Texas Surrogate Decision Maker Lookup
Who can make medical and money decisions for an adult in Texas who cannot decide: an agent, a guardian, or Texas's default surrogate order. Runs in your browser; nothing is stored.
Texas law checked against official sources on October 26, 2026.
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Who has authority in Texas
- With no agent and no guardian, this state's default surrogate law applies only to some decisions or settings (see the scope below). Outside that scope, someone may need a court appointment.
- If nobody is available or the family disagrees, a court can appoint a guardian. That is slower and costs more than documents signed in advance.
Texas's default surrogate order
- Spouse
- Adult children
- Parents
- Nearest living relative
- What it covers
- Applies only to adults in a hospital or nursing home, receiving home and community support services, or held in a county or municipal jail. It does not authorize withholding or withdrawing life-sustaining treatment, which a separate statute (166.039) covers.
- If more than one person is in the same group
- No majority rule is stated. Disputes over who may act can be resolved only by a court with probate jurisdiction.
- If nobody on the list is available
- If no one on the list is reasonably available, a second physician not involved in the treatment may concur with the treatment.
- Who decides the person cannot decide
- Applies to a patient who is comatose, incapacitated or unable to communicate; the attending physician must describe the incapacity and proposed treatment in the record.
- Limits
- Chapter 313 does not authorize withholding or withdrawing life-sustaining treatment.
- A surrogate cannot consent to voluntary inpatient mental health services, electroconvulsive therapy, or appointing another surrogate.
- For a jail inmate, consent lasts until the 120th day or release, whichever comes first.
- Consent must be based on what the patient would want, if known.
Source: Tex. Health & Safety Code 313.004 · Checked October 26, 2026
Narrower laws in this state
- Tex. Health & Safety Code 166.039: For a qualified patient (terminal or irreversible condition certified by the attending physician) with no directive, guardian or agent, the attending physician and one person from the same order (spouse, reasonably available adult children, parents, nearest living relative) may decide, including withholding or withdrawing life-sustaining treatment. If no one is available, a second physician or ethics committee representative must concur.
Less certain: This list was read from a stored copy of the Texas statutes, and Texas laws outside the chapters we read were not searched for a family consent rule.
Who decides in Texas without a power of attorney?
Texas's default surrogate law (Tex. Health & Safety Code 313.004) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse.
Texas's default surrogate law in full
Texas's default surrogate order
- Spouse
- Adult children
- Parents
- Nearest living relative
- What it covers
- Applies only to adults in a hospital or nursing home, receiving home and community support services, or held in a county or municipal jail. It does not authorize withholding or withdrawing life-sustaining treatment, which a separate statute (166.039) covers.
- If more than one person is in the same group
- No majority rule is stated. Disputes over who may act can be resolved only by a court with probate jurisdiction.
- If nobody on the list is available
- If no one on the list is reasonably available, a second physician not involved in the treatment may concur with the treatment.
- Who decides the person cannot decide
- Applies to a patient who is comatose, incapacitated or unable to communicate; the attending physician must describe the incapacity and proposed treatment in the record.
- Limits
- Chapter 313 does not authorize withholding or withdrawing life-sustaining treatment.
- A surrogate cannot consent to voluntary inpatient mental health services, electroconvulsive therapy, or appointing another surrogate.
- For a jail inmate, consent lasts until the 120th day or release, whichever comes first.
- Consent must be based on what the patient would want, if known.
Source: Tex. Health & Safety Code 313.004 · Checked October 26, 2026
Narrower laws in this state
- Tex. Health & Safety Code 166.039: For a qualified patient (terminal or irreversible condition certified by the attending physician) with no directive, guardian or agent, the attending physician and one person from the same order (spouse, reasonably available adult children, parents, nearest living relative) may decide, including withholding or withdrawing life-sustaining treatment. If no one is available, a second physician or ethics committee representative must concur.
Less certain: This list was read from a stored copy of the Texas statutes, and Texas laws outside the chapters we read were not searched for a family consent rule.
How authority works when someone cannot decide
An adult who can understand a decision makes it, even when family disagrees. Authority passes to someone else only when the person cannot decide, and the source of that authority matters.
The strongest source is a document the person signed while able: a health-care power of attorney or advance directive naming an agent for medical decisions, and a durable power of attorney for money and property. A court appointment (a guardian, or in some states a conservator for money) comes next, and it is slower and more expensive.
For health-care decisions only, most states also have a default surrogate law, sometimes called a family consent law. It lists who may decide when there is no agent and no guardian, usually starting with a spouse, then adult children, then parents and siblings. Doctors and hospitals apply it at the bedside.
There is no "next of kin" list for money
Default surrogate laws cover health care, not bank accounts, bills or property. Being a spouse, child or next of kin does not by itself let you sign checks or sell a house for another adult. Without a durable power of attorney, managing someone else's money usually needs a court appointment.
Federal benefits follow their own rules. Social Security says a power of attorney, an authorized representative or a joint account is not the same as being a payee; SSA appoints a representative payee. VA appoints a fiduciary for a beneficiary who cannot manage VA benefits.
What this tool does not do
- It reports what each state's statute says. It does not decide whether a person has capacity; the treating doctor does.
- It does not decide disputes between family members or replace a court order. A guardianship order or a power of attorney can change who decides.
- Hospitals, nursing homes and other states' laws can add steps. Ask the facility's patient-relations or legal office which law it applies.
- It is general legal information, not legal advice for your situation.
Frequently Asked Questions
Who makes medical decisions in Texas if there is no power of attorney?
Texas's default surrogate law (Tex. Health & Safety Code 313.004) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse. The full order, tie rule and limits are in Tex. Health & Safety Code 313.004.
Does next of kin in Texas have authority over money?
No default surrogate law covers money. In Texas, as everywhere, managing another adult's accounts or property takes a durable power of attorney or a court appointment.
Sources
- Tex. Health & Safety Code 313.004 (Consent to Medical Treatment Act, surrogate consent (Health & Safety Code 313.004))
- Tex. Health & Safety Code 166.039
- Social Security: representative payee FAQ
Texas law checked against the official text on October 26, 2026.
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