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A BILL TO BE ENTITLED
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AN ACT
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relating to an advance directive and do-not-resuscitate order of a |
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pregnant patient. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 166.033, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 166.033. FORM OF WRITTEN DIRECTIVE. A written |
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directive may be in the following form: |
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DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES |
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Instructions for completing this document: |
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This is an important legal document known as an Advance |
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Directive. It is designed to help you communicate your wishes about |
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medical treatment at some time in the future when you are unable to |
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make your wishes known because of illness or injury. These wishes |
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are usually based on personal values. In particular, you may want |
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to consider what burdens or hardships of treatment you would be |
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willing to accept for a particular amount of benefit obtained if you |
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were seriously ill. |
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You are encouraged to discuss your values and wishes with |
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your family or chosen spokesperson, as well as your physician. Your |
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physician, other health care provider, or medical institution may |
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provide you with various resources to assist you in completing your |
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advance directive. Brief definitions are listed below and may aid |
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you in your discussions and advance planning. Initial the |
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treatment choices that best reflect your personal preferences. |
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Provide a copy of your directive to your physician, usual hospital, |
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and family or spokesperson. Consider a periodic review of this |
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document. By periodic review, you can best assure that the |
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directive reflects your preferences. |
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In addition to this advance directive, Texas law provides for |
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two other types of directives that can be important during a serious |
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illness. These are the Medical Power of Attorney and the |
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Out-of-Hospital Do-Not-Resuscitate Order. You may wish to discuss |
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these with your physician, family, hospital representative, or |
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other advisers. You may also wish to complete a directive related |
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to the donation of organs and tissues. |
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DIRECTIVE |
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I, __________, recognize that the best health care is based |
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upon a partnership of trust and communication with my physician. My |
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physician and I will make health care decisions together as long as |
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I am of sound mind and able to make my wishes known. If there comes |
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a time that I am unable to make medical decisions about myself |
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because of illness or injury, I direct that the following treatment |
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preferences be honored: |
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If, in the judgment of my physician, I am suffering with a |
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terminal condition from which I am expected to die within six |
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months, even with available life-sustaining treatment provided in |
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accordance with prevailing standards of medical care: |
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| __________ |
I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR |
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I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) |
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If, in the judgment of my physician, I am suffering with an |
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irreversible condition so that I cannot care for myself or make |
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decisions for myself and am expected to die without life-sustaining |
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treatment provided in accordance with prevailing standards of care: |
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I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR |
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I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) |
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Additional requests: (After discussion with your physician, |
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you may wish to consider listing particular treatments in this |
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space that you do or do not want in specific circumstances, such as |
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artificial nutrition and fluids, intravenous antibiotics, etc. Be |
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sure to state whether you do or do not want the particular |
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treatment.) |
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| ________________________________________________________________ |
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| ________________________________________________________________ |
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| ________________________________________________________________ |
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After signing this directive, if my representative or I elect |
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hospice care, I understand and agree that only those treatments |
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needed to keep me comfortable would be provided and I would not be |
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given available life-sustaining treatments. |
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If I do not have a Medical Power of Attorney, and I am unable |
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to make my wishes known, I designate the following person(s) to make |
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treatment decisions with my physician compatible with my personal |
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values: |
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(If a Medical Power of Attorney has been executed, then an |
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agent already has been named and you should not list additional |
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names in this document.) |
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If the above persons are not available, or if I have not |
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designated a spokesperson, I understand that a spokesperson will be |
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chosen for me following standards specified in the laws of Texas. |
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If, in the judgment of my physician, my death is imminent within |
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minutes to hours, even with the use of all available medical |
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treatment provided within the prevailing standard of care, I |
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acknowledge that all treatments may be withheld or removed except |
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those needed to maintain my comfort. [I understand that under Texas
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law this directive has no effect if I have been diagnosed as
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pregnant.] This directive will remain in effect until I revoke it. |
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No other person may do so. |
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Signed__________ Date__________ City, County, State of |
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Residence __________ |
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Two competent adult witnesses must sign below, acknowledging |
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the signature of the declarant. The witness designated as Witness 1 |
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may not be a person designated to make a treatment decision for the |
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patient and may not be related to the patient by blood or marriage. |
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This witness may not be entitled to any part of the estate and may |
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not have a claim against the estate of the patient. This witness |
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may not be the attending physician or an employee of the attending |
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physician. If this witness is an employee of a health care facility |
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in which the patient is being cared for, this witness may not be |
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involved in providing direct patient care to the patient. This |
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witness may not be an officer, director, partner, or business |
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office employee of a health care facility in which the patient is |
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being cared for or of any parent organization of the health care |
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facility. |
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Witness 1 __________ Witness 2 __________ |
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Definitions: |
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"Artificial nutrition and hydration" means the provision of |
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nutrients or fluids by a tube inserted in a vein, under the skin in |
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the subcutaneous tissues, or in the stomach (gastrointestinal |
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tract). |
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"Irreversible condition" means a condition, injury, or |
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illness: |
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(1) that may be treated, but is never cured or |
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eliminated; |
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(2) that leaves a person unable to care for or make |
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decisions for the person's own self; and |
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(3) that, without life-sustaining treatment provided |
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in accordance with the prevailing standard of medical care, is |
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fatal. |
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Explanation: Many serious illnesses such as cancer, failure |
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of major organs (kidney, heart, liver, or lung), and serious brain |
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disease such as Alzheimer's dementia may be considered irreversible |
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early on. There is no cure, but the patient may be kept alive for |
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prolonged periods of time if the patient receives life-sustaining |
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treatments. Late in the course of the same illness, the disease may |
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be considered terminal when, even with treatment, the patient is |
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expected to die. You may wish to consider which burdens of |
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treatment you would be willing to accept in an effort to achieve a |
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particular outcome. This is a very personal decision that you may |
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wish to discuss with your physician, family, or other important |
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persons in your life. |
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"Life-sustaining treatment" means treatment that, based on |
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reasonable medical judgment, sustains the life of a patient and |
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without which the patient will die. The term includes both |
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life-sustaining medications and artificial life support such as |
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mechanical breathing machines, kidney dialysis treatment, and |
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artificial hydration and nutrition. The term does not include the |
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administration of pain management medication, the performance of a |
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medical procedure necessary to provide comfort care, or any other |
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medical care provided to alleviate a patient's pain. |
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"Terminal condition" means an incurable condition caused by |
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injury, disease, or illness that according to reasonable medical |
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judgment will produce death within six months, even with available |
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life-sustaining treatment provided in accordance with the |
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prevailing standard of medical care. |
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Explanation: Many serious illnesses may be considered |
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irreversible early in the course of the illness, but they may not be |
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considered terminal until the disease is fairly advanced. In |
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thinking about terminal illness and its treatment, you again may |
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wish to consider the relative benefits and burdens of treatment and |
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discuss your wishes with your physician, family, or other important |
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persons in your life. |
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SECTION 2. Sections 166.049 and 166.098, Health and Safety |
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Code, are repealed. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2015. |
