Arkansas Living Will: Requirements, Forms, and How to Make It Legally Valid

A grandfather in Fort Smith had a notarized living will that clearly stated no mechanical ventilation. When he was rushed to the local ER, doctors intubated him anyway — because the hospital didn't have a POLST or DNR order on file. The living will alone wasn't enough.

This disconnect between legal documents and clinical reality is the single biggest pitfall in Arkansas end-of-life planning. Here's how to create a living will that actually protects your wishes.

What an Arkansas Living Will Actually Is

Under Arkansas law, a living will is formally called an "Advance Care Plan" or "Declaration." It's a legal document that records your specific treatment preferences for two conditions:

1. Terminal illness — an incurable condition that will result in death within a short time
2. Permanent unconsciousness — a persistent vegetative state with no reasonable expectation of recovery

The document only activates when your treating physician makes a formal determination that one of these conditions exists and you lack decision-making capacity.

Arkansas Living Will Requirements for Legal Validity

The execution formalities under Arkansas Code § 20-6-103(c) are strict. A single technical mistake can void the entire document:

Signing: You (or another adult acting in your presence and at your explicit direction) must sign the document.

Finalization — choose one:

• Notarization before a qualified notary public (strongly recommended), OR
• Two-witness attestation where both witnesses are competent adults

Witness restrictions (if using witnesses):

• Neither witness can be your designated healthcare agent
• At least one witness must be unrelated to you by blood, marriage, or adoption
• That same witness must not be entitled to any portion of your estate under any will or intestate succession

The document must contain a specific attestation clause confirming the witnesses meet these criteria. Without it, hospitals can reject the form.

What to Include in Your Living Will

Arkansas law allows you to document specific instructions on:

• CPR — whether chest compressions, defibrillation, or mechanical ventilation should be attempted
• Mechanical ventilation — whether intubation should be used for temporary reversible conditions or refused entirely
• Artificial nutrition and hydration — preferences for feeding tubes and IV fluids (this is especially important — if you rely on default surrogates instead of a designated agent, ANH can only be withheld when two independent physicians certify it merely prolongs dying)
• Organ and tissue donation — anatomical gifts through Southern Legacy of Life, the state registry
• Psychiatric instructions — since Arkansas has no standalone psychiatric advance directive statute, any mental health preferences must be attached as a rider to your healthcare power of attorney

The Living Will's Limitation (And What Else You Need)

A living will tells doctors what you want. But it's a legal declaration of intent, not a medical order. Emergency responders — paramedics, EMS crews — are legally barred from interpreting or acting on a standalone living will.

To bridge this gap, you need:

• A POLST form — translates your preferences into active physician orders, printed on pink paper, portable across all care settings
• An EMS-DNR order — specifically directs emergency responders to withhold resuscitation at home

Both require a licensed physician's signature (MD or DO). Arkansas does not allow APRNs or nurse practitioners to sign POLST forms — a restriction that creates bottlenecks in rural counties where many clinics are staffed primarily by APRNs.

The Pregnant Patient Exception

If you're diagnosed as pregnant, your living will instructions to withhold or withdraw life-sustaining treatment will not be honored. Under Arkansas Code, the hospital must maintain life-sustaining measures if there's a medical possibility the fetus could develop to the point of a live birth — regardless of your written refusal.

How to Make Your Living Will Enforceable

Execution alone isn't enough. Your living will must be actively integrated into the medical system:

1. Upload to your physician's EHR — provide copies to your primary care doctor and any hospital where you might be admitted (UAMS Health, Baptist Health)
2. Register with the Arkansas Secretary of State (optional but recommended)
3. Coordinate with clinical orders — ask your physician about converting your preferences into a POLST if you have a serious progressive illness
4. Inform your healthcare agent — they need to know what you documented and where originals are stored
5. Review annually — especially after any change in health status, new diagnosis, or family change

Revocation and Amendment

You can revoke or amend your Arkansas living will at any time and in any manner while you retain capacity. Revocation becomes effective once communicated to your treating physician. Divorce automatically revokes a spouse's designation as healthcare agent unless the document explicitly states otherwise.

The Blended Family Complication

Arkansas is one of only three states that still enforces dower and curtesy — giving a surviving spouse an automatic life estate in one-third of all real property owned during the marriage (one-half if there are no children). This has nothing to do with your living will directly, but it creates family conflict that spills into medical decisions.

Example: your adult children from a first marriage serve as your healthcare agents. They authorize expensive long-term care that requires selling the family home. But your current spouse's automatic dower rights can block that sale — creating a financial standstill while care costs mount.

The solution: keep medical and financial authority strictly separated. Your living will and healthcare agent handle medical decisions. A separate financial power of attorney (or pre/post-nuptial agreement addressing dower release) handles property. Mixing these authorities in blended families leads to litigation.

Who Needs an Arkansas Living Will

Every competent adult in Arkansas should have one — not just elderly or terminally ill patients. Life-threatening situations don't follow a schedule:

• A 35-year-old in a car accident on I-40 who ends up on life support
• A new mother with surgical complications during delivery
• A healthy 50-year-old who suffers a massive stroke during a routine workday

Without a living will, your family must make these decisions under crisis pressure with no legal guidance. If family members disagree — a common scenario in blended families — the dispute can end up in probate court while you remain on unwanted life support.

The document costs nothing to create, takes 30 minutes to complete, and can be revoked at any time. There is no downside to having one in place.

The Cost Comparison

• Elder law attorney for advance directive drafting: $150–$325
• National legal software (LegalZoom, Rocket Lawyer): $9.99–$39.99/month
• Free state forms from Arkansas Department of Health: $0 (but zero execution guidance)

The free forms work — they're the same statutory templates attorneys use. The risk isn't in the form itself but in executing it incorrectly: wrong witnesses, missing attestation clauses, failure to coordinate with clinical orders. A single technical error voids the entire document.

Skip the Guesswork

The Arkansas Advance Directive & Living Will Kit gives you the complete Advance Care Plan form with a pre-built witness eligibility checklist, treatment preference matrix, and a step-by-step coordination guide that connects your legal document to a POLST medical order — so your wishes don't die in a filing cabinet while the ER makes decisions without them.

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