Advance directives keep your medical wishes intact when you cannot speak for yourself. They are among the documents families most often delay until it is too late to draft. The Pabst Law Firm, PLLC is a boutique Austin practice that drafts the full set of Texas advance directives, including directives to physicians, medical powers of attorney, and HIPAA releases, as part of our fixed-fee estate planning packages.
Frank Pabst serves as our CEO and Primary Attorney, acting as the lead architect for every medical directive. Frank ensures every document meets Texas Health and Safety Code requirements so hospitals and care providers actually honor your wishes. Nicky Pabst, our COO, leads the firm’s operational engine and administrative team, managing the logistics of your medical inventory and ensuring your documents are organized and accessible to your agents when a crisis occurs.
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What an Advance Directive is Under Texas Law
Advance directives are written documents that communicate your medical wishes in advance of a situation where you cannot communicate them yourself. Under the Texas Health and Safety Code, several distinct forms are recognized:
Directive to Physicians (Living Will): Tells healthcare providers what life-sustaining treatments you want or do not want in a terminal or irreversible condition.
Medical Power of Attorney: Designates a specific agent to make broader healthcare decisions for you when you cannot.
Out-of-Hospital DNR: Tells emergency medical responders (EMS) not to attempt resuscitation outside of a hospital setting.
HIPAA Authorization: Allows your designated agent and family members to access your medical records and discuss your care with providers. Federal HIPAA rules limit this access without an explicit authorization.
Who Needs an Advance Directive
Frank recommends that every adult over eighteen have these documents on file, regardless of their current health status:
Young Adults: Once a child turns eighteen, parents lose automatic authority to access their medical records or make decisions. Directives restore the family’s ability to coordinate care in an emergency.
Married Couples: Marriage does not automatically grant medical decision-making authority in Texas. A Medical Power of Attorney is required to explicitly name your spouse as your agent.
Single Adults: Without designated agents, the default may be a court-appointed guardian or a state-law surrogate hierarchy that may not match your preferences.
How Advance Directives Work in Texas Hospitals
Austin hospitals are required to ask whether you have an advance directive on file. Frank designs your plan to integrate with hospital protocols:
In Hospital: The directive to physicians and medical power of attorney guide hospital-based decisions. Your agent can speak to doctors, review treatment options, and authorize interventions on your behalf.
Emergency Response: EMS personnel follow out-of-hospital DNRs if they are physically present. Otherwise, standard resuscitation is provided.
Long-Term Care: Skilled nursing and home health agencies use these directives to coordinate care upon admission.
The Pabst Design and Execution Process
Frank has streamlined the execution of medical directives to fit the modern family’s schedule, utilizing secure video signings for maximum convenience:
Customized Execution: Directives to physicians and medical powers of attorney can be notarized or signed in front of two qualified witnesses. Frank ensures the correct execution method is used for every document.
Revocation and Updates: You can revoke or change your directives at any time by signing a written revocation or executing a new document. Frank recommends a review every three to five years or after any major change in health or relationships.
Accessibility: Under Nicky’s operational oversight, we emphasize providing copies to your primary care physician and designated agents so they are never locked away during a crisis.
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