In texas, a living will (in the past, also called Power of Attorney for Health Care or Durable Power of Attorney for Health Care) is now known as an Advance Directive. The Texas Advance Directive Act of 1999 did not invalidate documents prepared under other statutes; those documents are interpreted under the law in effect when they were written. Likewise, such documents prepared under the law of another state may be valid.
Like a Will, an Advance Directive is a legal document that can clearly and unequivocally register a person's wishes. A Will directs the disposition of a person's property and an Advance Directive acknowledges the person's intent concerning the administration of "life-sustaining treatment" when suffering from a "terminal" or "irreversible" condition. It only operates when "you are unable to make your wishes known because of illness or injury." An Advance Directive can be revoked at any time regardless of competency or mental state. One does not lose the right to seek life-sustaining care by signing an Advance Directive, because a person's stated desire always supersedes it.
Legal Formalities. The 1999 Act requires certain formalities of execution. It need not be signed in the presence of a notary, but two disinterested, competent adult witnesses must sign and actually witness the person's execution of the Advance Directive. To avoid conflicts of interest, certain persons may not serve as a witness. These include persons designated to make treatment decisions; relatives by blood or marriage; beneficiaries of the person's estate; persons having a claim against the estate; attending physicians or employees; employees of a health care facility involved in providing direct care to the patient; and officers, directors, partners or business employees of the medical institution or parent organization providing care. The Act contains a form of an Advance Directive which is now in common use, but it does not have to be in any particular form to be valid.
The Options. If a person becomes "unable to make medical decisions because of illness or injury" and the treating physician determines that death is expected within six months even with life-sustaining treatment, the Advance Directive provides two options:
1) I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR
2) I request that I be kept alive in this terminal condition using available life-sustaining treatment.
Designating a Person to Make Decisions. In addition, one may identify a person and alternates who are empowered to make medical treatment decisions if an illness or injury prevents the person from being able to do so.
Hospice Care. In the event that a person elects to receive "Hospice Care," the Advance Directive provides that such an election reflects an intent to choose option number one above.
If No Advance Directive. In the event that there is no document like an Advance Directive and a person becomes "incompetent or incapable of communication," health care decisions including the removal or withholding of life-sustaining treatment may be made by the physician and one of the following persons, in this order: the spouse, reasonable available adult children, the parents, or nearest living relative.
Miscellaneous. No insurance company, physician, health facility, health care provider, insurer or health care service plan may require the person to execute an Advance Directive.
Other Decisions. It is common for an Advance Directive to be considered and executed at the same time one executes a Will. The Act also suggests that one should consider organ donation at this time. Texas law also provides for the execution of a Medical Power of Attorney for Health Care and for a document entitled "Out of Hospital Do Not Resuscitate Order."