forms to assist individuals in preparing advanced directives. Forms for a medical power of attorney, directive to physicians, and an out-of-hospital do not resuscitate form are included.
The Texas A&M Real Estate Center has written this article that discusses durable powers of attorney, medical powers of attorney, and other advance directives. The article links to forms throughout.
A "directive to physicians" is a legal document that allows a person to outline their preferences for medical care. They are often used to leave specific instructions for end-of-life treatment.
Directives to physicians are sometimes called a "living will." Living wills can be created at any time by a competent adult or their designated agent.
This document is different from a medical power of attorney. A medical power of attorney designates a person to make medical decisions on their behalf. A living will allows a person to speak for themselves.
Section 166.031 of the Texas Health and Safety Code states that an advanced directive covers "life-sustaining treatment", which is defined in Section 166.002 as any treatment that is absolutely necessary to continue the life of the patient.
This does not include pain management medication or any other medical procedures or care designed to relieve pain and assist in a patient's comfort.
A directive to physicians will be used when a person becomes incompetent or can't otherwise speak for themselves to explain what course of treatment they would prefer, according to Section 166.038 of the Texas Health and Safety Code.
The directive is active from the time it is executed and lasts until it is revoked, according to Section 166.041 of the Texas Health and Safety Code. A directive may be revoked at any time. Texas law allows the person who created the directive (referred to as the "declarant" in the statutes) to revoke their directive in a few different ways, as outlined in Section 166.042:
This subchapter governs directives to physicians for medical care. A "directive" is defined in this subchapter as "an instruction to administer, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition."
This statute allows a competent adult to create a written directive at any time. Requirements for having the document signed and/or notarized and notifying the attending physician of the existence of a written directive are also outlined here.
This statute contains instructions and a sample form for creating a directive to physicians for medical treatment.
This FAQ from Texas Law Help covers the basics of directives to physicians in Texas, including information on these directives are used, requirements for a valid directive, and more.
This sample form for a directive to physicians is from the Texas Department of Health and Human Services.
This is a sample form for a living will from the Texas A&M Real Estate Center.A directive to physicians and family or surrogates form is available from the Texas Hospital Association as a PDF or an MS Word document.
A medical power of attorney gives someone else the right to make decisions about their medical care on their behalf. There are different types of powers of attorney. For more information on other types, please see our Research Guide to Powers of Attorney.
A medical power of attorney is usually a kind of durable power of attorney — meaning that it will last after the principal has been incapacitated. According to Section 166.152(g) of the Texas Health and Safety Code, it lasts until:
In the event that you cannot make decisions about your own medical care, this document would allow someone you trust to make those decisions for you. It is a common part of later-life planning and legal preparations for people with disabilities.
Note that a medical power of attorney differs from a "living will," which allows you to state what medical procedure you do and do not want performed. For example, a living will would allow you to tell doctors that you do not want to receive a blood transfusion. A medical power of attorney does not discuss specific procedures but instead gives someone else the authority to make decisions about those procedures for you.
Known as the Texas Advanced Directives Act, this chapter governs how and when three advanced medical directives (directive to physicians, medical powers of attorney, and do not resuscitate orders) may be issued, executed, and revoked.
This page from TexasLawHelp.org explains what a medical power of attorney does and how it might be useful.
This article from legal publisher Nolo explains the difference between living wills and medical power of attorneys and the role they play in estate planning.
This form for a medical power of attorney is available from the Department of Health and Human Services in English and in Spanish.
eFileTexas's self-help section contains this interactive interview that will help you create completed forms for a durable power of attorney, medical power of attorney, an advance directive to physicians, a HIPAA medical records release, or all of the above.
The Texas A&M Real Estate Center has written this article that discusses durable powers of attorney, medical powers of attorney, and other advance directives. The article links to forms throughout.
This disclosure statement from the Texas A&M Real Estate Center satisfies the form requirements found in Texas Health & Safety Code 166.164.
An "out-of-hospital do-not-resuscitate order" is a legal document for people who wish to die without any medical intervention. These orders are used by those who prefer to die without any medical intervention. The order tells emergency medical professionals not to provide certain life-saving treatments. It is sometimes called an "OOH-DNR" or just a "DNR."
According to Section 166.081(6a) of the Texas Health and Safety Code, the following life-saving treatments are covered in a DNR order:
According to Section 166.081(7), of the Texas Health and Safety Code, an out-of-hospital setting can include any location where a medical professional is called to provide assistance. The statute includes the following:
Subchapter C of Chapter 166 of the Texas Health & Safety Code governs out-of-hospital do-not-resuscitate orders.
This statute allows a competent adult to create a written out-of-hospital do-not-resuscitate order at any time. Requirements for having the document signed and/or notarized, notifying the attending physician of the existence of the written directive, and including it as part of the patient's medical record are also outlined here.
This statute sets out requirements for what must be present in the out-of-hospital do-not-resuscitate order form.
This section governs procedures for responding healthcare professionals to comply with a DNR order.This statute allows DNR identification devices to be taken as evidence that the person has a valid DNR in place.
This article from Texas Law Help explains the legal procedures under Texas law for out-of-hospital do-not-resuscitate orders.
This is a sample form for an out-of-hospital do-not-resuscitate order from the Texas Department of Health & Human Services.
This is a sample form for an out-of-hospital do-not-resuscitate order from the Texas Hospital Association.
This is a sample form for an out-of-hospital do-not-resuscitate order from the Texas A&M Real Estate Center.
According to Section 137.001 of the Texas Civil Practice and Remedies Code, a declaration of mental health treatment is a "document making a declaration of preferences or instructions regarding mental health treatment". A person can use the declaration of mental health treatment to refuse or consent to certain types of mental health treatment.
According to Section 137.001 of the Texas Civil Practice and Remedies Code, mental health treatment refers to the following types of treatment:
A declaration for mental health treatment is active as soon as it is executed. However, unlike other types of advanced directives, a declaration for mental health treatment is only valid for three years from the execution date. After this period is up, the declaration automatically expires and a new declaration will need to be issued in its place. There are a few exceptions according to Section 137.002 of the Texas Civil Practice and Remedies Code:
Section 137.010 of the Texas Civil Practice and Remedies Code allows a person to revoke an existing declaration for mental health treatment as long as they are not incapacitated (defined in Section 137.001(6) as unable to make mental health treatment decisions on their own behalf). A few different options for revoking a declaration for mental health treatment are provided:
This section outlines who may execute a declaration of mental health treatment and its validity period.
This section governs the procedure for executing a declaration for mental health treatment, including requirements for witnesses.
This statutes outlines requirements and procedures for revoking a declaration of mental health treatment.
A statutory form for a declaration of mental health treatment is found in Section 137.011 of the Texas CPRC.
This article from Disability Rights Texas gives a great explanation of how a declaration of mental health treatment works and what it specifically covers. A sample form is included.
This helpful FAQ from Texas Law Help explains how a medical power of attorney differs from a declaration of mental health treatment in terms of what types of treatments each directive allows for and the length of time they are active.
This is a sample form for a declaration of mental health treatment from the Texas Department of Health & Human Services.
This is a sample form for a declaration of mental health treatment from the Texas Hospital Association. This form is also available in Spanish.
A statutory form for a declaration of mental health treatment is found in Section 137.011 of the Texas CPRC.
