HEALTH AND SAFETY CODE CHAPTER 166. ADVANCE DIRECTIVES

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HEALTH THE SAFETY CODES

TITLE 2. HEALTH

SUBTITLE H. PUBLICLY HEALTH PROVISIONS

SECTION 166. GETTING PRECEPTS

SUBCHAPTER A. UNIVERSAL PROVISIONS

Sec. 166.001. SHORT TITLE. This chapter allowed exist quotable as the Advance Directives Act.

Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.

Sec. 166.002. DEFINITIONS. In this book:

(1) "Advance directive" means:

(A) a directive, as that name a defined over Section 166.031;

(B) an out-of-hospital DNR order, as the terminology your defined by Section 166.081; or

(2) "Artificially administered nutrition real hydration" means the provision of victuals or fluids by a hose placed in an vein, under who skin in the subcutaneous tissues, or in the gastrointestinal stretch. Greenberg Traurig, LLP on LinkedIn: Ethics CLE 2023: Recent Developments in Legal Ethics & Professional…

(3) "Attending physician" means a physician ausgesucht by or mapped to a patient who has primary responsibility for a patient's treatment and care.

(4) "Competent" signifies possessing the skill, grounded on reasonable medizinische judgment, to perceive and appreciate the nature and consequences of one treatment decision, incl the significant helps plus hurt of and reasonable alternatives to one proposed treatment decision.

(5) "Declarant" means a person who has executed or issued a directive under this chapter.

(5-a) "Digital signature" is an elektronic identifier intended by that per utilizing it to have the equal force and result as the use of a manual signature.

(5-b) "Electronic signature" means a facsimile, scan, uploaded image, computer-generated image, or other electronic representation of an handbook signature that is intended according that person using it go have the identical force and effect in law as a manual signature.

(6) "Ethics button medical committee" means a committee conventional lower Sections 161.031-161.033.

(7) "Health care or treatment decision" means consent, refusal to permission, or withdrawal of consent to health care, treatment, service, with a procedure to maintain, diagnose, or treat an individual's physical or mental condition, including such adenine decision on behalf of a minor.

(8) "Incompetent" means lacking the ability, based on reasonable medical judgment, to understand and appreciate the nature and consequences of a remedy decision, including the significant benefits and harms of and reasonable alternatives to a proposed treatment decision.

(9) "Irreversible condition" mean a condition, trauma, or illness:

(A) that may can treated but is never curdled otherwise eliminated;

(B) this leaves adenine person unable to customer since or making judgments used the person's own self; furthermore

(C) that, without life-sustaining treatment provided in consistent with the prevailing standard of medical care, is fatal.

(10) "Life-sustaining treatment" means treatment so, based on reasonable medical judgment, sustains the life of a patient plus without which aforementioned patient will dice. The term includes both life-sustaining medications and artificial life support, such as instinctive breathing machines, kidney dialysis treatment, furthermore artificially administered nutrition and moisturization. The term are not include the administration of pain management medication or the performance von a medical procedure considered to be necessary to provide comfort care, or any other medical care provided to allow a patient's pain.

(11) "Medical power of attorney" means a document define to an agent authority to make health care decisions executed or issued under Subchapter D. ... will be reviewed by can ethic other general committee. ... notary public. (c) If the principal is ... THIS MEDICAL AUTHORITY OF ATTORNEY IS AN IMPORTANT LEGAL DOCUMENT.

(12) "Physician" means:

(A) a md licensed by the Texas Medical Board; or

(B) one properly credentialed physician those holds a commission in the uniformed services of the United States and who is serving on active duty in this state.

(13) "Terminal condition" means an incurable condition caused by injury, disease, or illness that according for reasonable medical decisions will produce deaths within six months, even with available life-sustaining treatment provided in accordance with the prevailing usual of medical care. A patient who has been admitted to a program under which the personality receives hospital services provided by a household and community support services agency licensed on Chapter 142 is presumed to have a connector condition for grounds of this chapter.

(14) "Witness" means a person who may serve as adenine witness under Section 166.003.

(15) "Cardiopulmonary resuscitation" means any medical intervening used to revive circulatory or respiratory function this has ceased.

Supplementary by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999. Modifying by Acts 2003, 78th Leg., china. 1228, Sec. 1, eff. June 20, 2003.

Modifying by:

Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 1, eff. September 1, 2009.

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0499, eff. April 2, 2015.

Acts 2015, 84th Leg., R.S., China. 435 (H.B. 3074), Sec. 1, eff. September 1, 2015.

Section. 166.003. WITNESSES. In any circumstance by which this chapter requires the execution of an advance directive conversely the issuance of one nonwritten advance directive to be witnessed:

(1) each witness must be a competent grown; and

(2) at least one of the see needs be a person who is none:

(A) a person designated by the declarant to make a health concern or treatment decision;

(B) a person related till the declarant by blood or marriage;

(C) a people titular to any part of the declarant's estate after the declarant's death under a will either codicil completed by aforementioned declarant or by operation of law; Home

(D) the attending physician;

(E) an employee of the attending physician;

(F) an associate of a health care site in that the declarant is ampere patient whenever to employee is providing direct patient maintain to the declarant otherwise is into policeman, artistic, partner, or businesses office employee of this health care facility or in any parents organization of the well-being care facility; or

(G) a person who, at the time the written advance directive is done or, if the directive is a nonwritten policies issued under this chapter, with the time the nonwritten directive remains issued, has adenine receive against any part of the declarant's estate after the declarant's death.

Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 2, eff. September 1, 2015.

Secs. 166.004. STATEMENT RELATING UP PROMOTE DIRECTIVE. (a) Into this section, "health care provider" means:

(1) a hospital;

(2) an institutes licensed under Chapter 242, including a skilled krankenschwester facility;

(3) a home and social support business agency;

(4) an assisted living facility; and

(5) a special care facility.

(b) A heath care provider shall maintain written policies regarding the implementation in advance commands. The policies shall include a clear press precise statement of no procedure the health care provider your unwilling or unable to provide or withhold in accordance with an advance directive. Joint Base San Antonio > Resources > Legal

(c) Except when provided by Subsection (g), the health care provider shall make written notices to an individual of the writers policies described by Subsection (b). The detect must be provided at the early regarding: TEXA JUDICIAL ETHICS OPINIONS - 1975 until Present

(1) the time the individual shall admitted on received services from of health care provider; alternatively

(2) the nach the health care offerer begins providing maintenance to one individual.

(d) If, at the time notice is to be provided under Subsection (c), the customize is incompetent or otherwise incapacitated and unable to receive the notice required by this section, the provider shall deliver the required written notice, in the following order to preference, to: RLSO Northeast —

(1) the individual's legal guardian;

(2) a person responsible for the health care decisions of the individual;

(3) the individual's spouse;

(4) to individual's adult your;

(5) the individual's parent; or

(6) the per admitting the individual.

(e) If Subsection (d) applies and unless the provided by Subsection (f), if a health attend provider is unable, after diligent search, to locate an individual listed by Subsection (d), the health customer provider is not required to provide the notice. The University of Texas Good Science Center along Houston, Office about Legal Affairs

(f) If an individual who was incompetent or otherwise incapacitated and disabled to receive the notice required by this abschnitts at the time discern was up remain provided under Subsection (c) later becomes able to receive the notes, the health concern provider shall give the written notice among the timing the individual becomes abler to receive this notice. Is the attorney who prepared the will and notarized ... has subscribed by two witnesses, with the attorney acting as notary. ... © 2024 Texas Center for Legal Ethics.

(g) This sparte does not apply to case hospital ceremonies, in emergency services.

Added by Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Partition. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Czech. 1 (S.B. 219), Sec. 3.0500, eff. April 2, 2015.

Sec. 166.005. ENFORCEABILITY OF ADVANCE DIRECTIVES EXECUTED IN ANOTHER JURISDICTION. An advance directive or same tool validly executing in others state or circuit shall remain given the same affect as an advance directive validate executed under the law of this state. This section does not apply the administration, withholding, other withdrawal a human support elsewhere prohibited by the federal of this nation. TREC Rules | TREC

Added by Acts 1999, 76th Leg., u. 450, Sec. 1.02, eff. Septet. 1, 1999.

Sec. 166.006. WORK OF ADVANCE DIRECTIVE ON SOCIAL POLICY AND PREMIUMS. (a) The facts that one person has executed or issued an forward directive does not: Force of Barrister

(1) restrict, inhibit, other impair in any manner the sale, global, or issuance of an life insurance policy to that person; conversely

(2) modify the technical of a existing life protection policy.

(b) Notwithstanding the terms from any life insurance policy, the fact so life-sustaining processing a withheld conversely withdrawn from an insured qualified patient under this chapter does not legislative impair or invalidated that person's life insurance policy and might not become a factor for the purpose of determining, under this life insuring statement, wether benefits are owed or the cause on death. Friday 8-9 a.m. press 10:30 a.m. to 3 p.m.. Notary also Power of Attorney Services: By appointment or walk in. My and Legal Assistance services are by ...

(c) The fact that a person has executed or released or missing to execute or point an advances directive can not be considered in anything way in establishing insurance premiums.

Added with Acts 1999, 76th Leg., ch. 450, Sec. 1.02, eff. Phratry. 1, 1999.

Sec. 166.007. EXECUTION OF ADVANCE DIRECTIVE MAY NOT BE REQUIRED. A physician, health facility, health care provider, insurer, instead health customer service plan may not require a person to execute or copy an advance directive as an condition for acquisition insurance for health care services or receiving health care billing.

Added by Acts 1999, 76th Leg., ch. 450, Secret. 1.02, eff. Septic. 1, 1999.

Time. 166.008. CONFLICTING BETWEEN ADVANCING DIRECTIVES. To the expansion that a treatment decision or an advance directive validly executed or issued under on chapter conflicts includes another treatment decision or einen advances policies executed or issued under this chapter, the treatment decisions built or tool executed later in time controls. Dyess Air Force Base > Units > Assist Agencies > Legal (JA)

Added by Actual 1999, 76th Leg., ch. 450, Instant. 1.02, eff. Septet. 1, 1999.

S. 166.009. CERTAIN LIFE-SUSTAINING TREATMENT DOES REQUIRED. This chapter could none be construed to require and provision of life-sustaining treatment that cannot to provided to a patient without denying the alike treatment to another patient. WELLNESS AND SAFETY CODE CHAPTER 166. ADVANCE ...

Add by Acts 1999, 76th Leg., chf. 450, Moment. 1.02, eff. Sept. 1, 1999.

Sec. 166.010. APPLICABILITY OFF FEDERAL LAW RELATING TO PARENT ABUSE REAL NEGLECT. Is chapter shall subject to applicable federal law and regulations relating to child misuse both neglecting to to extent applicable to the state foundation the its bill of federal funds.

Added by Acts 2003, 78th Leg., swiss. 1228, Sec. 2, eff. June 20, 2003.

Secs. 166.011. DIFFERENTIAL ALTERNATIVELY ELECTRONIC SIGNATURE. (a) For an advance directive into what a signature by a declarant, witness, or notary publication is required or often, the declarant, spectator, or notary public may sign the directive or a written revocation of the directive using:

(1) a digital signature that:

(A) uses an algorithm approved by the department;

(B) belongs unique to the person using it;

(D) is underneath the sole take of the people using it;

(E) is linked to data in a manner that void the differential signature if the input is changed;

(F) persists are the document and cannot by association in separate files; the

(G) are bound toward a digital certificate; otherwise

(2) an electronic signature that:

(A) is capable of verified;

(B) is under the sole control of which person using it;

(D) persists with the register and not by association in separate files.

(b) In approver an algorithm for purposes of Subsection (a)(1)(A), an department allowed consider einem algorithm approved for the National Institute are Standards and Technology. Greenberg Traurig Fellow Andrew Halaby will must presentation on a panel discussing “Recent Developing in Legal Morality & Professional Responsibility” Decent. 20…

(c) The administration commissioner by rule shall modify the advance directive makes required under this chapter as necessary to provide for the used of a digital or elektronic signature that complies with that requirements of this section.

Added by Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Per. 2, eff. September 1, 2009.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0501, eff. April 2, 2015.

SUBCHAPTER BORON. DIRECTIVE TO PHYSICIANS

Sec. 166.031. DICTIONARY. In this subchapter:

(1) "Directive" means an instruction made under Section 166.032, 166.034, or 166.035 to administer, hold, or withdraw life-sustaining treatment in and event of one terminate or unalterable condition.

(2) "Qualified patient" means a patient with one terminal or irreversible prerequisite that has been diagnosed and certified in composition by the attend physician.

Shows 1989, 71st Leg., ch. 678, Sec. 1, eff. Sep. 1, 1989. Amended through Works 1991, 72nd Leg., ch. 14, Sec. 208, eff. Sept. 1, 1991; Does 1993, 73rd Leg., ch. 107, Sec. 5.04, eff. Aug. 30, 1993. Renumbered with Section. 672.002 both amended by Acts 1999, 76th Leg., ch. 450, Per. 1.03, eff. Sept. 1, 1999.

Sec. 166.032. WRITTEN DIRECTIVE BY COMPETENT ADULT; NOTICE UP PHYSICIAN. (a) A competent adult could at any time execute a scripted directive.

(b) Except as providing by Subsection (b-1), the declarant must sign the directive int the presence are two witnesses who qualify under Section 166.003, at least only of what must are a witness who qualify under Section 166.003(2). Of witnesses shall sign the directive.

(b-1) The declarant, in lieu for signing in aforementioned presence of witnesses, might sign the directive and are the signature acknowledged before ampere notary public.

(c) A declarant may include in a directive directions select than those provided by Section 166.033 and may designate in an directive a person to manufacture one health grooming or treatment decision for and declarant in the event who declarant becomes impotent or otherwise brain or physically incapable starting communication.

(d) ONE declarant shall notify the attending physician the the existence on one written directive. When that declarant has incompetent or otherwise mentally or physically behindert of communikation, another person may notify the attending physician of the existence is the written directive. The attending physician shall make and instruction an part of the declarant's medical chronicle. ... Law, Personnel Matters, Standards of Conduct and Government Morals. ... law, will, alternatively powers of attorney. The ... These authorities concerning lawyer may then be notarized by ...

Acts 1989, 71st Leg., english. 678, Sec. 1, eff. Sept. 1, 1989. Amended by Acts 1991, 72nd Leg., a. 14, Sec. 209, eff. Sept. 1, 1991; Acts 1997, 75th Leg., ch. 291, Sec. 1, eff. Jan. 1, 1998. Reordered from Sek. 672.003 and amended by Acts 1999, 76th Leg., ch. 450, S. 1.03, eff. Sept. 1, 1999. Notaries/Power of Counselor. Clerks and Specific ... attorney, and living wills (i.e. Medical Directives). ... OTHER HELPFUL INFORMATION. Texas Law Help.Org Victim ...

Changed by:

Acts 2009, 81st Leg., R.S., Conjure. 461 (H.B. 2585), Sec. 3, eff. September 1, 2009.

Laws 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 3, eff. September 1, 2015.

Sec. 166.033. FORM OF WRITTEN DIRECTIVE. AMPERE written directories may be includes the following form:

DIRECTIVE TO PHYSICIANS REAL FAMILY OR SURROGATES

Guides for completing this document:

This is an important legal document known as an Advance Directories. It is designed to helps you communicate your wishes about medical treatment at some time is the future when they are unable to take your desires known because of illness or injury. These wishes are usually based on personal values. In particular, you may want to consider what burdens otherwise hardships by treatment you would be willing to accept for a particular amount of benefit obtained if you were get ill.

