reglab/statecodes huggingface dataset:
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.043. Reexecution of Directive

Sec. 166.043.  REEXECUTION OF DIRECTIVE.  A declarant may at any time reexecute a directive in accordance with the procedures prescribed by Section 166.032, including reexecution after the declarant is diagnosed as having a terminal or irreversible condition.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.013 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.044. Limitation of Liability for Withholding or Withdrawing Life-Sustaining Procedures

Sec. 166.044.  LIMITATION OF LIABILITY FOR WITHHOLDING OR WITHDRAWING LIFE-SUSTAINING PROCEDURES.  (a)  A physician or health care facility that causes life-sustaining treatment to be withheld or withdrawn from a qualified patient in accordance with this subchapter is not civilly liable for that action unless the physician or health care facility fails to exercise reasonable care when applying the patient's advance directive.
(b)  A health professional, acting under the direction of a physician, who participates in withholding or withdrawing life-sustaining treatment from a qualified patient in accordance with this subchapter is not civilly liable for that action unless the health professional fails to exercise reasonable care when applying the patient's advance directive.
(c)  A physician, or a health professional acting under the direction of a physician, who participates in withholding or withdrawing life-sustaining treatment from a qualified patient in accordance with this subchapter is not criminally liable or guilty of unprofessional conduct as a result of that action unless the physician or health professional fails to exercise reasonable care when applying the patient's advance directive.
(d)  The standard of care that a physician, health care facility, or health care professional shall exercise under this section is that degree of care that a physician, health care facility, or health care professional, as applicable, of ordinary prudence and skill would have exercised under the same or similar circumstances in the same or a similar community.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.015 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.0445. Limitation on Liability for Performing Certain Medical Procedures

Sec. 166.0445.  LIMITATION ON LIABILITY FOR PERFORMING CERTAIN MEDICAL PROCEDURES.  (a)  A physician or a health care professional acting under the direction of a physician is not subject to civil liability for participating in a medical procedure performed under Section 166.046(d-2).
(b)  A physician or a health care professional acting under the direction of a physician is not subject to criminal liability for participating in a medical procedure performed under Section 166.046(d-2) unless:
(1)  the physician or health care professional in participating in the medical procedure acted with a specific malicious intent to cause the death of the patient and that conduct significantly hastened the patient's death; and
(2)  the hastening of the patient's death is not attributable to the risks associated with the medical procedure.
(c)  A physician or a health care professional acting under the direction of a physician has not engaged in unprofessional conduct by participating in a medical procedure performed under Section 166.046(d-2) unless the physician or health care professional in participating in the medical procedure acted with a specific malicious intent to harm the patient.
Added by Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 1, eff. September 1, 2023.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.045. Liability for Failure to Effectuate Directive

Sec. 166.045.  LIABILITY FOR FAILURE TO EFFECTUATE DIRECTIVE.  (a)  A physician, health care facility, or health care professional who has no knowledge of a directive is not civilly or criminally liable for failing to act in accordance with the directive.
(b)  A physician, or a health professional acting under the direction of a physician, is subject to review and disciplinary action by the appropriate licensing board for failing to effectuate a qualified patient's directive in violation of this subchapter or other laws of this state.  This subsection does not limit remedies available under other laws of this state.
(c)  If an attending physician refuses to comply with a directive or treatment decision and does not wish to follow the procedure established under Section 166.046, life-sustaining treatment shall be provided to the patient, but only until a reasonable opportunity has been afforded for the transfer of the patient to another physician or health care facility willing to comply with the directive or treatment decision.
(d)  A physician, health professional acting under the direction of a physician, or health care facility is not civilly or criminally liable or subject to review or disciplinary action by the person's appropriate licensing board if the person has complied with the procedures outlined in Section 166.046.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.016 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.0465. Ethics or Medical Committee Decision Related to Patient Disability

Sec. 166.0465.  ETHICS OR MEDICAL COMMITTEE DECISION RELATED TO PATIENT DISABILITY.  (a)  In this section, "disability" has the meaning assigned by the Americans with Disabilities Act of 1990 in 42 U.S.C. Section 12102.
(b)  During the review process under Section 166.046(b), the ethics or medical committee may not consider a patient's disability that existed before the patient's current admission unless the disability is relevant in determining whether the medical or surgical intervention is medically appropriate.
Added by Acts 2023, 88th Leg., R.S., Ch. 915 (H.B. 3162), Sec. 4, eff. September 1, 2023.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.047. Honoring Directive Does Not Constitute Offense of Aiding Suicide

