Choosing a Natural End
Documents That Make Life and Death Easier

You know that you can always refuse life-sustaining medical treatment. The tricky part comes when you are no longer able to understand your options or communicate your wishes to the health-care professionals. While Texas may not yet condone physician-assisted suicide or mercy killing, it is all-in for permitting the natural process of dying. You just have to know how to get it done.

What are The 4 Healthcare Documents That You Need?

Thus, if you want to control your destiny as much as possible, there are 4 must-have documents: the Medical Power of Attorney, the Directive to Physicians, the Out- of -Hospital Do -Not – Resuscitate, and the In-Hospital Do Not Resuscitate.
In the Medical Power of Attorney, you are appointing an agent to make health-care decisions for you if you are unable to do so. Those decisions can include turning off life-support and refusing life-sustaining treatment. Before making the appointment, you need to thoroughly talk about your wishes with your agent and make sure your agent is willing to follow them. You can, by the way, fire your agent at any time.

In the Directive to Physicians, you are letting people know your existing desires regarding comfort care and life-sustaining treatment in the event you are diagnosed with a terminal or irreversible health condition. The health- care professionals cannot require you to have a Directive to Physicians, and they cannot require that you use their facility’s form if you do decide to execute a Directive. The Directive can be customized as much as you want. Practice tip: many people will execute a basic Directive with their estate planning documents, and then put in place a more detailed Directive after they receive a dire diagnosis.

Do-Not-Resuscitate Forms In Texas

The Do-Not-Resuscitate documents come in two very different forms. Unlike the Directive to Physicians, a DNR must also be signed by your attending physician. The Out-of-Hospital DNR is a legally binding order that documents your instructions to health- care professionals acting outside a hospital setting not to initiate or continue cardiopulmonary resuscitation, advanced airway management, artificial ventilation, defibrillation or transcutaneous cardiac pacing. The form requires your signature; if you are not competent to do so, then your proxy or health care agent can sign it.

The In-Hospital DNR is an order instructing a health- care professional not to attempt cardiopulmonary resuscitation on a you if your circulatory or respiratory function ceases. Think of it as a “no code blue” order. It is issued in a health- care facility or hospital and does not require your signature. However, the physician does have to inform you or (in case you are incompetent) make a good faith effort to inform your proxy or agent of the DNR order.

With this many documents in play, it is fairly easy to get a conflicting instruction. Under Texas law, the treatment decision or document executed last in time controls.
Few people want to spend their final days hooked up to machines in a hospital or nursing home. These documents are your best chance under existing Texas law for a natural way out.