Remember Terri Schiavo? She was the young woman who collapsed in 1990 for unknown reasons at the age of 26 and spent the next 15 years, until her death, in medical facilities being nourished through a feeding tube. Whether she was brain dead has been a topic of impassioned debate and expensive, heart-wrenching litigation.
The legal documents needed to specify your wishes in this type of situation are called “advance health care directives”, such as a “living will” and “medical power of attorney”.
Living Wills are sometimes called Health Care Directives or Medical Directives. Under the Federal Patient Self Determination Act (PSDA), you have the right to be informed about healthcare choices and make decisions on how you are to be treated, including making medical care decisions, in advance. You have a right to create a health care directive under Title 20 (Public Health and Welfare) of the Arkansas Code. You can create a valid Living Will that meets these criteria using the downloadable forms offered on this website.
In Arkansas, the following requirements must be met to create a valid Living Will:
- The person must be an adult
- The person must have the capacity to make health care decisions
- The person is not being forced into writing a Living Will
A Living Will usually covers specific directives as to the course of treatment that is to be taken by care-givers or, in some cases, forbidding treatment and/or food and water, should the principal be unable to give informed consent (“individual health care instruction”) due to incapacity. A durable power of attorney for health care under the “Durable Power of Attorney for Health Care Act” appoints an individual (a proxy) to direct health care decisions should the principal be unable to do so.
The “Uniform Rights of the Terminally Ill Act” has been enacted by the Arkansas Legislature. This law allows a person to declare a living will, specifying that he or she does not wish to be kept alive through life support if terminally ill or in a coma. The person may also obtain a “health care power of attorney”. This power of attorney appoints an agent to make medical decisions for them in case he or she becomes incompetent.
Many people make use of this act because they do not wish to endure any pain or suffering if weakened by a fatal disease. They want to “die with dignity,” so that family members will not have to go through the emotional pain of watching their loved one sleep through many years of life with no response to any stimuli.
The living will directs withholding or withdrawing of procedures that artificially sustain vital functions and prolong the dying process. It requests permission to die naturally with only the provision of appropriate pain easing medication and comfort care. In addition, when making a living will, you have a choice about whether you want to have artificially supplied nutrition and hydration. You can also elect to have your healthcare representative or your attorney make this determination for you.
Competent adults have the right to control the decisions related to their medical care, including life-prolonging procedures. The living will serves as the final expression of your right to refuse treatment and accept the consequences of the refusal.
You should notify your physician about the living will. He/she will then place a copy of it in your medical record. Legally, the living will does not obligate your physician to withhold or withdraw life-prolonging procedures. However, the living will is evidence of your desires and will be given great weight in determining your intent if you are unable to give directions regarding your care.