| a |
|
CONDITIONS
UNDER WHICH YOU MAY EXECUTE A LIVING WILL
|
 |
| a |
 If at any time you should have an incurable injury, disease, or illness or be
in a continual profound comatose state with no reasonable chance of recovery,
certified to be a terminal and irreversible condition by two physicians who have
personally examined you, one of whom shall be your attending physician, and the
physicians have determined that your death will occur whether or not
life-sustaining procedures are utilized and where the application of
life-sustaining procedures would serve only to prolong artificially the dying
process, you may direct that such procedures be withheld or withdrawn and that
you be
permitted to die naturally with only the administration of medication or the
performance of any medical procedure deemed necessary to provide you with comfort
care. The declaration for living will provided here allows you to reduce to
writing your decision to forego the use of life-sustaining procedures if
you are suffering from a terminal condition.
|
|
ADDITIONAL INFORMATION ABOUT THIS LIVING WILL |
 |
| |
|
 |
Registration (Optional not
Mandatory)
The secretary of state of
Louisiana has established a registry where your declaration may be
registered. You may register the original, multiple original, or a
certified copy. The secretary
of state will issue a do-not-resuscitate identification bracelet to
qualified patients listed in the registry. The identification
bracelet will include your name, date of birth, and the phrase "DO NOT
RESUSCITATE". The secretary of state may charge a fee of twenty
dollars for registering a declaration and issuing a do-not-resuscitate
identification bracelet. You may contact the secretary of state by telephone at
number (225)922-0103 or visit their web site at
http://www.sec.state.la.us
|
|
Revocation
You may revoke your declaration for living will at any time. A
written revocation must be filed with the secretary of state along with a
filing fee in the amount of $5.00. You must also provide a copy of the
revocation of your living will for placement in your medical records.
|
|
 Executing and Delivering Your Living Will
After
your declaration has been printed it must be signed in front of two witnesses.
The original should be submitted to your
physician for entry in your medical records. Copies should be made and
given to trusted family members. Any attending physician who refuses to
comply with your declaration shall make a reasonable effort
to transfer you to another physician.
|
|
