Taking Care of Mom and Dad: Sample Living Will

TO MY FAMILY, DOCTORS, LAWYERS AND ALL THOSE CONCERNED WITH MY CARE

I, [YOUR PARENT'S NAME] being of sound mind, make this statement as a directive to be followed if I become unable to participate in decisions regarding my medical care.

If I should be in an incurable or irreversible medical or physical condition with no reasonable expectation of recovery, I direct my attending physician to withhold or withdraw treatment that merely prolongs my dying. I further direct that treatment be limited to measures to keep me comfortable and to relieve pain.

These directions express my legal right to refuse treatment. Therefore I expect my family, doctors and everyone concerned with my care to regard themselves as legally and morally bound to act in accord with my wishes, and in so doing to be free of any legal liability for having followed my directions.

I especially do not want:

[LIST EXCLUDED TREATMENTS OR THERAPIES]

Other instructions and comments:

[OTHER PREFERENCES OR INSTRUCTIONS]

Proxy Designation Clause: Should I become unable to communicate my instructions as stated above, I designate the following person to act in my behalf:

[PROXY'S FULL NAME]

[PROXY'S FULL ADDRESS]

If the person I have named above is unable to act on my behalf, I authorize the following person to do so:

[ALTERNATE'S FULL NAME]

[ALTERNATES'S FULL ADDRESS]

This Living Will Declaration expresses my personal treatment preferences. The fact that I may have also executed a document in the form recommended by state law should not be construed to limit or contradict this Living Will Declaration, which is an expression of my common-law and constitutional rights.

[DATE]

[YOU PARENT'S SIGNATURE]

[WITNESS' SIGNATURE]

[WITNESS' FULL LEGAL NAME]

[WITNESS' FULL ADDRESS]

[WITNESS' SIGNATURE]

[WITNESS' FULL LEGAL NAME]

[WITNESS' FULL ADDRESS]