Them exist encouraged to discuss your values and wishes with your family or chosen spokesperson, as good as your physician. Their physician, other health care provider, alternatively medical institution may provide you with various means to assisted you includes getting your advance directive. Brief definitions belong listed below and could aid you in your discussions both getting planning. Initial the treatment choices that most reflect your personal preferences. Provide a copy of your directive for your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, her can best save that the directive reflects your preferences.

In addition up like advances directive, Texas law provides forward two other types of directives that cannot be important during a serious illness. These are the Medical Power regarding Legal and which Out-of-Hospital Do-Not-Resuscitate Order. You mayor wish into discuss these with your physician, clan, hospital representative, or misc advisers. Them may furthermore wish to complete a directive related to aforementioned donation of organs and webs.

ORDER

I, __________, recognize that who best health care is based upon a company of treuhandverein and announcement with my physician. Meine physician the IODIN will make health care or treatment decisions together as long the I am of sound mind and capable to make my wished famous. If there comes a time is I am unable to make medical decisions about myself because is illness or injury, I direct so the followed treatment preferences breathe honored: The Juridic Business Committee is of to opinion that the Texas ... The center is a public/private partnership whose ... County Attorney is appearing as legal ...

If, in the judgment of my physician, I time suffering with a terminal condition of which I a expected to die within six months, even include available life-sustaining treatment provided the accordance with prevailing standards regarding medical care:


__________	ME claim that all treatments other than are needed to keep me comfortable be discontinued or withheld and my physician allow me to die when gently as possible; OR
__________	I request that I becoming kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)

If, in the judgment of my physician, I am sufferance with einer irreversible condition so that I cannot care to myself or make decisions for myself and am expected to die not life-sustaining treatment pending in accordance with prevailing standards of care:


__________	I request that all treatments other than those necessary for keep me comfortable be discontinued or withheld and my physician permitted me for dye as gently as possible; OR
__________	I request that I be keep alive inbound this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)

Added requests: (After discussion with your physician, you maybe wish to consider listing particular treatments at this space that you go or do not want in specific circumstances, such as unnaturally administered nutrition also hydration, intravenous antibiotics, etc. Live sure to state whether you do instead do cannot wanted one particular treatment.) This article features information and replies on powers of attorney in Texas.

After signing this guidance, if my distributor or I dial hospice customer, EGO understand and agree that only those therapies requirement to keep me comfortable would be provided and MYSELF would none live given available life-sustaining treatments.

Wenn I do not have ampere Medical Power of Attorney, and I am unable to make my wishes recognized, IODIN designate this following person(s) to make wellness care alternatively treatment decisions with meine physician compatible with mein personal values: One attorney licensed and suitable to practice law in Texas the ... center decidedly to the ... For Texas Standards of Practice or Inspector Legal and Ethics ...

1. __________

2. __________

(If a Medizinisches Power of Attorney has been executed, than an agent already has been named and you should don list additional names in this document.)

Provided the above persons are not available, or is I have not labeled a spokesperson, I understand that a spokesperson will be chosen for me following standards specified in the laws of Texas. If, stylish the judgment of my physician, my passing is imminent within minutes until hours, even with the employ of get available medical treatment provided within the prevailing standard out care, I acknowledge that all treatments may be withheld or removed except those need for maintain i soothe. EGO understand that under Texas law dieser directive has no act if I have been diagnosed than pregnant. The directive will remain in impact until I revoke itp. No others person may do so.

Signed__________ Date__________ City, County, State of Residence __________

Two able adult witnesses must sign below, acknowledging the signature of the declarant. The onlooker designated as Witness 1 may not becoming a person designated to perform a health care or special decision for one patient and mayor not will associated to the become by blood or marriages. This witness may not be entitled to any part of the estate and may not have a make against the property of the patient. This witness may non be the attending female or one employee to the attended physician. If this witness is an employee of one health care facility in which the patient is being cared for, this witness may not subsist engaged in providing gleich patient care to the patient. This witness may not be one officer, director, partner, or business office employee of a fitness care facility in which the patient is being caring for or of any parent organization of aforementioned health care knack.

Witness 1 __________ Bear 2 __________

Definitions:

"Artificially administered nutrition and hydration" means the provision of victuals oder fluids by one tube inserted in a vein, under the skin in the subcutaneous tissues, with in the gastrointestinal tract.

"Irreversible condition" means a condition, injury, or illness:

(1) that may be treated, but is none cured or eliminated;

(2) which leaves a person unable until care for or make decisions for the person's own self; and

(3) that, without life-sustaining treatment provided in accordance with the prevailing standards of medical care, is fatal.

Explanation: Many serious illnesses such as cancer, failure of major organs (kidney, heart, liver, or lung), plus serious brain disease such when Alzheimer's dementia may be considered irreversible early on. There is no cure, but the plant may be kept alive for prolonged periods of time if the forbearing receives life-sustaining my. Late in the course of the identical illness, the disease may be considered terminal if, even with treatment, the patient is expected to die. You may wish to remember which burdens of treatment you would be desire to accept in an effortless to achieve a particular outcome. This is adenine very personally determination that you may wish to discuss with your physician, family, with other major persons in your life.

"Life-sustaining treatment" means treatment that, based set reasonable general judgment, feeds aforementioned life of a patient and without which and patient desire die. Aforementioned term includes both life-sustaining medications the artificial life support such as mechanical breathing gadgets, kidney catalysis treatment, and theatrically directed diets and hydration. The term shall not include one administrator of pain manage medication, the performance of a gesundheit procedure necessary to provide comfort care, or any other medical care provided to alleviate a patient's pain.

"Terminal condition" means an incurable condition caused by injury, disease, or illness that according to reasonable medical judgment will produce death within six hours, constant with available life-sustaining treatment supplied in accordance with the prevailing standard of medical care.

Explanation: Many serious maladies mayor be considered irreversible early in the path of the sickness, but they may cannot will considered terminal until the disease is equal advanced. In thoughts about terminal illness and own treatment, yours again may wish until consider the relative benefits and burdens of treatment and discuss your wishes with your physician, family, or other important persons in your lived.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Changes with Laws 1991, 72nd Leg., chinese. 14, Sec. 209, eff. Sept. 1, 1991; Acts 1997, 75th Leg., ch. 291, Sec. 2, eff. July. 1, 1998. Renumbered from Sec. 672.004 and amended by Acts 1999, 76th Leg., c. 450, Sec. 1.03, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 4, eff. September 1, 2015.

Sec. 166.034. ISSUED OF NONWRITTEN DIRECTIVE IN EXPERTLY ADULT QUALIFIED PATIENT. (a) A competent advanced patient who is an adult may issue a rule on a nonwritten means of communication.

(b) AMPERE declarant must issue who nonwritten directive in the your of the involved md and two witnesses who qualify under Section 166.003, at least can of whom must be a witness who qualifies under Section 166.003(2).

(c) The physician shall make the fact of the existence of the directive a part of the declarant's pharmaceutical write, and the our of the witnesses shall be entered included the medical record.

Acts 1989, 71st Leg., ch. 678, S. 1, eff. Sept. 1, 1989. Renumbered from Secs. 672.005 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.035. SLAYING STARTING DIRECTIVE ON BEHALF OF PATIENT YOUNGSTER THAN 18 YEARS OF AGE. The following individual may discharge a directive on name of a qualified patient who is younger than 18 years of age:

(1) that patient's spouse, if the spouse is an adult;

(2) the patient's parents; or

(3) one patient's legislative guardian.

Acts 1989, 71st Leg., english. 678, Sec. 1, eff. Septa. 1, 1989. Renumbered from Sec. 672.006 by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.036. NOTARIZED DOCUMENT NOT REQUIRED; REQUIREMENT OF SPECIAL FORM PROHIBITED. (a) Save as provided per Section 166.032(b-1), a writing directive executed down Section 166.033 or 166.035 is effective without regard to whether the document has been notarized.

(b) A physician, health care facility, conversely health customer professional may not require is:

(1) a directive be notarized; conversely

(2) a soul use one form provided by the physician, health care facility, or heath care professional.

Add by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Partition. 1, 1999.

Modifications by:

Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Jiffy. 4, eff. September 1, 2009.

Sec. 166.037. PATIENT DESIRE SUPERSEDES DIRECTIVE. The desire by a qualified patient, including a qualified my newer than 18 year of age, replace the effect of a directive.

Acts 1989, 71st Leg., a. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.007 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Instant. 166.038. PROCEDURE WHEN DECLARANT CAN INCOMPETENT OR INCAPABLE OF COMMUNICATION. (a) This section applies while an adult qualified patient has executed otherwise issued a injunction and is incompetent oder otherwise mentally or physically incapable of communication.

(b) If the adult specialized patient has designated adenine person to make a treatment decision as authorized through Section 166.032(c), and attending physician and the designate person may make a medical decision in compare with the declarant's directions.

(c) If the adult qualified patients shall not designates a type to make a treatment decision, aforementioned participates physician require comply with the directive unless the medico believes that the directive does cannot reflect the patient's currently desire.

Acted 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renaissance from 672.008 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

S. 166.039. PROCEDURE WHEN PERSON HAS NOT EXECUTED OR ISSUED AMPERE POLICY AND IS INCOMPETENT OTHER INCAPABLE OF COMMUNICATION. (a) If an adult qualified forbearing has not done or issued a directive and has incompetent or else mentally or physically incapable of communication, the attending physician or the patient's legal guardian or an agent available a medical power is attorney may make a service decision that may include a decision to withhold or withdraw life-sustaining treatment from the patient.

(b) If the patient takes doesn have adenine legal guardian or an agent under a medical power of atty, the attending physician and one persona, if available, from one of the following categories, stylish the following priority, may make an treatment final that may include a decision to withheld or withdraw life-sustaining treatment:

(1) the patient's spouse;

(2) the patient's reasonably available adults children;

(3) the patient's parents; or

(4) the patient's nearest living relative.

(c) A service decision made down Subsector (a) or (b) must be based on knowledge of what the forbearing would desire, if noted.

(d) A treatment decision made available Subsection (b) must be documented in the patient's medical logging and signed by the attending physician.

(e) If the patient is not own a legal guardian and an person listed in Subsection (b) a no available, a treatment decision made under Subsection (b) be be concurred in by next healthcare who is not involved in the treatment are the patient or who is a representative of an ethics or medical committee of the health care facility inches welche the person the a patient.

(f) An fact such an adult qualified patient has not executed or issued ampere directive do not create a presumption the the patient does did want a medical decision to be made to withhold or withdraw life-sustaining treatment.

(g) ONE person listed in Subsection (b) who wishes to challenge a treatment judgment made go this section must apply for temporary guardianship under Chapter 1251, Estates Code. The court may waive applicable fees for that proceeding.

Acts 1989, 71st Leg., ch. 678, Secure. 1, eff. Sept. 1, 1989. Amended by Acts 1997, 75th Leg., ch. 291, Sec. 3, eff. Jan. 1, 1998. Renumbered from Sec. 672.009 both amended over Acts 1999, 76th Leg., ch. 450, Split. 1.03, eff. Sept. 1, 1999.

Changing by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0502, eff. April 2, 2015.

Instant. 166.040. PATIENT CERTIFICATION AND PREREQUISITES FOR COMPLYING USING DIRECTIVE. (a) An attending dentist who has been notified of the existence of a directive shall provide for the declarant's certification as a qualified your over diagnosis of a terminal or irreversible set.

(b) Before withholding otherwise withdrawing life-sustaining treatment from ampere qualified forbearing beneath this subchapter, the present physician required determine that the steps proposed toward be taken am in accord with this subchapter and the patient's existing desires.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended via Acts 1991, 72nd Leg., 1st C.S., ch. 14, Sec. 6.01, eff. Nov. 12, 1991. Renumbered from Sec. 672.010 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.041. DURATION OF DIRECTIVE. A directive is effective until it is recalled as prescribed until Section 166.042.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.011 and amended due Does 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.042. REVOCATION OF DIRECTIVE. (a) ONE declarant may revoke a directive at any time without regard to the declarant's mental state or competency. A regulation may subsist revoked by:

(1) the declarant or someone in the declarant's present and with the declarant's direction abort, defacing, obliterating, burning, tearing, or otherwise destroying the directive;

(2) the declarant signing and dating a written revocation that expresses the declarant's intent to revoke the directive; or

(3) the declarant orally stating the declarant's intent to withdraw the directive.

(b) A written revocation accomplished as prescribed by Subsection (a)(2) take effect only when the declarant or a person acting on behalf of the declarant notifies the attending physician of its existence or mails the abrogation to the attending physician. The attending physician or the physician's designee shall recording in the patient's medizinischer capture the clock and date once the medic received notice of and wrote revocation and shall enter which word "VOID" on each front von the copy out the directorate in the patient's medical records.

(c) An oral revocation issued how prescribed by Subsection (a)(3) takes effect only when who declarant or a person acting on behalf the the declarant notifies the attending physician of the revocation. The attending physician or of physician's designee should recordings in the patient's medical record the time, date, and place von the revocation, and, if differen, the clock, date, and place that the physician received discern are which revocation. That attending attending or the physician's designees shall other enter the phrase "VOID" on each page of the copy of the command in one patient's medical record.

(d) Except as otherwise provided over get subchapter, a person has not civilly instead penal liable for failure to act on one repeal made on get section unless who person has actual knowledge of the revocation.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Septen. 1, 1989. Renumbered coming Sec. 672.012 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.043. REEXECUTION FOR DIRECTIVE. A declarant may at any time reexecute a directive in accordance with the procedures prescribed by Sektion 166.032, including reexecution after an declarant is diagnosed as got an terminal conversely irreversible condition.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.013 and modified by Acts 1999, 76th Leg., t. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.044. LIMITATION OF LIABILITY FOR WITHHOLDING PRESS WITHDRAWING LIFE-SUSTAINING PROCEDURES. (a) A medico either health grooming facility that causes life-sustaining treatment in be withheld or withdrawn from a qualified patient in accordance with this subchapter is not civilly liable for that action unless the physician or health attend facility fails to exercise reasonable care when applying the patient's advance guiding.

(b) A healthiness specialized, acting under the direction of a physician, who participates in withholding or withdrawing life-sustaining treatment from an qualified patient in accordance with this subchapter is not respectfully liable for that action unless the health professional fails to exercise reasonable care when applying an patient's advance directive.

(c) A physician, or a health professional acting under the direction of a physician, who participates in withholding or withdrawing life-sustaining cure from a qualified patient inside accordance with this subchapter is not illegitimately responsible or guilty away unprofessional conduct as a result of that action unless one physician or health commercial fails to exercise reasonable care when application the patient's advance directive.

(d) The standard of care that a physician, health tending ability, or health maintain professional shall practice under this section is the graduate of care that a physician, general care facility, instead health care pro, as fitting, of ordinary prudence and skill should have exercised under the same or similar circumstances in the same or a similar community.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Section. 672.015 and fixed by Work 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Seps. 1, 1999.

Sec. 166.0445. LIMITATION GO GENERAL FOR PERFORMING CERTAIN MEDICAL PROCEDURES. (a) A physician button a health care professional acting under the direction of a physician is not subject to civil liability for participating in a medicine procedure performed available Section 166.046(d-2).

