viernes, 21 de agosto de 2009

Life Sustaining Statute, Nevada

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Directive to Physicians as Provided by Nevada Revised Statutes, Section 449.610

DIRECTIVE TO PHYSICIANS

Date __________________

I, _______________, being of sound mind, intentionally and voluntarily declare:

1. If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians, and where the application of life-sustaining procedures would serve only to artificially prolong the moment of my death and where my physician determines that my death is imminent whether or not life-sustaining procedures are utilized, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally,

2. It is my intention that this directive shall be honored by my family and attending physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences from such refusal.

3. If I have been diagnosed as pregnant and that fact is known to my physician, this directive shall have no force or effect during the course of my pregnancy. I understand the full import of this directive and I am emotionally and mentally competent to execute it.

Signed _________________________________________________

STATE OF _______

COUNTY OF __________

Dated: _________________________

Then and there personally appeared the within named ________________________________ and __________________________, who, being duly sworn, depose and say: That they witnessed the execution of the within Directive to Physicians of the within named _______________, that said declarant subscribed said Directive to Physicians and declared the same to be his Directive to Physicians in their presence, that they thereafter subscribed the same as witnesses in the presence of said declarant and in the presence of each other and at the request of said declarant; that the said declarant at the time of the execution of said Directive

to Physicians appeared to them to be of full age and of sound mind and memory, and that they make this affidavit at the request of said declarant.

________________________________________

Witness

________________________________________

Witness

Subscribed to and sworn to before me this ________ day of _________, 20_____.

_____________________________________________

Notary Public


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