| a |
|
CONDITIONS
UNDER WHICH YOU MAY EXECUTE A LIVING WILL
|
 |
| a |
 If at any time you should have
an incurable condition certified in
writing by your attending physician and one other qualified physician to be terminal or you have been unconscious, comatose, or otherwise incompetent so as to
be unable to make or communicate responsible decisions concerning your
person, you may direct that such procedures which
would only prolong the dying process be withheld or withdrawn, and that
you be permitted to die naturally with only the administration of
medication to provide you comfort care.
|
|
ADDITIONAL INFORMATION ABOUT THIS LIVING WILL |
 |
| |
|
 |
Election of Treatment(s)
This living will provides for the withholding of life-sustaining
procedures if you are terminally ill or in a persistent vegetative
state. Life-sustaining procedures include artificial nutrition
and hydration and any additional treatments
that you specify to be considered
life-sustaining.
|
|
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.
|
|
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.
|
|
Revocation
A declaration may be
revoked at any time and in any manner by which you are able to communicate
an intent to revoke, without regard to mental or physical condition.
A revocation is only effective as to the attending physician or any health
care provider upon communication to that physician or health care provider
by you or by another who witnesses your revocation.
|
|
Ancillary Effect of
Executing Living Will
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.
|
|
 Executing and Delivering Your Living Will
After you have completed
your living will, you must gather two witnesses for signing. The original or a copy should be
submitted to your physician for entry in your medical records. If you
revoke your living will, you should also submit the original to your
physician to be placed in your medical records as well.
|
SOURCE: Utah Statutes §75-2-1104; Directive for medical services |
|
