Healthcare Directives & Living Wills in Texas
Advance directives let you decide — in advance — what kind of medical care you want if you cannot speak for yourself. They protect your family from having to guess, and they protect you from getting treatment you would never have chosen.
Three documents your family will be glad you signed.
Healthcare directives are the part of estate planning most people put off the longest and miss the most when they are needed. They are the documents that tell your family what you want when something happens that prevents you from telling them yourself — a stroke, a car accident, an extended surgery that goes wrong, the slow decline of dementia. They are also the documents that give your family the legal authority to access information, make decisions, and act on your behalf at the moment when waiting for a court order is the worst possible option.
We draft three documents on every healthcare engagement, and we use Texas statutory forms for each. The Directive to Physicians (the living will) tells doctors what life-sustaining treatment you do or do not want in terminal or irreversible conditions. The Medical Power of Attorney names the one person empowered to make all other medical decisions for you. The HIPAA Authorization gives your named agents legal access to your medical records and direct communication with your providers. Together, the three cover everything your family will be asked.
What each one says and what each one does.
These three are inseparable in practice. Hospitals expect to see all three together. We draft them as a coordinated set, not as separate items.
Directive to Physicians
The Texas living will. States your wishes about artificial respiration, feeding tubes, dialysis, resuscitation, and other life-sustaining treatments if you are diagnosed with a terminal or irreversible condition. Speaks directly to physicians without requiring an agent to interpret.
Medical Power of Attorney
Names the one person who makes medical decisions you have not specifically addressed in the directive. Authority to consent to treatment, refuse treatment, choose facilities, access records, and make end-of-life decisions when the directive does not apply.
HIPAA Authorization
Federal patient-privacy law (HIPAA) prevents medical providers from sharing your records without your written permission. This authorization names the family members and agents who are allowed to receive your medical information directly from your providers.
The conversation to have with your family.
A signed document is necessary, but it is not sufficient on its own. The documents only work if your named agents know they exist, know where to find them, and have some sense of what you would actually want when the time comes. We strongly encourage every client to have a thirty-minute conversation with their named medical agent — usually a spouse, an adult child, or a close sibling — before the documents go in the binder.
The conversation does not have to be long or morbid. It needs to cover the basics: what you value at end of life, what kinds of quality of life feel acceptable to you, whether religious or personal beliefs shape your preferences about specific treatments, and how you would want your agent to weigh comfort against duration. Many families discover during this conversation that they have different assumptions about each other. Better to discover that around the dinner table than in the ICU at 2 a.m.
- Where the documents live — Binder location, digital copy access, who has copies.
- Your view on life support — What you do and do not want — and the conditions in which you want it.
- Faith and personal values — Religious or philosophical convictions that should guide decisions.
- Comfort vs. duration — How you would want the trade-off weighed if it has to be.
Specific situations to cover before they happen.
We do not just hand you a generic form. We walk through specific scenarios that hospitals encounter and ask how you would want each handled. Your answers become the document.
- Cardiopulmonary resuscitation (CPR)
Whether and when you would want resuscitation attempted.
- Mechanical ventilation
Short-term while you heal — yes or no? Long-term with no recovery expected?
- Artificial nutrition and hydration
Feeding tube and IV fluids in extended unconsciousness.
- Dialysis
If your kidneys fail and recovery is unlikely.
- Surgery in extreme cases
Major surgery when prognosis is poor.
- Blood transfusions
Particularly relevant for clients with religious objections.
- Comfort-only care
When you would want care shifted entirely to comfort and pain management.
- Organ and tissue donation
What you authorize and which organs.
Statutory forms every hospital recognizes.
Texas has standardized statutory forms for all three healthcare documents — the Directive to Physicians (Texas Health & Safety Code Chapter 166), the Medical Power of Attorney (also Chapter 166), and an Out-of-Hospital Do-Not-Resuscitate (OOH DNR) order for those who want it. Using the statutory forms is a meaningful advantage because every Texas hospital, EMS service, hospice, and long-term care facility is trained on them. The documents are presented, read, and acted on without the friction that custom forms sometimes generate.
We use the current statutory forms on every engagement, customize the substantive content to your specific wishes, and add a HIPAA authorization that matches the people you have named on the medical POA. The package goes into your binder with a one-page summary card you can carry in your wallet or share with family. We also keep digital copies on file, and many of our clients store digital copies with their primary care physician's office so the documents are present in the chart when needed.
If you spend significant time outside Texas — a second home in another state, frequent travel, college-aged children attending out-of-state universities — we can prepare matching documents using the destination state's statutory forms. Out-of-state healthcare directives are generally honored under reciprocity principles, but some hospitals will move faster with a state-specific form in hand. We discuss this during the consultation and make a recommendation based on where you actually spend time.
Questions about advance directives in Texas.
Yes, at any time, as long as you have capacity to do so. The Directive to Physicians can be revoked orally, in writing, or by physical destruction of the document. The Medical Power of Attorney can be revoked in writing or by clear oral notice to your agent. We recommend a written revocation followed by a fresh document so there is no ambiguity in your file.
Your medical agent has the authority to make decisions, and Texas providers are required to follow the agent's direction so long as it is consistent with your directive and applicable law. Family disagreement does not override the agent. That said, we encourage choosing a medical agent who can communicate well with the rest of the family — it makes the process easier even when authority is clear.
The Directive to Physicians is a healthcare directive that activates when you have a terminal or irreversible condition. The Out-of-Hospital DNR (OOH DNR) is a separate order signed with a physician that instructs EMS not to attempt resuscitation in any setting. Most clients do not need both — the directive covers most scenarios. We discuss whether an OOH DNR is appropriate during the consultation, particularly for clients with serious chronic illness.
Without a HIPAA authorization, a hospital is legally prohibited from telling your family whether you are even a patient there, let alone what your condition is. Your medical agent has implicit access through the medical POA, but other family members — adult children, siblings — do not unless they are named on the HIPAA authorization. We typically include several family members so information flows freely.
Yes — especially once they turn 18. At that point, HIPAA prevents you from receiving their medical information without their written authorization, even if they are still on your insurance and living at home. A college freshman in a car accident on a Saturday night is the most common scenario where parents discover this the hard way. We draft directives for young adults at a substantially reduced rate when we are already working with their parents.
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