Introduction to Living Wills and Advance Directives in Texas
A living will and advance directive are essential legal tools in Texas that enable you or your loved one to outline their healthcare preferences in the event they become unable to make or communicate medical decisions due to incapacity. Governed by the Texas Advance Directives Act (Texas Health and Safety Code, Chapter 166), these documents ensure a person’s wishes regarding medical treatment, particularly end-of-life care, are respected.
Living Will
A living will, formally called a Directive to Physicians and Family or Surrogates, specifies preferences for life-sustaining treatments, such as ventilators or feeding tubes, in the event of a terminal or irreversible condition.
Advance Directive
An advance directive is a broader term that encompasses the living will and other documents, such as a medical power of attorney, which appoints an agent to make healthcare decisions on one’s behalf. These tools provide clarity for healthcare providers and loved ones, reducing uncertainty during critical medical situations.
In Texas, advance directives must be signed and either notarized or witnessed by two qualified individuals to be legally valid. They can be changed or revoked at any time while the individual remains competent, offering flexibility to adapt to changing preferences. Understanding and utilizing these documents is crucial to ensure that your personal healthcare wishes are respected and followed.
Advance health care planning is an essential aspect of your comprehensive estate plan. You should consult with an experienced estate planning attorney in Texas to ensure that your living will or advance directive complies with the state’s laws.
Understanding Advance Directives and Their Types
Advance directives are legal documents that allow individuals to plan for their medical care in the event they become unable to make or communicate decisions due to incapacity. Advance directives in Texas include two primary types: the Directive to Physicians (living will) and the Family or Surrogate and the Medical Power of Attorney.
Both must be signed by the individual (the principal) and either notarized or witnessed by two qualified individuals to be legally valid. Advance directives take effect only when a physician determines the individual is incompetent to make decisions, and they can be modified or revoked at any time while the individual remains competent, offering flexibility to reflect changing preferences.
Directive to Physicians and Family or Surrogates (Living Will)
A allows you to specify their preferences for medical life-sustaining medical treatments, such as ventilators, artificial nutrition, or hydration, in the event of a terminal or irreversible condition. It becomes effective when a physician certifies that the individual is incapacitated and has a qualifying condition, as defined by Texas law. The living will directly instruct healthcare providers on whether to administer, withhold, or withdraw such treatments, focusing on end-of-life care scenarios.
Medical Power of Attorney
This directive appoints a trusted person, known as an agent, to make a broad range of healthcare decisions on behalf of the individual if they become unable to do so. Unlike a living will, which is limited to specific end-of-life treatment preferences, a medical power of attorney covers any medical decision, including those unrelated to terminal conditions, as long as the individual is deemed incompetent by a physician. The agent’s authority begins upon this determination and ends if the person regains capacity.
Out-of-Hospital Do-Not-Resuscitate (OOH-DNR)
In Texas, an Out-of-Hospital Do-Not-Resuscitate order is a legal document that instructs emergency medical services personnel and other healthcare professionals not to perform specific resuscitative measures if a person experiences cardiac or respiratory arrest outside a hospital setting. An OOH-DNR applies in settings such as private homes, nursing homes, hospice facilities, or during transport.
To be valid, an OOH-DNR order must be completed on a standardized form provided by the Texas Department of State Health Services, signed by the patient (or their legal representative if incompetent) and their attending physician, and either signed by two competent adult witnesses (one of whom cannot be a relative, heir, or healthcare provider) or notarized.
All of these legal documents ensure that your healthcare wishes are respected if you’re incapacitated. Please consult with our Texas estate planning attorney for more information on which legal option is best suited for your situation.

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At Texas Tax & Estate Law, we are skilled Texas estate planning lawyers who will guide you through the estate planning process. We’ll help you create a will and estate plan, ensuring that your wishes are followed after you pass away.
Creating a Comprehensive Estate Plan with Advance Directives
Many people believe that estate planning is solely about financial decisions. However, comprehensive estate planning in Texas involves preparing for the management and distribution of an individual’s assets and healthcare decisions during their lifetime and after their death. A comprehensive estate plan ensures that personal wishes are honored, minimizes legal complications, and provides peace of mind for both the individual and their loved ones. A critical component of your comprehensive estate plan is the inclusion of advance directives, which address medical decisions when a person becomes incapacitated.
Advance Directives Benefits
Incorporating advance directives into an estate plan offers numerous benefits, including autonomy over medical care, reduced emotional strain on loved ones, and alignment with personal values. However, individuals must consider potential challenges, such as ensuring the appointed agent understands their wishes or addressing complex medical scenarios not covered in a living will.
An OOH-DNR, for example, is specific to resuscitation and does not address other treatments, so it should align with broader directives. Working with an attorney and healthcare professional can clarify these nuances and tailor the plan to individual needs.
By proactively creating a comprehensive estate plan with advance directives, Texans can safeguard their legacy and ensure their medical and financial wishes are honored. Proper planning with advance directives lowers stress and conflict between family members during a medical crisis.
You should review and update your directives periodically as life circumstances evolve, such as marriage, health changes, or new diagnoses. Ensure that all legal requirements for signing and witnessing Texas advanced directives are followed. Contact our Texas estate planning attorney today to ensure that your directives are completed correctly and are legally valid.
Planning for End-of-Life Care in Texas
It is critical to have clear instructions for end-of-life care, including hospice and palliative care. Planning for end-of-life care in Texas involves legal, medical, and personal decisions to ensure your wishes are honored. This process, often referred to as end-of-life planning, enables you to outline your preferences for medical treatment, designate decision-makers, and ensure that their wishes are honored when you can no longer communicate.
In Texas, advance care planning is supported by advance directives, including living wills, DNR orders, and medical powers of attorney. These legal tools provide critical guidance for your physicians and family members if you are incapacitated or unable to make your own decisions.
Planning also reduces the emotional difficulty and uncertainty for your family when you are at the end of your life. It’s wise to discuss your wishes with your family and doctors to ensure that all are informed of your wishes.

