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In Texas your agent under a Medical Power of Attorney speaks for you when you are unable to communicate. But what happens when you have not clearly communicated and, better yet, documented your preferences?

Who makes your medical decisions? And how?

What happens if you are under a guardianship and unable to communicate?

How does your agent, your guardian, or anyone else determine what your preferences are? If they cannot, they must act in your best interest. But how do they determine what that is?

Your agent, or, if you have appointed no one, your closest kin, is likely to be emotionally distressed when you are in the hospital and unable to communicate. What might guide them, or you, as agent under a Medical Power of Attorney or next of kin?

This conundrum shows the importance of repeated conversations with family and physicians and repeated review of your Medical Power of Attorney and Advance Directive to Physicians and Surrogates. Our conditions change. Our goals change. Medical science changes.

Certainly no one should intrude on your choices.

But if you do not share, and better yet, document your choices, how can anyone know that they are acting on them? How can anyone ever be sure that they are acting in your best interest?

Both The Conversation Project and My Five Wishes have guidelines. While the Florida forms accompanying the latter are not valid in Texas, you can download Texas forms for your Medical Power of Attorney and Advance Directive to Physicians and Surrogates for free from the website of The Garrett Law Firm.


Elder law attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is an Approved Guardianship Attorney. She assists people in elder law, estate and special needs planning, guardianship and settling estates. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.

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