Revocation of Directive to Physicians and Family or Surrogates
STATUTORY REFERENCE
ALL REFERENCES ARE TO THE APPLICABLE TEXAS CODE
REVOCATION OF DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES
(Texas Health and Safety Code)
General information (§ 166.031)
A "directive" is an instruction to administer, withhold, or withdraw
life sustaining treatment in the event of a terminal or irreversible condition.
A "qualified patient" is a patient with a terminal or irreversible
condition that has been diagnosed and certified in writing by the attending
physician.
Execution and Witnesses (§ 166.032, 166.003)
A competent adult may at any time execute a written directive. The
directive must be signed by the principal in the presence of two witnesses
(who must themselves sign the document) who qualify as follows:
- each witness must be a competent adult; and
- at least one of the witnesses must be a person who is not:
- a person designated by the declarant to make a treatment decision;
- a person related to the declarant by blood or marriage;
- a person entitled to any part of the declarant's estate after the declarant's
death under a will or codicil executed by the declarant or by operation
of law;
- an employee of the attending physician;
- an employee of a health care facility in which the declarant is a patient
if the employee is providing direct patient care to the declarant or is
an officer, director, partner, or business office employee of the health
care facility or of any parent organization of the health care facility;
or
- a person who, at the time the written advance directive is executed
or, if the directive is a non-written directive issued under this chapter,
at the time the non-written directive is issued, has a claim against any part of the declarant's estate after the declarant's
death.
A declarant may include directions in a directive other than
those provided in the statutes and may designate a person to make a treatment
decision for the declarant in the event the declarant becomes incompetent
or otherwise mentally or physically incapable of communication.
A declarant must notify the attending physician of the existence
of a written directive.
If the declarant is incompetent or otherwise mentally or physically
incapable of communication, another person may notify the attending physician
of the existence of the written directive. The attending physician must
make a directive a part of the declarant's medical record.
Form of Written Directive (§ 166.033)
A written directive may be in the statutory form.
Patient Desire Supersedes Directive (§ 166.037)
The desire of a qualified patient, including a qualified patient
younger than 18 years of age, supersedes the effect of a directive.
Duration of Directive (§ 166.04)
A directive is effective until it is revoked as prescribed by statute.
Revocation of Directive (§ 166.042)
A declarant may revoke a directive at any time without regard to
the declarant's mental state or competency. A directive may be revoked
by:
- the declarant or someone in the declarant's presence and at the declarant's
direction canceling, defacing, obliterating, burning, tearing, or otherwise
destroying the directive;
- the declarant signing and dating a written revocation that expresses
the declarant's intent to revoke the directive; or
- the declarant orally stating the declarant's intent to revoke the directive.
A written revocation takes effect only when the declarant or
a person acting on behalf of the declarant notifies the attending physician
of its existence or mails the revocation to the attending physician. The
attending physician or the physician's designee must record in the patient's
medical record the time and date when the physician received notice of
the written revocation and must enter the word "VOID" on each page of the
copy of the directive in the patient's medical record.
An oral revocation takes effect only when the declarant or a person
acting on behalf of the declarant notifies the attending physician of the
revocation. The attending physician or the physician's designee must record
in the patient's medical record the time, date, and place of the revocation,
and, if different, the time, date, and place that the physician received
notice of the revocation. The attending physician or the physician's designees
must also enter the word "VOID" on each page of the copy of the directive
in the patient's medical record.
Except as otherwise provided, a person is not civilly or criminally
liable for failure to act on a revocation made under this section unless
the person has actual knowledge of the revocation.