Life-prolonging Procedures Information

A life-prolonging declaration mandates the implementation of all life-prolonging procedures necessary to extend life. You should use the declaration if you want extraordinary or heroic measures used to prolong your life.

The declaration orders the use of all medical procedures to prolong life, including appropriate nutrition and hydration, medication to ease pain and comfort care. Declarations must be voluntary, in writing, signed by you, the patient making the declaration, dated and witnessed by at least two individuals.

These witnesses may not be:

  • The person signing on your behalf
  • A parent, spouse, or child
  • Entitled to any part of your estate
  • Directly or financially responsible for the person’s medical care.

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:

  • 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.

As the patient, you may revoke a life-prolonging procedures declaration 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signed and dated revocation, physical cancellation such as destroying the declaration, or by telling someone that it is no longer in effect.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.

Life-prolonging procedures form