Living Will
What is an Advance Directive?
An Advance Directive enables you to guide your family and
physician if you are unable to communicate with them. It allows you to control
the extent to which life-sustaining medical measures will be used and can help
you protect your loved ones from being forced to make those difficult decisions.
A Living Will is NOT a property will. A Healthcare Proxy is a person you appoint
to make medical decisions for you if you are unable to make them for yourself.
This person may make decisions that are not clearly stated in your Advance
Directive.
Click
here to download the Arkansas Advance Directive (Adobe
.pdf format).
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Are Advance Directives only for Senior
Citizens?
No, even young people can be involved in car accidents or have
serious illness. Most of the court cases involving withholding of life-support
treatments have involved young people in their twenties or thirties.
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Who can fill one out?
Only competent persons age 18 or over can fill out an Advance
Directive. If the person is not competent or is under 18, Arkansas law allows
for proxy decision makers.
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Who can be a witness?
Competent adults over 18, but not the person named as Proxy.
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Who can be the Proxy?
Generally any competent person over 18, but this person is
usually a close relative or close friend. Your doctor usually does not want to
be the proxy. Please write the phone number of the proxy on the Advance
Directive.
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What To Do With The Living
Will/Advance Directive?
Do NOT put it in a safe deposit box, and do not mail it to the
hospital. Please bring it with you each time you are hospitalized, just as you
bring with you your insurance card and/or Medicare cards. Please give a copy
to your doctor and your family members so that they can discuss it with you
if they wish. Put the advance directive in a place it can be easily found if
you are hospitalized in an emergency. Someone close to you who would be likely
to accompany you to the hospital should have a copy.
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Withdrawing Specific
Treatments
The advance directive specifically names several treatments that
may be withdrawn if the patient is terminal. In filling out the living will, you
are saying that any or all of these treatments can be removed if you are
terminal and if these don't assist with pain control. If you ALWAYS want
artificial nutrition and hydration, even if you are permanently unconscious,
then cross out that line and initial it. Cross out any treatment that you always
want in every circumstance and initial it. (Most people do not cross out any of
the treatments.)
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Caring and Curing
Sometimes, when a person becomes very ill and is dying, the goal
of health care must become caring and not curing. When the medical condition of
the patient is such that there is little or nothing that medicine can do to
reverse the disease process, and the disease process is advanced, then the goal
of medical treatment is caring. This means helping the patient to be as
comfortable and pain-free as possible. A person filling out an Advance Directive
is essentially saying: "When medicine can't cure me, when the disease
process is advanced, and I am unable to communicate, then stop treating me
aggressively and use all methods available to make sure I am comfortable,
pain-free, and taken care of in a compassionate manner." The decision to
place a No Code Order on the patient or to remove life support technology, such
as ventilators or artificial nutrition and hydration, does NOT mean abandoning
the patient. These orders do mean that the patient is cared for so that the
patient is as comfortable and pain-free as possible. Patients and their families
are encouraged to discuss questions about their care with their physician,
nurses, or service personnel. These individuals will assist in resolving issues
or concerns.
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Can life support treatments,
even tube feedings, be withheld or withdrawn even if the patient does not have a
Living Will/Advance Directive?
Yes, the patient may almost always refuse treatment for himself
or herself. In addition, Arkansas law specifies who may make decisions for
incompetent persons in the absence of an Advance Directive. However,
nursing homes usually require tube feedings unless the person has an Advance
Directive.
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Can
unexpected recoveries happen?
Although there are occasional reports of unexplained recoveries
from terminal illness, your responsibility is to make the best decision based on
the most likely outcome from the information given to you by your physician.
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Is the Advance Directive legal in
other states?
Maybe. Arkansas law recognizes most advance directives from other
states, BUT other states may not recognize Arkansas Advance Directives.
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What if I change my mind?
If you change your mind about your Advance Directive, simply tear
it up and tell your family and your physician.
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Where do I get help with Advance
Directives?
Please contact a Patient Representative at (501)622-2280 Monday
- Friday, 8 a.m. - 4:30 p.m. for help with the following: To fill out an Advance
Directive, To receive a blank copy of an Advance Directive, To change or cancel
an existing Advance Directive, Contact an Ethical Consultant for help with life
support withdrawal, and life support systems including artificial nutrition,
or other ethical issues.
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Disclaimer
A Living Will/Advance Directive is NOT a No Code Order or a No
Treatment Order. Should you be involved in an emergency situation or have a
heart attack, you would still be coded and treated aggressively until you were
stabilized and an assessment of your condition could be made. The Advance Directive
takes effect ONLY when you are terminal, or would die in a relatively short
time, or are permanently unconscious. In an emergency situation, not even the
doctor may know if you are terminal. In any situation, only the physician with
your consent or your proxy/family's consent can write a medical order which
gives a No Code Order to stop treatment. The PURPOSE of an Advance Directive
is to make your wishes known so that a good decision can be made by your doctor
and family as to when to stop certain treatments. The Advance Directive is not
a medical order of any kind.
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