Maine Living Will

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CONDITIONS UNDER WHICH YOU MAY EXECUTE A LIVING WILL

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If you have a terminal condition you may elect that your life not be prolonged and that you do not want any life sustaining treatment, beyond comfort care, that would serve; only to artificially delay the moment of your death.

If you have a terminal condition or an irreversible coma or otherwise in a persistent vegetative state that your doctors reasonably feel to be irreversible or incurable, you may refuse any of the following: a) cardiopulmonary resuscitation, for example, the use of drugs, electric shock and artificial breathing; b) artificially administered food and fluids; and c) to be taken to a hospital if at all avoidable.
 

ADDITIONAL INFORMATION ABOUT THIS LIVING WILL

   
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Adding Additional Directives

This living will allows you to incorporate by reference other written statements of your desires.  If you talk to your physicians and family members and feel you must add other directives, do so in your own handwriting and attach to this form.
 

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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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Duty of Attending Physician(s)

When your living will becomes operative, your physician and other health care providers shall act in accordance with its provisions.  If your attending physician or other health care provider cannot in good conscience comply with the provisions of your living will or if the policies of the health care provider preclude compliance, your attending physician or health care provider shall so inform you, or, if you are incompetent, shall so inform your agent, or, if you have not designated a health care proxy, shall so inform your family, guardian or other representative.  Your physician and health care provider shall make every reasonable effort to assist in the your transfer to another physician or health care provider who will comply with your living will.
 

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Pregnancy

Notwithstanding other directions, if you are pregnant, you can elect that life-sustaining treatment not be withdrawn if it is possible that the embryo/fetus will develop to the point of live birth with the continued application of life-sustaining treatment.
 

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Revocation

Your living will may be revoked at any time and in any manner by you without regard to your mental or physical condition.  A revocation is effective upon communication to your attending physician or other health care provider by you or a witness to the revocation.  Your attending physician or other health care provider shall make your revocation a part of your medical records. 
 

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Ancillary Effect of Executing Living Will

Death resulting from the withholding or withdrawal of life-sustaining treatment does not constitute, for any purpose, a suicide or homicide. The making of a declaration does not affect in any manner the sale, procurement, or issuance of any policy of life insurance, nor does it modify the terms of an existing policy of life insurance.  A policy of life insurance is not legally impaired or invalidated in any manner by the withholding or withdrawal of life sustaining procedures from an insured qualified patient, notwithstanding any term of the policy to the contrary.
 

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Executing and Delivering Your Living Will

After you have printed out your declaration you must gather two witnesses over eighteen (18) for signing. None of the witnesses should be a beneficiary under your last will and testament or otherwise interested in your estate. The executed  original or copy  of original should be submitted to your physician for entry in your medical records. Copies should be made and given to trusted family members.


The price of this
Living Will is $10.00