You might think that if your living will says that you don’t want to be resuscitated, that’s all that you need to do to ensure that you will be allowed to die naturally if your heart or breathing stops.
Think again.
Livings wills, or advance directives, don’t apply in the event of emergencies. Emergency Medical Care Technicians (ambulance staff) and medical professionals in emergency departments of hospitals are forbidden from following your advance directive.
Why?
Advance directives are intended to provide instructions if you have a fatal illness, are in a coma for a long time, have advanced dementia, are near death, or if you have injuries that are so grave that your prospects are severely limited. But in an emergency, often it’s hard to tell right away what the long-term outlook is.
To show why “do not resuscitate” (DNR) orders that are part of advance directives are not honored in emergencies, consider a simple example. Suppose you are 50 years old and start choking on a bite of food in a restaurant. Suppose you stop breathing as a result. If a “do not resuscitate” order applied, no one would be allowed to apply the Heimlich maneuver to dislodge the food so that you could breathe again. Then you would die, when otherwise you might live another 35 years perfectly well.
To avoid tragedies like that, emergency workers are trained to err on the side of saving lives. But suppose you have a serious illness and are likely to die very soon, and really, truly, don’t want to be resuscitated in the event that your heart or breathing stops.
In Arizona, you can complete a separate Prehospital Medical Care Directive form, refusing resuscitation. If emergency workers see that you have a properly completed PMCD form, they will not try to revive you. There are some quirky requirements – the form must be printed on orange paper, for instance – and more information can be found at http://www.azdhs.gov/bems/resources/DNR.htm.
Can this form take the place of an advance directive/living will? No, because it addresses only one issue, resuscitation, and only one choice: not to be resuscitated. It does not apply during a regular hospital stay; it applies only to emergency personnel, such as those in ambulances or the emergency room.
While the state has a registry that allows all medical personnel to see your living will and health care POA if you register these documents with them, it does not register Prehospital Medical Care Directive forms. If you want the emergency room at Yavapai Regional Medical Center to know that you have completed this document, you can put it on file – before an emergency arises – by giving a copy to the hospital’s Health Information Management/medical records department.
