Appendix III, Legal Authority to Make Decisions

Revision 19-0; Effective July 7, 2019

Below is a general description of the types of legal authority available to make decisions on behalf of another person or to support a person to make his or her own decisions. More information about some of these options and guardianship is available at: https://hhs.texas.gov/laws-regulations/legal-information/guardianship.

Option	Definition	Enabling Statute
Supported Decision Making	A process of supporting and accommodating an adult with a disability to enable the adult to make life decisions, including decisions related to where the adult wants to live; the services, supports and medical care the adult wants to receive; whom the adult wants to live with and where the adult wants to work, without impeding the self-determination of the adult. A supported decision maker does not have the authority to make a decision on behalf of the person.	Texas Estates Code §1357.002(3)
Surrogate Decision Maker	"Surrogate decision-maker" means a person with decision-making capacity who is identified as the person who has authority to consent to medical treatment on behalf of an incapacitated patient in certain facilities (hospital, nursing facility) who needs medical treatment. A surrogate decision maker is authorized to consent to only medical treatment on behalf of the person.	Texas Health and Safety Code §313.002 (10)
Guardianship of Person	A guardian of the person is appointed by a court to act on behalf of an incapacitated person and, considering the preferences of the person, decides: Where the person will live. Whether to limit contact with family and friends. What medical or psychological treatment the person will receive. Where the person can go. What personal rights the person will have (e.g., drive a car, have a cell phone, date) within the limitations of the court order.	Texas Estates Code Chapter 1151. Rights, Powers, and Duties Under Guardianship
Guardianship of Estate	A guardian of the estate is appointed by a court to act on behalf of an incapacitated person and decides (with court approval): What should be done with the person’s property. Which bills to pay and when. How to invest the person’s money. Whether to enter into a contract to buy or sell property.	Texas Estates Code Title 3. Guardianship and Related Procedures
Medical Power of Attorney	A competent adult person may execute a medical power of attorney for someone to make any or all health care decisions on behalf of the person in accordance with the person’s wishes, including religious and moral beliefs, when the person is no longer capable of making them for himself or herself. Someone with medical power of attorney is authorized to make only health care decisions on behalf of a person in the event the person becomes incapacitated.	Texas Health and Safety Code §166.164
Durable Power of Attorney	A competent adult person may execute a durable power of attorney, which will continue in the event of future incapacity of the person in designating an agent who is empowered to take certain actions regarding the person’s property. Someone with durable power of attorney is not authorized to make medical and other health care decisions for the person.	Texas Probate Code §481
Advanced Medical Directives	A competent adult person may execute an advanced medical directive, which is “an instruction...to administer, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition.”	Health and Safety Code Chapter 166