Texas 2025 - 89th Regular

Texas House Bill HB1161 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R4384 LRM-D
2	2	By: Hinojosa H.B. No. 1161
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to an advance directive and do-not-resuscitate order of a
10	10	pregnant woman and information provided for an advance directive.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 166.033, Health and Safety Code, is
13	13	amended to read as follows:
14	14	Sec. 166.033. FORM OF WRITTEN DIRECTIVE. A written
15	15	directive may be in the following form:
16	16	DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES
17	17	Instructions for completing this document:
18	18	This is an important legal document known as an Advance
19	19	Directive. It is designed to help you communicate your wishes about
20	20	medical treatment at some time in the future when you are unable to
21	21	make your wishes known because of illness or injury. These wishes
22	22	are usually based on personal values. In particular, you may want
23	23	to consider what burdens or hardships of treatment you would be
24	24	willing to accept for a particular amount of benefit obtained if you
25	25	were seriously ill.
26	26	You are encouraged to discuss your values and wishes with
27	27	your family or chosen spokesperson, as well as your physician. Your
28	28	physician, other health care provider, or medical institution may
29	29	provide you with various resources to assist you in completing your
30	30	advance directive. Brief definitions are listed below and may aid
31	31	you in your discussions and advance planning. Initial the
32	32	treatment choices that best reflect your personal preferences.
33	33	Provide a copy of your directive to your physician, usual hospital,
34	34	and family or spokesperson. Consider a periodic review of this
35	35	document. By periodic review, you can best assure that the
36	36	directive reflects your preferences.
37	37	In addition to this advance directive, Texas law provides for
38	38	three [two] other types of directives that can be important during a
39	39	serious illness. These are the Medical Power of Attorney, [and] the
40	40	Out-of-Hospital Do-Not-Resuscitate Order, and the Health Care
41	41	Facility Do-Not-Resuscitate Order. You may wish to discuss these
42	42	with your physician, family, hospital representative, or other
43	43	advisers. You may also wish to complete a directive related to the
44	44	donation of organs and tissues.
45	45	DIRECTIVE
46	46	I, __________, recognize that the best health care is based
47	47	upon a partnership of trust and communication with my physician. My
48	48	physician and I will make health care or treatment decisions
49	49	together as long as I am of sound mind and able to make my wishes
50	50	known. If there comes a time that I am unable to make medical
51	51	decisions about myself because of illness or injury, I direct that
52	52	the following treatment preferences be honored:
53	53	If, in the judgment of my physician, I am suffering with a
54	54	terminal condition from which I am expected to die within six
55	55	months, even with available life-sustaining treatment provided in
56	56	accordance with prevailing standards of medical care:
57	57	__________ 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 __________ 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
58	58	__________ 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
59	59	__________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) __________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
60	60	__________ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
61	61	If, in the judgment of my physician, I am suffering with an
62	62	irreversible condition so that I cannot care for myself or make
63	63	decisions for myself and am expected to die without life-sustaining
64	64	treatment provided in accordance with prevailing standards of care:
65	65	__________ 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 __________ 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
66	66	__________ 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
67	67	__________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.) __________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
68	68	__________ I request that I be kept alive in this irreversible condition using available life-sustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE.)
69	69	Pregnancy directive:
70	70	If I am pregnant, my decision concerning life-sustaining
71	71	treatment is modified as follows:
72	72	________________________________________________________________ ________________________________________________________________
73	73	________________________________________________________________
74	74	________________________________________________________________ ________________________________________________________________
75	75	________________________________________________________________
76	76	________________________________________________________________ ________________________________________________________________
77	77	________________________________________________________________
78	78	(THIS SECTION IS OPTIONAL, IS COMPLETED ONLY FOR A PERSON OF
79	79	CHILD-BEARING AGE, AND DOES NOT AFFECT THE VALIDITY OF THIS FORM IF
80	80	LEFT BLANK.)
81	81	Additional requests: (After discussion with your physician,
82	82	you may wish to consider listing particular treatments in this
83	83	space that you do or do not want in specific circumstances, such as
84	84	artificially administered nutrition and hydration, intravenous
85	85	antibiotics, etc. Be sure to state whether you do or do not want the
86	86	particular treatment.)
87	87	After signing this directive, if my representative or I elect
88	88	hospice care, I understand and agree that only those treatments
89	89	needed to keep me comfortable would be provided and I would not be
90	90	given available life-sustaining treatments.
91	91	If I do not have a Medical Power of Attorney, and I am unable
92	92	to make my wishes known, I designate the following person(s) to make
93	93	health care or treatment decisions with my physician compatible
94	94	with my personal values:
95	95	1. __________
96	96	2. __________
97	97	(If a Medical Power of Attorney has been executed, then an
98	98	agent already has been named and you should not list additional
99	99	names in this document.)
