A life-prolonging declaration mandates the implementation of all life-prolonging procedures, which would extend life. Declarations must be voluntary, in writing, signed by the person making the declaration, dated and witnessed by at least two individuals.
These witnesses may not be the person signing on the person’s behalf; a parent, spouse, or child of the person; entitled to any part of the person’s estate; or directly or financially responsible for the person’s medical care.
The declaration orders the utilization of all medical procedures to prolong life, including appropriate nutrition and hydration, medication to ease pain, and comfort care.
A life-prolonging procedures declaration may be revoked at any time by a signed and dated revocation, physical cancellation such as destroying the declaration, or by telling someone that it is no longer in effect. If the life-prolonging procedures declaration is revoked, the physician must be informed.
As in the case of a living will, a life-prolonging procedures declaration does not become effective until certain conditions are met by the patient. These conditions are: the patient has been diagnosed as having an incurable injury, disease, or illness; a physician has certified in writing that the patient is in terminal condition--meaning that there can be no recovery and death will occur within a short period of time, and that life-prolonging procedures would only prolong the dying process.
The attached Life-Prolonging Procedures Declaration document should be used in the case of an individual who wants extraordinary or heroic measures used to prolong his or her life.