Sec. 166.047.  HONORING DIRECTIVE DOES NOT CONSTITUTE OFFENSE OF AIDING SUICIDE.  A person does not commit an offense under Section 22.08, Penal Code, by withholding or withdrawing life-sustaining treatment from a qualified patient in accordance with this subchapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.017 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.048. Criminal Penalty; Prosecution

Sec. 166.048.  CRIMINAL PENALTY;  PROSECUTION.  (a)  A person commits an offense if the person intentionally conceals, cancels, defaces, obliterates, or damages another person's directive without that person's consent.  An offense under this subsection is a Class A misdemeanor.
(b)  A person is subject to prosecution for criminal homicide under Chapter 19, Penal Code, if the person, with the intent to cause life-sustaining treatment to be withheld or withdrawn from another person contrary to the other person's desires, falsifies or forges a directive or intentionally conceals or withholds personal knowledge of a revocation and thereby directly causes life-sustaining treatment to be withheld or withdrawn from the other person with the result that the other person's death is hastened.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.018 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.049. Pregnant Patients

Sec. 166.049.  PREGNANT PATIENTS.  A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.019 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.050. Mercy Killing Not Condoned

Sec. 166.050.  MERCY KILLING NOT CONDONED.  This subchapter does not condone, authorize, or approve mercy killing or permit an affirmative or deliberate act or omission to end life except to permit the natural process of dying as provided by this subchapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.020 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.051. Legal Right or Responsibility Not Affected

Sec. 166.051.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.  This subchapter does not impair or supersede any legal right or responsibility a person may have to effect the withholding or withdrawal of life-sustaining treatment in a lawful manner, provided that if an attending physician or health care facility is unwilling to honor a patient's advance directive or a treatment decision to provide life-sustaining treatment, life-sustaining treatment is required to be provided the patient, but only until a reasonable opportunity has been afforded for transfer of the patient to another physician or health care facility willing to comply with the advance directive or treatment decision.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Renumbered from Sec. 672.021 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.03, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter B. Directive to Physicians › Section 166.053. Registry to Assist Transfers

Sec. 166.053.  REGISTRY TO ASSIST TRANSFERS.  (a)  The department shall maintain a registry listing the identity of and contact information for health care providers and referral groups, situated inside and outside this state, that have voluntarily notified the department they may consider accepting or may assist in locating a provider willing to accept transfer of a patient under Section 166.045 or 166.046.
(b)  The listing of a provider or referral group in the registry described in this section does not obligate the provider or group to accept transfer of or provide services to any particular patient.
(c)  The department shall post the current registry list on its website in a form appropriate for easy comprehension by patients and persons responsible for the health care decisions of patients.  The list shall separately indicate those providers and groups that have indicated their interest in assisting the transfer of:
(1)  those patients on whose behalf life-sustaining treatment is being sought;
(2)  those patients on whose behalf the withholding or withdrawal of life-sustaining treatment is being sought;  and
(3)  patients described in both Subdivisions (1) and (2).
(d)  The registry list described in this section shall include the following disclaimer:
"This registry lists providers and groups that have indicated to the Department of State Health Services their interest in assisting the transfer of patients in the circumstances described, and is provided for information purposes only.  Neither the Department of State Health Services nor the State of Texas endorses or assumes any responsibility for any representation, claim, or act of the listed providers or groups."
Added by Acts 2003, 78th Leg., ch. 1228, Sec. 5, eff. June 20, 2003.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0505, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.082. Out-of-Hospital Dnr Order; Directive to Physicians

