Yes, if at any point it is determined that it is not possible that the fetus could develop to the point of live birth with continued application of life-sustaining procedures, it is my preference that this document be given effect at that time.
LIW_MD04
vIf you have been diagnosed as pregnant, do you desire that this Living Will be enforced if the fetus will not survive?
LAL04003
Yes, if life-sustaining procedures will be physically harmful or unreasonably painful to me, I request that such harm or pain be considered in determining whether this document shall be effective if I am pregnant.
LIW_MD04
}Should pain or physical harm be considered in determining whether life-sustaining procedures should be withheld or withdrawn?
{NEXT_?}
Yes, include the section.
LIW_MD04
LDo you wish to state the effectiveness of this document if you are pregnant?
LAL04002
{NEXT_?}
Other requests:#|
LIW_MD06
^What other specific requests or instructions, if any, do you wish to include in this document?
If desired, use this space to state any other specific requests or instructions.
{NEXT_?}
LAL05255
SEVERABILITY. If any provision in this document is held to be invalid, such invalidity shall not affect the other provisions which can be given effect without the invalid provision, and to this end the directions in this document are severable.
LIW_MD07
3Do you wish to include this severability provision?
{NEXT_?}
Name: |
LIW_MD01
+Who is this Living Will being prepared for?
{NEXT_?}
No treatment, including artificial nutrition and hydrationArtificial nutrition and hydration requestedFull medical treatment requested
LIW_MD02
SHow much medical treatment do you wish to receive if you have a TERMINAL CONDITION?
{NEXT_?}
No treatment, including artificial nutrition and hydrationArtificial nutrition and hydration requestedFull medical treatment requested
LIW_MD03
^How much medical treatment do you wish to receive if you are in a PERSISTENT VEGETATIVE STATE?
{NEXT_?}
The Declarant's body#| Any needed organs or partsExcept the following:#| The following organs or parts:
LIW_MD05
(Which organs or tissues will be donated?
WMD05010
The following person or institution:#|
LIW_MD05
;Who, if anyone, will be designated to receive the donation?
If desired, enter the name of the individual or entity that will receive the donated organs, tissues, or parts. Only certain individuals and institutions are authorized to accept organs and tissues. If no recipient is named, the Declarant's organs and tissues will be given to those who can use them.
WMD05013
WMD05010
Any purpose authorized by law.#| The following purposes:TransplantationTherapyMedical researchEducation
LIW_MD05
2For what purposes will the donated organs be used?
WMD05019
Yes, regardless of any other provisions in this document, I direct my attending physician to maintain my organs on artificial support systems after my death until the donated organs and/or tissues are removed.
LIW_MD05
qAfter your death, shall life-support systems to be used to maintain the donated organs until they can be removed?
{NEXT_?}
Yes, include the Donation of Organs section.
LIW_MD05
@Do you wish to make an organ donation at the time of your death?
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