If, in the judgment of my physician, my death is imminent within minutes to hours, even with the use of all available medical treatment provided within the prevailing standard of care, I acknowledge that all treatments may be withheld or removed except those needed to maintain my comfort. This directive will remain in effect until I revoke it. No other person may do so.
Additional Requests:
1. In the event of a catastrophic failure such as heart attack, embolism, etc., that would cause my immediate death, please Do Not Resuscitate.
2. In the event of catastrophic failure such as heart attack, embolism, etc., and that I somehow survived, yet was rendered unable to interact or communicate with my family, then my final wishes are as follows: if not already at hospital, then move me to a hospice facility, make me comfortable, and discontinue life support.
3.
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In the event of catastrophic organ failure of the kidney, liver, etc., and death is imminent within hours, days, or weeks, then move me to a hospice facility, make me comfortable, and discontinue life support.
4. If for whatever reason, or in the event my ALS disease has progressed to the point where it has rendered me unable to interact or communicate with my family, then my final wishes are to be moved to a hospice facility, make me comfortable, and discontinue life support.
5. If I am diagnosed with Alzheimer's dementia, I do not wish to further burden my family. Plan a move to a hospice facility, make me comfortable, and discontinue life support.
6. When moved to a hospice facility, "make me comfortable" means: provide necessary medications to ease life-to-death transition during life support discontinuation.
7. When moved to a hospice facility, please notify my immediate family: _________, ________ and ________. My passing can be alone or in the company of my wife and/or adult children; no others. All other family and friends, local or abroad, do not need to be notified until after my