Arkansas Advance Healthcare Directives Remain Valid Under Guardianship and State Hospital Admission

Arkansans with valid advance healthcare directives generally retain those protections if they later become wards under guardianship or are admitted to the Arkansas State Hospital, according to Attorney General Tim Griffin.

This came on Wednesday, September 9th, in response to questions from State Representative Steve Unger about whether an existing advance directive remains enforceable after a person becomes a ward and is admitted to the State Hospital.

The Attorney General concluded that neither the appointment of a guardian nor admission to the Arkansas State Hospital automatically invalidates a valid advance directive.

Under Griffin’s interpretation of Arkansas law, the state and a ward’s guardian generally must honor the directive. However, the opinion recognizes exceptions when a controlling court order or a provision of state law applies to a particular healthcare decision.

Advance directives allow people to establish instructions concerning future healthcare decisions before circumstances arise in which they may no longer be able to make or communicate those decisions themselves.

Griffin addresses what happens to those previously established instructions when an Arkansan later comes under guardianship. Griffin concluded that becoming a ward does not, by itself, erase an otherwise valid directive.

The same principle generally applies when a ward is admitted to the Arkansas State Hospital. Admission alone does not invalidate the directive or eliminate the state’s obligation to honor it, according to the opinion.

The conclusion is not absolute. A court could issue an order controlling a particular healthcare decision, and state law contains exceptions that may apply depending on the circumstances of an individual case.

Unger asked whether the directive remains enforceable after both guardianship and admission to the State Hospital and whether the state is required to honor the directive. Griffin answered both questions generally in the affirmative.

The publicly released opinion does not identify a particular patient or case that prompted Unger’s request.

It also remains unclear whether the opinion will result in changes to existing procedures used by the Arkansas Department of Human Services, the Arkansas State Hospital or the state’s guardianship system. 

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Arkansas Advance Healthcare Directives Remain Valid Under Guardianship and State Hospital Admission