Advance Care Planning

It is your right to make decisions concerning your medical care. This includes not only the right to accept or refuse medical or surgical treatment, but also the right to formulate advance directives.

Stating your choices for your health care before there is a need will help your family by easing the responsibility and stress of making difficult decisions and will also help your physician by providing guidelines for your care.

Advance directives are communication tools. They are documents written in advance of serious illness, which state your choices for health care or name someone to make those choices for you if you become unable to make decisions.

Such decisions may include specific treatments, being placed on life-support equipment, and/or stopping treatment at a point you choose. Advance directives may also include requesting or declining life-sustaining treatment.

There are several types of advance directives. The three most often mentioned are a living will declaration, a durable power of attorney for health care decisions and a do not resuscitate directive. Kansas statutes recognize these documents.

You may tell your nurse, case manager or admissions counselor that you would like assistance in completing advance health care directives. He/she will make the necessary arrangements. You may also request the chaplain to visit with you should you wish to discuss your medical/ethical decisions surrounding your advance directives.

Services include providing the forms, witnessing, notarizing and photocopying. If you are not currently a patient, Newton Medical Center still offers assistance to help you with advance health care planning. You may call our Chaplain at (316) 804-6022 to make a personal appointment.

Documents can be changed or revoked at any time by replacing them with new updated ones. We appreciate you providing copies of your completed directive documents upon admission to the hospital or confirming that ones already on file with us reflect your most current health care choices.

Living Will Declaration

A living will declaration (LWD) states your wishes that your dying should not be artificially prolonged in cases of terminal illness. The Kansas living will is found in a statute titled The Natural Death Act. The statute allows an adult to state his or her desire to have life-sustaining procedures withheld or withdrawn and therefore be permitted to die naturally with only the administration of medication or procedures for comfort care. For the Living Will to be effective, two physicians must personally examine you and determine that you have a terminal condition. The physicians must agree that death will occur whether or not life-sustaining procedures are utilized, and if used would serve only to artificially prolong the dying process. Pain relief or other comfort care measures may be provided.

Download and fill out a living will form:

English Spanish

Durable Power of Attorney for Health Care Decisions

This document (DPOA-HCD) appoints another person to make health care decisions for you if you become unable to makes those decisions or communicate your own wishes.

The person you designate becomes known as your “agent” and should be someone who knows your goals and values and whom you trust. Your proxy agent should not be your doctor or nurse or anyone who takes care of you. Your agent is allowed to:

  • Give consent, refuse consent or withdraw consent to any care, treatment, service or procedure to maintain, diagnose or treat a physical or mental condition.
  • Make decisions about organ and tissue donation, autopsy and disposition.
  • Make all necessary arrangements for hospitalization, physicians or other care.
  • Request and receive all information and records and sign releases for your records.

You may choose specific powers that your agent will have and you may give instructions about any treatment you may or may not want to have, such as surgery or artificial nutrition and hydration.

Your agent and health care provider must follow your expressed wishes. They must also respect your wishes as stated in your living will declaration. And unless limited, the durable power of attorney for health care allows your agent to make decisions about withholding or withdrawing life-sustaining treatment in all types of illnesses. The durable power of attorney is not limited to terminal illness.

To be effective, both the DPOA-HC and the LWD documents must be notarized or witnessed by two adults who are not related to you and who will not inherit from you.

Download and fill out a Durable Power of Attorney for Health Care Decisions form in English or in Spanish.

Do Not Resuscitate Directive — Out-of-Hospital Setting

An individual’s Do Not Resuscitate (DNR) Directive is a signed, dated and witnessed form that allows you to say in advance your decision that if your heart stops beating or you stop breathing, no medical procedure will be done by EMS personnel to restart the heart or breathing. Of importance, this document must also be signed in advance by the individual’s attending physician. Not to be confused with a Living Will Declaration, which does not influence EMS providers, the DNR instructs that emergency life-saving measures not be attempted.

Download and fill out a DNR form in English or in Spanish.

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