What Is An Advanced Medical Directive?

Like many of you before my grandfather became ill I often questioned, what is an advanced medical directive? At 87 years-old my grandfather needed opened heart surgery. Our family was torn between what was the right avenue to take, how much should we do for him and when was it time to let him go. We soon learned that an advanced medical directive is a living will.

For my grandfather, the living will outlined his wishes in the event that he was struck by a terminal illness or was unconscious, incapable of making a decision for his health care. A basic advanced medical directive gave detailed instructions to family members for his wishes if specific situations arose. For instance, should prolonged life-sustaining procedures be pursued at this time? The patient can direct their physician to withhold or withdraw life-sustaining procedures that will simply prolong death which is inevitable regardless of the treatment and the procedures are not necessary for the patient's comfort or relief of pain.

Most directives mandate that the maker outline which procedures they want withheld and under what conditions of terminal illness or unconsciousness they would want medical services stopped. And would they like to donate their organs. The following is a common list of procedures for most medical directives that a person would need to accept or decline:
  • Intravenous supplied hydration
  • Feeding tube supplied for food
  • Surgery
  • CPR
  • Drugs-antibiotics or pain relievers
  • Dialysis
  • Chemotherapy
  • Being placed on a ventilator
An Advance Medical Directive allows the maker to refuse or accept life-sustaining treatment in any situation. Unlike a living will, a directive can be used to state your wishes about your health care in any situation in which you are unable to make your own decisions, not just when you are in a coma or are terminally ill. In addition, this signed piece of paper allows you to choose someone you trust to speak for you when you are incapacitated.

Preparing this directive affords you the luxury of choosing someone that you are comfortable with to insure that your decisions are followed to the letter if you are incapacitated. You can also visit before hand with the person that you choose and clearly state your wishes. If you don't believe in receiving blood products, then make this clear to the person you have chosen, tell them under no circumstances do you want any blood products.

The whole purpose of this directive is to give the maker complete control over their life while they are capable of making decisions and choices. It is simply a map for the person the maker chooses to place in charge of their health care should the need arise. It guides the decision person to follow the maker's wishes.

And the nice thing is that you don't need a separate living will if you have already made your wishes known about life-sustaining treatment in your Advanced Medical Directive. Most states will also recognize an Advanced Medical Directive no matter where it originates from. Hospitals will require your signed directive upon admittance. I will never question again what is an advanced medical directive, but I will always be thankful that my grandfather had one. It simply meant that we did not have to worry about making any decisions. My grandfather already had and we knew that we were doing what he wanted. It lifted the burden off our shoulders.

Brenda Segna

What is Texas Appellate Law?

The following is an overview of the Texas appellate law as well as the Fifth Circuit appellate law. Every step of an appeals process can involve numerous and complex issues or they can be resolved rather simply. The following overview is intended to be simply that, an overview.

In Texas courts a decision by a district judge can be appealed to the Court of Appeals and then to the Texas Supreme Court. If a case is in federal court, a decision by the federal district court can be appealed to the 5th Circuit and then the United States Supreme Court.

All cases begin in a trial court, before they ever reach an appellate court. The trial judge has the ability to dismiss the case on the pleadings early in the litigation as well as dismissing it after a summary judgment motion well into the litigation. The case has the potential of being tried before a judge or a jury and a final judgment could be entered after a full trial. And in some cases, the trial judge will enter a judgment that is different than the jury's verdict. But at some point, the proceedings in the trial court will come to an end. And at that point, a party unhappy with the outcome, typically the losing side, but sometimes even the winning side, has the opportunity to appeal.

An appeal is placed in motion with the filing of the notice of appeal in the trial court. The party appealing, which is referred to as the appellant, must also designate an appellate record. The appellate record consists of materials from the trial court that the appellant would like to present to the appellate court and use in appeal.

Appellate Panel and Oral Argument

An appellate panel decides appeals. The Texas Court of Appeal and the Fifth Circuit decides cases in three-judge panels. These judges are chosen randomly from the pool of available appellate judges on the courts. In appeals to state supreme courts and the U.S. Supreme Court, the entire court usually hears the appeal. State supreme courts typically have seven justices, and the U.S. Supreme Court has nine justices.

