Free Kansas Living Will Template
Kansas Living Will
I. Introduction
This document is a Living Will prepared by [Your Name], residing at [Your Address] in the state of Kansas. This Living Will outlines my preferences and instructions regarding medical treatment and end-of-life care if I am unable to communicate my wishes.
II. Declaration of Desires
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Healthcare Agent: I appoint [Your Healthcare Agent's Name] (hereinafter referred to as "my Agent") residing at [Your Healthcare Agent's Name Address] as my healthcare agent to make healthcare decisions on my behalf if I am unable to do so.
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End-of-Life Care: I desire that if my attending physician determines that my condition is terminal, and if the application of life-sustaining procedures will serve only to artificially prolong the dying process, then I request that such procedures be withheld or withdrawn.
III. Specific Instructions
In circumstances when I am unable to communicate my healthcare decisions, I instruct as follows:
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Artificial Life Support: I direct that artificial life-support treatments, including but not limited to cardiopulmonary resuscitation (CPR), mechanical ventilation, and artificial nutrition and hydration, shall be withheld or withdrawn if:
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My condition is terminal.
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Such treatments would only prolong the process of dying.
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There is no reasonable expectation of recovery.
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Comfort Care: I request to receive medications and treatments for pain relief and comfort even if they may hasten the dying process.
IV. Organ and Tissue Donation
I consent to donate any needed organs, tissues, or parts that can be used for transplantation or medical research purposes.
V. Miscellaneous Provisions
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Revocation: I reserve the right to revoke or amend this Living Will at any time, provided it is done so in writing and according to the laws of Kansas.
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Interpretation: This Living Will shall be interpreted under the laws of the state of Kansas.
VI. Signature and Witnesses
I sign this Living Will on [Date] in the presence of the following witnesses, who also sign in my presence.
[Your Name]
Witness 1
Name: [Witness 1 Name]
Address: [Witness 1 Address]
Witness 2
Name: [Witness 2 Name]
Address: [Witness 2 Address]
VII. Notary Acknowledgment
County of [County Name], State of Kansas
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]
