Living Will

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LIVING WILL
OF
JOHN DAVID ROBINSON

I, John David Robinson, willfully and voluntarily address this Living Will to my family, my physician, my attorney, my clergymen, and to all other persons whom it may concern. I.
In the anticipation of decisions that may have to be made about my own dying, if at such a time I become terminally ill and unable to participate in the decision regarding my medical healthcare, I hereby willfully and voluntarily make known my desire that my dying should not be artificially prolonged, and I expressly make known my right to refuse treatment. Further, I direct that I be allowed to die and not be kept alive by any type of artificial means or medication or any heroic measures except for those medications administered to alleviate suffering. II.

In determining whether or not my medical condition is terminal; I direct that my attending physician, in consultation with my family, determine that there can be no recovery from such condition and that my death is imminent. It is my intention that this declaration shall be honored by my family and physicians as the final expression of my legal rights to refuse medical, surgical or life support treatment and that they accept the consequences from such refusal. III.

It is further my desire and I so direct that my final days be lived out in my home located at 224 West Chestnut Street Riverside, South Dakota, and if this is not possible because of my medical condition, then I direct that I be placed in a hospice rather than a hospital. IV.

I understand that I have the right to revoke this Living Will at any time, either orally or in writing, by simply communicating that decision to members of my family or to my healthcare provider. V.

I understand the full weight and importance of this declaration in this Living Will, and I am mentally competent and of sound mind at the time of making and signing this declaration.
Dated___________________________...
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