Many states have enacted so-called living-will statutes that specify certain legal formalities for refusing care. The Texas law, for example, specifies a form that, if followed, will be binding even if the patient becomes incompetent after signing the form.
The form of later incompetency is central to the refusal of care by a terminally ill patient. The patient will usually become incompetent before dying. The patient wants his or her wishes honored after becoming incompetent. The health care provider wants to be assured that there will be no legal liability for the following the patient's wishes. The most effective way to ensure this is to have a written refusal of care from the patient. This may be in the form approved by the appropriate state statute; or, if there is no format established by statute, the health care provider may provider may provide a form patterned after the Texas declaration.
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