What Every Texan Needs to Know About How To Make A Living Will

Creating a living will is one of the most effective ways to make sure your medical wishes are respected if you lose the ability to communicate them yourself. In Texas, this document is formally known as a “Directive to Physicians and Family or Surrogates.” It gives instructions about whether or not to continue life-sustaining treatment if you are diagnosed with a terminal or irreversible condition. Knowing how to make a living will means understanding the requirements, your rights, and the steps involved in preparing and executing the document properly.

Once you understand what a living will does and why it matters, the next step is knowing exactly how to make one. Here’s a step-by-step breakdown of what you need to know:

1. What Is a Living Will and Why You May Need One
2. How To Make a Living Will: The First Steps
3. Signing and Witnessing Your Living Will
4. Where and How To Store Your Living Will
5. Should You Also Assign a Medical Power of Attorney?
6. Updating or Revoking a Living Will
7. When Does a Living Will Take Effect?
8. What if You’re Pregnant?
9. What Happens Without a Living Will?

What Is a Living Will and Why You May Need One

A living will is a legal document that outlines your healthcare decisions for end-of-life care. It focuses on situations where you are unable to make your own decisions due to a serious medical condition. Texas law distinguishes between two medical situations that can activate a living will:

• Terminal Condition: An illness or injury that is expected to cause death within six months, even with life-sustaining treatment.
• Irreversible Condition: A condition that may not be fatal in the short term but prevents recovery and leaves you unable to care for yourself or make decisions.

Without a living will, your loved ones may face stressful choices without clear guidance. By creating this document, you control how much or how little medical intervention you want, easing the emotional and legal burden on others.

How To Make a Living Will: The First Steps

Before completing your living will, you need to think about the kind of treatment you would want—or not want—if you could no longer speak for yourself. Consider how you feel about mechanical ventilation, tube feeding, dialysis, or being resuscitated.

Once you’re confident in your decisions, follow these steps:

1. Use the Official Form
   Texas law provides a standard form called the “Directive to Physicians.” You are not required to use this exact version, but it’s wise to follow its format to avoid confusion. The form can usually be obtained from hospitals, legal websites, or healthcare providers.
2. Be Mentally Capable When You Sign It
   You must be of sound mind and at least 18 years old when signing the document. If you are already unconscious, under guardianship for mental incapacity, or otherwise unable to make decisions, you cannot legally create or modify a living will.
3. Specify Your Wishes Clearly
   The document typically gives you two main choices:
   • Agree to life-sustaining treatment under certain conditions.
     
   • Request that life-sustaining treatment be withheld or withdrawn.
4. You may add more specific instructions if you want. For example, you can state your preferences on artificial hydration or pain medication.

Signing and Witnessing Your Living Will

Under Texas law, a living will must be signed by you and either two witnesses or a notary public. Each option is acceptable. However, there are strict rules if you choose witnesses:

• At least one witness must be someone who is not related to you, named as a beneficiary in your estate, or involved in your healthcare.
• Neither witness can be your attending physician or an employee of your care facility (unless they are also a clergy member or social worker).

Using a notary can simplify the process, especially if finding two eligible witnesses is difficult. However, if you plan to sign at a hospital or long-term care facility, ask if a staff notary or witness is available.

Where and How To Store Your Living Will

Creating your living will is only one part of the process. It must also be available when it’s needed. Consider the following storage practices:

• Keep the Original in a Safe but Accessible Place
  Don’t store your living will in a safety deposit box unless others can access it. A labeled file folder at home may be more practical.
• Give Copies to Relevant People
  Share your living will with your doctor, your medical power of attorney (if you have one), and close family members. Some people choose to keep a copy in their glove compartment when traveling or post a copy on the refrigerator for paramedics.
• Tell People It Exists
  A living will only works if others know you have one. Be sure your loved ones are aware of it and understand what you want.

Should You Also Assign a Medical Power of Attorney?

A living will and a medical power of attorney (MPOA) serve different roles, but they work well together. Your living will states your wishes about life support. Your MPOA appoints someone to make other medical decisions if you can’t.

You may want both documents in place so your healthcare choices are both clearly stated and actively managed by someone you trust.

When these documents conflict, Texas law generally defers to the living will. However, clarity and consistency between the two will prevent confusion.

Updating or Revoking a Living Will

You can change or cancel your living will at any time. There are no complicated procedures for this. Here are the ways to revoke it:

• Destroy the document.
• Sign a written statement revoking it.
• Verbally state that you want to cancel it.
• Create a new directive that replaces the old one.

If you get divorced, the living will remains valid unless you revoke or update it. If your health or beliefs have changed, don’t forget to review your living will to make sure it still reflects your preferences.

When Does a Living Will Take Effect?

Your living will does not apply the moment you enter a hospital or fall unconscious. Two conditions must be met:

1. Your doctor must diagnose a terminal or irreversible condition.
2. You must be unable to communicate your wishes.

At that point, your medical team will review your living will and act according to the instructions. They are not allowed to disregard it without reason, and hospitals are generally required to comply. However, if a facility or physician has a conscientious objection, they must transfer you to another provider who will honor your directive.

What if You’re Pregnant?

Texas law places restrictions on enforcing a living will if you are pregnant. If your doctor determines that life-sustaining treatment is needed to maintain the pregnancy, your directive may be set aside during that period. This exception is legally required, even if your living will says otherwise.

The law specifically states that life-sustaining treatment must continue if it is likely to result in the birth of a live, viable infant. This applies even if the treatment conflicts with your expressed wishes in your directive. Your healthcare providers are not permitted to withdraw or withhold interventions that could support fetal development, unless there is a medical determination that the fetus is not viable or the treatment will not help sustain the pregnancy.

Because of this legal requirement, you may want to add language to your directive acknowledging this limitation. While your instructions cannot override the statute, expressing your personal views can still help guide your loved ones and medical team in understanding your broader values and concerns. If you have strong feelings about pregnancy-related care in these situations, discuss them with your physician in advance. They can help document your preferences in your medical records and support respectful communication among your care team.

What Happens Without a Living Will?

If you become seriously ill or injured and don’t have a living will, decisions about life-sustaining treatment will fall to others. Your medical team will typically consult with your next of kin, which might include a spouse, adult children, or parents.

Without written instructions, your family may disagree about what you would have wanted. This can lead to delay, emotional distress, or even court involvement. Making a living will prevents these problems by giving clear guidance in advance.

Final Steps to Secure Your Texas Living Will for Peace of MindConclusion

Knowing how to make a living will is an important step in protecting your healthcare choices. It allows you to remain in control during situations where you may not be able to speak for yourself. By using the proper form, stating your preferences clearly, and ensuring your document is signed, witnessed, and shared, you take a significant step toward peace of mind. You also reduce the burden on your loved ones during difficult medical situations.

Take the time to create a living will that reflects your values and medical preferences. The effort you put in now can make a meaningful difference later.

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