Sec. 166.082.  OUT-OF-HOSPITAL DNR ORDER;  DIRECTIVE TO PHYSICIANS.  (a)  A competent person may at any time execute a written out-of-hospital DNR order directing health care professionals acting in an out-of-hospital setting to withhold cardiopulmonary resuscitation and certain other life-sustaining treatment designated by department rule.
(b)  Except as provided by this subsection, the declarant must sign the out-of-hospital DNR order in the presence of two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).  The witnesses must sign the order.  The attending physician of the declarant must sign the order and shall make the fact of the existence of the order and the reasons for execution of the order a part of the declarant's medical record.  The declarant, in lieu of signing in the presence of witnesses, may sign the out-of-hospital DNR order and have the signature acknowledged before a notary public.
(c)  If the person is incompetent but previously executed or issued a directive to physicians in accordance with Subchapter B, the physician may rely on the directive as the person's instructions to issue an out-of-hospital DNR order and shall place a copy of the directive in the person's medical record.  The physician shall sign the order in lieu of the person signing under Subsection (b) and may use a digital or electronic signature authorized under Section 166.011.
(d)  If the person is incompetent but previously executed or issued a directive to physicians in accordance with Subchapter B designating a proxy, the proxy may make any decisions required of the designating person as to an out-of-hospital DNR order and shall sign the order in lieu of the person signing under Subsection (b).
(e)  If the person is now incompetent but previously executed or issued a medical power of attorney designating an agent, the agent may make any decisions required of the designating person as to an out-of-hospital DNR order and shall sign the order in lieu of the person signing under Subsection (b).
(f)  The executive commissioner, on the recommendation of the department, shall by rule adopt procedures for the disposition and maintenance of records of an original out-of-hospital DNR order and any copies of the order.
(g)  An out-of-hospital DNR order is effective on its execution.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.002 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 5, eff. September 1, 2009.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0507, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.084. Issuance of Out-of-Hospital Dnr Order by Nonwritten Communication

Sec. 166.084.  ISSUANCE OF OUT-OF-HOSPITAL DNR ORDER BY NONWRITTEN COMMUNICATION.  (a)  A competent person who is an adult may issue an out-of-hospital DNR order by nonwritten communication.
(b)  A declarant must issue the nonwritten out-of-hospital DNR order in the presence of the attending physician and two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).
(c)  The attending physician and witnesses shall sign the out-of-hospital DNR order in the place of the document provided by Section 166.083(b)(7) and the attending physician shall sign the document in the place required by Section 166.083(b)(13).  The physician shall make the fact of the existence of the out-of-hospital DNR order a part of the declarant's medical record and the names of the witnesses shall be entered in the medical record.
(d)  An out-of-hospital DNR order issued in the manner provided by this section is valid and shall be honored by responding health care professionals as if executed in the manner provided by Section 166.082.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.004 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.085. Execution of Out-of-Hospital Dnr Order on Behalf of a Minor

Sec. 166.085.  EXECUTION OF OUT-OF-HOSPITAL DNR ORDER ON BEHALF OF A MINOR.  (a)  The following persons may execute an out-of-hospital DNR order on behalf of a minor:
(1)  the minor's parents;
(2)  the minor's legal guardian;  or
(3)  the minor's managing conservator.
(b)  A person listed under Subsection (a) may not execute an out-of-hospital DNR order unless the minor has been diagnosed by a physician as suffering from a terminal or irreversible condition.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.005 by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.  Amended by Acts 2003, 78th Leg., ch. 1228, Sec. 6, eff. June 20, 2003.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.086. Desire of Person Supersedes Out-of-Hospital Dnr Order

Sec. 166.086.  DESIRE OF PERSON SUPERSEDES OUT-OF-HOSPITAL DNR ORDER.  The desire of a competent person, including a competent minor, supersedes the effect of an out-of-hospital DNR order executed or issued by or on behalf of the person when the desire is communicated to responding health care professionals as provided by this subchapter.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.006 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.087. Procedure When Declarant Is Incompetent or Incapable of Communication

Sec. 166.087.  PROCEDURE WHEN DECLARANT IS INCOMPETENT OR INCAPABLE OF COMMUNICATION.  (a)  This section applies when a person 18 years of age or older has executed or issued an out-of-hospital DNR order and subsequently becomes incompetent or otherwise mentally or physically incapable of communication.
(b)  If the adult person has designated a person to make a treatment decision as authorized by Section 166.032(c), the attending physician and the designated person shall comply with the out-of-hospital DNR order.
(c)  If the adult person has not designated a person to make a treatment decision as authorized by Section 166.032(c), the attending physician shall comply with the out-of-hospital DNR order unless the physician believes that the order does not reflect the person's present desire.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.007 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.088. Procedure When Person Has Not Executed or Issued Out-of-Hospital Dnr Order and Is Incompetent or Incapable of Communication