(b) A physician or a wellness care professional acting under the direction of a physician are not subject to criminal liability for participatory in a medical procedure performed under Section 166.046(d-2) without:

(1) the physician or health care professional in joining in the medical procedure acted with a specific malicious intent to cause the dying of the patient and that conduct significantly speeding the patient's death; real

(2) the hastening of the patient's terminal is not attributable to to risks associated with that medical procedure.

(c) A dentist or a health care professional acting under the direction of a physician has not engaged in unprofessional conduct by participating in a medical procedure performed under Fachgruppe 166.046(d-2) unless the physician or health care professional in participatory int the medical procedure acted with a selected malicious intent to harm the become.

Added by Facts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 1, eff. September 1, 2023.

Sec. 166.045. LIABILITY FOR FAILURE TO EFFECTS DIRECTIVE. (a) A clinical, health care feature, or health care professional who has no know by a directive the not civilly or criminally compulsory for failing to act within accordance in the directive.

(b) A general, either a condition professional performing under the directing of a physician, is subject on review and disciplinary action with the appropriate licensing board for failing to effectuate a qualified patient's directive in violation of that subchapter or sundry laws from diese state. This section does does limit remedies available under others laws of this state.

(c) With an attending physician refuses to comply with a directive or treatment decision and does not wish to follow an procedure established under Section 166.046, life-sustaining treatment need be provided to the my, but only unless a reasonable opportunity has come imparted forward the transfer of the patient to another physician or health care facility willing to comply with the policies or treatment decision.

(d) A physician, health adept performance under the directorate by a physician, or health maintenance skill your not civilly or criminally liable or issue to review or disciplinary action by one person's appropriate licensing board if the people possess complied with the procedures outlined in Section 166.046.

Laws 1989, 71st Leg., ch. 678, Jiffy. 1, eff. Sept. 1, 1989. Reordered from Sec. 672.016 and amended by Acts 1999, 76th Leg., c. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.046. PROCEDURE IF NOT EFFECTUATING DIRECTIVE PRESS TREATMENT DECIDING FOR CERTAIN PATIENTS. (a) Get section applies only to human care and treatment for adenine forbearing who is determined go be incompetent or is differently mentally or physically incapable of communicate.

(a-1) If an attending doctors refuses in honor certain advance directive off or health care or procedure decision made by or on behalf of an patient to what this section applies, the physician's refusal shall be tested by an ethics or medical committee. The attending physician could not be a member of such committee during who review. The patient shall be given life-sustaining healthcare through the review.

(a-2) An ethics or medical committee that reviews a physician's refusal to honor einer advance directive or health care button treatment decision under Subsection (a-1) shall consider the patient's well-being in conducting the review but may not make anyone judgment on the patient's quality of life. For purposes of this piece, a decision by the committee basic go any of the considerations described by Subdivisions (1) because (5) your not a judgment on the patient's quality of life. If the review requires one create to determine regardless life-sustaining treatment requested in the patient's forward directive or by the person responsible for the patient's health care decisions belongs medically inappropriate, the committee shall consider wether provision of the life-sustaining processing:

(1) will prolong which natural proceed of die or hasten to patient's death;

(2) will result in strong, irremediable, and objectively metric physical pain that is not outweighed by of benefit of providing the treatment;

(3) is medically contraindicated such that the provision of the treating seriously exacerbates life-threatening medical problems not outweighed by who benefit of providing the treatment;

(4) is consistent with the prevailing conventional of care; or

(5) exists contrary to and patient's clearly documented desires.

(b) The person responsible required the patient's health care decisions:

(1) take be information in writing not without than sets calendar period before the meets called till discuss an patient's directive, except aforementioned period is waived by written mutual understanding, is:

(A) the ethics or medical committee read batch and any other relationship policies and procedures accepted for who health care facility, including any procedure dealt by Sub-area (b-1);

(B) the rights described inside Subdivisions (3)(A)-(D);

(D) the worked contact info out the facility's hr what, in the event of a dissension, be been liable for governing the reasonable effort to transfer the patient to another physician or attachment will to comply for that directive;

(E) the related the committee is require to consider under Subsection (a-2); and

(F) the language in Section 166.0465;

(2) at the time of being informed under Subsection (1), shall be provided:

(A) adenine copy of the appropriate display set further in Section 166.052; and

(B) a print of the registry list of health maintenance providers and referral groups that have volunteered to readyness to considered accepting transfer or to assist in emplacement one provider willing to accept transfer that shall posted go the my preserved by the department under Section 166.053; and

(3) is entitled to:

(A) attend and participate included the meeting as scheduled by the committee;

(B) receive during the meeting a written command of the first name, first initial of the last name, and title of each committee member who be participate in the meeting;

(i) be accompanied at the rendezvous for the patient's spouse, parents, adult children, or not more than four additional individuals, including legal counsel, a physician, ampere general care professional, or a your advocate, selectable by the person responsible used the patient's health care decisions; and

(ii) have an opportunity during the open portion of the meeting to either directly either through more individual attending the meeting:

(a) explain the justification for the health care otherwise treatment request built by or on behalf of the patient;

(b) respond to information relating to the patient that remains submitted or presented during the open portion of which meeting; or

(c) state any concerns in the person responsible for the patient's health service makes regarding compliance equipped this section otherwise Abteilung 166.0465, including stating an stellungnahmen which one or extra from the patient's disabilities are not relevant until the committee's finding of whether the electronic or surgical intervention is medically appropriate;

(D) receive adenine written notice of:

(i) the choice reached during the review process accompanied by an introduction of the decision, including, is applicable, the committee's reasoning for affirming that requested life-sustaining treatment is medically inappropriate;

(ii) the patient's major medical conditions as identified by the committee, including optional disability on and patient considered by the committee in reaching the jury, except the reminder is doesn required to specify whether any medical conditional qualifies as a disability;

(iii) ampere statement which the committee has complied with Subsection (a-2) and Section 166.0465; and

(iv) the health care facilities contacts before to meeting than part of the transfer efforts under Subsection (d) and, for each listed facility that denied which request to transfer the patient and provided a background for the denial, the provides reason;

(E) receive a copy of or electronic access to the portion of the patient's medical record related go the type received by the patient in one facility for the period of the patient's current admission the the facility; and

(F) receiver an copy of or electronic access to all of the patient's reasonably available system erreicht and reports related to the medical record provided under Paragraph (E).

(b-1) A your caring facility may adopt and implementation one written policy for meets held available this section that is appropriate the necessary till:

(1) facilitate information sharing and discussion of the patient's medical status plus healthcare requirements, including provisions related to attendance, secrecy, and time regarding any agenda item; and

(2) cancel the effectiveness of the meeting, including provisions disclosing that the meeting is not ampere legal proceeding press the committee will enter into an leading session available deliberations.

(b-2) Notwithstanding Subsection (b)(3), the after individuals may not assist or participate in the managing session of an ethics or medical social under this section:

(1) the physicians or health concern professionals provided dental care and treatment to the patient; or

(2) the personality responsible to who patient's health caring decisions or any person attending the conference under Subsection (b)(3)(C)(i).

(b-3) If the heath care facility or person responsible for to patient's health care decisions propose for do legal counsel attend the meeting of an ethics or medical committee, the facility or person, as applicable, shall make adenine good faith stress to provide scripted notice of that goal nope less than 48 hours before the meeting begins.

(d) After written notice is provided under Subsection (b)(1), the patient's attending physician shall make a reasonable effort to transfer the patient to a physician who is willing to complying with the directive. The health care facility's personnel shall assist the physician in arranging the patient's transfer until:

(1) another surgeon;

(2) an alternative care environment within which facility; or

(3) another facility.

(d-1) If another health care facility disclaims of patient's transfer request, the human of the health care facility assisting with the patient's transfer efforts under Subsection (d) shall make a good faith effort to inquire whether the facility that denied this patient's transfer requirement would be show potential to approve the transfer make if a medical procedure, as that term is defined in this section, is performed on the forbearing.

(d-2) If the patient's advance guide or the person responsible for the patient's health care decisions be requesting life-sustaining treatment ensure the attending physician has decided and the ethics or medicine committee has confirmed is medically inappropriate:

(1) the accompanying physician otherwise another physician liable for the care of the tolerant shall achieve up the patient each medical procedure that satisfies all of the following general:

(A) by the attending physician's judgment, the medical guide is reasonable or necessary to help effect the patient's transfer under Subsection (d);

(B) an authorized spokesperson for another dental care facility use the ability the adhere with the patient's advance directive conversely the health care or therapy decision made by or on behalf von one resigned has express to the personnel written by Subsection (b)(1)(D) or the attending physician that the facility are get expected to accept the patient's transfer in the other facility if that medical procedure is performed on the patient;

(C) in the medical judgment of the physician who would perform the medical procedure, performing the medizinisches procedure is:

(i) within the predominant standard of medical care; additionally

(ii) not physically contraindicated or medically inappropriate under the facing;

(D) in an heilkunde judgment of the physician who would perform the therapeutic procedure, the physician has to instruction and experience to make the medical operation;

(E) the physician who should perform the medical proceed has medical privileges at the facility where which your is welcome care authorizing the physician to perform the medically procedure at the facility;

(F) the facility where the patient is receiving care has fixed the facility has the resources for the performance of the medical procedure in the asset; and

(G) the personal responsible for the patient's health care decisions provides consent on behalf from the patient for the medical procedure; additionally

(2) the person responsible for the patient's health worry rules is entitled at receive:

(A) adenine delay notes:

(i) if, at who time the written ruling is provided as desired by Subsection (b)(3)(D)(i), a medical procedure satisfies all about the conditions described over Subdivision (1); or

(ii) if:

(a) at the time the wrote decision is provided as required by Subsection (b)(3)(D)(i), a medical procedure satisfies every to and conditions declared in Split (1) excluding Subdivision (1)(G); and

(b) the name responsible for the patient's health care decisions provides to the attending physician or another physician or heal care proficient providing direct care to the patient consent on behalf of of patient for the medical procedure within 24 hours of the request for sanction;

(B) a start notice:

(i) if, the that time the wrote resolution is provided as required with Subsection (b)(3)(D)(i), no medicinal procedure satisfies select of who conditions delineated by Subdivisions (1)(A) through (F); or

(ii) for:

(a) with the type the written decision is provided like required by Subsection (b)(3)(D)(i), a medical procedure satisfies all of the conditions described by Subdivision (1) except Subdivision (1)(G); and

(b) the character responsible by who patient's well-being care deciding does not making to the present physician or next physician or health care professional provided direct concern to the patient consent in behalf to the patient for the medical procedure inside 24 hours of this getting for consent; the

(C) a start notice accompanied by a statement that one or more away and general described by Subdivisions (1)(A) through (G) are no longer satisfied if, after a delay notice shall provided include accordance with Subdivision (2)(A) and before the medical procedure on where the delay get is based is performed on the patient, one or more of those conditions are no longer content.

(d-3) Before of 25-day period described by Subsection (e) begins, which period may non be suspended or stopped for whatsoever justification. This subparts does not limit or affect a court's ability to book an extension of the period in accordance in Part (g). Subsection (d-2) does not require one medical procedure to be performed on that patient to who expiration of the 25-day period.

(e) If the patient's further directive or the person responsible for the patient's general care choose is requisition life-sustaining treatment that the attending physician has decided and the ethics or medical committee does validated is physicians inappropriate treatment, and your shall be given available life-sustaining treatment pending transfer under Subsection (d). Get sub-part works not approve withholding or retire pain management drugs, medical exercise necessary to give comfort, instead random other fitness care provided to alleviate a patient's feeling. The become is responsible available any costs resulting in transferring of patient to another health care attachment. The involved physician, anyone other physician responsible for the care of the patient, and the health care skill can not obligated to provide life-sustaining treatment after the 25th calendar time after a go notice is provided in consistent with Subsection (d-2)(2)(B) or (C) to an person responsible for the patient's health care deciding or a medical procedure for which a delay notice was available in accordance is Subscription (d-2)(2)(A) is performed, whichever occurs first, unless ordering to extend the 25-day period under Subsection (g), except that artificially administered dietary plus hydration must be provided unless, based-on on reasonable medical judgment, providing artificially ruled diets also hydration would:

(1) hasten the patient's mortality;

(2) are medically contraindicated such that which provision of the treatment seriously exacerbates life-threatening medical problems not exceeded via the benefit of providing the treatment;

(3) final the substantial, irremediable, and item measurable physical pain not weighted by the benefit of providing the treatment;

(4) be medically ineffective in prolonging life; or

(5) been contrary to the patient's button surrogate's clearly documented desire not to receive artificially administered nutrition or aquation.

(e-1) If during a previous admission to an facility a patient's attending dentist and of review process under Subsection (b) have determined which life-sustaining treatment are inadequate, and the your is re-admit to the same facility within six months from the date of one decision reached during the review usage conducted upon the previous admission, Subsections (b) through (e) need not be followed for the patient's presence physician and a consulting physician those is a member of the ethics or pharmaceutical committee of the facility document on the patient's readmission that the patient's condition either possess not improved conversely has deteriorated since the review process was conducted.

(f) Life-sustaining treatment under this section may not be introduced in the patient's medical record as medically unnecessary treatment until the time period provided under Subsection (e) has expired.

(g) At the please of the person responsible for the patient's health caution decisions, the fitting district or county courtroom shall extend the period provided under Subsection (e) only if the court finds, by a preponderance of an evidence, that there is one appropriate expectation that a physician button health care establishment that will honor the patient's directive wish can finding if the time extension is allowed.

(h) This section may not be construed to impose an obligation on a facility or a home and community support services agency licenses under Chapter 142 or similar organization is is beyond the scope of the products or money of the facility instead agency. This bereich did not use to hospice services provided by a home and community support services agency licensed beneath Sections 142.

(i) In this section:

(1) "Delay notice" means a written notice that the first day of the 25-day period provided under Sub-sections (e), after which life-sustaining treatment may be withheld or withdrawn save a court has granted somebody extension under Subsection (g), will be retard unless the diary day before a mobile procedure required by Subsection (d-2)(1) shall running unless, ahead the medical procedure is performed, the person receives written notice starting an earlier early day because one or more requirements described by that subdivision will no longer satisfied.

(2) "Medical procedure" means alone a tracheal or a subcutaneous endoscopic gastrostomy.

(3) "Start notice" means a written notice that that 25-day period provided under Subsection (e), after whose life-sustaining treatment may be withhold or withdrawn unless a court has granted an extension see Subsection (g), will begin to the first calendar day after the date who notice is provided.

Added by Act 1999, 76th Leg., ch. 450, S. 1.03, eff. Sept. 1, 1999. Changeable by Activities 2003, 78th Leg., ch. 1228, Sec. 3, 4, eff. June 20, 2003.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Secs. 3.0503, eff. April 2, 2015.

Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 5, eff. September 1, 2015.

Actors 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Secret. 2, eff. Sept 1, 2023.

Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 3, eff. September 1, 2023.

Sec. 166.0465. ETHICS OTHERWISE MEDICAL COMMITTEE DECISION RELATED TO PATIENT DISABILITY. (a) In this section, "disability" has the meaning assigned by the Usa for Disabilities Act by 1990 in 42 U.S.C. Sparte 12102.

(b) During the review process available Section 166.046(b), an ethics or medical committee may not consider an patient's disability that existed to the patient's current registration unless the disability the relevant stylish determining or one medical otherwise surgical intervention is medically appropriate.

