What Every Texan Needs to Know About Health Directives Living Wills

A health directive living will is a written document that outlines your decisions about medical care if you become unable to speak for yourself. In Texas, this is formally called a “Directive to Physicians and Family or Surrogates.” It allows you to declare whether you want life-sustaining treatment if you develop a terminal or irreversible condition and can no longer communicate.

Understanding how this document works gives you control over future health care decisions. It also helps reduce uncertainty and emotional burden for your loved ones during stressful times. If you live in Texas and are over 18, you have the legal right to create one.

Let’s take a detailed look at everything you should know about health directives living wills:

1. Health Directives Living Wills: What It Means in Texas
2. Key Provisions to Include in Your Health Directive Living Will
3. Health Directive Living Will vs. Medical Power of Attorney
4. When a Health Directive Living Will Becomes Effective
5. Changing or Canceling a Health Directive Living Will
6. Where to Store and Share Your Health Directive Living Will
7. What Happens if You Don’t Have a Health Directive Living Will?
8. How to Get a Texas Health Directive Living Will Form
9. Why You Should Consider Creating One Today

Health Directives Living Wills: What It Means in Texas

The term “health directive living will” refers to a legally binding document that allows you to communicate your medical preferences in advance, in case you lose the ability to express them later. While often associated with aging or end-of-life planning, Texas law does not restrict this document to those who are elderly or seriously ill. You can create one at any stage of adulthood, regardless of your current health status, as long as you are of sound mind.

The purpose of a health directive living will is to give you control over specific treatments in advance, helping prevent unwanted or prolonged medical interventions. It also eliminates guesswork for those who may be called on to support your care. Without clear written instructions, your medical team and family may face difficult decisions without knowing your true preferences.

In Texas, the document does not take effect immediately upon signing. For it to become active, two licensed physicians—one of whom must be your attending physician—must first determine both of the following:

• You are diagnosed with a terminal or irreversible medical condition as defined by Texas law
• You are no longer able to make decisions or express your wishes in a coherent way

Only when both conditions are confirmed does your directive begin to guide treatment. At that point, your written choices act as a set of standing orders. For example, if you stated you do not wish to receive certain life-sustaining procedures under defined circumstances, that instruction becomes the reference point for all further decisions. If no such instruction exists, the care team may defer to your legally appointed representative, if one exists, or rely on family consensus.

This mechanism ensures that your right to informed consent remains intact—even if you cannot speak. It is not only a practical document but also a powerful legal tool that helps uphold your medical autonomy and protect your values during a time of vulnerability.

Key Provisions to Include in Your Health Directive Living Will

Your directive must clearly express your choices. You can be as general or specific as you wish, but the document must include certain required statements to comply with Texas Health and Safety Code § 166.033. At a minimum, you must include:

• A statement requesting or refusing life-sustaining treatment if your condition is terminal or irreversible
• Your signature and the date
• Signatures of two qualified witnesses or acknowledgment before a notary

Some people also choose to include additional preferences such as:

• Whether you want artificial nutrition and hydration
• Pain management instructions
• Instructions about dialysis or mechanical ventilation
• Religious or cultural beliefs that should guide treatment decisions

If you include these, they should be clear and written in your own words where possible. You can also attach explanatory notes if needed.

Who Can Witness or Notarize a Health Directive Living Will?

To be valid in Texas, your directive must be signed by either:

• Two qualified witnesses, or
• A notary public

If you use witnesses, Texas law restricts who may serve in this role. A witness must not be:

• Someone related to you by blood or marriage
• Someone entitled to any part of your estate
• Someone named as your health care agent
• A health care provider or employee of a health care facility where you are receiving treatment (unless they are a chaplain or social worker)

If you choose notarization instead of using witnesses, ensure the notary is licensed in Texas and available to confirm your identity and mental competence at the time of signing.

Health Directive Living Will vs. Medical Power of Attorney

These are separate legal documents. A health directive living will outlines your treatment choices, while a medical power of attorney names someone to make health care decisions for you.

You can have both. In fact, having both offers a stronger plan:

• Your health directive living will speaks for you directly
• Your medical power of attorney speaks on your behalf when your wishes are not addressed in your directive

In Texas, both documents can be used together. If there is ever confusion, your treatment team will rely on your directive first, then turn to your appointed agent for clarification or additional choices not covered in writing.

When a Health Directive Living Will Becomes Effective

Your directive only takes effect under two conditions:

1. You are diagnosed with a terminal or irreversible condition
2. You are unable to communicate or make medical decisions

A terminal condition means an illness that will cause death within six months, even with life-sustaining treatment. An irreversible condition means a situation where you cannot recover, and life-sustaining treatment only prolongs the dying process.

If you can still speak for yourself, your directive is not used. It will never override your current, spoken decisions while you remain mentally capable.

Changing or Canceling a Health Directive Living Will

You may change or cancel your directive at any time, as long as you are mentally competent. In Texas, you can revoke your directive in the following ways:

• By signing a written revocation
• By physically destroying the directive
• By verbally stating that you wish to cancel it (in the presence of a witness)
• By creating a new directive

If you create a new directive, it automatically replaces the older one. Make sure to tell your doctor and family about the changes. Always keep the most recent version easily accessible.

Where to Store and Share Your Health Directive Living Will

After completing your directive, make several copies. You should give one to:

• Your primary care physician
• Any specialists involved in your care
• The hospital or care facility where you receive treatment
• The person you trust most to act on your behalf

You should also keep one in a clearly labeled folder at home. Do not store it in a safe deposit box, where it may not be accessible in an emergency.

Some Texans also choose to file their directives with an online medical registry or keep them as part of a digital health file shared with loved ones.

What Happens if You Don’t Have a Health Directive Living Will?

If you don’t have a directive, your medical care will be decided by the person your care team believes is your legal surrogate. This might be your spouse, adult child, parent, or close friend. Texas law has a priority order for who may act as a surrogate when no directive or medical power of attorney exists.

The risk is that your surrogate may not know what you want, or loved ones may disagree on treatment decisions. Having a written directive prevents this uncertainty and helps your care team respect your preferences without delay.

How to Get a Texas Health Directive Living Will Form

Texas offers a standard form you can use. It’s called the “Directive to Physicians and Family or Surrogates” and is available from:

• Your doctor’s office
• Major hospitals and medical groups
• The Texas Health and Human Services website
• Legal or estate planning professionals

You don’t need an attorney to complete the form, but you should read each section carefully and consider talking to a medical professional or trusted advisor before finalizing it.

Why You Should Consider Creating One Today

Creating a health directive living will ensures that your medical choices are honored when you can’t speak for yourself. It helps your loved ones feel confident they’re doing what you would want. It also gives your care team clear directions and avoids delays or unnecessary interventions.

If you’re healthy and young, it may not seem urgent. But health emergencies can happen without warning. By taking a few minutes to prepare your directive now, you make sure your future care matches your values.

Conclusion

A health directive living will gives you the chance to protect your autonomy and ease the burden on your loved ones. In Texas, this document is legally recognized and easy to complete. By clearly outlining your preferences and keeping your directive accessible, you provide valuable guidance when it’s needed most. Whether you’re planning ahead or updating your existing documents, creating or reviewing your directive is a wise and compassionate step.

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FAQs About Health Directives Living Wills