Sec. 166.088.  PROCEDURE WHEN PERSON HAS NOT EXECUTED OR ISSUED OUT-OF-HOSPITAL DNR ORDER AND IS INCOMPETENT OR INCAPABLE OF COMMUNICATION.  (a)  If an adult person has not executed or issued an out-of-hospital DNR order and is incompetent or otherwise mentally or physically incapable of communication, the attending physician and the person's legal guardian, proxy, or agent having a medical power of attorney may execute an out-of-hospital DNR order on behalf of the person.
(b)  If the person does not have a legal guardian, proxy, or agent under a medical power of attorney, the attending physician and at least one qualified relative from a category listed by Section 166.039(b), subject to the priority established under that subsection, may execute an out-of-hospital DNR order in the same manner as a treatment decision made under Section 166.039(b).
(c)  A decision to execute an out-of-hospital DNR order made under Subsection (a) or (b) must be based on knowledge of what the person would desire, if known.
(d)  An out-of-hospital DNR order executed under Subsection (b) must be made in the presence of at least two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).
(e)  The fact that an adult person has not executed or issued an out-of-hospital DNR order does not create a presumption that the person does not want a treatment decision made to withhold cardiopulmonary resuscitation and certain other designated life-sustaining treatment designated by department rule.
(f)  If there is not a qualified relative available to act for the person under Subsection (b), an out-of-hospital DNR order must be concurred in by another physician who is not involved in the treatment of the patient or who is a representative of the ethics or medical committee of the health care facility in which the person is a patient.
(g)  A person listed in Section 166.039(b) who wishes to challenge a decision made under this section must apply for temporary guardianship under Chapter 1251, Estates Code.  The court may waive applicable fees in that proceeding.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.008 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0509, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.090. Dnr Identification Device

Sec. 166.090.  DNR IDENTIFICATION DEVICE.  (a)  A person who has a valid out-of-hospital DNR order under this subchapter may wear a DNR identification device around the neck or on the wrist as prescribed by department rule adopted under Section 166.101.
(b)  The presence of a DNR identification device on the body of a person is conclusive evidence that the person has executed or issued a valid out-of-hospital DNR order or has a valid out-of-hospital DNR order executed or issued on the person's behalf.  Responding health care professionals shall honor the DNR identification device as if a valid out-of-hospital DNR order form executed or issued by the person were found in the possession of the person.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.010 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0511, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.091. Duration of Out-of-Hospital Dnr Order

Sec. 166.091.  DURATION OF OUT-OF-HOSPITAL DNR ORDER.  An out-of-hospital DNR order is effective until it is revoked as prescribed by Section 166.092.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.011 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.092. Revocation of Out-of-Hospital Dnr Order

Sec. 166.092.  REVOCATION OF OUT-OF-HOSPITAL DNR ORDER.  (a)  A declarant may revoke an out-of-hospital DNR order at any time without regard to the declarant's mental state or competency.  An order may be revoked by:
(1)  the declarant or someone in the declarant's presence and at the declarant's direction destroying the order form and removing the DNR identification device, if any;
(2)  a person who identifies himself or herself as the legal guardian, as a qualified relative, or as the agent of the declarant having a medical power of attorney who executed the out-of-hospital DNR order or another person in the person's presence and at the person's direction destroying the order form and removing the DNR identification device, if any;
(3)  the declarant communicating the declarant's intent to revoke the order;  or
(4)  a person who identifies himself or herself as the legal guardian, a qualified relative, or the agent of the declarant having a medical power of attorney who executed the out-of-hospital DNR order orally stating the person's intent to revoke the order.
(b)  An oral revocation under Subsection (a)(3) or (a)(4) takes effect only when the declarant or a person who identifies himself or herself as the legal guardian, a qualified relative, or the agent of the declarant having a medical power of attorney who executed the out-of-hospital DNR order communicates the intent to revoke the order to the responding health care professionals or the attending physician at the scene.  The responding health care professionals shall record the time, date, and place of the revocation in accordance with the statewide out-of-hospital DNR protocol and rules adopted by the executive commissioner and any applicable local out-of-hospital DNR protocol.  The attending physician or the physician's designee shall record in the person's medical record the time, date, and place of the revocation and, if different, the time, date, and place that the physician received notice of the revocation.  The attending physician or the physician's designee shall also enter the word "VOID" on each page of the copy of the order in the person's medical record.
(c)  Except as otherwise provided by this subchapter, a person is not civilly or criminally liable for failure to act on a revocation made under this section unless the person has actual knowledge of the revocation.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16 1995.  Renumbered from Sec. 674.012 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0512, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.093. Reexecution of Out-of-Hospital Dnr Order