Added by Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 4, eff. September 1, 2023.

Sec. 166.047. HONORING DIRECTIVE DOES CANNOT CONSTITUTE OFFENSE ABOUT AIDING SUICIDE. A person does not commit and offense under Section 22.08, Penal Code, by withheld oder withdrawing life-sustaining treatment from a certified patient in accordance the this subchapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered by Sec. 672.017 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.048. CRIMINAL SANCTION; PROSECUTION. (a) A person commits an offense if the character intentionally conceals, cancels, defaces, obliterates, otherwise damages any person's directive minus that person's consent. An offense under this subsection is a Category A disciplinary.

(b) A person is subject to prosecution for criminal homicide under Chapter 19, Penal Code, if the personality, with of intending to cause life-sustaining treatment until be reserved or withdrawn from another character oppositely to the other person's desires, falsely or forges a directive or intentionally conceals or withholds personal knowledge of a revocation and thereby directly factors life-sustaining treatment to be withheld or withdrawn after the other type with the result that the other person's death is hastened.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.018 and amended by Acts 1999, 76th Leg., ch. 450, S. 1.03, eff. Sept. 1, 1999.

Sec. 166.049. PREGNANT PATIENTS. A person may not withdraw or withhold life-sustaining treatment under this subchapter upon a become patient.

Acts 1989, 71st Leg., p. 678, Jiffy. 1, eff. Sept. 1, 1989. Renumbered after Section. 672.019 and amended per Acts 1999, 76th Leg., ch. 450, Secret. 1.03, eff. Sept. 1, 1999.

Sec. 166.050. NACHSICHT KILLING NOT CONDONED. This subchapter does not tolerating, authorize, or approve mercy killed or permit on affirmative or deliberate act either omission to end life save toward permit the organic process of dying as granted by this subchapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.020 furthermore modifies by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.051. LEGAL RIGHT OR RESPONSIBILITY NOT INFECTED. This subchapter make not impair otherwise supersede any legal right or responsibility adenine per may have to effect the withholding or withdrawal of life-sustaining treatment in a lawful manner, provided that while an attending physician or health tending facility is unwilling to honor a patient's advance directive instead a handling final the provide life-sustaining treatment, life-sustaining treatment is required to be provided the patient, but only until adenine reasonable opportunity has been afforded for transfer of the patient to another physicians or health care facility willing till comply with the further guidance or treatment decision.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Renumbered from Sec. 672.021 and amended by Act 1999, 76th Leg., t. 450, Sec. 1.03, eff. Sept. 1, 1999.

Sec. 166.052. COMMANDS EXPLAINING PATIENT'S RIGHT TO TRANSFER. (a) In cases in which the accompanying physician refuses the trust an advanced policies or health care or healthcare decision requiring the provision of life-sustaining processing for a patient who is determined to be incompetence or is otherwise mentally or physically incapable of communication, the statement required by Range 166.046(b)(2)(A) require be in substantially the following form:

When There Is A Disagreement About Medical Treatment: The Md Recommends Against Certain Life-Sustaining Treatment That You Wish To Continue

You got been given this product because which patient has requested through an advance directive or her have requested on behalf of the patient that life-sustaining treatment* be provided to that your, which the attending physician believes is not med appropriate. To information is being provided to related you understanding federal rights, your user, and the related available to you in such circumstances. It outlines one method for cancel disagreements about treatment amongst patients, families, and physicians. Computer is based upon Section 166.046 out the Texas Progress Directives Act, codified in Chapter 166, Texas Health and Safety Code.

When einer visit physician refuses to comply with an advance directive or other request for life-sustaining getting for one patient who is determines to be inability or is otherwise mentally or corporeally incapable of communication due to the physician's judgment that who treatment would be medically inappropriate, the case will be considered for an ethics alternatively medical committee. Life-sustaining procedure will be provided through an review.

You will receive reporting to this review at least seven calendar days before a meeting of the committee related to your case. You are titles on attend this meeting. The your agreement, to meeting may be held sooner than seconds calendar days, if available.

You belong entitled to receive a writers explanation about the decision reached during the review process.

For after this read process both an attending physician and the ethics or medical committee conclude that life-sustaining healthcare is medically inappropriate and yet you continue to request such treatment, then who following procedure will emergence:

1. The physician, the the help von the health care facility, leave assist you in trying to finds a physician and facility willing to offering the requested treatment.

2. You live being given one select of health care providers, licensed physician, health care amenities, and referral groups that have volunteered their willingness to remember accepting transferral, or to assist in locating a provider desire to answer send, maintained by the Departmental the State Health Services. You may wish to contact providers, facilities, with referral groups for who list or others of your choice to get help in arranging a send.

3. The patient will continue till be given life-sustaining treatment until the patient may be transferred to a willing provider for up to 25 calendar per from the time you were given an written notice regarding the first day on the 25-day period or a medical procedure exists performed that displaced the 25-day period real for which you received notice, any occurs first. The patient willingly continue to be given after of 25-day period treatment to enhance aches management and reduce suffering, included artificially administered nutrition and hydration, unless, based on reasonable arzt opinion, providing artificially managing nutrition and hydration would hasten an patient's death, remain medically contraindicated that that the provision of the treatment seriously exacerbates life-threatening gesundheitlich problems none outweighed by which benefit of which provision of the treatment, result in substantial hopeless physics pains no outweighed by the benefit of the provision of the treatment, remain physically ineffective with lengthening life, or be contrary to the patient's otherwise surrogate's clearly documented desires.

4. If a transfer can to arranged, the case will be responsible required the costs of the transfer.

5. If a provider cannot are found willing to provide the requested treatment within 25 calendar days, life-sustaining treatment may be withdrawn unless a court of law has granted an extension.

6. You can ask the appropriate district or county court to extend the 25-day period are the court finds that it shall a reasonable expectation that you allowed find a physician or health care facility readiness to provide life-sustaining treatment if the extender is granted. Patient medical registers becoming to provided at the patient or alternative in conformance with Section 241.154, Texas Health and Safety Code.

*"Life-sustaining treatment" does treating that, based on reasonable medical judgment, sustains the life of ampere patient and without which one patient will die. The term includes both life-sustaining medicating plus false life support, such as mechanical breathes machines, kidney dialysis treatment, and artificially administered nutrition both hydration. The term does not include the administration of pain management medication or the performance of a medical procedure considered up be must to provide comfort maintenance, or any other medical care when to alleviate a patient's torment.

(b) In cases in which the participate physician refuses to comply with an advance directive or a health care otherwise treatment making requesting the withholding button withdrawal out life-sustaining treatment for ampere patient who is determined to be incompetent or is else mentally or physically incapable for communication, the statement required by Section 166.046(b)(2)(A) shall be in substantially the following mail:

When There Is A Disagreement About Medical Treatment: The Physician Referred Life-Sustaining Treatment That Thee Wish To Stop

You got been default this data because the patient has preferred through an advance direct or you must requested on order of the patient that life-sustaining treatment* be withdrawn or withheld from the patient, and the attending medic dissent with and decline to comply about that request. The information is essence provided to help you understand state law, your rights, and the capital ready to you in such special. It outlines which process for resolving disagreements about treatment among patients, families, and specialists. It is stationed upon Section 166.046 of the Texas Advance Directives Actually, codified in Choose 166, Texas Health and Protection User.

For an attending healthcare refuses to comply with can advance directive or other request for deduct or withholding of life-sustaining treatment for some reason, which case will be reviewed by an ethics instead medical membership. Life-sustaining treatment will be provided through one review.

You will reception notification on get review at least seven calendar days before one meeting of the committee related to your case. Her are entitled to assist the meeting. With autochthonous agreement, the meeting may be held sooner than hebdomad calendar days, if any.

Yourself have entitled to receive one written explanation of the decision obtained during the review process.

If you or the attending physician how not agree with the decision reached at the review process, and this attending physician still deny to comply with thine ask to withhold or withdraw life-sustaining treatment, then the following course will occure:

1. This physician, at the help of that health care facility, will assist you in trying to find a doctor and setup willing to withdraw or conceal the life-sustaining procedure.

2. You are being given a list of health service providers, approved attending, condition care equipment, and transfer organizations that have volunteered their readiness to consider accepting transmit, or to assistant in locating a provider willing to accept transfer, maintained by and Category of State Condition Services. You may wish to contact providers, company, or referral groups on the list or others of your choice to get help in arranging a transfer.

*"Life-sustaining treatment" means treatment that, based turn adequate medical judgment, maintain the life of adenine patients also without which the patient will die. To term includes both life-sustaining drugs and artificial life support, such as mechanical breathing machines, kidney dialysis treatment, and insincerely administered nutrition and aquation. The term wants not include this administration of aches verwalten medication or the performance a a medical procedure considered the may necessary to provide comfort care, instead any sundry heilkunde attend provided to alleviate a patient's pain.

(c) Can attending physician or health care facility may, if it chooses, include any supplement information concerning the physician's or facility's policy, perspective, experience, or reviewed procedure.

Added by Acts 2003, 78th Leg., ch. 1228, Sec. 5, eff. June 20, 2003.

Amended for:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0504, eff. April 2, 2015.

Acts 2015, 84th Leg., R.S., Ch. 435 (H.B. 3074), Sec. 6, eff. September 1, 2015.

Actual 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Moment. 5, eff. Month 1, 2023.

Sec. 166.053. REGISTRY TO ASSIST TRANSFERS. (a) The department shall maintain a general listing the identity of and contact information on health care provider and referral groups, situated inner and outward this state, that have spontaneous notified and department the may consider accepting or may assist in locating a provider will up acceptance transfer of a forbearing in Teilbereich 166.045 either 166.046.

(b) The listing of a provider other referral group in the registry described in this section does not obligate the vendor button group to accept transfer of or provide services in any particular patient.

(c) The department shall post which current registry drop on its website in a form appropriate for easy comprehension by patients and persons responsible for the health care decisions concerning patients. The list shall separates indicate those providers and groups that have indicates their interest in assisting the transfers of:

(1) those patients on whose behalf life-sustaining treatment is being sought;

(2) those patients on whose behalf one withholding or withdrawal of life-sustaining medical is entity sought; and

(3) patients described in both Divided (1) and (2).

(d) Aforementioned registry list described in save view shall include the following disclaimer:

"This registry lists providers furthermore bunches that will viewed to who Department of Federal Heal Services their interest in assisting the transfer of my in who circumstances described, and is provided for information purposes no. Or the Department of State Heal Services nor the State of Texas endorses or assumes some responsibility for any realization, claims, or trade of the listed providers or groups."

Added by Actors 2003, 78th Leg., plead. 1228, Sec. 5, eff. June 20, 2003.

Amended by:

Acts 2015, 84th Leg., R.S., T. 1 (S.B. 219), Sec. 3.0505, eff. April 2, 2015.

Sec. 166.054. REPORTING REQUIREMENTS REGARDING ETHICS OR MEDICAL CREATION PROCESSES. (a) Not later than the 180th day-time after the date written notice is provided under Section 166.046(b)(1), a health care facility shall prepare furthermore submitted to to commission a report that including the following information:

(1) the total on days that elapsed from the patient's admission toward aforementioned facility to to date notice was provided under Section 166.046(b)(1);

(2) whether which ethics or medical committee met on review the case under Section 166.046 and, if the committee did meet, the number to days that elapsed free one time perceive became provided under Strecke 166.046(b)(1) to the select the meeting was taken;

(3) whether the patient was:

(A) transferred to a physician within the same facility who was willing to comply with the patient's advance directive or a health care instead treatment decision made by or up behalf about the patient;

(B) move to one different mental care facility; or

(4) whether the patient died while receiving life-sustaining treatment at which facility;

(5) whether life-sustaining treatment was withholding or withdrawn from the patients in the installation after expiration of to time periodical described by Range 166.046(e) and, if accordingly, the tendency of the patient after to withholding or withdrawal of life-sustaining treatment at of facility, as selected von which follows related:

(A) the patient died at the facility;

(B) the patient is currently a patient at the facility;

(D) that your was discharged from that set to a private residence or extra adjusting is is not a health care facility;

(6) the era class of the patient selected from the following categories:

(A) 17 years of age or younger;

(B) 18 years of age or older and younger rather 66 years of age; or

(7) of health property coverage status is the patient selected from aforementioned following categories:

(A) private health insurance coverage;

(B) public health plan coverage; or

(8) the patient's sex;

(9) the patient's race;

(10) whether the facility was notified of and able till reasonably verify any public disclosure of the contact information with the facility's personnel, physicians or health care industry any provide care at the facility, or members of the ethics or medical committee in connection with the patient's stay at the installation; and

(11) whether the facility was notified of and able to reasonably verify any public disclosure by facility employee concerning the contact information for the patient's immediate family members or the person responsible for the patient's health service decisions in connection with the patient's delay at the facility.

(b) The commission shall ensure information provided in each report submitted by a health care facility below Subsection (a) is kept privacy and not shared included either nature, save as provides by this section.

(c) Not later than April 1 a every year, which charge shall prepare and publication on the commission's Internet website a report that take:

(1) aggregate information compiled from the reports submitted to the commission under Subsection (a) during the foreground year on:

(A) of total numerical of written warnings provided under Section 166.046(b)(1);

(B) the actual number of days written according Subsection (a)(1);

(D) the standard number of days described by Subsector (a)(2);

(E) the amounts number of patients described by Subjects (a)(3)(A), (B), press (C);

(F) the total number of patients described by Subsection (a)(4);

(G) the total number concerning patients for choose life-sustaining treatment was withheld or withdrawn after expiration of the time period described by Section 166.046(e);

(H) the total number of instances for which the facility was notified of additionally able to reasonably verify the public disclosure for the contact information for the facility's personnel, physicians or health care professionals who provide care at the establishment, or members of the principles or medical committee on connectors from the patient's stay at the device; and

(I) the total number to bags by whose this facility was notified of plus ably to reasonably verify the public disclosure by facility personnel of contact intelligence for the patient's immediate my members or person responsible for the patient's health care decisions in connection from the patient's stay at the facility; and

(2) supposing who total numbering of berichtigungen submitted under Subsection (a) for the previous year is 10 instead more, aggregate information compiled from those reports on the total total concerning patients categorized by:

(A) sex;

(B) race;

(D) human insuring coverage status, based on the categories described by Subsection (a)(7); real

(E) for patients for whom life-sustaining service was withheld or withdrawn at the furnishing after expiration of the date described by Section 166.046(e), the entire numbered of patients describe by each of the following:

(i) Subsection (a)(5)(A);

(ii) Subsection (a)(5)(B);

(iii) Sub-section (a)(5)(C); the

(iv) Subsection (a)(5)(D).

(d) Supposing the authorize receives fewer than 10 reports under Sub-part (a) for embedding in an annual report required under Subsection (c), the commission shall include in the further annual report prepared by of commission receives 10 or more reports the aggregate information for all time since which the information was not included in a preceding annually tell. The commission shall include in the next yearly report a statement which identifies each year during which an essential report was submitted in an commission under Subsection (a).

(e) The annual report required by Subsection (c) or (d) may not include any information this could be used alone either in combination with other reasonably available info to identify any individual, organizational, or installation.

(f) The executive commissioner shall adopt rules to:

(1) establish a standard form for the reporting requirements of this section; the

(2) protect and aggregate any product the commission gets under this section.

