You can write your own statement concerning life-sustaining treatment and other matters relating to your health care. Here are some options to use as a guide:
If I lose the ability to make or communicate medical decisions on my own behalf, either temporarily or permanently, and I:
have a terminal condition; or
am in an irreversible coma or a persistent vegetative state; or
suffer from severe brain damage or dementia; then
If my condition is temporary, do whatever is necessary to sustain my life. However, I do not want my life to be prolonged and I do not want life-sustaining treatment, beyond comfort care, that would serve only to artificially delay the moment of death. I especially do not want the following:
cardiopulmonary resuscitation, for example, the use of drugs, electric shock and artificial breathing; or
artificially administered nutrition and hydration.
Regardless of my condition, I want my life to be prolonged to the greatest extent possible.