patient doctor discussion

It is not just you.

Some of the written disclosures that hospitals hand out during their patient admission process are downright cryptic. Few people even realize what is being referenced when they read them.

And, sorry to say, the admissions clerk is probably not going to enlighten you. 

Which brings us to advance directives. 

Understanding Advance Directives

If you have ever received services from a hospital, skilled nursing facility, home and community support services agency, assisted living facility or special care facility, then you have received a multi-page document telling you about the provider’s policies on advance directives. Why? Because the providers are required to do so by law.

However, the providers are not required to define the term for you. I will. The definition is set out in the statute. “Advance directive” refers to 3 different types of instructions: a directive to physicians, an out-of-hospital do not resuscitate (“DNR”) order, and a medical power of attorney

A directive to physicians conveys your instructions regarding life-sustaining treatment in the event you have an irreversible condition or a terminal illness. A DNR order is signed by a physician and states that you should not be resuscitated if your heart stops beating, or if you stop breathing. A medical power of attorney appoints an agent to make your medical decisions if you become incapacitated.

Provider Policies and Your Rights in Advance Directives

Although the healthcare documents are vastly different, they are all lumped together under the name of “advance directive” because Texas law requires certain health care providers to maintain written policies on how they will implement each document. Texas law also requires that they tell you about those policies. In writing. 

When you receive such a disclosure, you may be tempted to sign the acknowledgment without reading the document. Ignore the temptation. There is no universal form for disclosure because each provider can draft its own policy. Some health care providers have policies that state that they are unwilling or unable to provide or withhold certain procedures. That information should be in the disclosure. You need to know the provider’s policies going in. They could end up being very important to your care.

Those same providers will ask, in writing, if you have an advance directive. If you do, then you can certainly give them a copy to keep in their file. However, they cannot require you to have one. No one – including physicians, insurers, and health care service plans – can require you to have an advance directive. 

If you do not have an advance directive and want to do one at the last minute, then you need to know a little detail in the law about who can witness an advance directive. At least one of the witnesses to the advance directive must be a person who is not named as your health care agent, related to you by blood or marriage, entitled to any part of your estate after your death, your attending physician, an employee of your attending physician, an employee of the health care facility or any officer or director of the health care facility.

That prohibits a lot of people who would otherwise be available to be a witness for you. You would be wise to consider your choices on having an advance directive before you need any kind of medical treatment. 

Advance directives are important documents. Your health care providers know that. You need to know that, too.

Hammerle Finley Can Help

Do you need estate planning assistance? Schedule a consultation with one of our experienced attorneys to discuss your options.

Attorney Virginia Hammerle has practiced litigation and estate planning for 40 years. She is founder and managing attorney for Hammerle Finley Law Firm.