The federal Patient Self-Determination Act of 1990 requires healthcare providers to tell you about your specific rights to issue advance directives allowed in your state. The act requires all healthcare providers which accept Medicare or Medicaid payments to ask all adult inpatients if they have advance directives. They must document answers and give information about state laws. They must tell you their own policies on advance directives. The following information is to explain your rights. It is not intended to serve as legal advice.

An advance directive is a document that states a patient’s choice about treatment. It may name someone to make choices if the patient cannot. With advance directives, patients can legally decide about their future medical treatment.

Arkansas law recognizes two types of advance directives: a living will declaration and a health care proxy designation. These are two different documents that serve different purposes. You do not have to have a living will or health care proxy designation for healthcare.

Living wills: A living will is a legal document that allows a competent person to accept, refuse, stop, or otherwise decide about medical care, especially treatment that keeps him / her alive. It is used when the person’s condition is terminal and goes into effect only when you no longer can decide. You may revoke your living will at any time. You may do this in writing with at least one witness or notary. You may also tell your doctor that you want to revoke your living will.

A living will must be signed in the presence of two witnesses who know you. These two people cannot be your relatives or heirs to your estate. They cannot be healthcare providers taking care of you or people who have claims against any part of your estate. You or someone acting for you is responsible for giving your doctor or other provider a copy of your living will. The living will then must be documented in your medical record.

If your doctor or other provider cannot follow your living will, he / she must tell you, your next of kin, or agent. If you want to be transferred to another doctor or other healthcare provider who will follow your living will, your doctor or provider must help transfer you.

Withholding or taking away medical care from a patient as requested by a properly executed living will is legal. No doctor or healthcare provider taking part in withholding or taking away treatment that keeps someone alive as requested by a living will shall be subject to a civil or criminal responsibility. He / she will not be guilty of unprofessional conduct if all actions otherwise conform with reasonable medical standards.

If you wish artificial food and fluids to be withheld or taken away, you must specify this in your living will be checking the proper space on the living will form.

The laws on advance directives differ from state to state, so it is unclear whether an Arkansas advance directive will be valid in another state. Because an advance directive is a clear expression of your wishes about medical care, it will influence that care no matter where you are admitted. However, if you plan to spend a great deal of time in another state, you might want to consider signing an advance directive that meets all legal requirements of that state.

Your Questions: Questions about advance directives should be discussed with your doctor, family members, close friends, or spiritual adviser. An ethical committee is available to assist you. A lawyer can answer your legal questions and help execute documents. You should review them periodically because laws may change. You may also change your mind.

Forms are available at the nursing station on your unit. For further assistance call the Chaplain or the Admissions Office.

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