This document gives physicians and family members clear instructions about the kind of treatment we DO want, and the kind of treatment we do NOT want if we can't speak for ourselves.

Without Advanced Medical Directives a patient's medical caregivers and family must attempt to determine the patient's wishes without clear guidelines.

An Advanced Directive to Physicians relieves the stress and guilt family members often feel when they try to make these kinds of decisions without guidance, and they can prevent the disagreements among family members that have so often been in the news recently. The written document assures our decision-makers that they are making the decisions we would have wanted.

The Texas Advanced Directive to Physicians, Families and Surrogates is not a "pull the plug" document. It specifically allows you to choose exactly what kind of life sustaining or comfort treatment you would want to have in two situations: an irreversible condition or a terminal condition.

Life-Sustaining Treatment is any medical treatment or medication that physicians believe will maintain a patient's life, and without which the patient will probably die. Kidney dialysis, pacemakers, breathing machines, feeding tubes and food or fluid provided through tubes or veins are all examples of life-sustaining treatment when a person has an irreversible or a terminal condition and is not expected to recover.

An Irreversible Condition is an illness or an injury that cannot be cured, but that can be treated. Many irreversible conditions ultimately reach a stage at which they are considered to be terminal. Such conditions as kidney failure, stroke or Alzheimer's Disease are irreversible, but patients can be kept alive with life-sustaining treatments for long periods of time.

A Terminal Condition is an injury or an illness that doctors expect will result in death within six months or less, even with life-sustaining treatment.

Signing a Directive to Physicians will not prevent any patient from receiving the care they want. The Directive only takes effect if a patient is unable to make his or her wishes known, and if a doctor has stated in writing that the patient is in a terminal or irreversible condition. The Advanced Directive can be changed at any time, even verbally if the patient is able to speak.

The Texas Directive to Physicians, Families and Surrogates is a simple document to complete. It does not require a notary. It does require the witnessing signatures of two adults over the age of 18, one of whom should not be a family member.

Completed copies of the Directive to Physicians, Families or Surrogates should be given to all your physicians, and a copy should be included in any hospital chart. Family members should also have copies, as should any other people who have an interest in your future care.

You do not have to have an attorney to prepare an Advanced Directive. The State of Texas makes available blank copies of the Directive to Physicians form in both English and Spanish.

The Legal Hotline for Older Texans also offers free advice and assistance with completing powers of attorney, do-not-resuscitate orders, and declaration of guardianship for Texans who are age 60 or over and have low income.