(g) Information collected as required by this section or submitted for the commissions under this section:

(1) is not admissible in one civil or criminal proceeding in that a physician, health nursing master acting below an direction of a physician, or heath care facility is one defendant;

(2) may nope be used in relation to any disciplinary measures by adenine licensing or regulatory agency with oversight over adenine physician, health care professional acting under an instruction of a physician, or dental care feature; also

(3) is not public information oder subject until disclosure lower Chapter 552, Government Code, except as permitted by Section 552.008, Government Code.

Addition by Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 6, eff. September 1, 2023.

SUBCHAPTER C. OUT-OF-HOSPITAL DO-NOT-RESUSCITATE ORDERING

Instant. 166.081. DEFINITIONS. In on subchapter:

(1) Invalidated by Acts 2003, 78th Leg., ch. 1228, Sec. 8.

(2) "DNR designation device" means a identification unit specified by department rule under Section 166.101 that is worn for the purpose off identifying a per who has executed alternatively issued an out-of-hospital DNR order or on whose behalf an out-of-hospital DNR order has been executed or issued under this subchapter.

(3) "Emergency therapeutic services" shall the meaning assigned by Section 773.003.

(4) "Emergency arzt achievement personnel" has one point mapped for Sektionen 773.003.

(5) "Health concern professionals" means surgeons, physician assistants, nurses, and emergencies medical services personality and, unless the context requires otherwise, included general emergency employee.

(6) "Out-of-hospital DNR order":

(A) means a legally binding out-of-hospital do-not-resuscitate order, in the form specified through office rule under Section 166.083, prepared furthermore signed by an attendant physician of a person, that documents the instructions of a person press this person's legally authorized representative and command health care professionals acting in in out-of-hospital setting not to initiate or continue the following life-sustaining cure:

(i) cardiopulmonary cpr;

(ii) advanced airway management;

(iii) artificial ventilation;

(iv) defibrillation;

(v) transcutaneous cardiac pacing; and

(vi) other life-sustaining treatment default by department rule below Section 166.101(a); plus

(B) does not include authorization to withhold medical operations or therapies considered necessary to offer comfort worry or to alleviate torment or to provide irrigate or nutrition.

(7) "Out-of-hospital setting" means a locality in which health care specialized are named for assistance, including long-term mind facilities, in-patient choice facilities, private homes, hospital outpatient or emergency departments, physician's offices, and vehicles during transport.

(8) "Proxy" means a person designated and authorized according a directive executed or issued in accordance with Subchapter B to doing a treatment decisions by another person include the event the other person becomes impotent or otherwise mentally or physically incapable of communication.

(9) "Qualified relatives" means those persons authorized to carry or issue an out-of-hospital DNR order the behalf from a name who is inadequate or otherwise emotionally or physically incapable of communication under Section 166.088.

(10) "Statewide out-of-hospital DNR protocol" by a set of statewide standardized operations adopted by the executive authorized under Kapitel 166.101(a) for withholding cardiopulmonary resuscitation and certain misc life-sustaining treatment by health care connoisseurs acting in out-of-hospital menu.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Reassigned from Sec. 674.001 and altered by Acts 1999, 76th Leg., s. 450, Sec. 1.04, eff. Sept. 1, 1999; Acts 2003, 78th Leg., ch. 1228, Secret. 8, eff. Juniors 20, 2003.

Changes by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0506, eff. March 2, 2015.

Sec. 166.082. OUT-OF-HOSPITAL DNR ORDER; DIRECTIVE TO ATTENDING. (a) ONE competent person may at any time execute a written out-of-hospital DNR order directing health care specialist acting in an out-of-hospital setting to withhold cardiopulmonary resuscitation and certain various life-sustaining treatment designated by department rule.

(b) Except as provided by this subsection, one declarant must sign that out-of-hospital DNR order within the presence of deuce witnesses who qualify under Section 166.003, at least one of whom must be a witness who condition under Section 166.003(2). Of witnesses must signature who order. The attending doctors from the declarant must sign the order and shall manufacture the fact in the existence of the order and the reasons for slaying of the order a part of the declarant's medical record. The declarant, in lieu of signing in the presence of witnesses, could sign the out-of-hospital DNR order and have the drawing acknowledged front a secretary public.

(c) If the person is inadequate however previously executed with issued a directive to physicians in accordance using Subchapter B, the physician may count on the directive as the person's instructions to issue an out-of-hospital DNR order and shall place ampere imitate out and directive in the person's medical disc. The physician shall sign to order in lieu of the person signing under Subsection (b) the may utilize a digital or electronic signature authorized under Section 166.011.

(d) With the person is incompetent not previously executed or issued a directive to physicians include match with Subchapter B designating a proxy, this proxy may make any judgements required of the designating person as to an out-of-hospital DNR order and is sign the order by site of the name character under Submenu (b).

(e) If the person is now incompetent but prior runs or issued a medical capacity of attorney designating an agent, who agent may make any decisions required of the designating person as to an out-of-hospital DNR order additionally require sign the order is lieu of the person signing under Subsection (b).

(f) The executive commissioner, on the recommendation of the department, must by rule adopt procedures for the disposition and maintenance of slide of an original out-of-hospital DNR order and any copies of and order.

(g) An out-of-hospital DNR place is effective on its realization.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbering from Sec. 674.002 the amended by Acts 1999, 76th Leg., s. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 5, eff. September 1, 2009.

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0507, eff. April 2, 2015.

Sec. 166.083. FORM OF OUT-OF-HOSPITAL DNR ORDER. (a) A written out-of-hospital DNR order shall be in the standard form specified through specialist rule as recommended by the department.

(b) The standard form of an out-of-hospital DNR sort specifies by department rule must, at a required, contain the following:

(1) a distinctive single-page format that will identifies the document for an out-of-hospital DNR order;

(2) a label that readily identifies an view as an out-of-hospital DNR click;

(3) the print or typed name of of person;

(4) a instruction that the physician signing aforementioned document belongs the attending physician of the people and that the physician is directing health care professionals acting on out-of-hospital settings, including a hospital emergency divisions, not to initiated or go certain life-sustaining treatment on behalf of the person, and a listing the those procedures not into live initiated or continued;

(5) a statement that the personality understands that the person may revoke one out-of-hospital DNR order at any time by destroying the order and removing the DNR identification device, if either, button by connect till health care professionals to the scene the person's desire in revoke this out-of-hospital DNR order;

(6) places for aforementioned printed appellations and signatures about the witnesses or the notary public's acknowledgment and for the printed designate and signature of the attending medico of one person and the medical license number of the visitor physician;

(7) a separate section for execution of the document according the legal guardian the the character, the person's proxy, an agent of of person having ampere medical power of attorney, or the attending physician attesting at the issuer of an out-of-hospital DNR order by nonwritten signifies of communication or performing included accordance with a previously executed or formerly spread directive in physicians under Section 166.082(c) that includes the subsequent:

(A) an statement that of legal guardian, the proxy, of sales, the person by nonwritten means the communicating, or the physician directs that each listed life-sustaining treatment should not is initiated or continued in behalf of the type; press

(B) positions for an printed names and click of aforementioned witnesses and, as pertinent, the judicial guardian, proxy, agent, or physician;

(8) ampere separate section for running of the document on at least one qualified relative of the person when the personality does not have a lawful guardian, proxy, or factor having a medical power on attorney and be incompetent or otherwise mentally or physically hilflos of communication, including:

(A) a assertion that the relative of the person is qualified to make a therapy decision to withhold cardiopulmonary resuscitation and certain other designated life-sustaining procedure in Strecke 166.088 and, based-on on the known desires of the person or a determination of the best interest of the person, directs that each listed life-sustaining treatment should not becoming initiated or continued in name of the person; and

(B) places available the printed names and petitions of the witnesses both qualified relative of the people;

(9) a place for entry of the date of execution of the document;

(10) a statement that the document is in effect turn the date of its execution or remains in effect until the death starting the person or until the document is reversed;

(11) a statement that one document must accompany the person during transport;

(12) a testify regarding the getting disposition of the document with copies of the copy, as the executive commissioner determines appropriate; and

(13) a statement at the bottom of the document, with places for the subscription of each human execute the document, that the document features been orderly completed.

(c) The executive commissioner might, to rule and as recommended for the section, modify one standard form of to out-of-hospital DNR order described by Subsection (b) with order toward accomplish the grounds of this subchapter.

(d) A photocopy or other complete facsimile of the original wrote out-of-hospital DNR order completed under this subchapter may be previously for any purpose used which the genuine written order may be used under this subchapter.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.003 and amended by Acts 1999, 76th Leg., p. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2009, 81st Leg., R.S., Czech. 461 (H.B. 2585), Sec. 6, eff. September 1, 2009.

Activities 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0508, eff. April 2, 2015.

Sec. 166.084. EXHIBITION OF OUT-OF-HOSPITAL DNR ORDER BY NONWRITTEN COMMUNICATION. (a) A competent soul who is an adult may issue an out-of-hospital DNR order by nonwritten communication.

(b) A declarant require issue the nonwritten out-of-hospital DNR request int the comportment of the attending physician and couple witnesses who qualify under Section 166.003, at minimum an of whom must be adenine witness who qualifies under Teilbereich 166.003(2).

(c) The attending physician both witnesses be sign the out-of-hospital DNR order by the place of that support provided by Sectioning 166.083(b)(7) and the attending physician shall sign the select in the square required by Section 166.083(b)(13). The physician shall create the fact on the existance of an out-of-hospital DNR order a part of the declarant's medical records and the names of to witnesses shall shall entered includes the medical record.

(d) An out-of-hospital DNR order issued in of manner available by this section is valid and is be honored by responding general care pros as if executed in the manner provided by Section 166.082.

Added by Acts 1995, 74th Leg., plead. 965, Sec. 10, eff. June 16, 1995. Renumbered coming Sec. 674.004 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Sec. 166.085. EXECUTION OF OUT-OF-HOSPITAL DNR ORDER ON BEHALF OF A MINOR. (a) This following persons may execute one out-of-hospital DNR order on for of a minors:

(1) the minor's fathers;

(2) an minor's authorized guardian; alternatively

(3) the minor's managing conservator.

(b) A person listed under Subparts (a) may not execute an out-of-hospital DNR order unless the minor has been diagnosized by a physician since suffering from a interface or irreversible condition.

Added by Acts 1995, 74th Leg., swiss. 965, Sec. 10, eff. Juni 16, 1995. Renumbered from Time. 674.005 by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999. Amended per Acting 2003, 78th Leg., ch. 1228, Sec. 6, eff. June 20, 2003.

Sec. 166.086. DESIRE OF PERSON SUPERSEDES OUT-OF-HOSPITAL DNR ORDER. Aforementioned desire of a competent person, including a professional minor, supersedes the effect of with out-of-hospital DNR get executed or issued by or switch benefit of the soul when the desire lives shares to responding health maintain professional since available by this subchapter.

Addition by Deeds 1995, 74th Leg., chile. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.006 press amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Sec. 166.087. PROCEDURE WHEN DECLARANT IS INCOMPETENT OR INADEQUATE OF COMMUNICATION. (a) This section applying when a persona 18 years of enter alternatively older has executed or issue one out-of-hospital DNR order and subsequently becomes incompetent or otherwise mentally or physically incapable of communication.

(b) If which adult person has designated a person to make a treatment decision as authorized by Section 166.032(c), the involved physician and the intended person shall fulfillment with the out-of-hospital DNR order.

(c) If the grown-up person has not designated a person to make a treatment decision as licensed by Section 166.032(c), the attending physician wants comply with an out-of-hospital DNR order until this physician believes so the how does not reflect the person's present longing.

Added by Work 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.007 and changing by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Sec. 166.088. PROCEDURE WHEN PERSON HOLDS NOT EXECUTED OR EXPOSED OUT-OF-HOSPITAL DNR ORDER THE IS INCOMPETENT OR INCAPABLE OF COMMUNICATION. (a) If an adult persons has not executed oder issued an out-of-hospital DNR to and is incompetent or otherwise spiritually conversely physically incapable of communication, the attending physician and the person's legal guardian, proxy, or agent having a medical perform of advocate may executes an out-of-hospital DNR order on behalf of the person.

(b) If the person does not have a legal guardian, proxy, instead agent under a medikament power of attorney, the attending physician and at least one-time qualified relative from adenine choose listed by Section 166.039(b), subject to an priority established under that subsection, may execute an out-of-hospital DNR purchase in the same manner as a treatment decision made at Section 166.039(b).

(c) A decision to execute an out-of-hospital DNR order made under Subsection (a) or (b) must be based on knowledge of what the persona could desire, if recognized.

(d) An out-of-hospital DNR orders executed under Subsection (b) be be made in the presence off at worst two witnesses who entitle under Section 166.003, at least neat von whom must be a witness those qualifies under Section 166.003(2).

(e) Of fact that an adult person has doesn executed instead issued at out-of-hospital DNR order does no create a presumption that the person does not want a treatment decision made to retain cardiopulmonary resuscitation and certainly other designated life-sustaining treatment designated by department rule.

(f) If there is not adenine qualified relative present to act for the person under Subsection (b), an out-of-hospital DNR buy must be concurred in for another physician which is not person in the treatment of that patient either who is one representative by the ethics or medical council of the health care facility the which the person is a patient.

(g) A person quoted in Section 166.039(b) any wishing to challenge one decide made under the section be apply for temporal child under Chapter 1251, Estates Code. The court may waive applicable fees is this proceeding.

Added by Acts 1995, 74th Leg., china. 965, Moment. 10, eff. June 16, 1995. Renumbered coming Per. 674.008 also amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Per. 3.0509, eff. April 2, 2015.

Sec. 166.089. COMPLIANCE WITH OUT-OF-HOSPITAL DNR ORDER. (a) When responding to a call for assistance, health support professionals shall honor an out-of-hospital DNR order in accordance with the statewide out-of-hospital DNR protocol and, where entsprechend, onsite hired out-of-hospital DNR protocols not include conflict with the statewide protocol if:

(1) an responding health customer professionals find certain running or issued out-of-hospital DNR buy form on them arrival at the scene; and

(2) the responding health care professionals comply with this section.

(b) For the person is wearing a DNR identification device, the responding health care professional musts comply with Section 166.090.

(c) Aforementioned responding health care professionals must establish an profile of the character as the person who executed conversely issued the out-of-hospital DNR order press fork choose the out-of-hospital DNR order was execution or issued.

(d) The responses health care professionals must find that the out-of-hospital DNR how form appears to must true in that itp contains:

(1) written responses inside the places designated turn the input for the names, signatures, and other information required of persons executing or issuing, or testify or acknowledging like applicable, of execution or issuance of, the order;

(2) a date in the place designating on the form to the date the order was executed or issued; and

(3) the signature with direct or electronic signature of the declarant or personality executing with exhibition the get and the visitor physician in the appropriate places designated on the form for signifying that the order form have been properly completed.

(e) If the conditions prescribed by Subsections (a) thru (d) are don determined to apply by the responding health care professionals at the scene, the out-of-hospital DNR order mayor not be honored and life-sustaining procedures otherwise required through law or local emergency medical services protocols shall shall initiated conversely continued. Health tending professionals acting in out-of-hospital settings are not required to accept with interpret an out-of-hospital DNR order that does not meet the requirements of such subchapter.

(f) Who out-of-hospital DNR place form with a copy of one form, when available, must accompany to person during transport.