Sec. 166.093.  REEXECUTION OF OUT-OF-HOSPITAL DNR ORDER.  A declarant may at any time reexecute or reissue an out-of-hospital DNR order in accordance with the procedures prescribed by Section 166.082, including reexecution or reissuance after the declarant is diagnosed as having a terminal or irreversible condition.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.013 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.094. Limitation on Liability for Withholding Cardiopulmonary Resuscitation and Certain Other Life-Sustaining Procedures

Sec. 166.094.  LIMITATION ON LIABILITY FOR WITHHOLDING CARDIOPULMONARY RESUSCITATION AND CERTAIN OTHER LIFE-SUSTAINING PROCEDURES.  (a)  A health care professional or health care facility or entity that in good faith causes cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule to be withheld from a person in accordance with this subchapter is not civilly liable for that action.
(b)  A health care professional or health care facility or entity that in good faith participates in withholding cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule from a person in accordance with this subchapter is not civilly liable for that action.
(c)  A health care professional or health care facility or entity that in good faith participates in withholding cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule from a person in accordance with this subchapter is not criminally liable or guilty of unprofessional conduct as a result of that action.
(d)  A health care professional or health care facility or entity that in good faith causes or participates in withholding cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule from a person in accordance with this subchapter and rules adopted under this subchapter is not in violation of any other licensing or regulatory laws or rules of this state and is not subject to any disciplinary action or sanction by any licensing or regulatory agency of this state as a result of that action.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.016 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0513, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.095. Limitation on Liability for Failure to Effectuate Out-of-Hospital Dnr Order

Sec. 166.095.  LIMITATION ON LIABILITY FOR FAILURE TO EFFECTUATE OUT-OF-HOSPITAL DNR ORDER.  (a)  A health care professional or health care facility or entity that has no actual knowledge of an out-of-hospital DNR order is not civilly or criminally liable for failing to act in accordance with the order.
(b)  A health care professional or health care facility or entity is subject to review and disciplinary action by the appropriate licensing board for failing to effectuate an out-of-hospital DNR order.  This subsection does not limit remedies available under other laws of this state.
(c)  If an attending physician refuses to execute or comply with an out-of-hospital DNR order, the physician shall inform the person, the legal guardian or qualified relatives of the person, or the agent of the person having a medical power of attorney and, if the person or another authorized to act on behalf of the person so directs, shall make a reasonable effort to transfer the person to another physician who is willing to execute or comply with an out-of-hospital DNR order.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.017 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.096. Honoring Out-of-Hospital Dnr Order Does Not Constitute Offense of Aiding Suicide

Sec. 166.096.  HONORING OUT-OF-HOSPITAL DNR ORDER DOES NOT CONSTITUTE OFFENSE OF AIDING SUICIDE.  A person does not commit an offense under Section 22.08, Penal Code, by withholding cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule from a person in accordance with this subchapter.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.018 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0514, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.097. Criminal Penalty; Prosecution

Sec. 166.097.  CRIMINAL PENALTY;  PROSECUTION.  (a)  A person commits an offense if the person intentionally conceals, cancels, defaces, obliterates, or damages another person's out-of-hospital DNR order or DNR identification device without that person's consent or the consent of the person or persons authorized to execute or issue an out-of-hospital DNR order on behalf of the person under this subchapter. An offense under this subsection is a Class A misdemeanor.
(b)  A person is subject to prosecution for criminal homicide under Chapter 19, Penal Code, if the person, with the intent to cause cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule to be withheld from another person contrary to the other person's desires, falsifies or forges an out-of-hospital DNR order or intentionally conceals or withholds personal knowledge of a revocation and thereby directly causes cardiopulmonary resuscitation and certain other life-sustaining treatment designated by department rule to be withheld from the other person with the result that the other person's death is hastened.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.019 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0515, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.098. Pregnant Persons