100	100	If the above persons are not available, or if I have not
101	101	designated a spokesperson, I understand that a spokesperson will be
102	102	chosen for me following standards specified in the laws of Texas.
103	103	If, in the judgment of my physician, my death is imminent within
104	104	minutes to hours, even with the use of all available medical
105	105	treatment provided within the prevailing standard of care, I
106	106	acknowledge that all treatments may be withheld or removed except
107	107	those needed to maintain my comfort. [I understand that under Texas
108	108	law this directive has no effect if I have been diagnosed as
109	109	pregnant.] This directive will remain in effect until I revoke it.
110	110	No other person may do so.
111	111	Signed__________ Date__________ City, County, State of
112	112	Residence __________
113	113	Two competent adult witnesses must sign below, acknowledging
114	114	the signature of the declarant. The witness designated as Witness 1
115	115	may not be a person designated to make a health care or treatment
116	116	decision for the patient and may not be related to the patient by
117	117	blood or marriage. This witness may not be entitled to any part of
118	118	the estate and may not have a claim against the estate of the
119	119	patient. This witness may not be the attending physician or an
120	120	employee of the attending physician. If this witness is an employee
121	121	of a health care facility in which the patient is being cared for,
122	122	this witness may not be involved in providing direct patient care to
123	123	the patient. This witness may not be an officer, director, partner,
124	124	or business office employee of a health care facility in which the
125	125	patient is being cared for or of any parent organization of the
126	126	health care facility.
127	127	Witness 1 __________ Witness 2 __________
128	128	Definitions:
129	129	"Artificially administered nutrition and hydration" means
130	130	the provision of nutrients or fluids by a tube inserted in a vein,
131	131	under the skin in the subcutaneous tissues, or in the
132	132	gastrointestinal tract.
133	133	"Irreversible condition" means a condition, injury, or
134	134	illness:
135	135	(1) that may be treated, but is never cured or
136	136	eliminated;
137	137	(2) that leaves a person unable to care for or make
138	138	decisions for the person's own self; and
139	139	(3) that, without life-sustaining treatment provided
140	140	in accordance with the prevailing standard of medical care, is
141	141	fatal.
142	142	Explanation: Many serious illnesses such as cancer, failure
143	143	of major organs (kidney, heart, liver, or lung), and serious brain
144	144	disease such as Alzheimer's dementia may be considered irreversible
145	145	early on. There is no cure, but the patient may be kept alive for
146	146	prolonged periods of time if the patient receives life-sustaining
147	147	treatments. Late in the course of the same illness, the disease may
148	148	be considered terminal when, even with treatment, the patient is
149	149	expected to die. You may wish to consider which burdens of
150	150	treatment you would be willing to accept in an effort to achieve a
151	151	particular outcome. This is a very personal decision that you may
152	152	wish to discuss with your physician, family, or other important
153	153	persons in your life.
154	154	"Life-sustaining treatment" means treatment that, based on
155	155	reasonable medical judgment, sustains the life of a patient and
156	156	without which the patient will die. The term includes both
157	157	life-sustaining medications and artificial life support such as
158	158	mechanical breathing machines, kidney dialysis treatment, and
159	159	artificially administered nutrition and hydration. The term does
160	160	not include the administration of pain management medication, the
161	161	performance of a medical procedure necessary to provide comfort
162	162	care, or any other medical care provided to alleviate a patient's
163	163	pain.
164	164	"Terminal condition" means an incurable condition caused by
165	165	injury, disease, or illness that according to reasonable medical
166	166	judgment will produce death within six months, even with available
167	167	life-sustaining treatment provided in accordance with the
168	168	prevailing standard of medical care.
169	169	Explanation: Many serious illnesses may be considered
170	170	irreversible early in the course of the illness, but they may not be
171	171	considered terminal until the disease is fairly advanced. In
172	172	thinking about terminal illness and its treatment, you again may
173	173	wish to consider the relative benefits and burdens of treatment and
174	174	discuss your wishes with your physician, family, or other important
175	175	persons in your life.
176	176	SECTION 2. Section 166.049, Health and Safety Code, is
177	177	amended to read as follows:
178	178	Sec. 166.049. PREGNANT PERSONS [PATIENTS]. A person of
179	179	child-bearing age that executes an advance directive may specify in
180	180	the advance directive the effect the person's pregnancy has on the
181	181	advance directive [A person may not withdraw or withhold
182	182	life-sustaining treatment under this subchapter from a pregnant
183	183	patient].
