Living Will

Living Will

I, {Name}, of {Address}, born {date}, and being of sound mental health and full mental capacity, do hereby direct this Living Will to my friends, family, loved ones, medical providers, hospitals, surgeons, and doctors in the event that I become incapacitated or incompetent to the point of being unable to communicate my desires.

This Living Will reflects my legal right to decline life-saving medical care and treatment in specific conditions. All parties responsible for my care should consider this document legally and ethically binding from this day forward.

In the event that I am in an incurable and irreversible condition {specific effects or circumstances}, I hereby direct doctors and medical personnel to do the following:

1.

Withhold life-sustaining treatment and procedures that will only serve to extend my condition or draw out my dying.

   a.

Specifically, DO NOT provide the following treatment and procedures (although this list should not be considered complete): {Specific treatment to avoid}

2.

Provide treatment, medication, and care that will reduce or eliminate pain and keep me comfortable, including treatment for pain or discomfort that is caused by withholding life-sustaining treatment.

   a.

Specifically, DO provide the following treatment and procedures (although this list should not be considered complete): {Specific approved treatment}

I, {Name}, hereby declare this Living Will to be my explicit desires and instructions in accordance with my legal and constitutional rights, in accordance with {State} law.

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Name, signature & date

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Witness, signature & date

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Witness, signature & date

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