Louisiana Living Will

I. Introduction

This Living Will document is made on [Date] by and between [Your Name], residing at [Your Address], referred to as the "Declarant," of sound mind and legal capacity.

II. Declaration of Intent

I, [Your Name], being of sound mind, hereby declare this document to be my living will, expressing my desires and wishes regarding medical treatment and end-of-life decisions if I am unable to communicate my wishes directly.

III. Health Care Proxy

• I appoint [Health Care Agent's Name], residing at [Agent's Address], as my Health Care Agent to make health care decisions on my behalf if I am unable to do so.

• If my primary Health Care Agent is unable, unwilling, or unavailable to serve, then I appoint [Secondary Health Care Agent's Name], residing at [Agent's Address], as my alternate Health Care Agent.

IV. Directions Regarding Life-Sustaining Treatment

If I am unable to communicate my healthcare decisions, and I am in a medical condition specified below, I direct that:

• If I am in a terminal condition, I request withholding or withdrawal of all treatments that would only prolong the dying process and request that life-sustaining measures be withheld or withdrawn.

• If I am in a state of permanent unconsciousness, and there is no reasonable expectation of my recovery, life-sustaining measures should be withheld or withdrawn.

V. Additional Provisions and Instructions

Even if the choices are to withhold or withdraw treatment in other circumstances, I further specify the following:

• Pain relief medication should always be provided as needed to ensure my comfort, even if it hastens my death.

• I do not wish to receive artificial nutrition and hydration if the burdens of the treatment outweigh the expected benefits.

• My healthcare agent shall have the authority to make decisions about autopsy, organ donation, and disposition of my body.

VI. Duration

This declaration remains valid and in force unless and until I revoke it.

VII. Signature and Witnesses

I sign this Living Will on [Date] in the presence of the following witnesses, who also sign in my presence.

Declarant

[Your Name]

Witness 1

Name: [Witness 1 Name]

Address: [Witness 1 Address]

Witness 2

Name: [Witness 2 Name]

Address: [Witness 2 Address]

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VIII. Notary Acknowledgment

Parish of [Parish Name], State of Louisiana

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.

Witness my hand and official seal.

Notary Public: [Notary's Name]

My Commission Expires: [Expiration Date]

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