Pennsylvania Living Will

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I. Introduction

This Living Will document is prepared by [Your Name], of sound mind, to express my desires regarding medical treatment and end-of-life care in the event I become incapacitated and unable to communicate my wishes. This Living Will is made under the laws of the Commonwealth of Pennsylvania.

II. Declaration of Intent

I, [Your Name], hereby declare the following:

1. I am of legal age and sound mind.

2. I understand the importance of documenting my preferences for medical treatment and end-of-life care.

3. I want my healthcare providers, family members, and agents to respect and honor my wishes as expressed in this Living Will.

III. Appointment of Health Care Agent

1. Health Care Agent: In addition to this Living Will, I hereby appoint [Health Care Agent Name] as my health care agent to make medical decisions on my behalf by my wishes stated herein.

2. Alternate Health Care Agent: If my primary health care agent is unable or unwilling to serve, I appoint [Alternate Health Care Agent Name] as my alternate health care agent.

IV. Medical Treatment Preferences

1. Life-Sustaining Treatments:

   • I do/do not wish to receive life-sustaining treatments, including but not limited to:

     • Cardiopulmonary resuscitation (CPR)

     • Mechanical ventilation

     • Artificial nutrition and hydration

2. Palliative Care:

   • I request appropriate pain management and comfort care measures to be provided to me.

3. Organ Donation:

   • I hereby authorize the donation of any of my organs or tissues for transplantation, medical research, or educational purposes.

V. Specific Instructions

1. Duration of Life-Sustaining Treatment:

   • If I am diagnosed with a terminal condition or in a persistent vegetative state with no reasonable chance of recovery, I direct that life-sustaining treatments be withheld or withdrawn.

2. Quality of Life:

   • I value quality of life over prolonging the process of dying. If medical professionals determine that my condition is irreversible and that I have no meaningful chance of recovery, I request that comfort care be provided to me.

VI. Signature and Witnesses

I attest that I executed this Living Will while in the company of the following witnesses, who observed and signed this document in both my presence and each other's presence.

Testator

[Your Name]

[Your Address]

Witness 1

Name: [Witness Name 1]

Address: [Witness Address 1]

Witness 2

Name: [Witness Name 2]

Address: [Witness Address 2]

VII. Revocation

I, the undersigned, do hereby reserve the full right and authority to revoke or make amendments to this Living Will whenever I see fit, at any point in the future. This is provided that I am in a mental state of complete soundness, lucid, and fully capable of making such critical decisions independently.

VII. Notarization

State of Pennsylvania

County of [County Name]

I, [Your Name], appeared before a Notary Public in the mentioned State and County on January 1, 2050, to confirm the execution of the prior document for its supposed purposes. Endorsed by my signature and official seal.

Notary Public

[Printed Name of Notary Public]
[Commission Number of Notary Public]
My Commission Expires: [Expiry Date of Notary Public's Commission]

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