Living Will
This Living Will serves as a declaration of my wishes regarding medical treatment and end-of-life care, in accordance with the laws of [State Name].
I, [Your Full Name], born on [Your Date of Birth], residing at [Your Address], hereby declare this Living Will as a reflection of my healthcare preferences.
Should I be unable to communicate my healthcare decisions due to a terminal illness or incapacitation, I wish for my healthcare providers to follow my directives as stated below:
Directions Regarding Treatment
I prefer the following types of medical interventions:
- Comfort care to relieve pain and suffering.
- No resuscitation measures, should my heart stop beating or I stop breathing.
- Life-sustaining treatment may be withheld or removed if it serves only to prolong the dying process.
Specific Treatments
I would like the following specific treatments addressed as needed:
- Artificial nutrition and hydration.
- Mechanical ventilation.
- Intravenous medications for pain management.
Healthcare Agent
If I am unable to make my own healthcare decisions, I designate the following person as my healthcare agent:
[Name of Healthcare Agent]
[Address of Healthcare Agent]
[Phone Number of Healthcare Agent]
Witnesses
This Living Will must be signed by me and witnessed by at least two individuals, who are not related to me and will not benefit from my estate:
First Witness: [Witness Name], [Witness Address], [Witness Signature]
Second Witness: [Witness Name], [Witness Address], [Witness Signature]
Date of Signing: [Date]
This document reflects my wishes and should be followed as such by my healthcare providers, family, and any appointed agents. It supersedes any previous Living Wills I have executed.