North Carolina Living Will
North Carolina Living Will
I. Introduction
This document is a Living Will prepared by [Your Name], a resident of [Your City], North Carolina. It is created to express my preferences regarding medical treatment and end-of-life care in the event I become incapacitated and unable to communicate my wishes.
II. Health Care Directives
A. End-of-Life Decisions
I, [Your Name], hereby declare the following instructions regarding end-of-life decisions:
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Terminal Condition: If I am diagnosed with a terminal condition certified by two physicians, and the application of life-prolonging measures would only artificially delay the moment of my death, I direct that such measures be withheld or withdrawn.
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Persistent Vegetative State: In the event I am in a persistent vegetative state with no reasonable expectation of recovery, I request that life-sustaining treatment, including artificial nutrition and hydration, be withheld or withdrawn, and that I be permitted to die naturally.
B. Palliative Care and Pain Management
I authorize the administration of pain relief and palliative care measures even if they may hasten my death, provided the primary intention is to alleviate suffering and enhance my comfort.
C. Artificial Nutrition and Hydration
I specify that if I am unable to ingest food or fluids orally and am in a terminal condition or persistent vegetative state, I do not wish to receive artificial nutrition or hydration through medical interventions.
D. Organ and Tissue Donation
I hereby consent to the donation of my organs, tissues, or body for transplantation, research, or educational purposes by applicable laws and regulations.
III. Health Care Agent
In the event I am unable to make health care decisions for myself, I appoint [Health Care Agent Name] as my Health Care Agent to make decisions on my behalf, including those outlined in this Living Will.
IV. Signature and Witnesses
I declare that I have signed this North Carolina Living Will on [Date], in the presence of the following witnesses who have also signed in my 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]
V. Notary
State of North Carolina
County of [Your County]
On this [Date] day of [Month], [Year], before me, the undersigned Notary Public, personally appeared [Your Name], known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that [he/she/they] executed the same for the purposes therein contained.
Notary Public
[Printed Name of Notary Public]
[Commission Number of Notary Public]
My Commission Expires: [Expiry Date of Notary Public's Commission]
