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CONDITIONS
UNDER WHICH YOU MAY EXECUTE A LIVING WILL
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 Any
competent adult may, at any
time, make a living will or written declaration and direct the providing,
withholding, or withdrawal of life-prolonging procedures in the event that
such person has a terminal condition, has an
end-stage condition, or is in
a persistent vegetative state.
In determining whether you have a terminal condition, an end-stage
condition, or are in a persistent vegetative state or may recover
capacity, or whether a medical condition or limitation referred to in an
advance directive exists, your attending or treating physician and at
least one other consulting physician must separately examine you.
The findings of each must be documented in your medical record and signed
by each examining physician.
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ADDITIONAL INFORMATION ABOUT THIS LIVING WILL |
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Designation of Agent
In the event you are unable to provide express and informed consent
regarding the withholding, withdrawal or continuation of life-prolonging
procedures, you may designate an agent to do so. However, this living will does not provide for the appointment of an agent to make general decisions
regarding your health. If you want to empower your agent with additional authority to
make your health care decisions, you must use a Power of Attorney for Health
Care.
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Anatomical Gifts
You will be able to enter
any instructions or limitations regarding your treatment or enter any
desires you have regarding
anatomical gifts.
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Operative Date
Your living will becomes operative when a copy is provided to
your attending physician; and you are determined by
your attending physician to be incompetent and in a terminal condition or
in a state of permanent unconsciousness.
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Executing and Delivering Your Living Will
 A living will must be signed by the
principal in the presence of two subscribing witnesses, one of whom is
neither a spouse nor a blood relative of the principal. If the
principal is physically unable to sign the living will, one of the
witnesses must subscribe the principal's signature in the principal's
presence and at the principal's direction.
Upon the execution of a
living will, the original must be given to your attending or treating
physician to be placed in your medical records. A copy should also be
given to a trusted family member or friend. If you revoke your living
will, you should also submit the original to your physician to be placed
in your medical records as well.
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Effect of Executing a Living Will
The making of a living will does not
affect the sale, procurement, or issuance of any policy of life insurance,
nor shall such making of an advance directive be deemed to modify the
terms of an existing policy of life insurance. No policy of life
insurance will be legally impaired or invalidated by the withholding or
withdrawal of life-prolonging procedures from an insured patient
notwithstanding any term of the policy to the contrary. A person
shall not be required to make an advance directive as a condition for
being insured for, or receiving, health care services. The withholding or
withdrawal of life-prolonging procedures does not, for any purpose,
constitute a suicide.
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