Living Will Example Document

The following documents are provided
only as conceptual examples and are not intended
to represent legally valid documents.
One should always consult with an attorney
to determine the legal requirements in each state.

LIVING WILL
OF
__PRINCIPAL NAME__

If I should ever have a terminal condition, I do not want my life to be artificially or unnaturally prolonged, and I do not want to receive any life-sustaining treatments beyond pain relief and comfort care that would only serve to artificially delay the moment of my death. Specifically, I do not want to receive either of the following:

a) cardiopulmonary resuscitation by the use of drugs, electric shock,
and/or artificial breathing.
b) artificially administered food and fluids.

If I should ever be in a terminal condition or an irreversible coma or a persistent vegetative state which attending doctors reasonably feel to be irreversible or incurable, then I do want to receive only such medical treatments as may be necessary to minimize pain and keep me comfortable.

Notwithstanding my other directions, I do want to receive all medical care necessary to treat my condition until doctors reasonably conclude that my condition is terminal or is irreversible and incurable or I am in a persistent vegetative state. At such time as doctors conclude that my condition is terminal, irreversible, incurable, and advanced to a point that it causes a hardship on my family, it is my desire is to be placed in Hospice care.

At such time as I expire, it is my desire to be sent to the nearest crematorium to be cremated as promptly as possible, without any funeral, viewing, or ceremony, in order to minimize difficult decisions, expense, and hardship to my surviving family members.

I have attached a Health Care power of Attorney which is to be honored in the absence of my being able to give health care directions.

Date: __________________________

________________________________

State of __STATE__
County of __COUNTY__

Subscribed, sworn to and acknowledged before me by __PRINCIPAL NAME__

this ___________day of ____________________, ________________

___________________________ ________________________
Notary Seal Signature of Notary

Health Care Power of Attorney
of
FOR NAME

I, __PRINCIPAL NAME__, as principal, designate __AGENT NAME__ as my agent for all matters relating to my health care, including, without limitation, full power to give or refuse consent to all medical, surgical, hospital, and related health care. This power of attorney is effective on my inabilityi to make or communicate health care decisions. All of my agent's actions under this power during any period when I am unable to make or communicate health care decisions or when there is uncertainty whether I am dead or alive, have the same effect on my heirs, devisees, and personal representatives as if I were alive, competent, and acting for myself.

If my agent is unwilling or unable to serve or continue to serve, I hereby appoint __ALTERNATE NAME__ as my agent.

I have completed and attached a Living Will for purposes of providing specific directions to my agent in situations that may occur during any period when I am unable to make or communicate health care decisions, or after my death. My agent is directed to implement those choices I have specified in the Living Will.

I have not completed a prehospital medical care directive pursuant to __STATE LAW__. This health care directive is made under __STATE LAW__, and continues in effect for all who may rely on it except those to whom I have given notice of its revocation.

Autopsy (under __STATE__ law, an autopsy may be required)
If not required by law, my agent may give consent to or refuse an autopsy.