Sec. 166.098.  PREGNANT PERSONS.  A person may not withhold cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule under this subchapter from a person known by the responding health care professionals to be pregnant.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.020 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0516, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.099. Mercy Killing Not Condoned

Sec. 166.099.  MERCY KILLING NOT CONDONED.  This subchapter does not condone, authorize, or approve mercy killing or permit an affirmative or deliberate act or omission to end life except to permit the natural process of dying as provided by this subchapter.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.021 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.100. Legal Right or Responsibility Not Affected

Sec. 166.100.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.  This subchapter does not impair or supersede any legal right or responsibility a person may have under a constitution, other statute, regulation, or court decision to effect the withholding of cardiopulmonary resuscitation or certain other life-sustaining treatment designated by department rule.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.022 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0517, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.101. Duties of Department and Executive Commissioner

Sec. 166.101.  DUTIES OF DEPARTMENT AND EXECUTIVE COMMISSIONER.  (a)  The executive commissioner shall, on the recommendation of the department, adopt all reasonable and necessary rules to carry out the purposes of this subchapter, including rules:
(1)  adopting a statewide out-of-hospital DNR order protocol that sets out standard procedures for the withholding of cardiopulmonary resuscitation and certain other life-sustaining treatment by health care professionals acting in out-of-hospital settings;
(2)  designating life-sustaining treatment that may be included in an out-of-hospital DNR order, including all procedures listed in Sections 166.081(6)(A)(i) through (v); and
(3)  governing recordkeeping in circumstances in which an out-of-hospital DNR order or DNR identification device is encountered by responding health care professionals.
(b)  The rules adopted under Subsection (a) are not effective until approved by the Texas Medical Board.
(c)  Local emergency medical services authorities may adopt local out-of-hospital DNR order protocols if the local protocols do not conflict with the statewide out-of-hospital DNR order protocol adopted by the executive commissioner.
(d)  The executive commissioner by rule shall specify a distinctive standard design for a necklace and a bracelet DNR identification device that signifies, when worn by a person, that the possessor has executed or issued a valid out-of-hospital DNR order under this subchapter or is a person for whom a valid out-of-hospital DNR order has been executed or issued.
(e)  The department shall report to the executive commissioner from time to time regarding issues identified in emergency medical services responses in which an out-of-hospital DNR order or DNR identification device is encountered.  The report may contain recommendations to the executive commissioner for necessary modifications to the form of the standard out-of-hospital DNR order or the designated life-sustaining procedures listed in the standard out-of-hospital DNR order, the statewide out-of-hospital DNR order protocol, or the DNR identification devices.
Added by Acts 1995, 74th Leg., ch. 965, Sec. 10, eff. June 16, 1995.  Renumbered from Sec. 674.023 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.04, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0517, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter C. Out-of-Hospital Do-Not-Resuscitate Orders › Section 166.102. Physician's Dnr Order May Be Honored by Health Care Personnel Other Than Emergency Medical Services Personnel

Sec. 166.102.  PHYSICIAN'S DNR ORDER MAY BE HONORED BY HEALTH CARE PERSONNEL OTHER THAN EMERGENCY MEDICAL SERVICES PERSONNEL.  (a)  Except as provided by Subsection (b), a licensed nurse or person providing health care services in an out-of-hospital setting may honor a physician's do-not-resuscitate order.
(b)  When responding to a call for assistance, emergency medical services personnel:
(1)  shall honor only a properly executed or issued out-of-hospital DNR order or prescribed DNR identification device in accordance with this subchapter; and
(2)  have no duty to review, examine, interpret, or honor a person's other written directive, including a written directive in the form prescribed by Section 166.033.
Added by Acts 2003, 78th Leg., ch. 1228, Sec. 7, eff. June 20, 2003.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 710 (H.B. 577), Sec. 1, eff. June 17, 2011.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter D. Medical Power of Attorney › Section 166.151. Definitions

