An advance directive lets you decide, ahead of time, how you want to be treated if you can no longer speak for yourself. In Texas, the phrase actually covers a small family of documents defined in Chapter 166 of the Health and Safety Code.1 The two that matter most for planning are the Directive to Physicians (often called a living will) and the Medical Power of Attorney.
This guide explains what each document covers, how they work together, and how to complete them.
- Directive to Physicians and Family or Surrogates (living will): your written wishes about life-sustaining treatment.2
- Medical Power of Attorney: names an agent to make health care decisions for you.3
- Out-of-Hospital Do-Not-Resuscitate (DNR) Order: instructs against resuscitation outside a hospital.
- Declaration for Mental Health Treatment: preferences for certain mental health care.
The Directive to Physicians (living will)
The Directive to Physicians, authorized by Subchapter B of Chapter 166, is Texas's version of a living will. In it you state, in advance, what you want to happen if you have a terminal or irreversible condition and can no longer communicate.2 You can direct that life-sustaining treatment be provided, withheld, or withdrawn, and you can add your own instructions about the care you would or would not want.
The directive speaks for you when you cannot speak for yourself, so your doctors and family are not left guessing about wrenching decisions. It is a statement of your wishes about treatment, which is different from naming a person to decide, and that difference is exactly why the second document exists.
The Medical Power of Attorney
A Directive to Physicians cannot anticipate every situation. The Medical Power of Attorney fills the gap by naming a trusted person, your health care agent, to make medical decisions for you whenever you are unable to, not just at the end of life.3 Your agent can choose doctors and facilities, consent to or refuse treatments, and weigh options as circumstances change.
The two documents are complementary. The living will records your wishes; the medical power of attorney appoints a human being to apply judgment to the situations a form could never predict. For the full detail on appointing a health care agent, along with the financial power of attorney, see our guide to powers of attorney in Texas.
How to complete your advance directives
- Use the Texas statutory forms. The Health and Safety Code provides model forms for both the Directive to Physicians and the Medical Power of Attorney, and the Texas Health and Human Services agency publishes them for free.1
- Choose your agent carefully. For the medical power of attorney, pick someone who knows your values and can stay calm under pressure. Name an alternate.
- Sign correctly. A Texas medical power of attorney must be signed before two qualified witnesses or acknowledged before a notary. At least one witness cannot be your agent, a relative, an heir, or your health care provider.3 The Directive to Physicians has a similar witnessing requirement.2
- Distribute copies. Give copies to your agent, your doctor, and close family, and keep the original where it can be found quickly.
Keep them current
Review your advance directives every few years and after major life events, a marriage, a divorce, a new diagnosis, or the death of the person you named as agent. You can revoke or replace them at any time while you have capacity, and a Texas medical power of attorney can be revoked by notifying your agent or provider regardless of your mental state.3
How advance directives fit your estate plan
Advance directives handle health care decisions during your life; they say nothing about your property. That is the job of a will, which takes over at death. A complete plan pairs your advance directives and powers of attorney with a valid will, so that both your medical care and your property are handled the way you want. To complete the will side, read how to write a will in Texas or create your Texas will here.
Sources
- 1Texas Health and Safety Code Chapter 166, Advance Directives (statutes.capitol.texas.gov)
- 2Texas Health and Safety Code Chapter 166, Subchapter B, Directive to Physicians (statutes.capitol.texas.gov)
- 3Advance Directives, Texas Health and Human Services (hhs.texas.gov)
Frequently Asked Questions
What is an advance directive in Texas? A set of documents under Health and Safety Code Chapter 166. The two main ones are the Directive to Physicians (living will) and the Medical Power of Attorney.
What is the difference between a living will and a medical power of attorney? A living will records your own wishes about life-sustaining treatment. A medical power of attorney names a person to make health care decisions for you in any situation.
Does a Texas advance directive need to be notarized? A medical power of attorney must be signed before two qualified witnesses or notarized. The Directive to Physicians has a similar witnessing requirement.
Can I change my advance directive? Yes. You can revoke or replace it at any time while you have capacity, and a medical power of attorney can be revoked by telling your agent or provider.
About the author
Max Kuch
Max Kuch writes about estate planning, wills and inheritance for Texas Will Template. He gathers the rules from the Texas statutes and the leading public data, then explains them in plain, accessible language so anyone can put their wishes in writing.