Why You Need a Living Will and Advance Directive Lawyer in Texas
An experienced estate planning lawyer ensures that your living will or advance directive documents meet all legal requirements. For example, common issues with advance directives include improper witnessing or vague language that could render them invalid. Texas Tax & Estate Law can effectively navigate these legal nuances, ensuring that your wishes are followed at the end of life. Without correct legal execution, your physicians may default to state protocols, potentially overriding your preferences.
An experienced Texas estate planning attorney can help you make your end-of-life plans to provide guidance and certainty to your loved ones in a stressful, challenging time. Texas Tax & Estate Law is a board-certified estate planning lawyer with extensive experience in healthcare directives. He can coordinate your advanced directives with other estate planning tools, such as financial powers of attorney, trusts, and other relevant documents.
Schedule a free consultation with Texas Tax & Estate Law today to devise legally sound and personalized healthcare directives that integrate seamlessly with your comprehensive estate plan.
Frequently Asked Questions
What is the difference between a living will and an advance directive in Texas?
In Texas, the terms living will and advance directive are often used in the context of healthcare planning, but they refer to related yet distinct concepts. Both are legal documents that allow individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes due to illness or incapacity. However, a living will is primarily focused on guiding healthcare providers and family members about whether to continue or withhold life-prolonging measures. An advance directive is a broader term that encompasses multiple types of legal documents, including the living will (also known as a Directive to Physicians) and a Medical Power of Attorney.
Do I need a lawyer to create a living will or advance directive in Texas?
In Texas, you do not legally need a lawyer to create a living will or advance directive, as the state provides statutory forms that individuals can complete on their own. These documents, which outline your medical treatment preferences in the event of incapacity, are designed to be straightforward to understand.
However, consulting Texas Tax & Estate Law can be beneficial in certain situations. If your medical wishes are complex, involve specific conditions, or you anticipate disputes among family members, an attorney can help ensure your advance directive is precise and tailored to your needs.
What decisions can I outline in a Texas living will?
a living will, formally known as a Directive to Physicians and Family or Surrogates, allows you to outline specific medical treatment preferences for situations where you are incapacitated and unable to communicate your wishes. This document, governed by the Texas Health and Safety Code, enables you to guide healthcare providers and loved ones on how to handle your medical care, particularly in end-of-life or terminal scenarios.
Who can I name as my healthcare agent in an advance directive?
You can name any competent adult as your healthcare agent, such as a spouse, adult child, sibling, parent, close friend, or other trusted individual. The person must be at least 18 years old and capable of making informed decisions about your medical care.
When does a living will or advance directive take effect in Texas?
In Texas, a living will or advance directive takes effect when a person becomes unable to make their own medical decisions due to incapacity, as determined by a physician, and specific conditions outlined in the document are met, such as a terminal or irreversible condition. The law specifies that the directive becomes active when the individual’s attending physician certifies in writing that the person is incompetent and has a qualifying condition, meaning they cannot communicate or make decisions about their medical treatment.
Does a living will cover end-of-life decisions such as life support or feeding tubes?
Yes, in Texas, a living will, also known as a Directive to Physicians and Family or Surrogates, covers end-of-life decisions, including preferences for life-sustaining treatments such as life support or feeding tubes. Under state law, the living will allows individuals to specify whether they want such treatments withheld or withdrawn in the event of a terminal or irreversible condition, as certified by a physician.
Can I include do-not-resuscitate (DNR) instructions in my advance directive?
You cannot include do-not-resuscitate (DNR) instructions directly in a standard advance directive, such as a Directive to Physicians and Family or Surrogates (living will). A DNR order is a separate legal document in Texas, governed by the Texas Health and Safety Code. A physician must issue it and requires specific forms, such as an Out-of-Hospital DNR or In-Hospital DNR, to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest.
How is a Texas living will different from a medical power of attorney?
In Texas, a living will and a medical power of attorney are distinct advance directive documents, each serving different purposes under the Texas Advance Directives Act. A living will is a written document that outlines a person’s specific preferences for medical treatment, particularly regarding life-sustaining measures like ventilators or feeding tubes, in the event of a terminal or irreversible condition when they are unable to communicate. It takes effect only when a physician certifies that the person is incapacitated and has a qualifying condition.
On the other hand, a medical power of attorney designates a trusted person (an agent) to make healthcare decisions on behalf of the individual if they become unable to do so due to incapacity. Unlike a living will, it is not limited to terminal or irreversible conditions. It can cover a broader range of medical decisions, including those not explicitly addressed in a living will.
Does a living will need to be notarized or witnessed in Texas?
A living will must be either notarized or witnessed to be legally valid, as outlined in the Texas Advance Directives Act. Specifically, the document requires the signature of the individual creating it (the principal) in the presence of two qualified witnesses or a notary public.
Can I change or revoke my living will or advance directive later?
You can change or revoke your living will (Directive to Physicians and Family or Surrogates) at any time, provided you are competent to make decisions. To change your living will, you can create a new directive that reflects your updated wishes, ensuring it meets the legal requirements (i.e., it must be signed and either notarized or witnessed by two qualified individuals). The new directive typically supersedes the previous one; therefore, you should distribute copies to your healthcare providers, agent (if applicable), and family to avoid confusion.

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