Once the briefing is completed, the appellate court will hear oral argument. The time between the close of briefing and oral argument varies tremendously between different courts. The Texas Courts of Appeal typically will set oral argument a few months after the close of briefing; the Fifth Circuit often takes well over a year to set oral argument. The Fifth Circuit, however, often decides cases without oral argument.

The oral argument in the Texas Court of Appeal is at most 30 minutes and is usually about 5 - 15 minutes. The Fifth Circuit usually sets oral argument at 10 minutes, but sometimes 20 minutes. By the time of oral argument, the judges on most appellate courts will have read the briefs, had at least one of their research attorneys or clerks prepare a bench memorandum discussing the issues, and often discussed it among themselves.

The lawyers at oral argument usually focus on just the most important aspects of their case, and the judges will frequently ask questions. This is not the time to reargue the entire case.

At the close of oral argument the case is submitted to the appellate court for a decision.


In a standard appeal process, the parties will file a total of three briefs with the court.

The appellant begins with the 'opening brief.' The appellant's opening brief will explain the facts and procedural history of the case, and then explain what went wrong in the trial court and why the appellate court should reverse the earlier decision.

Next, the non-appelling party, who is called the appellee, will file a responsive brief. In this brief, the appellee or respondent basically explains the facts and the procedural history of the case and then argues why the trial court reached the right result and why the appellate court should not reverse the decision.

Finally, the appellate can file a reply brief. In this brief, the appellant has the opportunity to argue why the respondent's claims are wrong. However, the appellant may not make any new legal argument in the reply brief; the appellate can only "reply" to the respondent.

All briefs must contain proper citations to legal authorities (cases, statutes, etc.) and proper citations to the appellate record.

Standards of Appellate Review

An appeal does not mean that a new trial has been granted. The appellate courts do not retry cases or hear new evidence, they do not even hear new legal arguments. Instead, appellate courts review what occurred in the trial court to see if the proper procedures have been followed and the proper law has been applied. Because of the restricted nature of this review, the issues that are raised on appeal are normally significantly different from those that are raised at trial.

In most cases, the appellate court will turn to the trial court or jury on factual issues. However, the appellate court determines and decides the definition of the law. On issues of law, the interpretation of prior case law, or a statute, or the Constitution, the appellate court will not defer to the trial court but will instead independently decide the issue.On an appeal if there is a pre-trial dismissal after a summary judgment motion or a demurrer, in most of these situations, the appellate court will review the materials and independently decide whether the case should have been dismissed or whether it should have been allowed to go to trial.On an appeal from a judgment after a trial, the appellate court will reverse the judgment only if it finds the trial court committed legal errors that were prejudicial which means the outcome would have been different during the trial. It should be noted that minor legal errors are normally not reason enough for a reversal. This rule is often referred to as the harmless error rule.


The appellate panel issues a written opinion which explains how it came to the decision that it did. Similar to the time between briefing and oral argument, the time between oral argument and the written decision can vary greatly between different courts. The Texas Court of Appeal has 90 days to issue an opinion, although they have the option of resubmitting the case and extending their time by 90 days. The Fifth Circuit has no deadline, and the time can vary tremendously.

If the appellate court deems it appropriate, the written opinion will be published in the official reports and will be binding authority for litigants in the future.

Rehearing by the Appellate Court

Any party that is dislikes or is disappointed with the opinion has a brief time window in which to request that the appellate court rehear the case. (When the time window closes, the appellate court loses jurisdiction to rehear the case.) Because of this, these petitions are almost never granted. If the arguments have already been made and considered, the court will more than likely not consider them again. And if the arguments have not already been made, the court probably won't consider new argument.

But, in very rare cases, the appellate court may have misunderstood the law or the applicable facts of the case. (Note: this is not the same as understanding but disagreeing with a party's claims about the law and the facts of the case.) If this is the situation, the appellate court has discretion to rehear the case.