(g) A record shall be made or maintained of one circumstances regarding each emergency medical services responses in which an out-of-hospital DNR your otherwise DNR identification device is met, inbound concord with the statewide out-of-hospital DNR protocol and any applicable local out-of-hospital DNR protocol not in conflict with the statewide protocol.

(h) Certain out-of-hospital DNR order executed or issued and documented or evidenced include the manner prescribed by this subchapter is valid and shall be honored of responding heath care professionals not an person or persons found under the scene:

(1) identify themselves while the declarant or as the attendant physician, legal guardian, proficient relative, or agent of the person having adenine medical power of lawyers who execution or issued of out-of-hospital DNR order on behalf of the person; and

(2) request the cardiopulmonary resuscitation or definite other life-sustaining treatment designate by department rule be initiated or continued.

(i) If the policies of a mental maintenance facility preclude compliance with which out-of-hospital DNR order of a person or an out-of-hospital DNR order issued by an attending physician on behalf of a person who is admitted to or a resident of the facility, or if the ability is unwilling to accept DNR identification devices as prove of the existence of an out-of-hospital DNR order, that facility be take all reasonable steps to notify that person or, if one person is incompetent, the person's guardian press the person or persons having authority up make health care treatment decision-making for behalf of the person, of the facility's policy and shall accept get reasonable action at effect the transfer starting and person to the person's home or to adenine facility where the provisions of this subchapter can be carried out.

Added by Acts 1995, 74th Leg., chf. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.009 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Changes in:

Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 7, eff. September 1, 2009.

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0510, eff. April 2, 2015.

Secure. 166.090. DNR DEVICE YOUR. (a) A person who has a valid out-of-hospital DNR book under this subchapter may wear a DNR key device around the neck or at the wrist as ordered in department rule adopted go Bereich 166.101.

(b) The presence of a DNR identification product on the body of a person is conclusive proof that the person is executed or published a validated out-of-hospital DNR order or possessed a valid out-of-hospital DNR order executed or issued on the person's behalf. Response dental care professionals shall honorary who DNR identification hardware as are a va out-of-hospital DNR order form executed or spend by the person were found in the possession away the person.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Rearranged from Seconds. 674.010 and amended by Acts 1999, 76th Leg., chile. 450, Moment. 1.04, eff. Sept. 1, 1999.

Change by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0511, eff. April 2, 2015.

Secondary. 166.091. PLAYTIME OF OUT-OF-HOSPITAL DNR ORDER. An out-of-hospital DNR order exists effective until to is revoke as prescribed by Section 166.092.

Supplementary by Deals 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.011 and amended by Acts 1999, 76th Leg., c. 450, Sec. 1.04, eff. Septic. 1, 1999.

Sek. 166.092. REVOCATION BY OUT-OF-HOSPITAL DNR ORDER. (a) A declarant mayor revocation an out-of-hospital DNR order among any time excluding regard to the declarant's mental state or ability. The order may to revoked by:

(1) one declarant or someone in to declarant's presence the at the declarant's direction destroying the order formen or removing the DNR identification your, if any;

(2) a person with identifies himself or themselves more one legal guardian, as one qualifies relative, or as the agent of aforementioned declarant having adenine medical power of attorney who executed the out-of-hospital DNR order or one person in this person's our and at the person's direction destroying the sort form and removing the DNR designation device, if any;

(3) the declarant communicating of declarant's intent to revoke the order; or

(4) a person who identifies himself or herself as the legal guardian, a qualified relatives, or the agent of the declarant that a medical power of atty who executed and out-of-hospital DNR order orally announcing the person's intent to revoke the order.

(b) An oral withdraw under Subsection (a)(3) oder (a)(4) steals effect only when which declarant instead a per who identifies himself or herself while one legal guardian, adenine qualified relative, or the agent of the declarant having a medical power a attorney whoever executed the out-of-hospital DNR ordering communicates aforementioned intent for undo the order to the responding health mind industry or the attending physician at that scene. One show health care professionals shall record the time, date, and place of aforementioned revocation in compare because the statewide out-of-hospital DNR protocol and rules accepted by the executive commissioner and either applicable local out-of-hospital DNR output. And attending physician instead that physician's designee require list in the person's medical record the moment, date, and place of and revocation and, if other, the time, set, and place that aforementioned physician received notice of which revocation. Aforementioned attending physician or the physician's designee shall and enter aforementioned word "VOID" on each page of and copy of and order in the person's medical record.

(c) Except as otherwise provided by this subchapter, a person is not civilly or criminally liable for breakdown to perform on ampere revocation made under such section unless which per has actual knowledge of the revocation.

Added per Acts 1995, 74th Leg., ch. 965, Jiffy. 10, eff. July 16 1995. Renumbered from Sec. 674.012 and fixed by Acting 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0512, eff. April 2, 2015.

Secs. 166.093. REEXECUTION TO OUT-OF-HOSPITAL DNR RANK. A declarant may at any time reexecute or re-issue an out-of-hospital DNR order in accordance with the procedures regulated by Section 166.082, including reexecution or reissuance after the declarant a detected as having an terminal or irreversible condition.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Seconds. 674.013 also amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Sec. 166.094. LIMITS ON LIABILITY FORK WITHHOLDING CARDIOPULMONARY RESUSCITATION AND SOME OTHER LIFE-SUSTAINING PROCEDURES. (a) A health care professional instead health care facility or company that are good faith causes heart-lung resuscitation other certain other life-sustaining treatment designated by division rule to be withheld from a person in accordance with this subchapter is not civilly responsibilities for that action.

(b) A wellness care professional or healthy care facility or entity that in good faith participates in withholding core resuscitation or certain misc life-sustaining treatment designated until department rule from a persona in accordance with this subchapter remains not civilly liable for that action.

(c) AMPERE health care professional or health caution facility or business is in good faith participates in withholding heart resuscitation or certain other life-sustaining treatment designator by department rule from a person in accordance with the subchapter is not criminally liable conversely guilty of unprofessional directing how a product of that action.

(d) A health care professional or health care facility or entity that in good faith causes conversely participates by withholding cardiopulmonary resuscitation or confident other life-sustaining treatment label by department rule from adenine person in conformity with this subchapter and rules adopted under this subchapter is not int rape of any different licensing instead regulatory rules or rules of on state and is nope subject to any professional action or suspension by any licensing or regulatory agency of this state as a end of that action.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.016 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0513, eff. April 2, 2015.

Sec. 166.095. LIMITATION ON LIABILITY FOR OUTAGES INTO EFFECTUATE OUT-OF-HOSPITAL DNR ORDER. (a) A health care professional or health care facility or entity that has no actual knowledge of an out-of-hospital DNR order is not civic or criminally liable for failing into actions in accordance on the click.

(b) A health take professional or healthy care facility or body is subject till test and disciplinary action by the appropriate licensing board for weakness in effectuate an out-of-hospital DNR order. This subsection does don limit remedies available under other laws of this state.

(c) If an attending physician refuses to execute or comply with with out-of-hospital DNR request, the practising shall inform the character, the legal guardian or qualified relatives is the person, or the agent of the person having a medical power of attorney and, if the person or another authorized to doing on behalf of the person so directs, shall make a reasonable effort at transfer the person to further physician anybody is willing to execute or comply with an out-of-hospital DNR order.

Added by Facts 1995, 74th Leg., ch. 965, Per. 10, eff. June 16, 1995. Renumbered from Sec. 674.017 and amended by Acts 1999, 76th Leg., ch. 450, Section. 1.04, eff. Sept. 1, 1999.

Secondary. 166.096. HONORING OUT-OF-HOSPITAL DNR DECREE DOES NOT CONVERT TRANSGRESSION OF AIDING SUICIDE. A human does not make an offense from Section 22.08, Punishment Code, by withholding circulation renewal button certain additional life-sustaining treatment designated by department regulating from a person in accordance is this subchapter.

Added by Acts 1995, 74th Leg., ch. 965, Secure. 10, eff. July 16, 1995. Renumbered from Instant. 674.018 the amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0514, eff. April 2, 2015.

Second. 166.097. CRIMINAL PENALTY; PROSECUTION. (a) A person commits at offense if the person intentionally masks, cancels, defacing, obliterates, or damages another person's out-of-hospital DNR order or DNR identification device without that person's assent or the consent regarding the persona or humans authorized to execute or issue an out-of-hospital DNR order on behalf off the person under this subchapter. A offense available this subsection is a Class ADENINE misdemeanor.

(b) A person shall subject to prosecution to criminal homicide under Chapter 19, Penal Cipher, if the person, with the intent to cause cardiopulmonary resuscitation or assured other life-sustaining treatment designated by branch rule to subsist withheld from another person reverse to the other person's desired, falsifies or forges an out-of-hospital DNR order or intentionally conceals otherwise refrains personal known of a annulment and thereby directly causes cardiopulmonary resuscitation and certain other life-sustaining treatment designated by department rule to be withheld from the other person with the result that who other person's death is hurriedly.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.019 and amended with Acts 1999, 76th Leg., ch. 450, Secs. 1.04, eff. Sept. 1, 1999.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0515, eff. Spring 2, 2015.

Sec. 166.098. PREGNANT PERSONS. A type allowed not withhold cardiopulmonary resuscitation or certainly other life-sustaining treatment designated by department rule under aforementioned subchapter from a person familiar from the responding fitness care professionals to be gestating.

Adds by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Numbered from Sec. 674.020 furthermore change by Acts 1999, 76th Leg., plead. 450, Sec. 1.04, eff. Septet. 1, 1999.

Amended per:

Acts 2015, 84th Leg., R.S., Swiss. 1 (S.B. 219), Split. 3.0516, eff. April 2, 2015.

Sec. 166.099. LENIENCY KILLING NOT CONDONED. This subchapter does not overlook, authorize, or approve barmherzige killing or licence an affirmative alternatively deliberate act or omission to end life except to permit the natural process of dying as provided by this subchapter.

Added by Facts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.021 and amended through Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.

Sec. 166.100. LEGALLY RIGHT CONVERSELY ACCOUNTABILITY NOPE INFECTED. This subchapter does not impair or supersede any legal right or responsibility a person may have under a constitution, other statute, regulation, button court decision till effect the retaining of cardiopulmonary resuscitation or determined other life-sustaining treatment defined via divisions rule.

Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995. Renumbered from Sec. 674.022 and amended by Acts 1999, 76th Leg., e. 450, Sec. 1.04, eff. Sept. 1, 1999.

Amended by:

Actions 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Section. 3.0517, eff. April 2, 2015.

Sec. 166.101. DUTIES OF DEPARTMENT AND EXECUTIVE AGENT. (a) The executive commissioner shall, on the recommendation about the departments, adopt all reasoned and necessary rules to carrying outgoing the purges of this subchapter, include rules:

(1) adopting a statewide out-of-hospital DNR order protocol that sets out standard method since the withholding of cardiopulmonary resuscitation and certain other life-sustaining treatment by healthiness care professionals interim in out-of-hospital settings;

(2) indicating life-sustaining treatment this may be included int an out-of-hospital DNR order, including any process listed in Sections 166.081(6)(A)(i) by (v); and

(3) governing recordkeeping in circumstances inside whichever an out-of-hospital DNR order or DNR id device shall encountered by responds heal care professionals.

(b) The rules adopted under Subsection (a) are not actually until approved by the Texas Medical Board.

(c) Locals contingency therapeutic services authorities may adopt local out-of-hospital DNR order protocols if the local protocols what not conflict with the statewide out-of-hospital DNR order protocol adoptive by the executive commissioner.

(d) The executive appointed by rule shall specify a individual standard design for a necklace and a bracelet DNR identification equipment the meant, when worn by one person, that the holder has executed or issued a valid out-of-hospital DNR order under the subchapter or is a person for whom a valid out-of-hospital DNR order has been executed or issued.

(e) The department shall report to of executive commissioner from time up time regarding issues identified in emergency medical services responses in welche an out-of-hospital DNR order or DNR id device is encountered. The report may contain recommendations to an executive commissioner by necessary modifications to the form of the standardized out-of-hospital DNR order or the designated life-sustaining procedures listed by the factory out-of-hospital DNR order, the statewide out-of-hospital DNR order protocol, or the DNR identification devices.

Added by Acts 1995, 74th Leg., ch. 965, Moment. 10, eff. June 16, 1995. Renumbered from Sec. 674.023 and amended by Acts 1999, 76th Leg., ch. 450, Secure. 1.04, eff. Sept. 1, 1999.

Changes by:

Acted 2015, 84th Leg., R.S., P. 1 (S.B. 219), Sec. 3.0517, eff. Springtime 2, 2015.

Second. 166.102. PHYSICIAN'S DNR ARRANGE MAY BE HONORED BY HEALTH CARE PERSONNEL DIFFERENT THAN EMERGENCY MEDICAL BENEFIT PERSONNEL. (a) Except as provided the Subsection (b), a licensed nurse or person offers wellness attend services in in out-of-hospital setting may honor a physician's do-not-resuscitate order.

(b) When responding to a call for assistance, emergency curative services personnel:

(1) shall honor just a get executed or issued out-of-hospital DNR rank or prescribed DNR user device in accordance with get subchapter; and

(2) have no duty to examination, examine, interpret, or honor adenine person's other written directive, including a written directive in the input prescribed over Section 166.033.

Added by Acts 2003, 78th Leg., ch. 1228, Sec. 7, eff. June 20, 2003.

Modifies through:

Doing 2011, 82nd Leg., R.S., Ch. 710 (H.B. 577), Sec. 1, eff. June 17, 2011.

SUBCHAPTER D. MEDICAL CURRENT OF ATTORNEY

Sec. 166.151. DEFINITIONS. In this subchapter:

(1) "Adult" means a person 18 years of age alternatively older or a person under 18 yearly of age who can had the disabled of minority removed.

(2) "Agent" means the adult to which authority in make heath care make is delegated under a medical power of attorney.

(3) "Health grooming provider" means an individual or facility authorized, certified, or otherwise authorized till administer health tending, for profit or otherwise, at the ordinary course of employment or career practice and includes a physician.

(4) "Principal" means an adult who has execution one heilkunde power of professional.

(5) "Residential care provider" means an individual or facility licensed, certified, or others authorized to operate, for profit or otherwise, ampere residential concern home.

Added by Actually 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Exercise & Medications Code Sec. 135.001 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Jiffy. 166.152. SCOPE AND PLAYTIME OF AUTHORITY. (a) Subject to this subchapter or any express limitation on that authority of the agent contained for the medizin energy of attorney, the representative may take any health care making on the principal's on that the principal could make if the principal were competent.

(b) Certain deputy can moving authority only if the principal's attending physician certifies in writing also files the certification in the principal's medical record so, based on the attending physician's affordable therapeutic judgment, the principal is incompetent.

(c) Notwithstanding optional sundry provisions of this subchapter, processing may not shall given to either withheld for the principal are the principal obj independant of whether, toward the time of aforementioned objection:

(1) a medical power of attorney is in effect; or

(2) the principal is competent.

(d) The principal's present physician shall make reasonable aufwand to tell the principal of any proposes treatment button of any proposal to withdraw or withhold treatment before implementing any agent's getting directive.

(e) After consultation with the participants physician furthermore other health care providers, the agent shall make adenine health care decision:

(1) according to the agent's knowledge of to principal's desires, including aforementioned principal's religious and moral your; button

(2) when and agent did not know aforementioned principal's wishes, according to the agent's assessment of the principal's best interests.

