Dallas Endoscopy Center, LLC - Notice of Advance Directives Policy

The above mentioned surgery center requires the following notice be signed by each patient prior to the scheduled procedure in order to be in compliance with the Self-Determination Act (PSDA) and state law and rules regarding Advance Directives. Advance Directives are statements that indicate the type of medical treatment wanted or not wanted in the event an individual is unable to make those determinations and who is authorized to make those decisions. The Advanced Directives are made and witnessed prior to serious illness and injury.

There are many types of Advanced Directives but the two most common forms are:

Living Wills

These generally state the type of medical care an individual wants or does not want if he/she becomes unable to make his/her decisions.

Durable Power of Attorney for Health Care

This is a signed, dated and witnessed paper naming another person as an individual's agent or proxy to make medical decisions for that individual if he/she should become unable to make his/her own decisions.

In the ambulatory care setting, if a patient should suffer a cardiac or respiratory arrest or other life-threatening situation, the signed consent implies consent for resuscitation and transfer to a higher level of care. Therefore, in accordance with federal and state law, the facility is notifying you it will not honor previously signed Advanced Directives for any patient. If you disagree, you must address this issue with your physician prior to signing this form.

You may download, print, and fill out the Texas Advance Directives document before coming to our facility.