Sec. 166.151.  DEFINITIONS.  In this subchapter:
(1)  "Adult" means a person 18 years of age or older or a person under 18 years of age who has had the disabilities of minority removed.
(2)  "Agent" means an adult to whom authority to make health care decisions is delegated under a medical power of attorney.
(3)  "Health care provider" means an individual or facility licensed, certified, or otherwise authorized to administer health care, for profit or otherwise, in the ordinary course of business or professional practice and includes a physician.
(4)  "Principal" means an adult who has executed a medical power of attorney.
(5)  "Residential care provider" means an individual or facility licensed, certified, or otherwise authorized to operate, for profit or otherwise, a residential care home.
Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991.  Renumbered from Civil Practice & Remedies Code Sec. 135.001 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter D. Medical Power of Attorney › Section 166.152. Scope and Duration of Authority

Sec. 166.152.  SCOPE AND DURATION OF AUTHORITY.  (a)  Subject to this subchapter or any express limitation on the authority of the agent contained in the medical power of attorney, the agent may make any health care decision on the principal's behalf that the principal could make if the principal were competent.
(b)  An agent may exercise authority only if the principal's attending physician certifies in writing and files the certification in the principal's medical record that, based on the attending physician's reasonable medical judgment, the principal is incompetent.
(c)  Notwithstanding any other provisions of this subchapter, treatment may not be given to or withheld from the principal if the principal objects regardless of whether, at the time of the objection:
(1)  a medical power of attorney is in effect;  or
(2)  the principal is competent.
(d)  The principal's attending physician shall make reasonable efforts to inform the principal of any proposed treatment or of any proposal to withdraw or withhold treatment before implementing an agent's advance directive.
(e)  After consultation with the attending physician and other health care providers, the agent shall make a health care decision:
(1)  according to the agent's knowledge of the principal's wishes, including the principal's religious and moral beliefs;  or
(2)  if the agent does not know the principal's wishes, according to the agent's assessment of the principal's best interests.
(f)  Notwithstanding any other provision of this subchapter, an agent may not consent to:
(1)  voluntary inpatient mental health services;
(2)  convulsive treatment;
(3)  psychosurgery;
(4)  abortion;  or
(5)  neglect of the principal through the omission of care primarily intended to provide for the comfort of the principal.
(g)  The power of attorney is effective indefinitely on execution as provided by this subchapter and delivery of the document to the agent, unless it is revoked as provided by this subchapter or the principal becomes competent. If the medical power of attorney includes an expiration date and on that date the principal is incompetent, the power of attorney continues to be effective until the principal becomes competent unless it is revoked as provided by this subchapter.
Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991.  Renumbered from Civil Practice & Remedies Code Sec. 135.002 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter D. Medical Power of Attorney › Section 166.153. Persons Who May Not Exercise Authority of Agent

Sec. 166.153.  PERSONS WHO MAY NOT EXERCISE AUTHORITY OF AGENT.  A person may not exercise the authority of an agent while the person serves as:
(1)  the principal's health care provider;
(2)  an employee of the principal's health care provider unless the person is a relative of the principal;
(3)  the principal's residential care provider;  or
(4)  an employee of the principal's residential care provider unless the person is a relative of the principal.
Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991.  Renumbered from Civil Practice & Remedies Code Sec. 135.003 by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle H - Public Health Provisions › Chapter 166 - Advance Directives › Subchapter D. Medical Power of Attorney › Section 166.154. Execution

Sec. 166.154.  EXECUTION.  (a)  Except as provided by Subsection (b), the medical power of attorney must be signed by the principal in the presence of two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2).  The witnesses must sign the document.
(b)  The principal, in lieu of signing in the presence of the witnesses, may sign the medical power of attorney and have the signature acknowledged before a notary public.
(c)  If the principal is physically unable to sign, another person may sign the medical power of attorney with the principal's name in the principal's presence and at the principal's express direction.  The person may use a digital or electronic signature authorized under Section 166.011.
Added by Acts 1991, 72nd Leg., ch. 16, Sec. 3.02(a), eff. Aug. 26, 1991.  Renumbered from Civil Practice & Remedies Code Sec. 135.004 and amended by Acts 1999, 76th Leg., ch. 450, Sec. 1.05, eff. Sept. 1, 1999.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 461 (H.B. 2585), Sec. 8, eff. September 1, 2009.