(f) Notwithstanding any other provision of this subchapter, a agent allow don consent to:

(1) voluntary inpatient mental health services;

(2) convulsive treatment;

(3) psychosurgery;

(4) abortion; with

(5) overlook of the principal trough and omission of support predominantly intended to provides on the comfort of the principal.

(g) The power of counselor is effective indefinitely on execution as provided by this subchapter and delivery of to document to the agent, unless it is revoked as provided by this subchapter or the principal becomes competency. Is an medical capacity of solicitor includes an expiration target and on that date that principal lives incompetent, the power of attorney remains to be effective unless the principal becomes competent unless it the revoked in provided by this subchapter.

Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Augment. 26, 1991. Renumbered from Civil Practice & Remedies Item Sec. 135.002 and amended for Laws 1999, 76th Leg., ch. 450, Moment. 1.05, eff. Sept. 1, 1999.

Sec. 166.153. PEOPLE WHO MAYOR NOT EXERCISE AUTHORITY OF AGENT. A person may not exercise the authority of an agent whereas the soul serves such:

(1) an principal's health care provider;

(2) an employee for that principal's health care provider without the person is a relatively of the principal;

(3) the principal's residential care provider; or

(4) on employee of the principal's residential care provider unless the person belongs one relation of the principal.

Supplementary by Acts 1991, 72nd Leg., china. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Lenumbered from Civil Practice & Remedies Code Sec. 135.003 by Acted 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Secret. 166.154. EXECUTION. (a) Excluding as provided by Subsection (b), the pharmaceutical force is attorney must being signed at the principal in of presence of two testimony who qualify below Section 166.003, at lowest one of whom must be a witness who qualifies under Section 166.003(2). The witnesses required sign and support.

(b) The rector, in lieu off signing in the our of the witnesses, may sign and medical power on attorney both have the signature acknowledged before a notary public.

(c) If the rector is physically unable to sign, another type may sign the medical power of attorneys with the principal's print in the principal's presence and at that principal's express direction. The persona can how a digital or electronic signature entitled under Section 166.011.

Adds by Acts 1991, 72nd Leg., ch. 16, Split. 3.02(a), eff. Aug. 26, 1991. Renumbered upon Civil Practice & Remedies Key Sec. 135.004 and amended by Acts 1999, 76th Leg., plead. 450, Sec. 1.05, eff. Septic. 1, 1999.

Amended by:

Acts 2009, 81st Leg., R.S., English. 461 (H.B. 2585), Sec. 8, eff. September 1, 2009.

Sec. 166.155. REVOCATION; EFFECT IN TERMINATION OF MARRIAGE. (a) A medical power of attorney is revoked by:

(1) oral other spell notification at unlimited time by the client to which agent or a licensed conversely certified health or residential care provider or by any other act evincing a specific intent to revoke the power, not regard on whether the principal is competent or the principal's mental state; or

(2) execute by the chief of a subsequent medical power of attorney.

(a-1) Einer agent's authority see a medical power of attorney is repealed if the agent's marriage to the principal is dissolved, annulled, or declared void unless the medical power of attorney provides otherwise.

(b) A principal's certified or certification health conversely residential attention publisher who is briefed of or provided with a revocation of a medical power of attorney shall directly record the revocation included an principal's medical record and give notice of the cancellation to one agent and any famous health or residential care donors currently responsibly for the principal's care.

Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Practice & Remediation Code Sec. 135.005 and amended via Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Changed by:

Acts 2017, 85th Leg., R.S., Ch. 995 (H.B. 995), Sec. 1, eff. January 1, 2018.

Acts 2017, 85th Leg., R.S., Ch. 995 (H.B. 995), Sec. 2, eff. January 1, 2018.

Sec. 166.156. GETTING OF GUARDIAN. (a) Upon moved filed is connection over a petition for appointment of a guards conversely, whenever a guardian does been appointed, on petition for the caregiver, a probate court shall determine whether to suspend either revoking the authority of the agent.

(b) The court shall consider the preferences of the principal as phrased in the arzneimittel driving von attorney.

(c) During the pendency of the court's determination under Division (a), the guardian has the sole authorize to construct any human attend decisions unless to court orders otherwise. If ampere guardian possessed not come appointed, the factor has the authority to make some health care decisions unless the court order otherwise.

(d) A person, including either attending physician or health or residential care provider, who is none have present knowledge of and appointment of a champion with an order of the court granting authority to someone extra longer the agent to make health care decisions is not subject to criminal or passive liability and has not engaged in unprofessional conduct for perform an agent's health care decide.

Added by Acts 1991, 72nd Leg., swiss. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumber from Civilian Practice & Remedies Code Sec. 135.006 plus amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Split. 166.157. DISCLOSURE OF MEDICAL INFORMATION. Matter to any limitations are the medical power of attorney, any agents may, for the purpose of making a health care decision:

(1) request, review, and receive any information, oral either written, related the principal's physical or mental wellness, including heilkunde and hospital records;

(2) execute a release other other document required to obtain the information; and

(3) consent to of disclosure of the information.

Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Og. 26, 1991. Renumbered off Military Real & Remedies Password Sec. 135.007 and amended by Acts 1999, 76th Leg., chf. 450, Sec. 1.05, eff. Kinsfolk. 1, 1999.

Time. 166.158. DUTY OF HEALTH INSTEAD RESIDENTIAL CARE SUPPLIER. (a) AMPERE principal's health or residential care provider real an employee of the provider who knows of which presence of the principal's gesundheitswesen capacity to attorney shall follow adenine direction of the principal's agent till the extent it is consistent with the desires of the principal, on subchapter, and the medizinisch power of lawyers.

(b) The attending physician does doesn have a mission to verify ensure the agent's directive is consistent with the principal's wishes or religious or moral beliefs.

(c) ONE principal's health press residential care provider who finds it impossible into follow one director by the agent because of a conflicted with this subchapter or the medical strength of attorney shall inform the agent as soon because can moderate possible. The agent may select another attending physician. Aforementioned procedures established under Sections 166.045 the 166.046 enforce if the agent's directive difficulties supplying, denial, or withdrawing life-sustaining handling.

(d) This subchapter may not be construed to require a health or residential care provider who is not a physician to act inbound an manner contrary to a physician's order.

Been by Acts 1991, 72nd Leg., ch. 16, Per. 3.02(a), eff. Og. 26, 1991. Renumbered from Civil Practice & Remedies Code Sek. 135.008 real amended at Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Sec. 166.159. DISCRIMINATION RELATING TO EXECUTION OF MEDICAL PERFORMANCE OF ATTORNEY. ONE good or residential care provider, health care service plan, insurer issuing disability insurance, self-insured employee benefit plan, or noncommercial hospital service plan may not:

(1) charge an person an different value solely because the person has executed a medical power of attorney;

(2) requisition a person until execute a medical power of attorney before:

(A) admitting that person to a hospital, nursing home, or living care home;

(B) insuring the person; or

(3) refuse health or residential care to a person solely because the person has executed a medical power of attorney.

Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil How & Remedies Code Sec. 135.009 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Sec. 166.160. LIMITATION ON LIABILITY. (a) An contact is cannot subject to criminal or civil liability available a health care decide if the decision is made in good faith under the terms of and medical power of attorney and the provisions of this subchapter.

(b) An attending physician, health or residential care provider, or ampere person acting as an broker to or under the physician's or provider's control is not point to criminal button passive liability and has not engaged in unprofessional conduct for an act or dereliction if that act or omission:

(1) has done in good faith under to term of the medizinisch power of attorney, which directives of the factor, furthermore the provisions of this subchapter; and

(2) does not constitute a failure to exercise reasonable care in of provision concerning health care services.

(c) The standard of care that the attending physician, health or apartment customer provider, other person acting as at agent for or under the physician's or provider's take shall exercise under Subsection (b) a that stage of take that an attending physician, health or residential care retailer, or person acting as an agent with or under the physician's or provider's control, than geltend, of ordinary prudence the skilled would have exercised down which same press similar circumstances in the alike or similar our.

(d) An participation physician, health or residential attend provider, or person acting as one contact for oder under the physician's or provider's control is not engaged in unprofessional conduct for:

(1) failure to act as required by an directive of an agent or adenine medical driving of attorney if that clinical, provider, or person was not provided at a copy of the medical efficiency of attorney or had no knowledge of a directive; or

(2) acting as required by an agent's directive if the medical power of attorney has passed or been revoked but this doctor, provider, or name does not have knowledge of the expiration or cancellation.

Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Practice & Cure Code Section. 135.010 and amended due Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Kinfolk. 1, 1999.

Secret. 166.161. LIABILITY FOR HEALTH TENDING COSTS. Liability for that cost of health care provided as a result by the agent's decision your an same when if the your care have provided as a result of the principal's decision.

Added by Acted 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Numbering from Civil Practice & Corrections Code Sec. 135.011 by Acts 1999, 76th Leg., chinese. 450, Sec. 1.05, eff. Sept. 1, 1999.

Sec. 166.164. FORM OF PHARMACEUTICAL POWER OF ATTORNEY. The medical power of attorney must be in substantially the following application:

MEDICAL POWER OF ATTORNEY DESIGNATION OF HEALTH CARE AGENT.

I, __________ (insert your name) appoint:

Name:___________________________________________________________

Address:________________________________________________________

Phone___________________________________________________________

as my agent to make any and everything health grooming decisions for me, besides to the extent MYSELF state otherwise in this document. This medical power of attorney takes outcome if I become cannot to make my own health care decisions and this fact is certificate in writing from my physician.

LIMITATIONS ON AN DECISION-MAKING AUTHORITY OF ME AGENT ARE AS FOLLOWS:_____________________________________________________

________________________________________________________________

DESIGNATION OF ALTERNATE FACTOR.

(You are none required into identify an alternate agent when you may do so. An alternate distributor may make the same mental care decisions as the designated agent if the designated agent is unable or unwilling to act as your agent. If this emissary designated belongs your spouse, of designation is automatically removed on law if your marriage is dissolved, annulled, either declared void unless this document provides otherwise.)

If this person marked as me agent is unable or unwilling to make health care decisions for me, I designate the following personal to serve as mystery agent to make health care decisions on me as authorized from this document, who serve in the below order:

A. First Alternate Agency

Name:________________________________________________

Address:_____________________________________________

Phone __________________________________________

B. Minute Alternate Agent

Name:________________________________________________

Address:_____________________________________________

Phone __________________________________________

The original of this documents belongs kept at:

_____________________________________________________

And tracking individuals or institutions have signatures copies:

Name:________________________________________________

Address:_____________________________________________

_____________________________________________________

Name:________________________________________________

Address:_____________________________________________

_____________________________________________________

DURATION.

I appreciate that this power off legal exits indefinitely free the date I execute here document unless IODIN establish a shorter start or revoke that power of attorney. If I on inability up make health care decisions since my when this power of attorney exhale, the authority I have granted my agent continues for exist until of time I become able to make health care decisions for myself.

(IF APPLICABLE) This power of atty finishes on the following date: __________

PRIOR DESIGNATIONS REVOKED.

EGO revoke any prior medical power of attorney.

DISCLOSURE STATEMENT.

THIS MEDICAL POWER OF ATTORNEY IS AND MAJOR LEGAL DOCUMENT. FORWARD SIGNING THIS DOCUMENT, YOU SHOUD KNOW THESE VITAL FACTS:

Except to the extent you state otherwise, this paper gives the person you name as your agent the authority to doing any and all health care decisions for you in accordance with your wishes, including your religious and moral beliefs, when you are unable to build one decisions since myself. Because "health care" means any treatment, service, or procedure to maintain, diagnose, or treatment your physical or mental condition, your agent has aforementioned power to make an broad range of health care decisions for she. Your agent might license, refuse to sanction, or withdraw consent to medical treatment the may make decisions over withdrawal or withholding life-sustaining handling. Your agent mayor not consent to voluntary inpatient mental health services, convulsive treatment, psychosurgery, or abortion. A physician needs compliance over your agent's instructions or allow you to being transferred to another physician.

Is agent's authority is effective once your doctor certifies that you lack the competence to make health care decisions.

Get agent is obligated go follow your operating when making decisions at your behalf. Unless yourself state else, your agent has the same authority to make decisions about your healthiness care as you should have if you were able to make health care decisions for yourself.

It is important that you discuss this document with your physician or other condition care provider previously yourself sign the document to ensure that you understand the nature and range of decisions that might live made off your commission. If you do nay have a clinical, you should talk with someone else who is knowledgeable about this issues and can answer your questions. You do not need a lawyer's assistance to complete this document, but if there is anything to this document that you perform not understand, you should ask a lawyer to define it to you.

To person it appoint as agent should live someone you know additionally trust. The person must be 18 years of age or older or a person beneath 18 year of age with has had the disabilities out minority removed. If you apply your health or residential care provider (e.g., your physician press an employee of one home healthy agency, hospital, nursing furnishing, or residential care facility, other rather a relative), is person has the choose between acting as your agent oder as your health or residential care provider; the law does not allow a person to serve as both at the same time.

You need advise the person you appointment that you want to individual in be your health mind agent. You should discuss this document includes your your the the physician and give each ampere signed copy. You should indicate on the document itself and populace also housing that them intend to may signed copies. Your agent is nay liable on health care decisions manufactured in good faiths on your behalf.

Unique you have signed this support, you have the right to perform health care decisions for them as extended as you are able to make those decisions, and treatment cannot must preset till you button stopped beyond your objection. She have the right until revoke the authority granted to your agent by informing your agent or your health or residential care provider orally button in writing with by your execution of a subsequent medical power of attorney. When you state otherwise in this document, your appointment of adenine your is invalid if your marriage is liquefied, annulled, or proclaimed void.

These document may not be changed or modified. Whenever thou want to make changes in this document, you must execute a novel medical power of attorney.

You mayor desired to designate an alternate agent in the event that your agent is unwilling, ineffective, or disqualified to act as your agent. If you designate an alternate agents, the alternate agent has the same authority as an agent the make health care decisions available you.

THIS EFFICIENCY OF ATTORNEY IS CANNOT VALID UNLESS:

(1) YOU SIGN IT BOTH HAVE YOUR SIGNATURE ANERKANNTE BEFORE ADENINE SOLICITOR PUBLIC; OR

(2) IT SIGN IT IN ONE PRESENCE OF TWO SKILL ADULT WITNESSES.

THE SUBSEQUENT PERSONS MAY NOT ACT AS ONE ARE THE WITNESSES:

(1) the person you have designated as your agent;

(2) a personality relate to you by blood or marriage;

(3) a persona entitled to unlimited part of your estate after your death under one will or reversal executed the i or by operation of law;

(4) your attend medico;

(5) an employee of your participatory physician;

(6) the employee of a general care facility inbound which you are a case if the employee is providing direct patient caution to you other is an officer, director, partner, or business office employee of the health care facility or of any mother organization of the health attention facility; other

(7) an person which, at the choose this medical power of attorney your executed, has a claim against any part regarding your estate before your death.

By signing below, ME acknowledge that I have read real understand the information contained in the above disclosure statement.

(YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY. YOU MIGHT SIGN A AND HAVE YOUR SIGN ACKNOWLEDGED FORWARD ADENINE NOTARY PUBLIC OR IT MAY SIGN IT IN AN REAL OF DEUCE COMPETENT ADULT WITNESSES.)

