1.) Cardiopulmonary resuscitation, for example, the use of drugs, electric shock,
and artificial breathing.
2.) Artificially administered food and fluids.
3.) To be taken to a hospital if it is at all avoidable.
C. Pregnancy: Regardless of any other directions I have given in this Living
Will, if I am known to be pregnant I do not want life-sustaining treatment withheld or
withdrawn if it is possible that the embryo/fetus will develop to the point of live birth
with the continued application of life-sustaining treatment.
D. Treatment Until My Medical Condition is Reasonably Known: Regardless
of the directions I have made in this Living Will, I do want the use of all medical care
necessary to treat my condition until my doctors reasonably conclude that my condition is
terminal or is irreversible and incurable, or I am in a persistent vegetative state.
E. Direction to Prolong My Life: I want my life to be prolonged to the greatest
extent possible.
3. Other Statements Or Wishes I Want Followed For End of Life Care:
NOTE: You can attach additional provisions or limitations on medical care that have not
been included in this Living Will form. Initial or put a check mark by box A or B below.
Be sure to include the attachment if you check B.
A. I have not attached additional special provisions or limitations about End of
Life Care I want.
B. I have attached additional special provisions or limitations about End of Life
Care I want.