Living Will
New Living Will Form
I, __________________________, being of sound mind and body, do not
wish to be kept alive indefinitely by artificial means.
Under no circumstances should my fate be put in the hands of pinhead
politicians who couldn't pass ninth-grade biology if their lives
depended on it or lawyers/doctors interested in simply running up the bills.
If a reasonable amount of time passes and I fail to ask for at least
one of the following:
______a Bloody Mary,
______a Margarita
______a Scotch and soda
______a Martini
______a Vodka
______a Steak
______Lobster or crab legs
______The remote control
______a Bowl of ice cream
______The sports page
______Chocolate
______Sex
it should be presumed that I won't ever get better.
Pull the plug.
Signature: ___________________________
Date: ___________________________
I, __________________________, being of sound mind and body, do not
wish to be kept alive indefinitely by artificial means.
Under no circumstances should my fate be put in the hands of pinhead
politicians who couldn't pass ninth-grade biology if their lives
depended on it or lawyers/doctors interested in simply running up the bills.
If a reasonable amount of time passes and I fail to ask for at least
one of the following:
______a Bloody Mary,
______a Margarita
______a Scotch and soda
______a Martini
______a Vodka
______a Steak
______Lobster or crab legs
______The remote control
______a Bowl of ice cream
______The sports page
______Chocolate
______Sex
it should be presumed that I won't ever get better.
Pull the plug.
Signature: ___________________________
Date: ___________________________