It is difficult for people to make good decisions when they are under stress or emotional strain. This is particularly true in the areas where there are no clear-cut answers, such as the use of life-support systems and determining levels of care. It is important that patients, if age 18 or older, communicate their wishes to their families and health care team, in case they become unable to make decisions for themselves. 

Advance directives are documents in which individuals give instructions about their preference for future health care. Under Texas law, these advance directives must be followed if patients become mentally or physically unable to express their wishes:

• Directive to Physicians and Family of Surrogates (also called a living will): Specific instructions about the kind of health care treatment that a person does and does not want. En español 
  
  
• Medical Power of Attorney (formerly called durable powers of attorney for health care): Gives an “agent” or “proxy” the power to make health care decisions. En español
  
  
• Out-of-Hospital Do-Not-Resuscitate (DNR) Order: A medical order, prepared and signed by the attending physician, that allows a patient to refuse specific life-sustaining treatments outside the hospital.

Complete and File an Advance Directive

It is the policy of UT Southwestern Medical Center to accept written advance directives from its patients who present them. Health care professionals who accept them from a patient should explain the patient’s responsibility regarding the directive.

Patients must provide health care providers in each clinical practice where they are seen with the most current copy of their advance directive – and to notify those providers if they modify or revoke an advance directive. Patients should request that the provider forward their advance directives to the Medical Records Department. The documents must be on file so that they are in effect during each hospital stay.