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CONDITIONS
UNDER WHICH YOU MAY EXECUTE A LIVING WILL
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 If you are very sick and not able to communicate your wishes for
yourself and you are certified by one physician who has personally
examined you, to have a terminal condition or to be in a persistent
vegetative state (You are unconscious and are neither aware of your
environment nor able to interact with others), you may direct that
life-prolonging medical intervention that would serve solely to prolong
the dying process or maintain you in a persistent vegetative state be
withheld or withdrawn. You may be allowed to die naturally and only
be given medications or other medical procedures necessary to keep you
comfortable. You may also direct that you receive as
much medication as is necessary to alleviate your pain.
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ADDITIONAL INFORMATION ABOUT THIS LIVING WILL |
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Election of Treatment(s)
After you have completed this form and printed it out, you will be
allowed you to check off treatments you want and don't want.
Among those are matters which relate to treatment while you are
permanently unconscious and the condition is irreversible. You
will be given the option of receiving artificial nutrition and
hydration and other treatment.
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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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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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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.
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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.
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 Executing and Delivering Your Living Will
You must gather two witnesses and appear before a notary public for
signing. Pay particular attention to the qualifications of the
witnesses expressed in the witness statement. After signing, you should provide a copy of your completed
living will to your attending physician and other health care providers
and they shall make it a part of your medical records. You should also
give a copy to trusted family members.
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SOURCE: West Virginia Code §16-30-4; Executing a living will
or medical power of attorney |
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