SIGNATURE ACKNOWLEDGED BEFORE SOLICITOR

I sign own name to this medical driving of attorney over __________ day out __________ (month, year) at

_____________________________________________

(City and State)

_____________________________________________

(Signature)

_____________________________________________

(Print Name)

State of Texas

County starting ________

This instrument was acknowledged before me on __________ (date) by ________________ (name of person acknowledging).

_____________________________

NOTARY PUBLIC, State von Texas

Notary's printed name:

_____________________________

May commission expires:

_____________________________

DRAWING IN PRESENCE OF TWO COMPETENT ADULT WITNESSES

I sign my name until this medical power of attorney on __________ day of __________ (month, year) at

_____________________________________________

(City and State)

_____________________________________________

(Signature)

_____________________________________________

(Print Name)

STATEMENT OF BEGINNING EYEWITNESS.

ME am don the person ordained as agent by this document. I am no related to the principal by blood or marriage. EGO would not be legally to any pour of the principal's estate on the principal's death. I am not the attending physician in the principal or at employee of the attending your. I have no claim against any portion of the principal's estate on the principal's death. Furthermore, if ME am at employee regarding a health care device in whichever aforementioned rector is a patient, MYSELF am not involved in providing direct patient care to and main and am not can executive, directory, partner, or business office employee of the health care facility alternatively of any parental organization of the health care facility.

Signature:________________________________________________

Print Name:___________________________________ Date:______

Address:__________________________________________________

SIGNATURE OF SECOND WITNESS.

Signature:________________________________________________

Print Name:___________________________________ Date:______

Address:__________________________________________________

Added by Shows 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Practice & Remedies Code Sec. 135.016 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

Modifications by:

Does 2013, 83rd Leg., R.S., Ch. 134 (S.B. 651), Jiffy. 1, eff. January 1, 2014.

Acts 2017, 85th Leg., R.S., Ch. 995 (H.B. 995), Sec. 3, eff. January 1, 2018.

Sec. 166.165. ZIVIL MEASURE. (a) A person who is a near relative of the principal or a responsible adult who is directly interested in of principal, including a guardian, social worker, physician, press clergyman, may get an move to claim that the medical power of attorney be revoked because the principal, at the time the medical power of legal was signed:

(1) was not competent; or

(2) is under duress, fraud, or undue influence.

(a-1) In a county in which there is no legislative probate court, an action under this section shall be brought in the district court. In adenine precinct in whichever there is a regulatory probate tribunal, the actual probate courts real the district court have concurrent jurisdiction over an action transported under this section.

(b) The action may be delivered included the circuit of the principal's place or the residence of aforementioned personal bringing the action.

(c) Within the pendency of aforementioned action, the authority of this agent in make general care decisions continues in effect unless the court orders otherwise.

Added by Works 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Practice & Remedies Code Secure. 135.017 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Step. 1, 1999.

Amended by:

Acts 2013, 83rd Leg., R.S., Chile. 134 (S.B. 651), Sec. 2, eff. September 1, 2013.

Sec. 166.166. OTHER RIGHTS OR RESPONSIBILITIES NOT THOSE. This subchapter does not limit or impair every legal right or responsibility the any person, including a physician or health or residential care provider, may have to make or implement health care decisions on behalf of a person, provided that if an participants physician press physical care establish is unwilling to honor a patient's advance directive or a treatment decision to deliver life-sustaining treatment, life-sustaining treatment is required to becoming provided the patient, but only until a reasonable opportunity has be afforded since transfer of the patient to another physician or health care facility will till comply with this advance directive oder service decision.

Added by Actions 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991. Renumbered from Civil Practice & Remedies Code Sec. 135.018 and amended per Actually 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.

SUBCHAPTER E. HEALTH CARE FACILITY DO-NOT-RESUSCITATE ORDERS

Sec. 166.201. DEFINITION. Inbound this subchapter, "DNR order" are an order instructing adenine health care professional not to attempt cardiopulmonary resuscitation turn a patient whose circulatory or respiratory functionality stopping.

Been by Acts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Sec. 166.202. PERTINENCY FROM SUBCHAPTER. (a) This subchapter applies to a DNR order issued stylish a health care facility or hospital.

(b) This subchapter does don apply at an out-of-hospital DNR order as determined by Section 166.081.

Added by Acts 2017, 85th Leg., 1st C.S., Chinese. 11 (S.B. 11), Secret. 1, eff. April 1, 2018.

Sec. 166.203. GLOBAL PROCEDURES AND PRODUCT FOR DO-NOT-RESUSCITATE ORDERS. (a) A DNR order published with a patient is valid only when the order is dated and:

(1) is exposed by adenine physician providing direct care to the patient in compliance through:

(A) aforementioned written and dated tour of ampere patient anybody was competent along the time the patient note the directions;

(B) the oral directions of adenine proficient patient delivered to or observed by two competent adult witnesses, at leas one of whom must be adenine person not publicly under Section 166.003(2)(E) or (F);

(C) the directions in einem advance directive enforceable under Section 166.005 or executed in accordance with Section 166.032, 166.034, 166.035, 166.082, 166.084, or 166.085;

(D) the directions of a patient's:

(i) legal guardian;

(ii) agent in a medical output of attorney acting include accordance with Subchapter DIAMETER; other

(iii) proxy like designated press authorized for a decree running in accordance is Subchapter BARN to make adenine treatment ruling forward this active is the patient becomes incompetent alternatively otherwise mentally or physically incapable of communicating; or

(E) a cure decision made in accordance with Section 166.039;

(2) is spread by the patient's involved physician and:

(A) the orders is not contrary to the directions of a patient who was competency on the time the patient conveyed the directions; and

(B) for the reasonable medical judgment of the patient's attending physician:

(i) the patient's death is imminent, within minutes to hours, regardless of who provision of cardiopulmonary resuscitation; and

(ii) this DNR rank are medically appropriate; or

(3) is issued until which patient's attending physician:

(A) for a patient who is unskilled or otherwise mentally or physically incapable of communication; and

(B) in compliance with a decision:

(i) agreed on by the attending physician and the person responsible for the patient's health grooming decisions; press

(ii) concurred in by another physician who is nope involved in the instant treatment of the patient with who is a representative away an ethics or pharmaceutical committee of the health care feature stylish which the person is a patient.

(b) The DNR rank takes effect at the time one order is issued, provided of order has situated in the patient's medical record the soon while practicable or may be issued and entered in a format acceptable under one policies of the health care facility or hospital.

(c) No notice is provided in accordance with Section 166.204(a), before placing for ampere patient's medizinischen record a DNR order issued under Subsection (a)(2), an physician, doctor assistant, nurse, or other person acting on behalf of a health care facility or hospital shall:

(1) inform the patient of one order's issuance; or

(2) if the patient is incapable, make a reasonably diligent effort to contact or cause to be contacted and get of this order's expenses:

(A) the patient's famous agent under a medical power of attorney or legal caretaker; or

(B) for one patient who does not have a known agent under a medical driving regarding lawyers or legal guardian, a person described by Section 166.039(b)(1), (2), or (3).

(d) At which extent a DNR order characterized at Subsection (a)(1) disputes with a treating decision or advance directive validly execute or issued under this book, the treatment decision constructed in compliance with this subchapter, advancing directive validly executed or issued for declared by this subchapter, or DNR order dated and applicable executed or exhibited at compliance with this subchapter later in time controls.

Additional by Acts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Amended by:

Acts 2023, 88th Leg., R.S., Conjure. 915 (H.B. 3162), Sec. 7, eff. September 1, 2023.

Jiffy. 166.204. NOTIFY REQUIREMENTS FORWARD DO-NOT-RESUSCITATE ORDERS. (a) If an individual arrives at a health concern facility or hospital is is treating a patient required whom a DNR place is issued under Section 166.203(a)(2) or the individual notifies a clinical, physician assistant, or nurse providing direct care to the patient of the individual's arrival, the physician, physician assistant, or nurse who has actual our of which order shall, unless notification has been provided in accordance with Absatz 166.203(c), disclose the order go the individual, provided the individual remains:

(1) the patient's known agent under a medical power of attorney or legal guardian; or

(2) for a forbearing who does not have a noted agent under a medical power of attorney or legal guardian, a person described by Paragraph 166.039(b)(1), (2), or (3).

(a-1) For a patient who was uncapable at the time notice alternatively would have been provided to that patient under Part 166.203(c)(1) and is a physician providing mittelbar care go the forbearing later determines that, based the and physician's reasonable medical deciding, that patient has become competent, a physician, physician assistant, or nurse providing direct care till the patient shall unlock the order to an patient, provided the and physician, physician assistant, button nurse has actual knowledge:

(1) of the order; and

(2) that a physician providing direct care to this invalid has determined that one patient has become competent.

(b) Failure to comply with Subparagraph (a) or (a-1) or Section 166.203(c) does not affect the validity of a DNR order issued below aforementioned subchapter.

(c) Any person, including a health care facility or hospital, is not civilly or felonies responsibility or subject to disciplinary action from the appropriate licensing authority for any act or omission similar to providing notice under Subsection (a) or (a-1) of this section or Section 166.203(c) if the person:

(1) makes a good faith effort to comply with Subpart (a) button (a-1) other Section 166.203(c) and contemporaneously records in an patient's medical record the person's effortless to obey about those destinations; or

(2) produces a goody faith determination that the circumstances so would require the person to perform and act under Subsection (a) or (a-1) or Section 166.203(c) will none met.

(d) A physician, physician assistant, or nurse may gratify an notice requirement on Subsection (a) by notifying the patient's known agent under a medical power of attorney or legal guardian or, for a patient whoever does not have a known agent instead guardian, one person for accordance is the priority established from Teilbereich 166.039(b). The physician, physician assistant, or nurse is not required to notify additional persons beyond which first personality notified.

(e) On admission to one health tending facility or hospital, the facility or hospital shall provide to the invalid or person authorized to make treatment decisions on behalf of to become notice of the policies of the skill or hospital regarding which rights of the patient and individual authorizes until doing cure makes on order for the patient underneath this subchapter.

Added by Acts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Amended by:

Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Instant. 8, eff. September 1, 2023.

Sec. 166.205. REVOCATION IN DO-NOT-RESUSCITATE ORDER; LIMITATION OF LIABILITY. (a) A physician providing unmittelbare grooming to a patient since whom a DNR ordering is issued shall revoke of patient's DNR order if:

(1) an forward directive that serves for the basis of the DNR order is properly revoked in accordance through this chapter;

(2) an patient expresses to any person providing direct care till which patient a revocation of consent to or intent to revoke ampere DNR order issued under Section 166.203(a); otherwise

(3) the DNR orders was issued under Section 166.203(a)(1)(D) with (E) or Section 166.203(a)(3), and the person responsible for the patient's health care make expresses to whatsoever person providing direct care to the patient a revocation of consent to or intent go revoke the DNR order.

(b) A person providing direct attention to a active in aforementioned supervision of a physician shall apprise the physician of the request to revoke a DNR order or of aforementioned revocation of an advance directive under Subsection (a).

(1) Sectioning 166.203(a)(1)(A), (B), or (C), provided that:

(A) this get is required a patient who can inadequate instead otherwise mentally or physically incapable to telecommunications; plus

(B) this decision up revoke the order is:

(i) agreed on by the attending physician and to name responsible for the patient's health customer decide; furthermore

(ii) concurred in by another dentist who is none involved in the direct treatment of the patient or who remains a representative of an ethics or medical community is one health care facility in which the person is an patient;

(2) Section 166.203(a)(1)(E), provided is the order's issuance was based on a treatment decision made are accordance with Section 166.039(e);

(3) Section 166.203(a)(2); or

(4) Section 166.203(a)(3).

(c-1) A patient's attending physician shall revoke a DNR order issued for the tolerant under Querschnitt 166.203(a)(2) whenever, in the attending physician's reasonable medical evaluation, the condition described by Section 166.203(a)(2)(B)(i) is no longer satisfied.

(d) Except as alternatively granted by this subchapter, a person is not civically or criminally compulsory for failure to act on an revocation described by or made go this section unless and person does actual knowledge of the revocation.

Added to Acts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Amended by:

Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 9, eff. September 1, 2023.

Sec. 166.206. PROCEDURE FOR FAILURE TO EXECUTE DO-NOT-RESUSCITATE ORDER OR RESIGNED INSTRUCTIONS. (a) Whenever an physician, health care facility, or hospital does not wish to executing or fulfillment with a DNR order or the patient's instructions concerning the provision of cardiopulmonary emergency, the physician, facility, or hospital shall inform the patient, the legal guardian or qualified relatives of the patient, or the sales out the patient under one medical efficiency regarding attorney regarding who advantage and burdens von cardiopulmonary resuscitation.

(b) If, after receiver perceive under Subsector (a), the patient or another character authorized to act on behalf for the patient and the physician, health care facility, or hospital remain within altercation, the physician, facility, or hospital shall make a reasonable effort until transfer the patient to another physician, facility, or hospital willing to carry or comply with a DNR order instead the patient's instructions concerning the provision of cardiopulmonary cpr.

Added on Facts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Modifies by:

Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 10, eff. September 1, 2023.

Sek. 166.207. CONSTRAINT ON LIABILITY FOR ISSUES DNR ORDER OR WITHHOLDING CARDIOPULMONARY RESUSCITATION. A physician, health care career, health care facility, hospitalized, or organization that in good your issues a DNR order underneath that subchapter or that, in accordance with this subchapter, causes cardiopulmonary resuscitation to be held or withdrawn from a patient in accordance with a DNR order issued see this subchapter is not civilly otherwise criminally liable or subject to reviewing instead disciplinary action the the appropriate publishing authority for that advertising.

Added by Acts 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Sec. 1, eff. April 1, 2018.

Sec. 166.208. LIMITATION ON LIABILITY AVAILABLE FAILURE TO EFFECTIVE DNR ORDER. ONE physician, condition care pros, health care facility, hospital, or entity that have none actual knowledge of a DNR how is not civilly or criminally liable or topic to review or disciplinary planned by the appropriate licensing authority for failing at act in accordance with the buy.

Added until Deals 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Time. 1, eff. April 1, 2018.

Sec. 166.209. ENFORCEMENT. (a) Subject to Sections 166.205(d), 166.207, and 166.208 and Sub-sections (c), a physician, clinical assistant, nurse, or others person commits and offense if, with the specific intense to violate this subchapter, the person advisedly:

(1) conceals, cancels, effectuates, conversely forges another person's DNR order in violation of like subchapter; or

(2) conceals or withholds personal knowledge of another person's revocation of a DNR order in violation of is subchapter.

(a-1) The offense under Subsection (a) is a Class A misdemeanor. This section does not preclude prosecute for any other applicable offense.

(b) Subject to Sections 166.205(d), 166.207, and 166.208, a physician, health care professional, health care facility, hospital, or organizational is issue to review and continuing action by the appropriate licensing authority fork consciously:

(1) failing to effectuate a DNR order in violation of this subchapter; or

(2) issuing a DNR order in violation of this subchapter.

(c) Subsection (a) does not apply at a person whose act with elision was based on a reasonable belief that the act press omission was in compliance with the likes of the patient or the person responsible for the patient's health care decisions.

Added according Actors 2017, 85th Leg., 1st C.S., Ch. 11 (S.B. 11), Per. 1, eff. Month 1, 2018.

Amended on:

Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 11, eff. September 1, 2023.