Medical Living Will
I. Declaration of Preferences
I, [Your Name], who currently resides at [Your Address], am writing this document to officially state my personal preferences regarding the medical treatment I wish to receive under various circumstances. My views and decisions on this matter are articulated in the following sections of this document:
II. Medical Living Will
Medical Preferences: If I am unable to communicate my medical wishes, I hereby express my preferences for life-sustaining treatments such as CPR, mechanical ventilation, or artificial nutrition and hydration as follows:
Cardiopulmonary resuscitation (CPR): I do wish to receive CPR
Mechanical ventilation: I not do wish to be placed on mechanical ventilation.
Artificial nutrition (tube feeding): I do not wish to receive artificial nutrition
Artificial hydration (intravenous fluids): I do wish to receive artificial hydration
III. Circumstances for Application
These preferences should be applied if I am:
In a persistent vegetative state with no reasonable chance of recovery
Terminally ill with no hope of meaningful recovery
Unable to communicate my wishes due to severe incapacitation
IV. Proxy Decision-Maker
If I am unable to make medical decisions for myself and there are uncertainties regarding my wishes, I designate [Proxy Name] as my healthcare proxy to make decisions on my behalf. Their decisions should align with the preferences stated in this document.
V. Distribution of Assets
Beneficiaries: I hereby distribute my assets among the following beneficiaries:
[Insert name of beneficiary 1]: My residential property is located at [insert address].
[Insert name of beneficiary 2]: $10,000 from my savings account.
Note: If a beneficiary predeceases me, their share shall be distributed equally among the surviving beneficiaries.
VI. Revocation of Prior Directives
This document serves as a revocation of any prior directives related to my medical care or any living wills that I have previously made.
VII. Signatures and Witnesses
This Will was signed and declared by [Your Name], the Testator, as his/her last will, in the presence of us, who, in his/her presence and at his/her request, and in the presence of each other, have hereunto subscribed our names as witnesses on this [Date].
Testator
Name: [Your Name]
Address: [Your Address]
Witness 1
Name: [Witness 1 Name]
Address: [Witness 1 Address]
Witness 2
Name: [Witness 2 Name]
Address: [Witness 2 Address]
VIII. Notary
State of [Your State], County of [Your County], ss:
On this [Date], before me, [Notary's Name], a notary public in and for the said state, personally appeared [Your Name], known to me to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed the same as his/her free act and deed.
Notary Public: [Notary's Name]
My Commission Expires: [Expiration Date]
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