184	184	SECTION 3. Section 166.083(b), Health and Safety Code, is
185	185	amended to read as follows:
186	186	(b) The standard form of an out-of-hospital DNR order
187	187	specified by department rule must, at a minimum, contain the
188	188	following:
189	189	(1) a distinctive single-page format that readily
190	190	identifies the document as an out-of-hospital DNR order;
191	191	(2) a title that readily identifies the document as an
192	192	out-of-hospital DNR order;
193	193	(3) the printed or typed name of the person;
194	194	(4) a statement that the physician signing the
195	195	document is the attending physician of the person and that the
196	196	physician is directing health care professionals acting in
197	197	out-of-hospital settings, including a hospital emergency
198	198	department, not to initiate or continue certain life-sustaining
199	199	treatment on behalf of the person, and a listing of those procedures
200	200	not to be initiated or continued;
201	201	(5) a statement that the person understands that the
202	202	person may revoke the out-of-hospital DNR order at any time by
203	203	destroying the order and removing the DNR identification device, if
204	204	any, or by communicating to health care professionals at the scene
205	205	the person's desire to revoke the out-of-hospital DNR order;
206	206	(6) a statement that if the person is of child-bearing
207	207	age, the person may specify in the form the effect the person's
208	208	pregnancy has on the out-of-hospital DNR order;
209	209	(7) places for the printed names and signatures of the
210	210	witnesses or the notary public's acknowledgment and for the printed
211	211	name and signature of the attending physician of the person and the
212	212	medical license number of the attending physician;
213	213	(8) [(7)] a separate section for execution of the
214	214	document by the legal guardian of the person, the person's proxy, an
215	215	agent of the person having a medical power of attorney, or the
216	216	attending physician attesting to the issuance of an out-of-hospital
217	217	DNR order by nonwritten means of communication or acting in
218	218	accordance with a previously executed or previously issued
219	219	directive to physicians under Section 166.082(c) that includes the
220	220	following:
221	221	(A) a statement that the legal guardian, the
222	222	proxy, the agent, the person by nonwritten means of communication,
223	223	or the physician directs that each listed life-sustaining treatment
224	224	should not be initiated or continued in behalf of the person; and
225	225	(B) places for the printed names and signatures
226	226	of the witnesses and, as applicable, the legal guardian, proxy,
227	227	agent, or physician;
228	228	(9) [(8)] a separate section for execution of the
229	229	document by at least one qualified relative of the person when the
230	230	person does not have a legal guardian, proxy, or agent having a
231	231	medical power of attorney and is incompetent or otherwise mentally
232	232	or physically incapable of communication, including:
233	233	(A) a statement that the relative of the person
234	234	is qualified to make a treatment decision to withhold
235	235	cardiopulmonary resuscitation and certain other designated
236	236	life-sustaining treatment under Section 166.088 and, based on the
237	237	known desires of the person or a determination of the best interest
238	238	of the person, directs that each listed life-sustaining treatment
239	239	should not be initiated or continued in behalf of the person; and
240	240	(B) places for the printed names and signatures
241	241	of the witnesses and qualified relative of the person;
242	242	(10) [(9)] a place for entry of the date of execution
243	243	of the document;
244	244	(11) [(10)] a statement that the document is in effect
245	245	on the date of its execution and remains in effect until the death
246	246	of the person or until the document is revoked;
247	247	(12) [(11)] a statement that the document must
248	248	accompany the person during transport;
249	249	(13) [(12)] a statement regarding the proper
250	250	disposition of the document or copies of the document, as the
251	251	executive commissioner determines appropriate; and
252	252	(14) [(13)] a statement at the bottom of the document,
253	253	with places for the signature of each person executing the
254	254	document, that the document has been properly completed.
255	255	SECTION 4. Section 166.084(c), Health and Safety Code, is
256	256	amended to read as follows:
257	257	(c) The attending physician and witnesses shall sign the
258	258	out-of-hospital DNR order in the place of the document provided by
259	259	Section 166.083(b)(8) [166.083(b)(7)] and the attending physician
260	260	shall sign the document in the place required by Section
261	261	166.083(b)(14) [166.083(b)(13)]. The physician shall make the fact
262	262	of the existence of the out-of-hospital DNR order a part of the
263	263	declarant's medical record and the names of the witnesses shall be
264	264	entered in the medical record.
265	265	SECTION 5. Section 166.098, Health and Safety Code, is
266	266	amended to read as follows:
267	267	Sec. 166.098. PREGNANT PERSONS. A person of child-bearing
268	268	age may specify in an out-of-hospital DNR order executed by the
269	269	person the effect the person's pregnancy has on the order [A person
270	270	may not withhold cardiopulmonary resuscitation or certain other
271	271	life-sustaining treatment designated by department rule under this
272	272	subchapter from a person known by the responding health care
273	273	professionals to be pregnant].
274	274	SECTION 6. This Act takes effect September 1, 2025.
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277	277
278	278	__________ 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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281	281
282	282	__________ 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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284	284
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286	286	__________ 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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290	290	__________ 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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294	294	________________________________________________________________
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298	298	________________________________________________________________
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300	300
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302	302	________________________________________________________________