DURABLE POWER OF ATTORNEY FOR HEALTH CARE by sampleresume

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									DURABLE POWER OF ATTORNEY FOR HEALTH CARE
1. Creation of the Form. By this document I intend to create a durable power of attorney by appointing the person designated below to make health care decisions for me. This power of attorney shall not be affected by my subsequent incapacity. Designation of Health Care Agent. I, do hereby designate and appoint: with address and telephone number of as my attorney-in-fact (hereinafter referred to as "Agent") to make health care decisions for me as authorized in this document. General Statement of Authority Granted. If I become incapable of giving informed consent to health care decisions, I hereby grant to my Agent full power and authority to make health care decisions for me including the right to consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure to maintain, diagnose or treat a physical or mental condition, and to receive and to consent to the release of medical information, subject to the statement of desires, special provisions and limitations set out in paragraph 4 herein. Statement of Desires Concerning Medical Treatment (Optional). a. I do not want my life to be prolonged and I do not want life-sustaining treatment to be provided or continued: i. if I am in an irreversible coma or persistent vegetative state, ii. if I am terminally ill and the application of life sustaining procedures would serve only to artificially delay the moment of my death, or iii. under any other circumstances where the burdens of the treatment outweigh the expected benefits. I want my agent to consider the relief of suffering and the quality as well as the extent of the possible extension of my life in making decisions concerning life-sustaining treatment. (Initials indicating preference for subparagraph "a")

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I want my life to be prolonged and I want life sustaining treatment to be provided unless I am in a coma or a vegetative state which my doctor reasonably believes to be irreversible. Once my doctor has reasonably concluded that I will remain unconscious for the rest of my life, I do not want life-sustaining
								
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