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1993-01-06
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#5630
@001 State the name of the declarant:
@002 State the street address of declarant:
@003 State the city, state address of declarant:
#end control section
#5630
/* Para. 4030: New Mexico Living Will */
DIRECTIONS UNDER THE NEW MEXICO RIGHT TO DIE ACT
DIRECTIONS OF @001
I, @001, of @002, @003, herewith state:
1. I am of sound mind and have reached the age of majority.
2. After due and mature deliberation I have decided that it is
consistent with my religious, moral and ethical beliefs that if
I should ever be certfied under the New Mexico Right to Die Act
as suffering from a terminal condition that "maintainence medical
treatment" as is defined by that act shall not be utilized to
prolong my life.
3. If the time comes when I, @001, can no longer take part in
decisions of my own future, let this statement stand as an
expression of my wishes while I am still of sound mind.
4. This statement is made after careful consideration and
is in accordance with my strong convictions and beliefs. I want
the wishes and directions here expressed carried out to the
extent permitted by law. Insofar as they are not legally
enforceable, I hope that those to whom this will is addressed
will regard themselves as morally bound by these provisions.
Signed:
_______________________________________________________________
@001
Date: _________________
Witnesses:
________________________________________________________________
________________________________________________________________