Tex. Health & Safety Code Section 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 (Witnesses), at least one of whom must be a witness who qualifies under Section 166.003 (Witnesses)(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 (Digital or Electronic Signature).

(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.

Source: Section 166.082 — Out-of-hospital Dnr Order; Directive to Physicians, https://statutes.­capitol.­texas.­gov/Docs/HS/htm/HS.­166.­htm#166.­082 (accessed Jun. 5, 2024).

166.001
Short Title
166.002
Definitions
166.003
Witnesses
166.004
Statement Relating to Advance Directive
166.005
Enforceability of Advance Directives Executed in Another Jurisdiction
166.006
Effect of Advance Directive on Insurance Policy and Premiums
166.007
Execution of Advance Directive May Not Be Required
166.008
Conflict Between Advance Directives
166.009
Certain Life-sustaining Treatment Not Required
166.010
Applicability of Federal Law Relating to Child Abuse and Neglect
166.011
Digital or Electronic Signature
166.031
Definitions
166.032
Written Directive by Competent Adult
166.033
Form of Written Directive
166.034
Issuance of Nonwritten Directive by Competent Adult Qualified Patient
166.036
Notarized Document Not Required
166.037
Patient Desire Supersedes Directive
166.038
Procedure When Declarant Is Incompetent or Incapable of Communication
166.039
Procedure When Person Has Not Executed or Issued a Directive and Is Incompetent or Incapable of Communication
166.040
Patient Certification and Prerequisites for Complying with Directive
166.041
Duration of Directive
166.042
Revocation of Directive
166.043
Reexecution of Directive
166.044
Limitation of Liability for Withholding or Withdrawing Life-sustaining Procedures
166.045
Liability for Failure to Effectuate Directive
166.046
Procedure if Not Effectuating Directive or Treatment Decision for Certain Patients
166.047
Honoring Directive Does Not Constitute Offense of Aiding Suicide
166.048
Criminal Penalty
166.049
Pregnant Patients
166.050
Mercy Killing Not Condoned
166.051
Legal Right or Responsibility Not Affected
166.052
Statements Explaining Patient’s Right to Transfer
166.053
Registry to Assist Transfers
166.054
Reporting Requirements Regarding Ethics or Medical Committee Processes
166.081
Definitions
166.082
Out-of-hospital Dnr Order
166.083
Form of Out-of-hospital Dnr Order
166.084
Issuance of Out-of-hospital Dnr Order by Nonwritten Communication
166.085
Execution of Out-of-hospital Dnr Order on Behalf of a Minor
166.086
Desire of Person Supersedes Out-of-hospital Dnr Order
166.087
Procedure When Declarant Is Incompetent or Incapable of Communication
166.088
Procedure When Person Has Not Executed or Issued Out-of-hospital Dnr Order and Is Incompetent or Incapable of Communication
166.089
Compliance with Out-of-hospital Dnr Order
166.090
Dnr Identification Device
166.091
Duration of Out-of-hospital Dnr Order
166.092
Revocation of Out-of-hospital Dnr Order
166.093
Reexecution of Out-of-hospital Dnr Order
166.094
Limitation on Liability for Withholding Cardiopulmonary Resuscitation and Certain Other Life-sustaining Procedures
166.095
Limitation on Liability for Failure to Effectuate Out-of-hospital Dnr Order
166.096
Honoring Out-of-hospital Dnr Order Does Not Constitute Offense of Aiding Suicide
166.097
Criminal Penalty
166.098
Pregnant Persons
166.099
Mercy Killing Not Condoned
166.100
Legal Right or Responsibility Not Affected
166.101
Duties of Department and Executive Commissioner
166.102
Physician’s Dnr Order May Be Honored by Health Care Personnel Other than Emergency Medical Services Personnel
166.151
Definitions
166.152
Scope and Duration of Authority
166.153
Persons Who May Not Exercise Authority of Agent
166.154
Execution
166.155
Revocation
166.156
Appointment of Guardian
166.157
Disclosure of Medical Information
166.158
Duty of Health or Residential Care Provider
166.159
Discrimination Relating to Execution of Medical Power of Attorney
166.160
Limitation on Liability
166.161
Liability for Health Care Costs
166.164
Form of Medical Power of Attorney
166.165
Civil Action
166.166
Other Rights or Responsibilities Not Affected
166.201
Definition
166.202
Applicability of Subchapter
166.203
General Procedures and Requirements for Do-not-resuscitate Orders
166.204
Notice Requirements for Do-not-resuscitate Orders
166.205
Revocation of Do-not-resuscitate Order
166.206
Procedure for Failure to Execute Do-not-resuscitate Order or Patient Instructions
166.207
Limitation on Liability for Issuing Dnr Order or Withholding Cardiopulmonary Resuscitation
166.208
Limitation on Liability for Failure to Effectuate Dnr Order
166.209
Enforcement
166.0445
Limitation on Liability for Performing Certain Medical Procedures
166.0465
Ethics or Medical Committee Decision Related to Patient Disability

Accessed:
Jun. 5, 2024

§ 166.082’s source at texas​.gov