This is the legally binding document that a friend's mother just wrote and executed. I love it.
Obviously this being a private matter, I've gotten consent to re-print it and still changed the names...
APPOINTMENT OF PATIENT ADVOCATE
I, Lisa _______, am of sound mind, and I voluntarily make this declaration. If I become terminally ill or in a persistent vegetative state or permanently unconscious as determined by at least two doctors, and if I am unable to participate in decisions regarding my medical care, I name my husband, Jim_______, Jr., as my patient advocate, with the power to make care, custody, and medical treatment decisions for me. I further declare that I do not wish to be kept alive while terminally ill or in a persistent vegetative state or permanently unconscious. Under any of these circumstances, I expressly authorize my patient advocate to make decisions to withhold or withdraw treatment which will allow or cause my death. In the event my husband is disqualified or otherwise unable to serve, I name my daughter, Annie ________, in his place. In the event my daughter is disqualified or otherwise unable to serve, I name my son-in-law, William _________, to serve in her place. Finally, I declare that I do not wish my picture taken, by photograph or video, while in a persistent vegetative state or permanently unconscious. In summary, if you are ever wondering what to do with me, ask me. IÅfll tell you. If I canÅft tell you, ask Jim or Annie or Bill. Whatever you do, donÅft ask Bill Frist or Tom DeLay. In fact, donÅft ask Tom DeLay anything unless you are having a problem with termites. I understand he was a termite exterminator before he rose to power in the Congress.
Date: ______________________________ ____________________________________
Lisa______
Signed in the presence of:
____________________________________
Witness
and
____________________________________
Witness
Tuesday
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