A family making a medical decision for a relative who cannot speak may not know what that person would have wanted. A written directive records those wishes in advance. In Texas, the document goes by a few names, and the rules for signing it are specific enough that a mistake can leave it unused when it matters.
Texas Uses Several Names for the Document
A living will states preferences about treatment such as mechanical ventilation, artificial nutrition, and CPR if a person cannot speak for themselves. Texas health care providers know it as a Directive to Physicians. Under Section 166.032 of the Texas Health and Safety Code, any competent adult may make one in writing at any time. The directive comes into play when the person has a terminal or irreversible condition and cannot make decisions.
Signing Requires Witnesses or a Notary
The person signs the directive in front of two qualified witnesses, and at least one of them must meet a stricter standard set out elsewhere in the same chapter. Instead of using witnesses, a person can sign and have the signature notarized. A Dallas living will lawyer walks through who can serve as a witness before the signing, since a poor choice can create problems later.
Telling the Physician Completes the Process
The statute also expects the person to tell the attending physician that a directive exists. If the person is incompetent or unable to communicate, someone else may do so. The physician must then place the directive in the patient’s medical record. A directive does little good if the hospital never learns it exists. Copies should go to the physician, the family, and the person named to make medical decisions, so each of them knows where to find the original.
DNRs and Directives Are Not the Same
The two documents are easy to confuse, but they serve different purposes. A closer comparison of advance directives versus DNRs explains that the directive is the document about life support, while a DNR is generally signed by a terminally or irreversibly ill person or a surrogate, often at hospice admission.
Planning Before Capacity Is Lost
New documents can only be signed by someone who understands what they are signing, so timing matters. Families dealing with a parent or spouse who is declining can follow an incapacity planning checklist that starts with finding existing documents and checking whether they still work.
A Dallas living will lawyer can review those documents with the family while the signer can still understand and approve any changes.
Related Documents Fill In the Gaps
A directive works best alongside other documents. Common companions include:
- A medical power of attorney, which names someone to make health care decisions more broadly.
- An out-of-hospital DNR, which covers resuscitation preferences outside a hospital.
- A durable power of attorney for financial matters.
The financial side is covered by a Dallas power of attorney, which gives a trusted person authority over financial matters if the signer cannot. A durable version stays in effect if the signer becomes incapacitated, and signing it alongside the medical documents helps the two agents work together.
When the Directive Is Not Enough
A directive does not name someone to handle finances, and it does not replace court oversight when no documents exist. A person without a medical agent may eventually need a Dallas guardianship proceeding, which is a court process that typically takes months and carries ongoing duties such as annual reports.
Older clients may work with Dallas elder law planning, which guides clients through documents like powers of attorney, living wills, and trusts so that the pieces fit together instead of standing alone. Reviewing the whole set together also reveals gaps, such as a missing agent or an outdated form.
A Move to Texas Deserves a Fresh Look
People relocate for work and family, and a directive signed in another state may not carry over. Anyone who has moved to Dallas benefits from having a Dallas living will lawyer confirm that their wishes are recorded in a form Texas hospitals will follow.
About the Firm
Ellen Williamson Law, PC was founded in Dallas in 2013 by attorney Ellen Williamson, who earned her J.D. from SMU Dedman School of Law in 2004 and spent more than seven years at the SBA’s disaster loan processing center, explaining complicated processes to overwhelmed people. The firm focuses on estate planning, probate, and guardianship.
Anyone who has not yet put medical wishes in writing can reach out to the firm about preparing a directive and signing it with the right witnesses before a health crisis forces the question.