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CONDITIONS
UNDER WHICH YOU MAY EXECUTE A LIVING WILL
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 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would only prolong the dying process be withheld or withdrawn, and that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.
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ADDITIONAL INFORMATION ABOUT THIS LIVING WILL |
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Designation of Agent
This
living will allows you to designated a health care agent who may
make treatment decisions for you when you are unable to make them
yourself. Your health care
agent, in consultation with your
attending physician, has the power and guidance to make health care decisions
according to your wishes when you are in a terminal condition and cannot
do so. Your health care
agent has the same
right as you have to examine your medical records and to consent to their
disclosure for purposes related to your health care or insurance unless
you limit this right in this document.
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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: Wyoming Statutes §35-22-102; Declaration concerning
life-sustaining procedures in terminal condition. |
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