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In the realm of healthcare planning, the Massachusetts Living Will form stands out as a crucial tool for individuals wishing to express their medical treatment preferences in advance. This document empowers you to outline your desires regarding life-sustaining treatments in situations where you may no longer be able to communicate your wishes. By clearly stating your preferences, you provide guidance to your healthcare providers and loved ones during challenging times. The form typically addresses various medical scenarios, such as the use of resuscitation efforts, mechanical ventilation, and artificial nutrition. Importantly, it allows you to designate a healthcare proxy—someone you trust to make medical decisions on your behalf if you're unable to do so. Understanding the intricacies of the Massachusetts Living Will form can help ensure that your values and choices are honored, giving you peace of mind and clarity for both you and your family.
Massachusetts Living Will Example
Massachusetts Living Will Template
This Living Will is designed to be in compliance with the laws of the Commonwealth of Massachusetts. It serves as a directive for medical treatment preferences in the event that I, the undersigned, become unable to communicate my wishes directly. This document reflects my desires regarding life-sustaining treatment, artificial nutrition, and hydration.
Personal Information:
- Full Name: ________________________________________
- Date of Birth: ______________________________________
- Address: ___________________________________________
- City: ______________________________________________
- State: Massachusetts
- Zip Code: _________________________________________
- Phone Number: ______________________________________
Health Care Directive:
I, _________________________ (full name), being of sound mind, hereby make this declaration as a directive to be followed if I become incapacitated to the point where I can no longer actively participate in decisions regarding my medical care. My wishes regarding life-sustaining treatment, should I be in a state of permanent unconsciousness, terminal condition, or if my physicians determine that my condition is beyond medical help and I am unable to communicate my wishes, are as follows:
- Life-sustaining treatment, including CPR:
[ ] I wish to receive all forms of life-sustaining treatment that may extend my life, including CPR.
[ ] I do not wish to receive life-sustaining treatment if it only prolongs the process of dying or if I am unlikely to regain consciousness.
- Artificial Nutrition and Hydration:
[ ] I wish to receive artificial nutrition (feeding) and hydration (fluids) regardless of my medical condition.
[ ] I do not wish to receive artificial nutrition and hydration if the burdens of the treatment outweigh the expected benefits.
- Pain Relief:
[ ] I wish to receive treatment to relieve pain and other symptoms, even if it hastens my death, to ensure my comfort and maintain dignity.
Designation of Health Care Proxy:
In addition to this Living Will, I hereby designate the following individual as my Health Care Proxy to make medical decisions on my behalf in case I am unable to communicate my wishes:
- Name: ___________________________________________
- Relationship: ____________________________________
- Primary Phone: ___________________________________
- Alternative Phone: _______________________________
This Living Will is not intended to revoke or conflict with any of my existing health care directives; in the case of any discrepancy, my most recently executed directive will prevail.
Signature: ___________________________ Date: _________________
This document is signed in the presence of witnesses, who affirm that I am at least 18 years of age, of sound mind, and under no duress or undue influence at the time of signing.
Witness 1 Signature: _______________________ Date: _______________
Witness 2 Signature: _______________________ Date: _______________
File Overview
| Fact Name | Description |
|---|---|
| Purpose | A Massachusetts Living Will allows individuals to express their wishes regarding medical treatment in the event they become unable to communicate their preferences. |
| Governing Law | The Massachusetts Living Will is governed by Massachusetts General Laws, Chapter 201, Section 9, which outlines the legal framework for advance directives. |
| Eligibility | Any adult who is 18 years or older can create a Living Will in Massachusetts, ensuring their healthcare preferences are respected. |
| Signature Requirements | The document must be signed by the individual creating the Living Will, and it is recommended to have it witnessed by two adults who are not related. |
| Revocation | A Living Will can be revoked at any time by the individual, either verbally or in writing, ensuring flexibility in changing healthcare wishes. |
| Healthcare Proxy | While a Living Will outlines specific medical treatment preferences, it can be complemented by appointing a healthcare proxy to make decisions on behalf of the individual. |
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