ADVANCE DIRECTIVES

Every patient has the right to be told about his medical condition, the proposed treatment, the risks of not having the treatment and other treatments available. This information helps us make informed decisions about accepting or choosing not to have the treatment our doctors suggest.

Only what happens when an adult patient needs medical treatment but is unable to give informed consent (permission) or to tell the doctor what medical care he does and does not want? When patients are unable to decide or to communicate their wishes about their medical care, their rights may be at risk. Others will be making their healthcare decisions for them, perhaps without knowing what the patients would have wanted. For this reason, a growing number of people are using advance directives to state their medical care wishes in writing.

Advance directives protect our right to specify the treatment we want, or to refuse medical treatment we do not want, in the event we lose the ability to make decisions. Advanced directives are not only for older Americans or those who have a serious and/or progressive illness, but also for healthy younger adults -- anyone may lose the ability to speak for his or herself because of an accident, a trauma or a sudden unexpected illness.

The four types of advance directives recognized in Texas are:

• Medical Power of Attorney (formerly known as Durable Power of Attorney for Health Care)
• Directive to Physicians and Family or Surrogates (commonly referred to as a Living Will)
• Out-of-Hospital Do-Not Resuscitate Order
• Declaration for Mental Health Treatment

Help with Advance Directives

For help with filling out an advance directive, ask facility personnel to contact the appropriate staff member to assist you further. If you have an advance directive and you believe it is being ignored, please contact the administrator on duty for access to the facility's ethics committee as applicable. You may also contact the Texas Department of Health, Health Facility Compliance Division, 1100 West 49th Street, Austin, TX 78756 (1-800-228-1570) regarding your concerns.

This information is provided to comply with the State Advance Directives Act and the federal Patient Self-Determination Act. Complaints concerning failure by a hospital, nursing home or home health agency to follow federal and state advance directive requirements may be filed with the Texas Department of Health, Health Facility Compliance Division, 1100 West 49th Street, Austin, Texas 78756 (1-800-228-1570). You are not required to complete these forms as part of patient registration in a hospital, nursing home or home health care agency, or at any time in the future should you choose not to do so.

Please note that the Out-of-Hospital Do Not Resuscitate Form is not available in Spanish, but the Spanish instructions are on page 2 of the form.

Catholic Resources on Advance Directives

Joint letter from the Texas Catholic Conference and the Catholic Health Association of Texas on Advance Directives

We live in a world in which technology, medicine, and law have made a discussion of the issues that confront us at the end of life both controversial and heartbreaking for people who are trying to discern the right thing to do.  Just as each of us is unique, each end of life decision is unique to the individual within the Catholic context.

As Catholics, we seek a dignified death that recognizes the end of one’s human existence that respects the person’s spiritual nature.  Natural death occurs without human intervention.  A dignified death is one that recognizes that man comes from God at the beginning of his existence and returns to Him at the end.  The individual dies, as far as possible, in possession of their faculties surrounded by loved ones, comforted and aided by the spiritual and sacramental gifts of Faith.  Death is only dignified when it respects the essential dignity of the person as someone created by God.

CONCERNS WITH CURRENT TEXAS LAW

The intent of the law is to assist the patient and the family in understanding the complexities of modern medicine and the options that are available to them in a compassionate environment.

We believe the changes to current law that would enhance the legislative intent include:

• Include nutrition and hydration, including by artificial means, as a basic part of health care that must be provided to the patient, unless it hastens death, or creates a disproportionate burden to benefit, or causes harm given a patient’s individual condition.
• Clarify the definition of “irreversible condition” to ensure that the disabled receive the care they need, that their autonomous decisions are respected, and that they are not discriminated against in any way.
• Revise the process under section 166.046 to provide better and more compassionate communication through a patient liaison who is trained in hospice care.
• Extend the time period for notification to the family about the process to at least seven to fifteen days.

We believe that the patient and their family is the first concern and that natural death with dignity is the primary goal of everyone and every institution involved in this profound moment in our human existence that touches not only the patient and the family, but also caregivers as well.

Faithfully yours,