Review by a Higher Court

A party who is dissatisfied with the results on appeal can also petition a higher appellate court to review the case. In Texas, this would be the Texas Supreme Court, and in the Fifth Circuit, it is the U.S. Supreme Court. (If a federal issue is involved, the U.S. Supreme Court can take cases from the Texas courts.)

With a few exceptions (like death penalty appeals), the Texas and U.S. Supreme Courts are not required to take any particular case; they choose what cases they will decide. The courts generally do not view themselves as simply providing a second layer of appellate review. Instead, they view themselves as insuring uniformity in the law in important issues. As a result, the Texas and U.S. Supreme Courts are likely to take cases where the lower courts have reached different conclusions on the same issue. They are not likely to take a case merely because the appellate court reached the wrong result.

Consequently, the petition asking the higher court to take review must be carefully drafted with this in mind.

Interlocutory Appeals and Appellate Writs

Most appeals involve cases that have been concluded in the trial court, but there are times when a party can appeal from a trial court order before the case is over. In the Fifth Circuit, these are called interlocutory appeals. In the Texas Court of Appeal, these are technically not appeals at all, but are original proceedings, called writ petitions, asking the Court of Appeal to issue an order (or writ) directing the trial court to modify one of its orders. The circumstances in which a party can file an interlocutory appeal or a petition for an appellate writ vary from court to court and are often very technical.

That defines what Texas Appellate Law is; I'd like to thank Diamond McCarthy LLP for taking the time to answer my questions as I wrote this piece. If you have further questions or inquiries you should speak with a lawyer in your area today or check with a law library in Texas.

Brenda Segna

Criminal Law Explained For Anyone

Criminal law is the set of rules that the government has decided on, setting forth acts that are considered dangerous to human life as opposed to civil law, which is generally less violent and dangerous. These would include threats of harm, bodily injury and lewd sexual acts. It determines not only the crime but also the punishment. In many cases, the punishment is decided upon in a way that fits the crime that was committed. In other cases, the punishment is already mandated by state or federal law. Civil matters and white collar crimes are handled by separate divisions.

The enforcement of these laws is done at the state level. At one time, both penal and civil law were considered together but today they are separate and distinct. Crimes of this violent and offensive nature are separated because they hold very serious consequences when the law is broken.

Each different type of crime has its own unique characteristics, elements that separate it from other crimes. The most serious of crimes will be punished by death or capital punishment. Physical punishment, like caning, has been prohibited in much of the world, although it is still practiced in some places.

Generally, even for these very serious crimes, the punishment is incarceration or jail time. The increments of time served in jail will depend on the crime and can be anywhere from an hour to a lifetime. The sentence will always depend on the crime.

Some judges will hand down a sentence that allows parole or probation. Parole is when the government allows a convicted felon to live outside the prison after they have served a satisfactory amount of time behind bars. They would then be on probation, which is the supervision that the government will keep over the ex-inmate until such time as they are deemed fit to live among normal society without being watched for criminal activities.

Many times there will be fines imposed for acts of crime. People can have their homes and property seized to pay for these fines, even if they are serving time in prison, as well.

There are five objectives to enforcing these laws. They are retribution, incapacitation, restitution, rehabilitation and deterrence. The main objective is left up to the differing opinions of the community governments and judges that pass down sentences. They will determine which one fits the particular situation. Retribution is usually the main objective. It stands for making the criminal pay for his actions. They have committed their crime and they must pay for it in some way. This is the eye for an eye effect.

Incapacitation is a goal for judges who need to keep this person away from everyone else so that they can no longer be a threat. This usually consists of jail time or death. Restitution is taking from them and giving to their victims or government, usually monetarily through fines. Rehabilitation is often encouraged in civil matters but it is generally accepted that violent criminals will have a difficult time with it. The final of these objectives of criminal law is deterrence. This can be done on an individual or group level. Deterrence focuses on imposing fees or other penalties on someone or a group of people in order to keep others from committing the same act.

A pardon [http://www.pardons.ca] is the forgiveness of a crime and the penalty associated with it. Find out how to obtain Canadian pardons [http://www.pardons.ca] and U.S. Entry Waivers.